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Dr. Sam Wise, medical director at San Diego Valley Hospital, hasjust conducted a meeting in which he informed those in attendanceof an acute outbreak of Zika virus. In the past 36 hours, two menand one woman, completely unrelated to one another, have presentedto Valley’s ER with the symptoms of Zika virus. Their onlycommonality is that they all live within an area of 17 squaremiles.

Patient 1, Stevie, is a 24-year-old graduate student at SanDiego State University. He is not in a relationship and has had nosexual contact in more than three months. He has not traveled outof the greater San Diego area in the past five months, and he hasnever left the west coast of the United States.

Patient 2, Tiffany, is a 31-year-old marketing executive. She ismarried with two children, ages 3 and 4. Tiffany was in Seattle fora weekend, two weeks ago, but she has, otherwise, not left SanDiego in more than six months. Her husband and children have notleft San Diego in more than a year. Tiffany’s husband and herchildren exhibit no symptoms of Zika.

Patient 3, Enrique, is a 39-year-old carpenter. He owns his ownbusiness, which has him traveling all over the region, within a100-mile radius of San Diego. However, he has never traveled anyfarther than that. Enrique is married with four children, agedbetween 3 and 8 years of age. No one in Enrique’s family hasexhibited any Zika symptoms.

Because all of the children are too young to date, and there areno extramarital behaviors in either Tiffany’s or Enrique’srelationships, the possibility of others being infected throughsexual intercourse is eliminated. As well, none of the infectedparties have traveled to a high risk area.

As the director of community relations at San Diego ValleyHospital, Dr. Wise has charged you with the task of writing anarticle to be released to the public through the local newspaper.Dr. Wise has charged you with informing the public of a potentialZika outbreak. Your article must include a discussion of theepidemiological triangle, modes of transmission, symptoms of Zika,high-risk populations, associated morbidities, known vaccines,prevention measures, etc. Your article must be written in a layfashion. In order to assist you in writing the article, thehospital’s epidemiologist has provided you with these CDC-supportedresources.