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Health Alerts

The Snohomish Health District Health Officer Dr. Gary Goldbaum sends alerts via email to local health care providers. Alerts cover current local, regional or national health threats and important updates on medical care and protocols. Alerts are written as needed to cover urgent or emergent health issues.

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Zika virus infection update

Today’s topic: Zika virus infection update

Action requested:  Be aware of current recommendations to prevent transmission of Zika virus and to manage suspected Zika virus infection.

Background: This is a follow up to my January 29 alert. The Centers for Disease Control & Prevention (CDC) and the Washington State Department of Health have issued updated guidance about Zika virus infection, summarized below.


  • Obtain travel history from all pregnant women and advise pregnant women to avoid travel to areas with active Zika transmission.   
  • Be alert to the symptoms of Zika in patients with relevant travel history. Only about 20 percent of patients with Zika infection will have symptoms. If present, symptoms include acute onset of fever, maculopapular rash, arthralgia and conjunctivitis. Zika may be associated with Guillain-Barré syndrome in some cases and also with microcephaly and other poor pregnancy outcomes in infants of women who were infected while pregnant.
  • Advise men who have recently traveled to an area with Zika transmission to avoid sexual contact with pregnant partners, or to correctly and consistently use condoms.
  • Consider dengue and chikungunya in symptomatic travelers. Dengue and chikungunya circulate in the same areas as Zika, and blood should be sent to commercial laboratories for dengue and chikungunya testing if Zika is suspected. If dengue is a possibility, patients should avoid aspirin and non-steroidal anti-inflammatory drugs (NSAIDS) until dengue has been ruled out.
  • Call the Snohomish Health District to arrange Zika testing.  Testing is currently available only at CDC, and must be approved by the Health District. Please obtain travel history, including dates of travel, before calling the Health District.  CDC will test:
  • All persons with travel to an area with known Zika virus transmission (regardless of pregnancy status) reporting two or more of the following symptoms: acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis, during or within 2 weeks of travel. Obtain specimens during the first week of illness if possible.
  • Pregnant women with travel to an area with known Zika virus transmission (at any trimester)
  • With clinical illness consistent with Zika virus disease -testing recommended during the first week of illness if possible.
  • Asymptomatic –testing can be offered 2-12 weeks after pregnant women return from travel.
  • Babies born to women with a history of travel during pregnancy to an area with known Zika virus transmission, with evidence of maternal infection or fetal infection

To test, collect 2 mL serum (0.25 mL minimum), separate, refrigerate, and transport cold to the Washington Public Health Laboratories. Be sure to also collect serum for commercial dengue and chikungunya testing, if indicated.

For questions or to request testing, call 425-339-5278.


You can find my recent health alerts posted on the Provider pages of our website, at


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Health alerts include information about diseases or other health risks or issues that affect Snohomish County.