County of Marin Health and Human Services

Zika Information: Health Care Providers

The evolving Zika virus outbreak and science base have presented challenges for providers who are asked to educate, counsel, screen, monitor and manage patients with Zika virus exposure. Updated resources for providers are available at the CDPH Zika website.

Updated Guidance for Timing of Pregnancy after Zika Exposure (August 10, 2018)

mosquito_zika.jpgProviders should provide anticipatory guidance to pregnant women and couples considering pregnancy. Pregnant women should not travel to the areas with risk of ZIKV transmission. Partners of pregnant women and couples considering pregnancy should know the risks to pregnancy and take prevention steps. All travelers should strictly follow steps to prevent mosquito bites and prevent sexual transmission during and after the trip.

CDC now recommends that men with possible Zika virus exposure who are planning to conceive with their partner wait at least 3 months after symptoms or possible exposure (travel to or residence in an area with risk of Zika). These updated recommendations are based on emerging data, which suggest that risk of infectious Zika virus in semen appears to decline substantially during the 3 months after onset of symptoms.

Men with possible Zika virus exposure whose partner is pregnant should use condoms or the couple should not have sex for the entire pregnancy to reduce the risk of transmission.

Questions about Zika Virus (ZIKV) Diagnostic Testing in Marin County

  • ZIKV testing by detection of viral RNA (nucleic acid testing, NAT) or serology (IgM antibody testing) is available in commercial clinical laboratories throughout California and, as is typical of screening for other infectious diseases, can be directed to traditional commercial laboratory resources. Please submit your specimens to commercial laboratories for processing using your regular clinical testing protocol.
  • All positive ZIKV tests will be sent from commercial laboratories to the CDPH public laboratory for confirmatory testing.
  • Marin County's Communicable Disease Prevention Control (CDPC) unit will be notified of confirmed positive test results.

Who should be tested for ZIKV?

Definition of ZIKV exposure:

The definition of potential ZIKV exposure includes: (1) travel to an area where ZIKV is circulating; OR (2) having had sex with a person (male or female, symptomatic or asymptomatic) who traveled to an area where ZIKV is circulating up to 8 weeks prior to conception.

Who should be considered for ZIKV testing?

Pregnant Women (see Interim Guidance) - Updated January 10, 2018
  1. Symptomatic Pregnant Women with possible ZIKV exposure and symptoms (acute onset of fever, rash, arthralgia, or conjunctivitis) of ZIKV disease should be tested concurrently for ZIKV NAT in serum and urine and IgM antibody testing if 12 weeks or less since symptom onset.
  2. Asymptomatic Pregnant Women with recent but without ongoing exposure are not routinely tested but instead should be assessed carefully for factors that increase the likelihood of Zika infection.
  3. Asymptomatic Pregnant Women with ongoing possible ZIKV exposure and without prior evidence of laboratory-confirmed Zika virus infection should be offered: NAT testing on serum and urine three times during pregnancy starting with the initiation of prenatal care and coinciding with non-consecutive prenatal visits. Testing each trimester may be considered.
Infants and Children
  1. Infants born to mothers with positive or inconclusive test results for ZIKV infection
  2. Infants born to mothers who have been unable to receive Zika screening, and have had a ZIKV exposure up to eight eight weeks prior to conception.
  3. Children with Microcephaly or Congenital Zika Syndrome whose mothers traveled to or resided in an area with ongoing ZIKV transmission during their pregnancy

Testing is not recommended for asymptomatic, non-pregnant persons.

For the CDC weekly updated map: All Countries & Territories with Active Zika Virus Transmission