Public Health Update from BCHHS: Zika Guidance Update

September 13, 2016

As of 8/31/16, there have been 49 travel-associated cases of Zika virus disease reported in NC.

There continue to be no locally acquired mosquito-borne cases of Zika in NC.

There have been 35 cases of Zika locally acquired via mosquitoes in the US (in South Florida).

Remember that physicians are required to report suspected or confirmed Zika virus and that approval is required for submission of specimens to the State Lab of Public Health.

  • Please contact the Communicable Disease Branch at 919-733-3419 or your local health department (828-250-5109 for Buncombe County Disease Control; available 24/7) if Zika virus infection is suspected.

Assessing pregnant women

All pregnant woman in the US should be assessed for possible Zika virus exposure at each prenatal visit.

Who should be tested for Zika?


** Sexual exposure includes vaginal sex, oral sex, anal sex, or other activities that might expose a partner to genital secretions.

Individuals who did not travel to a Zika affected area but have had > 3 symptoms of Zika virus infection (fever, rash, arthralgias, or conjunctivitis) in the past 14 days not explained by another etiology AND have a history of mosquito bite(s) within 2 weeks of symptom onset may be considered for Zika virus testing.

Recommendations for Prevention of Sexual Transmission of Zika Virus (From: Brooks JT, Friedman A, Kachur RE, LaFlam M, Peters PJ, Jamieson DJ. Update: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, July 2016. MMWR Morb Mortal Wkly Rep 2016;65:745–747.


What tests should be done if Zika virus is suspected?

  • For an algorithm with testing and interpretation recommendations for pregnant women with possible exposure to Zika virus, see (Oduyebo T, Igbinosa I, Petersen EE, et al. Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States, July 2016. MMWR Morb Mortal Wkly Rep 2016;65:739–744.)
  • See for specific guidance on testing for Zika virus in symptomatic persons depending on time of symptom onset in relation to specimen collection.

Where can test specimens be sent? Testing for Zika virus is now available through several commercial labs, in addition to the NC State Lab of Public Health. (See attachment for more details.)

How do I manage infants with possible Zika virus infection? 

See (Russell K, Oliver SE, Lewis L, et al. Update: Interim Guidance for the Evaluation and Management of Infants with Possible Congenital Zika Virus Infection — United States, August 2016. MMWR Morb Mortal Wkly Rep 2016;65:870–878.)

This is an evolving situation and recommendations are likely to change as new information becomes available. Updated information and guidance are available from CDC at

As always, contact Buncombe County Disease Control at 828-250-5109 if you have any questions regarding this or other communicable disease matters.