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Hawaii J Med Public Health. 2019 Apr;78(4):123-127.

Zika Virus: Relevance to the State of Hawai'i.

Lew WJ1,2,3,4, Tsai WY1,2,3,4, Balaraman V1,2,3,4, Liow KK1,2,3,4, Tyson J1,2,3,4, Wang WK1,2,3,4.

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Saint Francis High School, Mountain View, CA (WJL).
Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI (WYT, JT, WKW).
Department of Pediatrics, Kapiolani Medical Center for Women and Children, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI (VB).
Department of Medicine, Clinical Professor of Medicine (Neurology), John A. Burns School of Medicine, University of Hawai'i at Manoa, Director, Hawai'i Pacific Neuroscience, Honolulu, HI (KKL).


Zika virus (ZIKV) is spread among human populations primarily through the bite of Aedes mosquitoes. While most ZIKV infections are asymptomatic or cause self-limited symptoms, the major concerns are its association with Guillain-Barré Syndrome and fetal microcephaly together with other birth defects, known as congenital Zika syndrome (CZS). This article reviews the confirmed Zika cases in the continental United States (U.S.) and Hawai'i thus far, as well as literature of Zika research relevant to Hawai'i. The first case of CZS within the U.S. was reported in Hawai'i, highlighting the unique position of Hawai'i for emerging and re-emerging infectious diseases. Recent studies of the Zika outbreak in Florida demonstrate the key role of Ae. aegypti mosquito in transmission; continuous and proactive vector surveillance in Hawai'i is warranted. Additionally, an updated interim pregnancy guidance for pregnant women with possible ZIKV exposure was summarized. Due to recent decline of ZIKV transmission in the Americas, the risk of ZIKV importation to Hawai'i has been greatly reduced. However, given the presence of Aedes mosquitoes, climate condition, and status of Hawai'i as a travel destination and foreign import market, public health officials and healthcare providers should remain vigilant for a potential outbreak of mosquito-borne diseases in the future.


Hawai‘i; Zika virus; congenital Zika syndrome; microcephaly


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