Blood & Tissue Safety: Geographic areas at increased risk for Zika virus transmission through blood or tissue donation

Zika virus information for blood collection establishments and tissue recovery organizations

CDC is working with US Food and Drug Administration (FDA); state, territorial, and local health departments; and blood collection establishments and tissue recovery organizations to help ensure the safety of our blood and tissue supply and reduce the risk of Zika virus transmission through blood transfusion and tissue transplants. Zika virus disease is a nationally notifiable condition. Domestic cases are reported to CDC by state, territorial, and local health departments using standard case definitions.

FDA: 2019 Safety and Availability Communicationsexternal icon

Areas at increased risk for Zika virus transmission through blood or tissue donation in U.S. states

To protect the blood and tissue supply, CDC, in collaboration with FDA, has a process to define areas at increased risk for Zika virus transmission through blood or tissue donation.   For the purposes of blood and tissue safety interventions, areas at increased risk for Zika virus transmission will be identified at the county level in U.S. states. Defined areas of risk can be different from areas for which CDC has issued travel guidance.

Updated as of February 28, 2019:

There are currently no areas at increased risk of Zika virus transmission through blood or tissue donation in the U.S. states.

Previously listed areas at increased risk for Zika virus transmission through blood or tissue donation in U.S. states for the purposes of blood and tissue safety intervention:

• Hidalgo County, Texas – From September 1, 2017 – February 7, 2018
• Cameron County, Texas – From December 9, 2016 – August 29, 2017
• Miami-Dade County, Florida – From July 29, 2016 – June 2, 2017
• Palm Beach County, Florida – From August 24, 2016 – November 2, 2016

Areas with risk of Zika outside of U.S. states

Based on laboratory analyses and mathematical modeling, a conservative yet plausible estimate for introduction of Zika virus and substantive risk of exposure in North America, South America, Central America, and the Caribbean is January 1, 2014 (1,2,3). Furthermore, scientific evidence confirms Zika virus presence in some African and Asian countries for decades, in some cases dating back to the 1950’s (4,5,6).

Please refer to the world map at this link for areas with risk of Zika outside of the United States:

The map categorizes countries in 4 shaded categories:

• Country or territory with current Zika outbreak (Red)
• Country or territory with any prior or current reports of mosquito-borne Zika transmission (Purple)
• Country or territory with the vector and no reported mosquito-borne Zika transmission (Yellow)
• Country or territory with no mosquitoes that spread Zika (Green)

For the purposes of blood and tissue safety intervention, the following list indicates the date an area’s shade first became purple (or red) after the map updates were introduced on February 28, 2019: 

France: October 21, 2019
Kiribati: February 6, 2020

References

1. Lednicky J, Beau De Rochars VM, El Badry M, et al. Zika Virus Outbreak in Haiti in 2014: Molecular and Clinical Data. Reithinger R, ed. PLoS Neglected Tropical Diseases. 2016;10(4):e0004687. doi:10.1371/journal.pntd.0004687.
2. Faria NR, Quick J, Claro IM, Theze J, de Jesus JG, Giovanetti M, Kraemer MUG., Hill SC, Black A, da Costa AC, Franco LC, Silva SP, Wu CH, Raghwani J, Cauchemez S, du Plessis L, Verotti MP, de Oliverira WK, Carmo EH, Coelho GE, Santelli ACFS, Vinhal LC, Henriques CM, Simpson JT, Loose M, et al. Establishment and cryptic transmission of Zika virus in Brazil and the Americas. Nature. 2017; 546: 406-410. Doi:10.1038/nature22401.
3. Metsky HC, Matranga CB, Wohl S, Schaffner SF, Freije CA, Winnicki SM, Qu J, Baniecki ML, GladdenYoung A, Lin AE, Tomkins-Tinch Ch, Ye SH, Park DJ, Luo CY, Barnes KG, Shah RS, Chak B, Barbosa-Lima G, Delatorre E, Vierira YR, Paul LM, Tan AL, Barcellona CM, Porcelli MC, et al. Zika virus evolution and spread in the Americas. Nature.2017;546:411-415. Doi:10.1038/nature22402.
4. Dick GW, Kitchen SF, Haddow AJ. Zika virus. I. Isolations and serological specificityexternal icon. Trans R Soc Trop Med Hyg. 1952 Sep;46(5):509–20. doi: PMID: 12995440
5. Marchette NJ, Garcia R, Rudnick A. Isolation of Zika virus from Aedes aegypti mosquitoes in Malaysia. The American journal of tropical medicine and hygiene. 1969;18:411–415.
6. Duffy MR, Chen TH, Hancock WT, Powers AM, Kool JL, Lanciotti RS, Pretrick M, Marfel M, Holzbauer S, Dubray C, Guillaumot L, Griggs A, Bel M, Lambert AJ, Laven J, Kosoy O, Panella A, Biggerstaff BJ, Fischer M, Hayes EB. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med. 2009 Jun 11;360(24):2536-43. doi: 10.1056/NEJMoa0805715. PubMed PMID: 19516034.