FactSheet Preventing and Managing Laboratory Worker Exposure to Zika Virus Zika virus is primarily spread by the bites of infected mosquitoes. However, workers in biomedical laboratories working with the virus are also at risk of infection. This guidance provides employers and workers with information to prevent and manage occupational exposure to Zika virus. The guidance may be updated as more information becomes available. How Laboratory Exposures Occur The Zika virus has been found to spread through Quick Facts exposure to blood, semen and vaginal fluid. • Zika can produce not only mild symptoms, Researchers are continuing to investigate but also serious birth abnormalities. whether other materials also spread the virus. • Sharps injuries are among the most likely However, Zika virus has been detected by sources of laboratory worker exposure to viral culture in many other human body fluids, Zika virus. including urine, amniotic fluid, breast milk, • Zika virus exposures can be effectively saliva, cerebrospinal fluid, aqueous humor (fluid controlled by following existing biosafety in the eyeball between the cornea and lens) guidelines and OSHA standards. and cervical mucous. Zika virus has also been • Generally, work with samples of Zika virus detected on swabs of the nasopharynx. can be done at Biosafety Level 2. Limit access to active work areas and conduct For laboratory workers, the most likely sources aerosol-generating procedures in biosafety of exposure to Zika virus include: cabinets or other containment devices. • Punctures and cuts from needlesticks and • Workers should always report exposure other contaminated, sharp objects. incidents, including sharps injuries, to their • Compromised skin with cuts, abrasions or supervisor. Ensure exposed workers receive dermatitis that contacts contaminated materials. prompt medical attention. Workers may also be exposed to the Zika virus through: • The eyes, nose and mouth. This may occur Employers must identify and comply with by splashes or sprays of infectious liquids or standards and regulations requiring control of droplets from laboratory samples, accidentally workers’ Zika virus exposure, when applicable touching the face with contaminated gloves or (e.g., OSHA’s Bloodborne Pathogens (BBP) when handling contaminated waste. standard (29 CFR 1910.1030)). In all cases, • Bites of infected mosquitoes being studied in employers should assess and control their the laboratory, particularly if such mosquitoes workers’ Zika virus exposure risk, consider are not properly contained. relevant advisory documents, and review new • Contact with blood or other body fluids of information as it becomes available, including infected animals being studied in the laboratory. from the Centers for Disease Control and Prevention (CDC). Preventing Worker Exposures Laboratory Risk Assessments Employers and workers in laboratories should Perform a risk assessment of the work follow required and recommended infection environment when introducing new tasks and as prevention and biosafety practices to minimize part of developing safety precautions. the risk of infection. Determine whether work with certain specimens or procedures, such as those that could create Follow standard biosafety practices for aerosols, require higher levels of biocontainment laboratory work involving pathogens or other precautions. • Controls in place in laboratories that routinely work with potentially infectious Consider the risk and reproductive effects of Zika samples can also protect workers from virus infection for workers who are or may become exposure to Zika virus. pregnant and for workers with sexual partners • Use universal precautions, as required who are or may become pregnant. Zika virus can by OSHA’s Bloodborne Pathogens (BBP) be spread between sexual partners or from a standard (29 CFR 1910.1030). pregnant woman to her fetus. Zika virus infection •Always work at the appropriate biosafety is a cause of serious birth defects, including level (BSL) for the tasks being performed: microcephaly: www.cdc.gov/zika/pregnancy. www.cdc.gov/biosafety/publications/bmbl5. For Zika virus, most work, including related Prevention animal studies, can be done at BSL-2 and Whenever workers have occupational exposure ABSL-2. to human blood, body fluids or other potentially • Follow arthropod containment guidelines for infectious materials (OPIM), employers must studies involving live, infected arthropods comply with OSHA’s Bloodborne Pathogens (e.g., mosquitoes): www.astmh.org/ (BBP) standard (29 CFR 1910.1030). Among subgroups/acme. Work at arthropod other requirements, employers whose workers containment level (ACL)-2 in areas where have occupational exposure, as defined in the Zika virus is established in the resident standard, must implement universal precautions: mosquito population; otherwise, ACL-3. www.osha.gov/SLTC/bloodbornepathogens/ • Conduct experiments involving worker_protections.html. recombinant or synthetic Zika virus nucleic Laboratory employers also must comply with acids in accordance with NIH guidelines: OSHA’s personal protective equipment (PPE) www.osp. od.nih.gov/biotechnology/nih- standards (29 CFR 1910 Subpart I), including guidelines. the Respiratory Protection standard (29 CFR • Consult CDC’s Zika-specific guidance: www. 1910.134), and other applicable OSHA and State cdc.gov/zika/laboratories/lab-safety. html. Plan requirements for protecting workers from hazards that may be present in the laboratory. Proper hand hygiene consists of scrubbing with The BBP standard requires the use of soap and water for at least 15 seconds. When engineering and work practice controls to hands are visibly soiled, always wash with soap eliminate or minimize employee exposure and water. If soap and water are not available, (29 CFR 1910.1030(d)(2)). For example, where use an alcohol-based hand rub containing at the BBP standard applies, employers must least 60 percent alcohol, but then wash with 1 ensure that workers immediately perform proper soap and water as soon as possible. hand hygiene after any contact with blood Where the BBP standard applies, employers and OPIM, as well as promptly after removing must also consider and use safer devices, gloves or other PPE (29 CFR 1910.1030(d)(2)). such as specially engineered sharps designed The BBP standard also requires that employers to minimize exposure risk, wherever ensure that workers immediately flush mucous possible (see www.osha.gov/OshDoc/ membranes with copious clean water after any data_BloodborneFacts/bbfact02.pdf). OSHA contact with blood or OPIM (29 CFR 1910.1030(d) recommends using safer devices even if no (2)). Eyes should be flushed with saline or a specific OSHA standard applies. sterile irrigant. If requested by a worker who is pregnant or may Immediately report any possible exposures to become pregnant, or whose sexual partner is a supervisor. pregnant or may become pregnant, consider OSHA recommends using engineering controls, reassigning the worker to tasks that reduce or following safe work practices, performing proper eliminate the risk of exposure to Zika virus. hand hygiene and flushing mucous membranes (after contact with blood or OPIM) even if no 1) U.S. Department of Health and Human Services, Centers specific OSHA standard applies. for Disease Control and Prevention, “Show Me the Science – When & How to Use Hand Sanitizer.” While there is no evidence of Zika virus their health and safety concerns and their risk of transmission through aerosol exposure, it is transmitting the virus to others. If the exposure best to minimize the risk. Always use biosafety falls under the BBP standard (29 CFR 1910.1030), cabinets for activities that generate potentially employers must provide this confidential infectious aerosols.2 counseling. Worker Training Advise all workers with a suspected occupational OSHA’s BBP standard requires employers to exposure to Zika virus (i.e., for whom infection train workers as follows: initially when they are has not yet been ruled out through medical assigned to tasks where occupational exposure to evaluation) to: human blood or OPIM may take place, every year • Avoid mosquito bites for three weeks after the after that and whenever changes to a worker’s suspected exposure. job affect occupational exposures covered by the • Use condoms during sex or abstain from sex standard: 29 CFR 1910.1030(g)(2). Train workers with a pregnant partner for the duration of the who have potential exposure to Zika virus about: pregnancy or until Zika virus infection has been • How Zika virus spreads, their risks of ruled out, even if no symptoms of Zika are exposure, and signs and symptoms of Zika. present: www.cdc.gov/zika/pregnancy. • Adverse birth outcomes, including microcephaly • With a partner who is not yet pregnant, use and other problems in fetuses and infants, a condom during sex or abstain from sex caused by infection during pregnancy. for eight weeks, for exposed women, and • Protecting themselves by following rules and for six months, for exposed men, if planning procedures to reduce exposures. to conceive or until Zika virus infection is • Seeking medical evaluation after an exposure ruled out. Even couples who do not plan to incident and if signs or symptoms of Zika become pregnant should use a condom or develop. abstain from sex for the same time periods to 3 • Any applicable requirements of the BBP standard minimize the risk of transmitting the virus. (29 CFR 1910.1030) or other OSHA standards. If Signs or Symptoms of Zika