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US officials issue travel alert for Miami area as Zika cases rise to 15

BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i4298 (Published 03 August 2016) Cite this as: BMJ 2016;354:i4298
  1. Michael McCarthy
  1. Seattle

The US Centers for Disease Control and Prevention (CDC) is warning pregnant women not to travel to the area north of Miami, Florida, where health officials say that as many as 15 people have become infected with the Zika virus from local mosquitoes.

It is the first time in the agency’s 70 year history that it has issued a travel alert for a region in the United States.

“We advise pregnant women to avoid travel to this area and pregnant women who live or work in this area and their partners to make every effort to avoid mosquito bites and prevent sexual transmission of Zika,” said Tom Frieden, CDC director, in a telebriefing with reporters on 1 August.

In its updated guidance,1 the CDC advises that all pregnant women who live in or frequently travel to the area or who were there on or after 15 June should be tested for Zika in the first and second trimester of pregnancy. Pregnant women who have had unprotected sex with a partner who has traveled to or lives in the area should also be tested, the guidance said—and all pregnant women, no matter where they live in the US, should be assessed for possible Zika exposure during each prenatal care visit.

Frieden said that mosquito control efforts by officials in Florida seemed not to have eliminated the area’s mosquito population. This failure may be due to the complex urban environment where the mosquitoes are found, which may contain hidden breeding areas and small amounts of standing water where mosquitoes can continue to hatch, but the mosquitoes may also be resistant to the insecticides used, he said.

CDC vector control experts have been dispatched to the area, Frieden added, but results of insecticide sensitivity testing may not be known for three weeks or more.

Mosquito species capable of transmitting the Zika virus are found throughout the southern US and as far north as Minnesota and Maine, and CDC officials expect that the US will see additional individual cases and small clusters of Zika infection in the coming months. However, they do not expect large outbreaks such as those seen in Latin America and the Caribbean.

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