Advice for people living in or traveling to South Florida

November 18, 2016

On August 1, 2016, CDC issued guidance for people living in or travelinglocal-fl-map-1200px to a 1-square-mile area of the Wynwood neighborhood in Miami, FL, identified by the Florida Department of Health as having mosquito-borne spread of Zika. On August 19, CDC also issued guidance for a 1.5-square-mile section of Miami Beach identified to have mosquito-borne spread of Zika; on September 17, this section was expanded to a 4.5-square-mile area.

On September 19, CDC updated guidance for the Wynwood-designated area after three mosquito incubation periods passed without any new locally transmitted cases of Zika.

On October 13, Florida announced a new area of mosquito-borne spread of Zika in an additional 1-square-mile area in Miami-Dade County, FL. Because local spread of Zika virus continues to be reported in Miami-Dade County, CDC updated its travel and testing guidance on October 19 to apply recommendations to all of Miami-Dade County.

Red and Yellow Area Designation

CDC designates areas for Zika virus transmission prevention in the continental United States and Hawaii as red or yellow.

  • Zika active transmission area (red area): A geographic area where local, state, and CDC officials have determined that the intensity of Zika virus transmission presents a significant risk to pregnant women. The intensity of Zika virus transmission is determined by several factors including geographic distribution of cases, number of cases identified, known or suspected links between cases and population density.
  • Zika cautionary area (yellow area): A geographic area where local transmission has been identified, but evidence is lacking that the intensity of transmission is comparable to that in a red area. Although the specific level of risk in yellow areas is unknown, there is still a risk to pregnant women. Additionally, areas adjacent or close to red areas may have a greater likelihood of local Zika virus transmission and are considered to pose a risk to pregnant women.

Currently, red areas include a 4.5-square-mile area of Miami Beach and a 1-square-mile area of Little River in Miami-Dade County, FL. The rest of Miami-Dade County is a yellow area.

Guidance for Zika cautionary areas (Yellow areas)

Travel

  • Pregnant women should consider postponing travel to all parts of Miami-Dade County.

Testing and Diagnosis

  • Pregnant women who lived in, traveled to, or had sex without a condom with someone who lived in or traveled to Miami-Dade County after August 1, 2016, should be tested for Zika virus.
    • Pregnant women with symptoms of Zika should be tested for Zika virus.
    • Pregnant women without symptoms who live in or frequently travel (daily, weekly) to Miami-Dade County should talk to their healthcare provider about getting tested in the first and second trimesters of pregnancy.
    • Pregnant women who traveled (limited travel) to Miami-Dade County or who had sex without a condom with a partner who lived in or traveled to Miami-Dade County should be tested for Zika virus, regardless of symptoms.

Pregnancy Planning

  • Women who traveled (limited travel) to Miami-Dade County or had sex without a condom with a person who lives in or traveled to Miami-Dade County may consider waiting at least 8 weeks after symptoms started or last possible exposure before trying to get pregnant. Although the level of risk in yellow areas is unknown, pregnant women are still at risk.
  • Men who traveled (limited travel) to Miami-Dade County or had sex without a condom with a person who lives in or traveled to Miami-Dade County may consider waiting at least 6 months after symptoms started or last possible exposure before trying to get their partner pregnant.
  • People living in Miami-Dade County who do not have symptoms and are interested in trying to become pregnant should talk to their healthcare provider about pregnancy plans.
  • Women who live in or frequently travel to Miami-Dade County who are diagnosed with Zika should wait at least 8 weeks after symptoms started before trying to get pregnant.
  • Men who live in or frequently travel to Miami-Dade County who are diagnosed with Zika should wait at least 6 months after symptoms started before trying to get their partner pregnant.
  • Given the limited data available about the persistence of Zika in body fluids and the chances of harm to a pregnancy when the woman is infected with Zika around the time of conception, some couples with a partner with possible Zika virus exposure may choose to wait longer or shorter than the recommended period to try to get pregnant.

Prevention

  • Pregnant couples and couples trying to get pregnant who live in or travel to Miami-Dade County should be aware of active Zika virus transmission and should strictly follow steps to prevent mosquito bites.
  • Women and men who live in or traveled to Miami-Dade County should be aware of active Zika virus transmission, and those who are pregnant or who have a pregnant sex partner should use condoms during sex or not have sex during the pregnancy.

Guidance for Zika active transmission areas (Red areas)

Currently, red areas include a 4.5-square-mile area of Miami Beach and a 1-square-mile area of Little River in Miami-Dade County, FL.

Travel

  • Pregnant women should not travel to these areas.
  • Women and men who are planning to get pregnant in the near future should consider avoiding nonessential travel to these areas.

Testing and Diagnosis

  • Pregnant women with symptoms of Zika should be tested for Zika.
  • Pregnant women who lived in, traveled to, or had sex without a condom with a person who lived in or traveled to the 4.5-square-mile area of Miami Beach after July 14, 2016, should be tested for Zika.
  • Pregnant women who lived in, traveled to, or had sex without a condom with a person who lived in or traveled to the 1-square-mile area of Little River after August 1, 2016, should be tested for Zika.

Pregnancy Planning

  • Women who traveled to these areas or had sex without a condom with a person who lives in or traveled to these areas should wait at least 8 weeks after symptoms started or last possible exposure to try to get pregnant. Although the level of risk in yellow areas is unknown, pregnant women are still at risk.
  • Men who traveled (limited travel) to these areas or had sex without a condom with a person who lives in or traveled to these areas should wait at least 6 months after symptoms started or last possible exposure before trying to get their partner pregnant.
  • People living in these areas who do not have symptoms and are interested in trying to become pregnant should talk to their healthcare provider about pregnancy plans.
  • Women who live in or frequently travel to these areas who are diagnosed with Zika should wait at least 8 weeks after symptoms started before trying to get pregnant.
  • Men who live in or frequently travel to these areas who are diagnosed with Zika should wait at least 6 months after symptoms started before trying to get their partner pregnant.
  • Given the limited data available about the persistence of Zika virus in body fluids and the chances of harm to a pregnancy when the woman is infected with Zika around the time of conception some couples with a partner with possible Zika virus exposure may choose to wait longer or shorter than the recommended period.

Prevention

  • Pregnant couples and couples attempting pregnancy who live in or travel to these areas should be aware of active Zika virus transmission and should strictly follow steps to prevent mosquito bites.
  • Women and men who live in or traveled to these areas should be aware of active Zika virus transmission, and those who are pregnant or who have a pregnant sex partner should use condoms during sex or not have sex during the pregnancy.

Guidance for areas of previous active transmission

The guidance for yellow areas applies to the identified area in Wynwood, FL, with previous active Zika transmission. However, women and men living in or who traveled to the area should be aware that the location was considered to have active Zika virus transmission from June 15 to September 18, 2016. Pregnant women should talk to their doctor or other healthcare provider about getting tested for Zika. Partners of pregnant women should use condoms consistently and correctly to prevent passing Zika during sex, or they should not have sex during the pregnancy.

  • Women who traveled to the area from June 15 to September 18, regardless of whether they had symptoms, should wait at least 8 weeks before trying to get pregnant.
  • Men who traveled to the area from June 15 to September 18, regardless of whether they had symptoms, should wait at least 6 months before trying to get their partner pregnant.

For questions on mosquito control in Florida

Florida health officials can answer specific questions on their mosquito control program. Aerial treatment of areas with products that rapidly reduce both young and adult mosquitoes can help to limit the number of mosquitoes that carry the Zika virus. Repeated aerial applications of insecticide has reduced mosquito populations as a part of an integrated mosquito management program.