DC & Maryland Suspected Zika Cases

For DC Residents and other states EXCEPT Maryland:

1. The physician or provider should fill out completely the Zika Virus Reporting Form (below, or direct CDC link)
2. NOTE: Symptoms, date of onset, pertinent travel history (location, dates of travel, departure and return to US) and immunization history for Yellow Fever, Japanese Encephalitis, or tick-borne diseases should be noted.

Fax completed form to:

1. (202) 442-8060 District of Columbia Department of Health-Division of Epidemiology-  Disease Surveillance & Investigation
2. (202) 715-4691 GWU Microbiology Laboratory

Draw two tigerstripe tubes:

1. Send blood to lab labeled for Zika Virus Testing. The lab will appropriately store the sample until notified by the DC DOH to send samples. 

The Zika Virus Reporting form will be evaluated by the Division of Epidemiology at District of Columbia Department of Health. Approval/Response will be sent to: Olga Kochar and Salome Mendoza (olga.kochar@gwu-hospital.com and salome.mendoza@gwu-hospital.com) for specimen submission

NOTE TO PROVIDERS: Please let the patient know to expect a call from DC Department of Health staff member. The DC Department of Health will interview all patients, even those with only a positive travel history

If you have any questions regarding this important issue, you may contact the Division of Epidemiology–Disease Surveillance and Investigation:

• Phone: (202) 442-8141 (8:15am-4:45pm)
• 1-844-493-2652 (after-hours calls)
• Fax: (202) 442-8060
• Email: doh.epi@dc.gov 

For Maryland Residents, please note the following:

1. 1. The provider should call the Maryland Department of Health and Mental Hygiene at (410) 767-6700. State that you are currently evaluating a Maryland resident for Zika virus.
   2. MD DHMH will then instruct you on what forms to complete and where to direct them.
   3. Approval/Response will be sent to: Olga Kochar and Salome Mendoza (olga.kochar@gwu-hospital.com and salome.mendoza@gwu-hospital.com) for specimen submission

department_of_health_specimen_approval_instructions_to_providers.pdf
File Size:	194 kb
File Type:	pdf

Download File

---

zika_virus_reporting_form_v6.pdf
File Size:	543 kb
File Type:	pdf

Download File

---