HEALTH ALERT

Enhanced Zika Disease Surveillance in High-Risk Area
October 3, 2016

Summary

The Texas Department of State Health Services (DSHS) has long considered the southernmost areas of the state to be at greater risk of supporting local mosquito transmission of Zika virus. This is based upon historical experience with local transmission of dengue virus, which is related to the Zika virus and transmitted by the same type of mosquitoes. Local transmission of dengue is most commonly reported in Texas from August through December.

As testing options and availability have expanded and knowledge of the disease epidemiology has improved, guidance to healthcare providers on appropriate Zika infection testing of patients has evolved. The goals of testing are to diagnose patients and, from a public health perspective, to define the temporal and spatial distribution of the disease burden.

Enhanced Zika Surveillance

DSHS is asking the healthcare community to assist in improving surveillance for locally transmitted Zika disease. Toward that end, DSHS is expanding the testing criteria for those with major signs/symptoms of Zika disease (fever, arthralgia, rash, and conjunctivitis), but who have no travel history to an area of local Zika transmission or sexual exposure to Zika virus:

• DSHS continues to recommend testing of male and female patients with no travel history or sexual exposure who have at least three of the four major signs/symptoms of Zika disease.
• DSHS continues to recommend testing of pregnant women who have traveled to areas of active Zika transmission, regardless of presence or absence of symptoms.
• The new recommendation is to test pregnant women residing in Cameron, Hidalgo, Starr, Webb, Willacy, or Zapata counties who are experiencing two or more of the major signs and symptoms of Zika disease and have no travel history or sexual exposure.
• Preconceptioncounseling should be provided to patients contemplating having a baby. For fullwomen's Zika prevention guidance, visit http://texaszika.org/healthcareprof.htm.

The current comprehensive guidance on Zika testing can be found at http://texaszika.org/healthcareprof.htm.

Background

Capacity for Zika testing has increased, as it is no longer limited to U.S. Centers for Disease Control and Prevention (CDC) or state public health laboratories. Under Emergency Use Authorizations issued by the Food and Drug Administration, there are now a number of commercial laboratories that offer molecular assays for detection of Zika virus RNA, and some are also offering serology for Zika IgM.

DSHS continues to recommend that healthcare providers consult with their local health department or DSHS Regional Office to facilitate appropriate test selection and submission of specimens. 

For More Information

Texas-specific information and links to CDC resources: TexasZika.org.