Update: More Zika Cases in More States

The Centers for Disease Control and Prevention now says there have been 258 cases of Zika virus in the U.S., with 35 states reporting at least one confirmed case—up from 29 states counted just two weeks prior. Florida has seen the most (59), followed by New York (42) and Texas (34). Connecticut and New Mexico reported their first confirmed cases during that time. While most cases are still presumed to be travel-related, it is thought that six were transmitted sexually, from men to women. This is noteworthy in the urgent care setting, as male patients suspected of Zika infection should be advised to abstain from sexual contact or to use condoms until they are confirmed to be virus-free. Supportive care for all Zika patients includes rest, fluids, and use of analgesics and antipyretic medications. However, the CDC recommends against aspirin and other nonsteroidal antiinflammatory drugs in order to reduce risk for hemorrhage. Patients who have traveled to certain parts of Africa, the Caribbean, Central American, and South America should be referred for testing if they complain of fever, rash joint pain, or red eyes. Eighteen of the confirmed U.S. Zika patients are pregnant woman. While the CDC has yet to verify a link between Zika and birth defects, public health officials in Brazil, where Zika is more common, believe the virus can cause microcephaly in newborns who were exposed in the womb. Beyond pregnant women, there have been cases of Guillain-Barre syndrome reported in patients following suspected Zika virus infection. The CDC has created a homepage for Zika-related information, including updates on affected travel areas and recommendations for testing and care (http://www.cdc.gov/zika/index.html).