A Guide on how to Protect Against Zika Virus

September 05, 2016

Zika virus transmission and infection cases are spreading through the United States, prompting numerous advisories and precautions. Zika is transmitted through mosquito bites, unprotected sex involving infected partners, and exposure to infected blood or bodily fluids. At this time there are no reported cases of airborne transmission of the virus.

Signs and symptoms of Zika infection include:

• fever

• rash

• joint pain

• pink or red eyes

• muscle pain

• headache

About Zika

The Centers for Disease Control and Prevention (CDC) reports only about 20 percent of people infected with Zika will develop symptoms. Symptoms are usually mild, usually do not require hospitalization, and persist for two to seven days. Zika poses little harm to most people, but it may cause a serious birth defect of the brain called microcephaly (which can result in smaller brains and heads) to unborn children. Still, fatalities have occurred. In July, an elderly Utah man with an underlying health condition who had traveled to a Zika hot zone was the first confirmed Zika-related death in the U.S. A baby girl whose mother had traveled to El Salvador while pregnant died in Houston shortly after being born. There are no vaccinations or medication available to prevent or treat Zika, and no over-the-counter diagnostic tests for the virus. Health practitioners can determine if someone is infected by conducting blood or urine tests.

For the most up-to-date information, visit the CDC Zika virus website www.cdc.gov/zika/.

The site lists U.S. maps showing areas with local Zika transmission and U.S. travel-associated cases, the latest data for Zika infection cases in the U.S., including cases in pregnant women and pregnancy outcomes, and a world map of all countries and territories around the globe with active Zika virus transmission. Brazil, the epicenter of the outbreak, registered 91,387 likely cases of the Zika virus from February to April 2, 2016. Active Zika outbreaks have been reported in at least 57 countries and territories, mostly in the Americas but also in France, Italy and New Zealand.

Recent developments

As of August 24, 2016, Wyoming and Alaska were the only states with no laboratory-confirmed Zika virus cases reported. New York reported 601 travel-associated cases, most in the New York City metropolitan area, tops among all states. Florida was second with 471 reported cases.  Texas was third with 125 cases. Florida is the only state to have reported locally-acquired cases – 29. In total, 2,488 travel-associated cases had been reported in the U.S.

On August 26, the U.S. Food and Drug Administration recommended universal testing of donated whole blood and blood components for Zika virus in all U.S. states and territories. “We are issuing revised guidance for immediate implementation in order to help maintain the safety of the U.S. blood supply,” said Luciana Borio, M.D., the FDA’s acting chief scientist.

Earlier in August, theme parks in Florida began handing out free bottles of insect repellent to visitors, including Universal Florida, Walt Disney World, Sea World, Busch Gardens in Tampa Bay, and Adventure Island in Tampa Bay. The parks have all placed signage on park grounds explaining where visitors can pick up repellant. Aerosol cans are also available in the rooms at the parks’ resorts.

In Miami, the mosquito season has extended from 317 to 337 days, according to a Capital Weather Gang report.

The Florida Department of Health has identified two areas of Miami-Dade County where Zika is being spread by mosquitos. The CDC in August issued an unprecedented travel warning to parts of Miami-Dade County specifically and South Florida in general (home of the popular South Beach). It’s the first time the CDC has warned people not to travel inside the continental U.S. for fear of catching an infectious disease.  As of August, 13 babies in the U.S. have been born with birth defects related to the virus.

“With 40 million travelers to and from areas where Zika is actively circulating, many can come back who feel perfectly fine,” CDC Director Dr. Tom Frieden said. “But the virus could be hitchhiking in their blood. That’s why everyone who travels to one of those areas should use insect repellent for at least three weeks after they return.”

Public health officials fear Zika cases will surface in Texas and Louisiana, due to flooding and problems getting rid of standing water.

OSHA and NIOSH have developed a Zika virus website. It offers information about Zika virus infection in humans, control and prevention, Zika virus exposures and cases, and travel to Zika-affected areas. OSHA and NIOSH have released interim guidance for protecting workers from exposure to Zika virus.

Who’s at risk?

At-risk workers include:

• healthcare and laboratory personnel exposed to blood or bodily fluids of infected individuals;

• workers in mosquito control operations and other outdoor workers potentially exposed to mosquitos;

• airlines, airline crew members, and cruise line workers;

• workers traveling to Zika hot zones who are or may become pregnant or whose sexual partners may become pregnant.

OSHA recommends that employers train employees on how to protect themselves and how to eliminate areas where mosquitos breed at worksites, such as standing water in tires, buckets, cans, bottles and barrels. Employers should also provide insect repellents and protective clothing for at-risk employees, and encourage their use.  

Employees at risk of exposures should use insect repellent with EPA-registered active ingredients on skin not covered by clothing, and wear clothing that covers all of the body including the ankles, lower legs, and hats with mosquito netting to protect the face and neck. Additional personal protective equipment, including gloves and respirators, might be necessary for employees who routinely work with insecticides to control mosquitos and healthcare workers exposed to infected patients.

Who should get tested?

The CDC recommends Zika virus testing for people who live or have traveled to an area with a current Zika outbreak, or who have had unprotected sex with a partner who has lived or traveled to an area with Zika. All pregnant women should be assessed for Zika virus at each prenatal care visit. Pregnant women with possible exposure to Zika who have symptoms should see a doctor immediately for testing, according to the CDC. Pregnant women with possible exposure to Zika who do not have symptoms should be offered testing up to 12 weeks after their last possible exposure. Women who become pregnant within eight weeks after visiting an area with Zika should talk to their doctor, according to the CDC.

Employer do’s and don’ts

• According to legal experts, U.S. employers cannot prohibit pregnant employees from traveling on business to countries or parts of the U.S. where Zika has been found. This could result in gender or pregnancy discrimination claims. The U.S. Supreme Court has ruled that Title VII prohibits employers from taking adverse actions against women from jobs that might pose reproductive health risks.

• Employers cannot prohibit employees from personal travel to Zika hot zones.

• The Americans with Disabilities Act (ADA) allows employers to request a medical examination when an employer has a reasonable belief based on objective evidence that an employee poses a “direct threat” due to a medical condition. Because the Zika virus is not transmitted from person to person in casual contact, legal experts say the ADA standard would not be satisfied in most job settings.

• Since no public health quarantines have been placed on people returning from Zika areas, employers who prohibit employees from coming to work when they return from travel to a Zika hot zone risk exposure to legal claims involving privacy, disability, wage and hour, contracts, and potential race and national origin discrimination charges.

• Employers should educate workers who are nervous about travel or other potential Zika exposures. Explain how Zika is transmitted. Assure workers that the spread of Zika is being monitored 24/7 by public health agencies. Emphasize good mosquito bite prevention practices. Refer employees to Zika information websites of the CDC and OSHA and NIOSH.

Interim Guidance for Protecting Workers from Occupational Exposure to Zika Virus

For more guidance on how to protect workers’ from the Zika Virus, click here to access the OSHA & NIOSH interim guidance fact sheet.