Preventing Vectorborne Transmission of Zika Virus Infection During Pregnancy

Puerto Rico, USA, 2016-2017

Katherine Kortsmit; Beatriz Salvesen von Essen; Lee Warner; Denise V. D'Angelo; Ruben A. Smith; Carrie K. Shapiro-Mendoza; Holly B. Shulman; Wanda Hernández Virella; Aspy Taraporewalla; Leslie Harrison; Sascha Ellington; Wanda D. Barfield; Denise J. Jamieson; Shanna Cox; Karen Pazol; Patricia Garcia Díaz; Beatriz Rios Herrera; Manuel Vargas Bernal


Emerging Infectious Diseases. 2020;26(11):2717-2720. 

In This Article

Abstract and Introduction


We examined pregnant women's use of personal protective measures to prevent mosquito bites during the 2016–2017 Zika outbreak in Puerto Rico. Healthcare provider counseling on recommended measures was associated with increased use of insect repellent among pregnant women but not with wearing protective clothing.


During 2016–2017, Puerto Rico had active transmission of Zika virus (ZIKV). During January 27, 2016–June 10, 2017, the Puerto Rico Department of Health (PRDH) reported 40,357 confirmed cases of ZIKV infection, including 3,833 cases among pregnant women.[1–3] Because of the severity of adverse birth outcomes (e.g., brain and eye abnormalities, microcephaly, other birth defects) linked to maternal ZIKV infection,[4,5] the Centers for Disease Control and Prevention (CDC)[6–9] and PRDH[10] released guidance for preventing ZIKV. In areas where ZIKV transmission was active, pregnant women were advised to prevent mosquito bites by wearing protective clothing (long-sleeved shirts and long pants), and by using Environmental Protection Agency (EPA)–registered insect repellent.[6–10]