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<!DOCTYPE html>
<html lang="en-US">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
<title>Understanding Zika</title>
<meta name="description" content="A visual guide to understanding the Zika virus.">
<meta name="keywords" content="zika,virus,flavivirus,understanding zika virus,mosquito,mosquito-borne">
<meta name="author" content="Involution Studios">
<meta name="twitter:card" content="summary_large_image">
<meta name="twitter:creator" content="@goinvo">
<meta name="twitter:title" content="Understanding Zika">
<meta name="twitter:url" content="http://understandingzika.org/">
<meta name="twitter:description" content="A visual guide to the #Zika virus.">
<meta name="twitter:image" content="http://understandingzika.org/assets/images/zika-twitter-card.jpg">
<meta name="viewport" content="initial-scale=1, width=device-width">
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<link rel="stylesheet" href="./assets/css/zika.css" media="screen">
</head>
<body>
<div class="container">
<nav>
<div class="menu">
<ul>
<li id="expand">≡ </li>
<li id="page-title">ZIKA</li>
<li><a href="#what-is-zika">Overview</a></li>
<li><a href="#where-is-zika">Infected Areas</a></li>
<li><a href="#transmission">Transmission</a></li>
<li><a href="#prevention">Prevention</a></li>
<li><a href="#zika-symptoms">Symptoms</a></li>
<li><a href="#treatments">Treatment</a></li>
<li><a href="#action-plan">Action Plan</a></li>
<li><a href="./understanding_zika.pdf" target="blank">Download</a></li>
<li><a href="mailto:[email protected]?subject=Feedback for Understanding Zika">Feedback</a></li>
</ul>
</div>
<!--<div class="providers"><a href="http://www.cdc.gov/mmwr/volumes/65/wr/mm6502e1.htm">For Healthcare Providers</a></div>-->
</nav>
<div class="header">
<h1 class="title"><span id="title-understanding">Understanding</span> <span id="title-zika">Zika</span></h1>
<div class="header-note">Images from USDA & Felipe Dana/AP</div>
</div>
<div class="article">
<div class="row">
<div class="column one-half" id="what-is-zika">
<h2>What is Zika</h2>
<p>Zika is a <strong>virus</strong> spreading quickly throughout Latin America that is carried by <strong>mosquitoes</strong> and causes mild illness. There has been an unconfirmed link between Zika-infected <strong>pregnant women</strong> and a condition called <strong>microcephaly</strong>, in which babies are born with underdeveloped brains, as well as an autoimmune disease of the nervous system called Guillain-Barré syndrome (GBS).<sup><a href="#ref-1">1</a></sup></p>
</div><!--end #what-is-->
<div class="column one-half" id="spread">
<h2>How it Spreads</h2>
<div class="row">
<div class="way_spread column one-half">
<div class="image">
<img src="./assets/images/spread-mosquito.png" alt="person to mosquito to person" class="scale-with-grid">
</div>
<p>Person <span class="arrow">→</span> mosquito <span class="arrow">→</span> person</p>
</div>
<div class="way_spread column one-half">
<div class="image">
<img src="./assets/images/spread-mother.png" alt="mother to unborn child" class="scale-with-grid">
</div>
<p>Mother <span class="arrow">→</span> unborn child</p>
</div>
</div>
<div class="row">
<div class="way_spread column one-half">
<div class="image">
<img src="./assets/images/spread-partner.png" alt="person to partner" class="scale-with-grid">
</div>
<p>Person <span class="arrow">→</span> sexual partner</p>
</div>
<div class="way_spread column one-half">
<div class="image">
<img src="./assets/images/spread-bloodbank.png" alt="person to partner" class="scale-with-grid">
</div>
<p>Person <span class="arrow">→</span> blood bank <span class="arrow">→</span> person</p>
</div>
</div>
</div><!--end spread-->
</div> <!--end row 1 -->
<div class="row">
<div class="column one-half" id="overview-prevent">
<h2>How to Prevent it</h2>
<ul>
<li id="prevent-travel">
<div class="image">
<img src="./assets/images/prevent-travel-2.png" alt="avoid travel">
</div>
<p class="description">Avoid travel to areas with confirmed Zika cases, especially if you are pregnant</p>
</li>
<li id="prevent-longsleeves">
<div class="image">
<img src="./assets/images/emptywater.png" alt="longsleeved shirt">
</div>
<p class="description">Remove still water in flowerpots, buckets, animal water bowls, and kid pools to prevent potential mosquito breeding grounds.</p>
</li>
<li id="prevent-bugspray">
<div class="image">
<img src="./assets/images/prevent-bugspray.png" alt="bugspray">
</div>
<p class="description">Use insect repellents containing DEET or picaridin, or cover up with long-sleeved shirts and trousers. Apply sunscreen BEFORE applying insect repellent</p>
</li>
<li id="prevent-close">
<div class="image">
<img src="./assets/images/prevent-close-2.png" alt="no open windows">
</div>
<p class="description">Keep doors and windows covered with screens or closed. Sleep with mosquito netting if exposed to the outdoors.</p>
</li>
</ul>
</div><!-- end #prevent -->
<div class="column one-half" id="signs">
<h2>When to Tell Your Doctor</h2>
<div class="text">
<p>If you have been exposed to a Zika-infected area, watch for these signs of Zika Disease.</p>
<p>Incubation period is likely a few days to one week. Symptoms are usually mild and last several days to a week.</p>
<p>Only about 1 in 5 infected people develop symptoms.</p>
<img src="./assets/images/1in5.png" alt="1 in 5 infected people" class="scale-with-grid">
</div>
<div class="signs-image">
<img src="./assets/images/zika-symptoms.png" alt="headache, fever, painful or red eyes, joint pain, itching/rash, muscle pain" class="scale-with-grid">
</div>
</div><!--end signs-->
</div> <!--end row 2 -->
<div class="row" id="timeline">
<h2>Zika Timeline</h2>
<ul>
<li>
<div class="timeline-image">
<img src="./assets/images/1947-zika-forest.jpg" alt="Zika Forest in Uganda" class="scale-with-grid">
</div>
<span class="year">1947</span>
<div class="description">
<p>The name comes from the Zika Forest in Uganda where the virus was first isolated. It was identified first in rhesus monkeys through a monitoring network of sylvatic yellow fever.<sup><a href="#ref-4">4</a>, <a href="#ref-9">9</a></sup></p>
</div>
</li>
<li>
<div class="timeline-image">
<img src="./assets/images/1952-first-case-zika.png" alt="Research paper by GWA, Dick et. al isolating first human case of Zika" class="scale-with-grid">
</div>
<span class="year">1952</span>
<div class="description">
<p>A paper was published confirming the first case of Zika virus in a human - a 10 year old Nigerian female. The research effort was initially studying an outbreak of jaundice suspected to be yellow fever.<sup><a href="#ref-4">4</a>, <a href="#ref-8">8</a>, <a href="#ref-13">13</a></sup></p>
</div>
</li>
<li>
<div class="timeline-image">
<img src="./assets/images/1951-map.png" alt="Global map with parts of Africa and Asia highlighted" class="scale-with-grid">
</div>
<span class="year">1951-1981</span>
<div class="description">
<p>The virus spread throughout a narrow equatorial belt from Africa to Asia, but reported cases were rare.<sup><a href="#ref-4">4</a></sup></p>
</div>
</li>
<li>
<div class="timeline-image">
<img src="./assets/images/2007-yap-island-outbreak.jpg" alt="Air Force photo - Mark Duffy interviews family on Yap Island investigaing Zika outbreak" class="scale-with-grid">
</div>
<span class="year">2007</span>
<div class="description">
<p>In April of 2007, Zika made it outside of Africa and Asia for the first time when it spread to Yap Island in Micronesia. There were 49 confirmed cases, 59 unconfirmed cases, no hospitalizations, and no deaths. The virus spread throughout neighboring islands over the next few years.<sup><a href="#ref-4">4</a>, <a href="#ref-21">21</a></sup></p>
</div>
</li>
<li>
<div class="timeline-image">
<img src="./assets/images/2014-world-cup.jpg" alt="Miguel Discart - 2014 world cup fans gather in the street" class="scale-with-grid">
</div>
<span class="year">2014</span>
<div class="description">
<p>The virus spread across pacific ocean to French Polynesia (where its link with Guillain-Barré Syndrome first arose) and other neighboring islands in the largest outbreak to date. It is believed that the 2014 Soccer World Cup, drawing a multitude of international fans, was responsible for the spread of Zika to Brazil.<sup><a href="#ref-19">19</a>, <a href="#ref-23">23</a>, <a href="#ref-24">24</a></sup></p>
</div>
</li>
<li>
<div class="timeline-image">
<img src="./assets/images/2015-zika-mosquitoes.jpg" alt="IAEA Imagebank - Zika-carrying mosquitoes are studied in Brazil" class="scale-with-grid">
</div>
<span class="year">2015</span>
<div class="description">
<p>In April of 2015, Zika spread from the ongoing outbreak in Brazil to Mexico, Central America, Caribbean, and South America where it reached pandemic levels.<sup><a href="#ref-4">4</a>, <a href="#ref-25">25</a></sup></p>
</div>
</li>
<li>
<div class="timeline-image">
<img src="./assets/images/level2alert.png" alt="level 2 alert" class="scale-with-grid">
</div>
<span class="year">15 Jan 2016</span>
<div class="description">
<p>CDC issued a Level 2 travel alert for travelers to affected countries and guidelines for pregnant women to consult their doctors before traveling to a Zika-infected area.<sup><a href="#ref-3">3</a>, <a href="#ref-4">4</a>, <a href="#ref-12">12</a></sup></p>
</div>
</li>
<li>
<div class="timeline-image">
<img src="./assets/images/2016-minister-gaviria.jpg" alt="Health Minister Alejandro Gaviria, one leader from Columbia who suggests a delay in pregnancy" class="scale-with-grid">
</div>
<span class="year">23 Jan 2016</span>
<div class="description">
<p>Five South American countries advised women to postpone getting pregnant until more is known about the risks, prompting criticism from women's health organizations and general public.<sup><a href="#ref-5">5</a>, <a href="#ref-26">26</a></sup></p>
</div>
</li>
<li>
<div class="timeline-image">
<!-- <img src="" alt="" class="scale-with-grid"> -->
</div>
<span class="year">2 Feb 2016</span>
<div class="description">
<p>31 isolated cases in the US, in 11 states and DC. These were all travel associated cases with the exception of one case of sexual transmission in Dallas, TX. Travel-related cases were also reported in Spain, the UK, Ireland, and others.<sup><a href="#ref-3">3</a>, <a href="#ref-12">12</a>, <a href="#ref-20">20</a>, <a href="#ref-27">27</a></sup></p>
</div>
</li>
</ul>
</div><!--end timeline row-->
<div class="row" id="where-is-zika">
<div id="traveled">
<h2>Zika Virus Cases<sup><a href="#ref-17">17</a>, <a href="#ref-18">18</a>, <a href="#ref-22">22</a></sup></h2>
<img src="./assets/images/map.png" longdesc="Uganda in 1947, Gabon in 1975, Senegal in 1988, Malaysia in 1969, Yap Island in 2007, Cambodia in 2010, French Polynesia in 2014, Mexico in 2015, Brazil in 2015, and Texas in 2016" class="scale-with-grid">
</div>
<div id="now">
<div id="where-list">
<h2><span class="no-caps">There are an estimated</span> 1.6 Million <span class="no-caps">cases of Zika virus in </span>33 Countries<sup><a href="#ref-30">30</a></sup></h2>
<div class="row">
<div id="americas" class="columns eight">
<h3>Americas</h3>
<ul class="columns three">
<li>Barbados</li>
<li>Bolivia</li>
<li>Brazil**</li>
<li>Colombia**</li>
<li>Costa Rica</li>
<li>Curacao</li>
<li>Dominican Republic</li>
</ul>
<ul class="columns three">
<li>Ecuador</li>
<li>El Salvador**</li>
<li>French Guiana</li>
<li>Guadeloupe</li>
<li>Guatemala</li>
<li>Guyana</li>
<li>Haiti</li>
</ul>
<ul class="columns three">
<li>Honduras</li>
<li>Jamaica</li>
<li>Martinique</li>
<li>Mexico</li>
<li>Nicaragua</li>
<li>Panama</li>
<li>Paraguay</li>
</ul>
<ul class="columns three">
<li>Puerto Rico</li>
<li>Saint Martin</li>
<li>Suriname**</li>
<li>U.S Virgin Islands</li>
<li>Venezuela**</li>
<li>United States*</li>
</ul>
</div>
<div id="pacific" class="columns two">
<h3>Oceania/Pacific Is.</h3>
<ul>
<li>American Samoa</li>
<li>Samoa</li>
<li>Tonga</li>
</ul>
</div>
<div id="africa" class="columns two">
<h3>Africa</h3>
<ul>
<li>Cape Verde</li>
</ul>
</div>
</div>
<div class="row">
<p>*35 travel-associated Zika disease cases in the U.S. have been reported</p>
<p>**Also report having significant increase in cases of microcephaly and/or GBS</p>
<p class="updated">Last Updated 8.Feb.2016<sup><a href="#ref-3">3</a></sup></p>
</div>
</div>
</div>
</div> <!--end row 3 / #where -->
<div class="row">
<div class="column" id="transmission">
<h2>Transmission</h2>
<p>The Zika virus is not yet fully understood. However, there are 4 known ways to transmit the Zika virus.</p>
<div class="row">
<div class="way_spread columns three">
<div class="image">
<img src="./assets/images/spread-mosquito.png" alt="person to mosquito to person" class="scale-with-grid">
</div>
<h3>Person <span class="arrow">→</span> mosquito <span class="arrow">→</span> person</h3>
<p>Zika is most commonly transmitted from person to person by the Aedes mosquito, which live in urban areas and are active during the day (usually mornings and late afternoons).<sup><a href="#ref-1">1</a>, <a href="#ref-3">3</a></sup></p>
</div>
<div class="way_spread columns three">
<div class="image">
<img src="./assets/images/spread-mother.png" alt="mother to unborn child" class="scale-with-grid">
</div>
<h3>Mother <span class="arrow">→</span> unborn child</h3>
<p>Zika virus can spread from an infected mother to the placenta and their unborn baby. The virus will not infect infants conceived after the virus has cleared from the blood.<sup><a href="#ref-2">2</a></sup> There is no evidence suggesting a risk for future birth defects.<sup><a href="#ref-1">1</a></sup></p>
</div>
<div class="way_spread columns three">
<div class="image">
<img src="./assets/images/spread-partner.png" alt="person to partner" class="scale-with-grid">
</div>
<h3>Person <span class="arrow">→</span> sexual partner</h3>
<p>Transmission of Zika during sex is possible but rare. If an infected male partner has the virus in their blood stream, their semen can be contagious. It is unknown how long Zika can live in semen. Infected individuals should abstain from sex or use a condom for 6 months after the infection.<sup><a href="#ref-10">10</a></sup></p>
</div>
<div class="way_spread columns three">
<div class="image">
<img src="./assets/images/spread-bloodbank.png" alt="person to partner" class="scale-with-grid">
</div>
<h3>Person <span class="arrow">→</span> blood bank <span class="arrow">→</span> person</h3>
<p>There may also be a chance of transmission through blood transfusions, but no conclusive evidence has been found.<sup><a href="#ref-10">10</a></sup></p>
</div>
</div>
</div><!--end spread-->
</div>
<div class="row">
<div class="column nine columns" id="prevention">
<h2>Prevention</h2>
<p id="vaccinations">Currently no vaccinations exist to prevent Zika. The best way to prevent infection is to avoid mosquito bites.</p>
<div class="mosquito" id="mosquito-1"></div>
<div class="mosquito" id="mosquito-2"></div>
<div class="mosquito" id="mosquito-3"></div>
<div class="row">
<div class="column one-third" id="prevent-travel-2">
<div class="image">
<img src="./assets/images/prevent-travel-2.png" alt="avoid travel">
</div>
<p>Avoid travel to areas with confirmed Zika cases, especially if you are pregnant. See above for Zika-infected areas.<sup><a href="#ref-2">2</a>, <a href="#ref-14">14</a></sup></p>
</div>
<div class="column one-third" id="prevent-bugspray-2">
<div class="image">
<img src="./assets/images/prevent-bugspray-2.png" alt="apply spray every 2-3 hours">
</div>
<p>Apply insect repellent every few hours. Do not spray repellent on the skin under clothing. If you are also using sunscreen, apply it first before repellent. Follow instructions on the label. Insect repellent is safe for pregnant women.<sup><a href="#ref-2">2</a>, <a href="#ref-14">14</a></sup></p>
</div>
<div class="column one-third" id="prevent-spray-clothes">
<div class="image">
<img src="./assets/images/emptywater.png" alt="empty water">
</div>
<p>Remove still water in flowerpots, buckets, animal water bowls, and kid pools to prevent potential mosquito breeding grounds.<sup><a href="#ref-2">2</a>, <a href="#ref-14">14</a></sup></p>
</div>
</div>
<div class="row">
<div class="column one-third" id="prevent-longsleeves-2">
<div class="image">
<img src="./assets/images/prevent-longsleeves-2.png" alt="longsleeve shirt and pants">
</div>
<p>Wear long-sleeve shirts and pants to avoid mosquito bites.<sup><a href="#ref-2">2</a>, <a href="#ref-14">14</a></sup></p>
</div>
<div class="column one-third" id="prevent-close-2">
<div class="image">
<img src="./assets/images/prevent-close-2.png" alt="close door and windows">
</div>
<p>Choose lodging that is air-conditioned, has screens on the doors and windows, or purchase a mosquito bed net.<sup><a href="#ref-2">2</a>, <a href="#ref-14">14</a></sup></p>
</div>
<div class="column one-third" id="prevent-baby-net">
<div class="image">
<img src="./assets/images/wearcondom_360.png" alt="condom">
</div>
<p>If you have traveled to a Zika-infected area, wear a condom during sex or abstain from sex for 6 months.<sup><a href="#ref-10">10</a></sup></p>
</div>
</div>
<div class="row">
<div class="column one-third" id="prevent-net">
<div class="image">
<img src="./assets/images/prevent-net.png" alt="put mosqiuto netting on beds">
</div>
<p>Choose a WHOPES-approved bed net with 156 holes per square inch that is long enough to tuck under the mattress. Permethrin-treated nets help kill mosquitoes; do not wash them or expose them to sunlight.<sup><a href="#ref-2">2</a>, <a href="#ref-14">14</a></sup></p>
</div>
<div class="column one-third" id="prevent-directions">
<div class="image">
<img src="./assets/images/prevent-directions.png" alt="follow directions">
</div>
<p>Follow directions on the label when applying insect repellent to children. Spray repellent onto hands first to apply to a child’s face. Avoid applying repellent to the child’s hands, mouth, eyes, or open wounds.<sup><a href="#ref-2">2</a>, <a href="#ref-3">3</a>, <a href="#ref-14">14</a></sup></p>
</div>
<div class="column one-third" id="prevent-baby-net">
<div class="image">
<img src="./assets/images/prevent-baby-net.png" alt="put mosquito netting on carriers">
</div>
<p>DO NOT apply insect repellent to babies younger than 2 months old. Instead, dress them in long sleeves and cover the stroller or carrier with mosquito netting.<sup><a href="#ref-2">2</a>, <a href="#ref-3">3</a>, <a href="#ref-14">14</a></sup></p>
</div>
</div>
<div class="row">
<div class="column one-third" id="prevent-spray-clothes">
<div class="image">
<img src="./assets/images/prevent-spray-clothes.png" alt="spray clothes with bugspray">
</div>
<p>Mosquitoes can bite through thin clothing. Treat clothing and gear (boots, pants, socks, tents) with an insecticide called permethrin. Follow directions on label and DO NOT apply directly to the skin.<sup><a href="#ref-2">2</a>, <a href="#ref-14">14</a></sup></p>
</div>
</div>
</div>
<div class="column three columns" id="right-spray">
<h2>Choosing the right bug spray</h2>
<p>Use an insect repellent with one of these active ingredients:</p>
<div class="sprays" id="deet">
<h3>DEET</h3>
<ul>
<li class="spray-off"><img src="./assets/images/off.png" alt="off bug spray logo" class="scale-with-grid"></li>
<li class="spray-sawyer"><img src="./assets/images/Sawyer-logo1.jpg" alt="sawyer logo" class="scale-with-grid"></li>
</ul>
<ul>
<li class="spray-cutter"><img src="./assets/images/cutter.png" alt="cutter logo" class="scale-with-grid"></li>
<li class="spray-ultrathon"><img src="./assets/images/ultrathon_logo.png" alt="ultrathon logo" class="scale-with-grid"></li>
</ul>
</div>
<div class="sprays" id="picaridin">
<h3>Picaridin, KBR 3023, Bayrepel, or icaridin</h3>
<ul>
<li class="spray-sss"><img src="./assets/images/sss.png" alt="sss logo" class="scale-with-grid"></li>
<li class="spray-autan"><img src="./assets/images/autan_logo_m.png" alt="autan logo" class="scale-with-grid"></li>
</ul>
</div>
<div class="sprays" id="eucalyptus">
<h3>Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)</h3>
<ul>
<li class="spray-repel"><img src="./assets/images/repel-logo.png" alt="repel logo" class="scale-with-grid"></li>
</ul>
</div>
<div class="sprays" id="ir3535">
<h3>IR3535</h3>
<ul>
<li class="spray-sss"><img src="./assets/images/sss.png" alt="sss logo" class="scale-with-grid"></li>
<li class="spray-skinsmart"><img src="./assets/images/skinsmart.png" alt="skinsmart logo" class="scale-with-grid"></li>
</ul>
</div>
<p>The EPA has not yet evaluated common natural insect repellents for effectiveness. The CDC recommends using repellents containing proven safe and effective ingredients. Examples used in unregistered insect repellents are: citronella oil, cedar oil, geranium oil, peppermint oil, soybean oil, and pure oil of lemon eucalyptus.<sup><a href="#ref-14">14</a></sup> Visit <a href="www.cdc.gov/features/StopMosquitoes" target="blank">www.cdc.gov/features/StopMosquitoes</a> for more information.</p>
</div>
</div>
<div class="row" id="zika-symptoms">
<div class="column one-half">
<h2>Symptoms of Zika Disease<sup><a href="#ref-1">1</a></sup></h2>
<div class="para">
<img src="./assets/images/1in5.png" alt="1 in 5 infected people" class="scale-with-grid" />
<p>About 1 in 5 people infected with Zika virus actually become ill.<sup><a href="#ref-3">3</a></sup></p>
</div>
<div class="para">
<img src="./assets/images/incubation.png" id="incubation" alt="1 in 5 infected people" />
<p>Incubation period is unknown but is likely a few days to one week. Symptoms are usually mild and last several days to a week.<sup><a href="#ref-3">3</a></sup></p>
</div>
<p>Hospitalization is uncommon. Zika is not known to be deadly, but those with preexisting health problems can have fatal complications.<sup><a href="#ref-3">3</a></sup> There have also been cases of Guillain-Barré Syndrome following suspected Zika infection, but the relationship is not known.<sup><a href="#ref-4">4</a></sup></p>
</div>
<div class="column one-half signs-image">
<div class="warning">If you have been to a Zika-infected area and have at least 2 symptoms, contact your doctor.</div>
<img src="./assets/images/zika-symptoms.png" alt="headache, fever, painful or red eyes, joint pain, itching/rash, muscle pain" class="scale-with-grid">
</div>
</div><!--end row-->
<div class="row" id="symptoms-microcephaly">
<div class="column one-half microceph-image">
<div class="warning">If you have been to a Zika-infected area and are pregnant or recently gave birth, contact your doctor.</div>
<img src="./assets/images/symptoms-microcephalacy.png" alt="seizures,small head size, coordination difficulties, dwarfism/short stature, backward-sloping forehead, hyperactivity, facial distortions, delays in speech and movement" class="scale-with-grid">
</div>
<div class="column one-half">
<h2>Symptoms of Microcephaly</h2>
<p>There is an unconfirmed link between birth complications such as microcephaly and Zika infection during pregnancy.<sup><a href="#ref-3">3</a></sup></p>
<p>There have been over 4,700 reported cases of microcephaly in newborns in Brazil since October 2015.<sup><a href="#ref-15">15</a></sup></p>
<p>Brazil saw 20 times more cases of microcephaly in 2015 than past years.<sup><a href="#ref-28">28</a></sup></p>
<div class="graph">
<h3>Suspected Cases of Microcephaly in Brazil 2010-2015</h3>
<img src="./assets/images/microcephaly_cases_brazil.png" alt="153 in 2010, 139 in 2011, 175 in 2012, 167 in 2013, 147 in 2014, and 3174 in 2015" class="scale-with-grid" />
</div>
</div>
</div><!--end row-->
<div class="row" id="treatments">
<div class="column one-half" id="treatment-adults">
<div class="treatment-header">
<h2>Treatment for Adults</h2>
<div class="treatment-image">
<img src="./assets/images/treatment-adults.png" alt="adult">
</div>
</div>
<div class="treatment-plan">
<p>If you have Zika symptoms within 2 weeks of traveling to a Zika-infected area:<sup><a href="#ref-2">2</a></sup></p>
<ul>
<li>Contact your doctor</li>
<li>Take medicine (acetaminophen or paracetamol) to relieve fever and pain.</li>
<li>To reduce the risk of bleeding, do NOT take aspirin, aspirin products, or other non-steroidal anti-inflammatory drugs such as ibuprofen until Dengue can be ruled out.</li>
<li>Get rest and drink plenty of fluids.</li>
<li>Prevent additional mosquito bites to avoid spreading the disease.</li>
</ul>
</div>
</div>
<div class="column one-half" id="treatment-pregnant">
<div class="treatment-header">
<div class="treatment-image">
<img src="./assets/images/treatment-pregnant.png" alt="pregnant woman">
</div>
<h2>Treatment for Pregnant Women</h2>
</div>
<div class="treatment-plan">
<p>There is no cure for Zika virus.<sup><a href="#ref-1">1</a></sup> If you are pregnant, your doctor will treat you for the virus, while also monitoring your baby. The next steps will most likely be:<sup><a href="#ref-11">11</a>, <a href="#ref-16">16</a></sup></p>
<ul>
<li>An ultrasound to test for microcephaly or calcium deposits in your baby’s brain</li>
<li>You may get an amniocentesis (also called amnio) to check the amniotic fluid that surrounds your baby in the womb for Zika.</li>
<li>The placenta and umbilical cord may also be tested after birth.</li>
<li>Your baby’s growth should be monitored by ultrasound every 3-4 weeks. You may be referred to a maternal-fetal medicine specialist.</li>
</ul>
</div>
</div>
</div><!--end row-->
<div class="row" id="flavivirus">
<div class="column">
<h2>One of Many Flaviviruses</h2>
<p>Zika, like dengue, yellow fever, and others, is part of the flavivirus family. Flaviviruses are arboviruses, which means they are spread via infected arthropod vectors such as ticks and mosquitoes. Zika, yellow fever, and dengue grow very well in the human body, and easily reinfect mosquitoes. Flaviviruses enter the bloodstream, infect cells in the immune system, travel to the lymph nodes and target different organs.<sup><a href="#ref-31">31</a></sup></p>
<div class="row">
<div class="column columns five">
<div id="flavivirus-zika">
<h3>Zika</h3>
<p>Zika induces fever, rash, joint and muscle pain, and red eyes. Fatal cases are rare and are usually due to complications from pre-existing health conditions. There is no vaccine for zika.<sup><a href="ref-31">31</a></sup></p>
</div>
<div id="flavivirus-yellow">
<h3>Yellow Fever</h3>
<p>Yellow Fever infects the liver. It can cause fever, headache, nausea, and vomiting, and in serious cases may cause fatal heart, liver, and kidney conditions. The yellow fever vaccine has been in use for several decades.<sup><a href="#ref-31">31</a>, <a href="#ref-32">32</a></sup></p>
</div>
<div id="flavivirus-dengue">
<h3>Dengue</h3>
<p>Dengue can cause high fever, rash, and muscle and joint pain, and in serious cases may cause fatal shock and hemorrhage within the body. Dengue is one of the fastest spreading vector-born viral diseases and has increased by 30 times in the past 50 years.<sup><a href="#ref-34">34</a></sup> A vaccine for all four variations of dengue was recently developed and licensed in Brazil, the Philippines, and Mexico, but not in the U.S.<sup><a href="#ref-31">31</a>, <a href="#ref-32">32</a>, <a href="#ref-35">35</a></sup></p>
</div>
</div>
<div class="column columns seven graph">
<img src="./assets/images/FlavivirusGraph_v3.png" alt="Prevalence of Zika, Yellow Fever, & Dengue Virus Cases. dengue at 1.2 million in 2008, 3+ million in 2013. zika at 5,000 in 2007, 20,000 in 2013, and 1.6 million in 2016. Yellow fever remains around 0.2 million from 2007-2016" class="scale-with-grid" />
<p>*Yellow fever value of 200,000 cases based on yearly estimate by WHO<sup><a href="#ref-32">32</a></sup></p>
</div>
</div>
</div>
</div><!--end row-->
<div class="row" id="dont-know">
<div class="column">
<h2>What We Still Don't Know</h2>
<div class="columns three">
<img src="./assets/images/dontknow.png" alt="?" class="scale-with-grid" />
</div>
<div class="columns nine">
<p>We don't know for sure if Zika is the cause of the increase in microcephaly.<sup><a href="#ref-28">28</a></sup></p>
<p>We don't know for sure how many of the more than 4,700 reported cases of microcephaly in Brazil are related to Zika, as it is difficult to diagnose and can have other causes.</p>
<p>We don't know for sure if Zika is the cause of the increase in Guillain-Barré Syndrome.<sup<a href="#ref-28">28</a></sup></p>
<p>The possible connection of Zika with microcephaly and Guillain-Barré Syndrome suggest mutation in the virus to become more pathogenic to humans. We don't know exactly what has changed about Zika virus and why.<sup><a href="#ref-28">28</a></sup></p>
</div>
</div>
</div>
<div class="row" id="action-plan">
<div class="column">
<h2>The <em>Who</em> Action Plan<sup><a href="#ref-8">8</a></sup></h2>
<div class="row">
<div class="columns three">
<div class="action-item">
<div class="image">
<img src="./assets/images/PrioritizeResearch.png" alt="spyglass with droplet" class="scale-with-grid">
</div>
<p>Prioritize research into Zika virus disease by convening experts.</p>
</div>
</div>
<div class="columns three">
<div class="action-item">
<div class="image">
<img src="./assets/images/EnhanceSurveillance.png" alt="airplanes" class="scale-with-grid">
</div>
<p>Enhance surveillance of Zika virus and potential complications.</p>
</div>
</div>
<div class="columns three">
<div class="action-item">
<div class="image">
<img src="./assets/images/communication.png" alt="speech bubble with nodes" class="scale-with-grid">
</div>
<p>Strengthen risk communication to help countries meet International Health Regulations.</p>
</div>
</div>
<div class="columns three">
<div class="action-item">
<div class="image">
<img src="./assets/images/ClinicalMgmt.png" alt="doctors" class="scale-with-grid">
</div>
<p>Provide training on clinical management, diagnosis and vector control at WHO Collaborating Centres.</p>
</div>
</div>
</div>
<div class="row">
<div class="columns three">
<div class="action-item">
<div class="image">
<img src="./assets/images/StrengethenLabs.png" alt="microscope" class="scale-with-grid">
</div>
<p>Strengthen the capacity of laboratories to detect the virus.</p>
</div>
</div>
<div class="columns three">
<div class="action-item">
<div class="image">
<img src="./assets/images/CurbSpread.png" alt="culture" class="scale-with-grid">
</div>
<p>Support health authorities in curbing spread of infected mosquitoes by providing larvicide to treat standing water sites.</p>
</div>
</div>
<div class="columns three">
<div class="action-item">
<div class="image">
<img src="./assets/images/ClinicalCare.png" alt="doctors" class="scale-with-grid">
</div>
<p>Collaborate with other health agencies to prepare recommendations for clinical care and follow-up of people with Zika virus.</p>
</div>
</div>
</div>
</div>
</div><!--end row-->
<div class="row" id="references">
<div class="column">
<h2>References</h2>
<ol>
<li id="ref-1"><span class="li-color">Roberts, M. (2016. Feb, 1). “<a href="http://www.bbc.com/news/health-35459797" target="blank">Zika-linked condition: WHO declares global emergency</a>.” BBC News Online.</span></li>
<li id="ref-2"><span class="li-color">Gallagher, J. (2015, Feb, 5). “<a href="http://www.bbc.com/news/health-35441675" target="blank">Zika outbreak: Travel advice</a>” BBC News Online.</span></li>
<li id="ref-3"><span class="li-color">Centers for Disease Control and Prevention (2016). “<a href="http://www.cdc.gov/zika/" target="blank">Zika Virus</a>.”</span></li>
<li id="ref-4"><span class="li-color">Wikipedia (2016) “<a href="https://en.wikipedia.org/wiki/Zika_virus" target="blank">Zika Virus</a>.”</span></li>
<li id="ref-5"><span class="li-color">“<a href="http://www.bbc.com/news/world-latin-america-35388842" target="blank">Zika virus triggers pregnancy delay calls</a>.” (2016. Jan, 23).</span></li>
<li id="ref-6"><span class="li-color">“<a href="http://www.mayoclinic.org/diseases-conditions/microcephaly/basics/symptoms/con-20034823" target="blank">Microcephaly</a>.” (2016). Mayo Clinic.</span></li>
<li id="ref-7"><span class="li-color">Centers for Disease Control and Prevention (2016). “<a href="http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html" target="blank">Zika virus: clinical evaluation & disease</a>”.</span></li>
<li id="ref-8"><span class="li-color">World Health Organization. (2016. Jan). “<a href="http://www.who.int/mediacentre/factsheets/zika/en/" target="blank">Zika virus</a>.”</span></li>
<li id="ref-9"><span class="li-color">Swails, B., McKenzie, D. (2016. Feb, 3). “<a href="http://www.cnn.com/2016/02/02/health/zika-forest-viral-birthplace/" target="blank">Uganda's Zika Forest, birthplace of the Zika virus</a>.”</span></li>
<li id="ref-10"><span class="li-color">Szabo, Liz. (2016. Feb, 5). “<a href="http://www.usatoday.com/story/news/2016/02/03/zika-q-and-a/79751476/" target="blank">Zika Q&A: What you need to know about sex, saliva, sperm banks</a>.”</span></li>
<li id="ref-11"><span class="li-color">March of Dimes. (2016. Feb). “<a href="http://www.marchofdimes.org/complications/zika-virus-and-pregnancy.aspx" target="blank">Zika virus and pregnancy</a>.”</span></li>
<li id="ref-12"><span class="li-color">“<a href="http://www.bbc.com/news/uk-35391712" target="blank">Zika virus: Three Britons infected, say health officials</a>.” (2016. Jan, 23). BBC News.</span></li>
<li id="ref-13"><span class="li-color">Dick, GWA, et. al. (1952). “Zika virus isolations and serological specificity.” Trans R Soc Trop Med Hyg (1952) 46 (5): 509-520. doi: 10.1016/0035-9203(52)90042-4</span></li>
<li id="ref-14"><span class="li-color">Centers for Disease Control and Prevention (2016). “<a hrefe="http://www.cdc.gov/zika/prevention/index.html" target="blank">Zika virus: prevention</a>”.</span></li>
<li id="ref-15"><span class="li-color">Carless, W. (2016. Feb, 3). “<a href="http://www.usatoday.com/story/news/world/2016/02/03/brazil-zika-birth-defect-drop-hospital-microcephaly/79791768/" target="blank">On Brazil's Zika front lines, cases of microcephaly are actually dropping</a>.” USA Today.</span></li>
<li id="ref-16"><span class="li-color">Centers for Disease Control and Prevention (2016). “<a href="http://www.cdc.gov/mmwr/volumes/65/wr/mm6502e1.htm" target="blank">Interim Guidelines for Pregnant Women During a Zika Virus Outbreak — United States, 2016</a>.”</span></li>
<li id="ref-17"><span class="li-color">Phillips, s. (2016. Feb, 4). “<a href="http://fox5sandiego.com/2016/02/04/blood-bank-rejecting-donors-who-visited-zika-areas/" target="blank">Blood bank rejecting donors who visited Zika areas</a>.” Fox5 San Diego News.</span></li>
<li id="ref-18"><span class="li-color">Withnall, A. (2016. Jan, 28). “<a href="http://www.independent.co.uk/life-style/health-and-families/health-news/zika-how-virus-spread-around-world-a6839101.html" target="blank">How the Zika virus spread around the world</a>.” Independent.</span></li>
<li id="ref-19"><span class="li-color">Musso, D., (2015). “Zika Virus Transmission from French Polynesia to Brazil.” Emerg Infect Dis. 2015 Oct; 21(10): 1887. doi: 10.3201/eid2110.151125</span></li>
<li id="ref-20"><span class="li-color">Fox, M. (2016. Feb, 2). “<a href="http://www.nbcnews.com/storyline/zika-virus-outbreak/zika-virus-can-spread-sexual-contact-health-officials-dallas-confirm-n510076" target="blank">Dallas Reports First Case of Sexual Transmission of Zika Virus</a>.”</span></li>
<li id="ref-21"><span class="li-color">Wilcox, E. (2010). “<a href="http://www.wpafb.af.mil/news/story.asp?id=123219950" target="blank">Lt Col Mark Duffy of USAF School of Aerospace Medicine Receives the 2010 James H. Nakano Citation for the Article ‘Zika Virus Outbreak on Yap Island, Federated States of Micronesia.</a>’”</span></li>
<li id="ref-22"><span class="li-color">Parry, L. (2016. Feb, 2).“'<a href="http://www.dailymail.co.uk/health/article-3428938/Game-changing-Zika-virus-scary-gets-warns-expert.html" target="blank">Game-changing' Zika virus is about as scary as it gets, warns expert</a>.” Daily Mail, UK.</span></li>
<li id="ref-23"><span class="li-color">Seibel, M. (2016. Feb, 4). “<a href="http://www.star-telegram.com/news/nation-world/world/article58432243.html" target="blank">French researcher says Zika link to Guillain-Barré Syndrome is ‘almost certain’</a>.”</span></li>
<li id="ref-24"><span class="li-color">Photo by <a href="https://www.flickr.com/photos/miguel_discart/14277835198/in/photolist-nKFCYo-nP7mSE-nKFDRA-nKFxqb-o3aYkK-nKGkM6-o5C7hb-o5MLFq-o5U33D-o6iALK-nQkEjG-o1GHhg-odQhcb-ocwyAx-nYyX5w-iM51KQ-nYsCxL-p6MRxa-nYPw55-o8o3UZ-o28ycW-f57byo-nPfKEA-dkULi9-nZiRMw-jJ2yZn-nNUwQj-pH6vQb-p3Gi3e-nJcLbJ-pXkmPj-oRNZJG-dkUNjN-oDPBzR-oaA85i-o5U2uz-o3Rzas-o5U22k-oiGbnm-o21QXk-qf7GTa-odAyNb-okRozr-nXbJw1-o4mMDk-nG1xTF-nrbBtj-o7wXiK-nNpnAf-nNpzZx" target="blank">Miguel Discart</a>.</span></li>
<li id="ref-25"><span class="li-color">Photo by <a href="https://www.flickr.com/photos/iaea_imagebank/24407404799/in/photolist-DbNk78-fvEXR4-fvETn6-DBk3Nc-DKAirB-Dc6SmP-DBk1g8-Dc6RbT-CXf3aW-8VnCcF-DHW6bX-CLqAjf-DzEWzc-CLqzU7-DzEW4H-DHW4P8-CLqyBs-CLqy9o-DgPpTb-Dxwh3S-BCimRP-C2e22m-CbP14k-BCihNP-C2dWWs-pAKfpe-C2e3L3-oppw9W-oyv588-dcAVdB-oydVZx-DKhGPp-CMTRsk-DGYfro-DGYeey-DiaXvy-AVqThX-92EMis-92EMdC-92EM3U-92BDEH-92BDuX-92ELmm-92BCE4-92EKF7-92EKtN-D9vKBM-4Y9VRz-AT9SQE-AjM4wi" target="blank">IAEA Imagebank</a>.</span></li>
<li id="ref-26"><span class="li-color">Image retrieved from <a href="https://panampost.com/panam-staff/2015/02/25/colombias-price-controls-a-cure-worse-than-the-disease/" target="blank">Panam Post</a>.</span></li>
<li id="ref-27"><span class="li-color">Image retrieved from <a href="https://publichealthwatch.wordpress.com/2016/02/03/texas-reports-first-case-of-sexually-transmitted-zika-virus-in-u-s/" target="blank">Public Health Watch</a>.</span></li>
<li id="ref-28"><span class="li-color">Roeder, A., (2016). “<a href="http://www.hsph.harvard.edu/news/features/zika-virus-in-brazil-may-be-mutated-strain/?utm_source=Twitter&utm_medium=Social&utm_campaign=Chan-Twitter-General" target="blank">Zika virus in Brazil may be mutated strain</a>.” Harvard T.H. Chan School of Public Health.</span></li>
<li id="ref-29"><span class="li-color">Wapps, J. (2016. Feb, 5). “<a href="http://www.cidrap.umn.edu/news-perspective/2016/02/who-local-zika-cases-33-nations-gbs-numbers-climb" target="blank">WHO: Local Zika cases in 33 nations as GBS numbers climb</a>.” University of Minnesota Center for Infectious Disease Research and Policy.</span></li>
<li id="ref-30"><span class="li-color">“<a href="https://en.wikipedia.org/wiki/Zika_virus_outbreak_(2015%E2%80%93present)" target="blank">Zika virus outbreak (2015–present)</a>.” Wikipedia.</span></li>
<li id="ref-31"><span class="li-color">Mackenzie, J. (2016. Feb, 4). “<a href="http://theconversation.com/zika-dengue-yellow-fever-what-are-flaviviruses-53969" target="blank">Zika, dengue, yellow fever: what are flaviviruses?</a>” The Conversation.</span></li>
<li id="ref-32"><span class="li-color">“<a href="http://www.who.int/mediacentre/factsheets/fs100/en/" target="blank">Yellow Fever</a>.” (2014. March). World Health Organization.</span></li>
<li id="ref-33"><span class="li-color">“<a href="http://www.who.int/mediacentre/factsheets/fs117/en/" target="blank">Dengue and severe dengue</a>.” (2015. May). World Health Organization.</span></li>
<li id="ref-34"><span class="li-color">“<a href="http://www.foxnews.com/health/2013/01/16/dengue-is-fastest-spreading-tropical-disease-who-says.html" target="blank">Dengue is fastest-spreading tropical disease, WHO says</a>.” (2013) Fox News Health.</span></li>
<li id="ref-35"><span class="li-color">World Economic Forum (2015. Jan, 4). “<a href="http://www.weforum.org/agenda/2016/01/how-close-are-we-to-beating-dengue" target="blank">How close are we to beating dengue?</a>”</span></li>
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