Z1. Were you told by a healthcare No professional you were infected with the Zika Virus? Yes Z1a. When were you diagnosed with Zika Virus? Z1b. Provide any contact information for the healthcare professional (e.g., name, group, facility, phone number, etc.): Z2. Describe areas you traveled to, and (Document areas traveled to, and the places where she lived, the places you lived, during this during this pregnancy.) pregnancy. For the next question, sex refers to any method of sexual contact including vaginal, anal, and oral. Z3. During this pregnancy, have you No had sex with a man, even once? Yes Z3a. Was he diagnosed with a Zika Virus infection? No Yes If yes, Z3a(i). When was he diagnosed? Z3b. Did he travel to or reside in an area with active transmission of Zika Virus? No Yes If yes, Z3b(i). When was it? Z4. Did you recently have any symptoms such as: Z4a. joint pain? No Z4a(i). When? Yes Z4a(ii). Describe the joint pain and reasons. Z4b. conjunctivitis, which is also No called “pink eye” or “red eye”? Z4b(i). When? Z4b(ii). Describe the conjunctivitis and reasons. Yes
Z1. Were you told by a healthcare professional you were infected with the Zika Virus? No Yes Z1a. When were you diagnosed with Zika Virus? Z1b. Provide any contact information for the healthcare professional (e.g., name, group, facility, phone number, etc.): Z2. Describe areas you traveled to, and the places you lived, during this pregnancy. (Document areas traveled to, and the places where she lived, during this pregnancy.) For the next question, sex refers to any method of sexual contact including vaginal, anal, and oral. Z3. During this pregnancy, have you had sex with a man, even once? No Yes Z3a. Was he diagnosed with a Zika Virus infection? No Yes If yes, Z3a(i). When was he diagnosed? Z3b. Did he travel to or reside in an area with active transmission of Zika Virus? No Yes If yes, Z3b(i). When was it? Z4. Did you recently have any symptoms such as: Z4a. joint pain? Z4b. conjunctivitis, which is also called “pink eye” or “red eye”? No Yes No Yes Z4a(i). When? Z4a(ii). Describe the joint pain and reasons. Z4b(i). When? Z4b(ii). Describe the conjunctivitis and reasons.