Download Zika Virus Algorithm Draft alternate v13

All women of child-bearing age. (P1)
Travel to area
with active Zika
Transmission No
(D1)
Yes
Male Sexual
Planned Travel
Resident of area
Partner with
To area with
with
active
Zika
Travel to area
active Zikawith active Zika No transmission No Transmission
(D1)
Transmission
(D1)
(D1)
Yes
Yes
No
Stop
Mosquito
Yes Prevention &
Contraception
Advice (P2)
Confer with state health
department
regarding Zika
Determine
if
Uncertain
testing (P4)
Pregnant (P3)
Test for Zika
Not Pregnant
Pregnant
Test Male Sexual
Virus IgM 1st
Male
Sexual
Partner for Zika
Pregnant
No, and Male Sexual Partner is
visit, and mid 2nd
Partner
Virus IgM 2-12
Traveler to area with active Zika
with > 1
Trimester (P5)
Transmission
Patients
weeks after
No
No, and
symptoms
with > 1
return from
Resident of symptoms No, and Traveler to area with
(D3)
Patient’s
travel
(P5)
Zika
Prone
active
Zika
transmission
Yes
Zika virus
(D3)
Area
result
Test Male Sexual
Yes
(D4)
Partner for Zika Virus
Test for Zika Virus – Supportive Care
within 1 Week of
Negative
Positive
within 1 Week of
Symptom Onset
Rest,
Fluids,
Symptom Onset
•RT-PCR
Test
Analgesics,
•RT-PCR Test
•If
RT-PCR
test negative
•Routine Pre-natal Care
Antipyretics
•If RT-PCR test
and symptoms > 4
•Assess pregnancy dating
(Avoid
negative and
days do serologic test
& fetal ultrasound @ 18symptoms > 4 days do aspirin/NSAIDs in
for Zika IgM and
20 wks gestation to
serologic test for Zika case of dengue)
neutralizing antibody
assess fetal anatomy
IgM and neutralizing
test (at lab discretion)
(P7)
•Consider repeat fetal
antibody test (at lab
(P5)
discretion) (P5)
ultrasound later in
Male Sexual
pregnancy (P6)
.
Partner’s
Zika
.
Pregnant
virus result
Positive or
Patient’s
(D5)
Inconclusive
Zika virus
• Serial Fetal Ultrasound for
result
Pregnant Patient (every 3(D4)
Fetal
•Test Pregnant
4 weeks) until birth (P7)
Patient for
.
Positive or Negative Ultrasound
Zika Virus
Inconclusive
for Pregnant
• Consider Amniocentesis
Infection 2-12
Patient(P7)
for pregnancy > 15 weeks
weeks after
she or partner Post-exposure
gestation; Zika virus RTreturn from
counseling for
PCR on amniotic fluid (P8)
Provider
travel
(P6)
Pregnant
Determines Fetal
Provider
patient
& male
Ultrasound
Determines Negative
sexual partner
Result (D6)
Amniocentesis
(Mosquito
Abnormalities
result
prevention,
Absent
(D5)
Advice to use
Abnormalities Present or
Abnormal or
condoms)
inconclusive
Inconclusive
Pregnancy
Provider Considers Referral to maternalOutcome
fetal medicine or infectious disease
(D7)
Mother’s Zika test negative
specialist for pregnancy management (P9)
with history of travel,
Mother’s Zika test, Amniocentesis,or Fetal
symptoms, or male sexual
Ultrasound positive, abnormal or inconclusive
partner Zika test positive
Positive,
Inconclusive
AND Negative
Known
Pregnant
(D2)
Live Birth, Zika Testing within
48 hours of delivery(P10)
Non-Live Pregnancy
Outcome, Zika Testing (P11)
Confer with State Health Department
Regarding Zika Testing for live or nonlive pregnancy outcome(P12)