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CDC Team Member Speaks to St. Thomas Rotary East; WHO Issues New Guidelines

p>On Thursday the World Health Organization issued new guidelines aimed at preventing women from giving birth to children with severe birth defects that can be caused by the Zika virus.

Because there is no vaccine available and the virus continues to spread, the WHO recommends that women delay pregnancy where there’s Zika transmission. The V.I. Department of Health has not released a statement that addresses this recommendation yet. (See link to new WHO guidelines in Related Links section below)

This announcement comes a day after a member of the U.S. Centers for Disease Control and Prevention’s Zika response team gave a presentation about the virus and answered questions during the St. Thomas Rotary East’s weekly meeting on Wednesday.

Giving presentations at schools and to various community organizations has been part of Health’s strategy to address Zika and slow its spread. This week saw no new Zika cases, though three new cases of the virus were reported on St. Thomas last week.

“Outreach to esteemed community organizations such as the Rotary Club and public involvement is foundational to our efforts,” Health Commissioner Michelle Davis said in a statement about the meeting.

Health, in partnership with U.S. Centers for Disease Control and Prevention, has given more than 600 community presentations on Zika in the territory, Davis said. That concerted outreach is part of the reason the CDC is calling the Virgin Islands a model for Zika response efforts. 

During the Rotary meeting, Rachel Fischer, a member of the CDC’s Zika virus response team on St. Thomas, explained that the common symptoms of Zika are fever, rash, joint pain and red eyes.

Fischer said they can also include muscle pain, headache, pain behind the eyes and vomiting. Those symptoms sound a lot like flu or dengue, she said, both of which Zika can be easily misidentified as without confirmation from a blood test.

Zika is spread by the bites of infected Aedes species mosquitoes. Because Zika’s symptoms are generally mild and only last up to a week, people don’t always realize they are infected and often don’t seek medical care, Fischer said.

“It is believed that once you’ve had Zika, you are immune to future infections,” said Fischer, adding that there is no vaccine or treatment for Zika yet.

To date, 15 of the 24 confirmed Zika cases have occurred on St. Croix. St. Thomas has eight confirmed cases and St. John has one case.

There have been 276 reported (suspected) cases in the territory since the start of the outbreak in January. A total of 204 cases – an increase of four from last week – have come back negative for Zika and 45 are currently pending results.

Dr. Esther Ellis, Health’s territorial epidemiologist, said the turnaround time for getting results to the territory has improved, since now it takes about two weeks instead of a month. Ellis did not attend the Rotary meeting, but did answer follow-up questions. 

According to the World Health Organization, 10 countries have reported evidence for person-to-person transmission from a man to a women, likely through a sexual route. The Virgin Islands has not reported any sexually transmitted cases of Zika, as it’s difficult to tell whether a case was transmitted through sexual contact or through the bite of a mosquito.

At this time Health is not testing sexual partners of people who test positive for Zika, Ellis said.

Ellis explained that the live virus has been detected in semen at least 24 days after the onset of symptoms. Virus particles were found at least 62 days after the symptoms started, but that doesn’t confirm the presence of the live virus.

“Studies are under way to better understand how long Zika virus can stay in the semen of infected men, whether the concentration of virus in semen declines consistently or if it varies, and whether or not there are differences between the semen of men with symptomatic and asymptomatic Zika infection,” Ellis said. 

Ellis said that Zika virus stays in semen longer than blood and that a male can pass it to his female or male sex partners. What’s not known is whether or not a woman can pass the virus through her vaginal fluids and if saliva could be a conduit as well.

But according to the new WHO guidelines, Zika virus has been found in saliva and urine, though it’s uncertain if the virus can be transmitted by them.

There have been 15 cases of dengue this year, eight on St. Croix and seven on St. Thomas. No new dengue cases have been reported for the past two months, but the disease is still circulating in the territory and Heath continues to test for it.

Ellis said it is theoretically possible for a person to have Zika and other mosquito-borne diseases like dengue at the same time, but that there’s not data to support it yet. In the past, people have had dengue and chikungunya at the same time.

“In regards to mosquito-borne diseases like Zika, chikungunya and dengue – we know that prevention works – wear protective clothing, use insect repellant and mosquito-proof your home. Until we have a vaccine, prevention is key,” Ellis said.

In April the CDC confirmed that Zika can cause microcephaly, a condition marked by abnormal smallness of the head and stunted brain development. If unborn babies contract Zika while in the womb, they could suffer birth defects.

Health is continuing to offer free Zika testing for pregnant women regardless of if they are showing symptoms or not. The CDC has contracted a private company to inspect the homes of pregnant women for potential mosquito breeding risks and to offer larvicide treatment if necessary.

Any households with a pregnant woman that would like this free service or want additional information about it can call Health’s Emergency Operations Center at 340-712-6205.

Davis said, “We also look to the community at large to play a role in being informed and spreading this important public health messages. By working together, we can limit the impact of this virus and protect those who are most at risk.”

Health is distributing education materials in English and Spanish, as well as prevention tools like mosquito nets, insect repellent and condoms to pregnant women at the following locations:

On St. Croix  

– Department of Health MCH Clinic   

– Department of Health WIC Clinic

– Juan F. Luis Hospital and Medical Center  

– Frederiksted Health Center 

 On St. John   

– Health Care Connection

– Myrah Keating Smith Community Health Center 

 On St. Thomas

– Department of Health MCH Clinic (Pediatric)      

– Department of Health Community Health Clinic (Prenatal)        

– Roy Lester Schneider Hospital

– East End Medical Center

For local information about Zika virus, call the Department of Health Emergency Operations Center at 340-712-6205. For more general information about the Zika virus, call toll free: 1-800-CDC-INFO.

Health is also partnering with several labs and clinics throughout the territory to provide free virus infection testing. Health said that if you are turned away from testing or are told to pay for testing then to call the Health Department, since it has agreements in place with several facilities. These places should not be charging for Zika testing:

On St. Croix:

– Acute Alternative Medical Group, 772-2883.

– Beeston Hill Clinical Lab, 773-4990.

– Clinical Laboratory Inc. (Sunny Isle), 778-5369.

– Frederiksted Health Care, Inc., 772-0260.

– Gov. Juan F. Luis Hospital & Medical Center, 778-6311.

– Primary Care PLLC, 718-7788.

 On St. John:

– Myrah Keating Smith Community Health Center, 693-8900.

 On St. Thomas:

– Community Medical Laboratory, 776-7444.

– Cranston/Dottin Biomedical Lab, 774-6256.

– Doctors Clinical Laboratory, 774-2760.

– Havensight Medical Laboratory, 774-5515.

– Roy Lester Schneider Hospital, 776-8311.

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