By now, you have probably heard something about the Zika virus that has been making headlines recently. But what are the risks and what do you need to know about it? Let me break it down for you…
The Zika virus first appeared in the Zika forest in Uganda in 1947 and has been very common in Africa and Asia. The virus, however, just began spreading in the Western Hemisphere last May after an outbreak in Brazil.
The World Health Organization recently declared the Zika virus an international public health emergency because of the link to birth defects, estimating that up to four million people could be infected by the end of the year. The Centers for Disease Control and Prevention (CDC) is urging pregnant women to avoid travel to a number of countries in the Caribbean and Central and South America where the outbreak continues.
How is Zika virus passed from person to person?
Zika virus can be transmitted through four different ways:
The Zika virus is transmitted primarily by the female Aedes aegypti mosquito that bites during the day. The mosquito gets infected from biting someone that has the Zika virus infection and then the mosquito transmits the virus when it bites others. The Aedes aegypti can bite more than one person because it has evolved into an intermittent biter and prefers to bite more than one person during the feeding period, making it a very efficient mosquito vehicle to cause an epidemic. The A. aegypti mosquito has been found in the U.S. primarily in Florida along the Gulf Coast and in Hawaii. However, in hot weather it has been found as far north as Washington DC, New York and Chicago.
A mother can pass the Zika virus to her fetus during pregnancy. The most dangerous time is thought to be during the first trimester when some women do not even realize they are pregnant.
- Sexual Transmission:
Sexual transmission of Zika virus has been reported from men to their female sexual partners. This is of particular concern during pregnancy. All reported cases of sexual transmission of Zika virus have been from symptomatic male partners. There have been no reported cases of transmission from a woman to a man through sex. The CDC recommends that pregnant women whose male partners have been in areas with a known Zika outbreak abstain from sex or use condoms for the remaining pregnancy.
- Blood Transfusions:
Blood transfusions can also transmit Zika, and there have been multiple reports of this type of transmission in Brazil. Since the virus typically remains in the blood for less than 28 days, the FDA recommends a donor deferral of four weeks for those at risk.
What are the symptoms?
An estimated 80 percent of persons infected with Zika virus have no symptoms. When symptoms develop they are usually mild and include:
- Joint pain
- Red eyes for several days to a week
Severe disease requiring hospitalization is uncommon and fatalities are rare.
How is it treated?
Currently, there is no vaccine or medication available to prevent or treat Zika virus infection.
Zika in the U.S.
From Jan. 1, 2015 to March 2, 2016, there have been 153 laboratory confirmed cases of travel-associated Zika virus disease in the U.S.; however, no locally acquired vector-borne cases have been reported. U.S. territories (American Samoa, Puerto Rico, and U.S. Virgin Islands) have seen 107 locally acquired cases and one case of travel-associated Zika.
Zika link to birth defect – microcephaly
The current Zika outbreak in Brazil marked an increase in the number of infants born with microcephaly, an unusually small head that can cause brain damage and a range of developmental delays. In Brazil there are usually 150 cases of microcephaly reported each year. Now, Brazil is investigating about 4,000 cases.
Zika virus has been confirmed in some infants with microcephaly, but it is unclear how many microcephaly cases are a direct result of Zika. The full spectrum of outcomes associated with infection during pregnancy and the factors that increase risk to the fetus are unknown. Clinicians and scientists, however, plan to further study this connection.
Zika link to neurological syndrome
Although not confirmed, there may be a link between Zika and Guillain-Barré syndrome, a rare neurological autoimmune disorder that targets the nervous system and can cause paralysis. Similar post viral infection complications have led to Guillain-Barré and research is ongoing to establish a definitive link between Zika and this rare syndrome.
What can travelers do to protect themselves?
Persons residing in or traveling to areas of active Zika virus transmission should take the following steps to prevent mosquito bites:
- Stay in a screened or air-conditioned room.
- Sleep under mosquito nets.
- Wear long pants, long sleeves, shoes and hats.
- Wear insect repellant at all times (Use an EPA-registered insect repellant and reapply as directed).
- Apply sunscreen before applying insect repellant.
- Adults should spray mosquito repellant onto hands and then apply to a child’s face.
- Cover children’s cribs, strollers and baby carriers with mosquito netting.
- Treat clothes and gear with permethrin or purchase permethrin-treated items that remain protective after multiple washings. DO NOT use permethrin directly on skin.
What lab tests are available?
Commercially available tests for Zika infection are not currently available, and because it is closely related to dengue and yellow fever, it may cross-react with antibody tests for those viruses.
To detect Zika, a blood or tissue sample from the first week in the infection must be sent to the CDC Arbovirus Lab or a few CDC designated state laboratories that conduct molecular and antibody testing.
What are recommendations for pregnant women and those of child bearing age?
The CDC recommends that pregnant women consider postponing travel to any area where Zika virus transmission is ongoing. Pregnant women, or women who are trying to become pregnant, who do travel to these areas should talk to their doctors or other healthcare providers first and strictly follow steps to avoid mosquito bites during the trip.
The CDC also recommends that pregnant women whose male partners have lived in or traveled to areas with a ongoing Zika virus transmission abstain from sex or use condoms for the remaining pregnancy.
Are there guidelines for caring for pregnant women during an outbreak?
On Feb. 12, the CDC updated its interim guidelines for U.S. healthcare providers caring for pregnant women during a Zika virus outbreak. Guidelines include a new recommendation to offer serologic testing to asymptomatic pregnant women (women who do not report clinical illness consistent with Zika virus disease) who have traveled to areas with ongoing Zika virus transmission. Testing can be offered two to twelve weeks after pregnant women return from travel. The guidance also expands to women who reside in areas with ongoing Zika virus transmission, and includes recommendations for screening, testing and management of pregnant women.
Pregnant women who reside in areas with active Zika virus transmission have an ongoing risk for infection throughout their pregnancy. Healthcare providers recommend discussing reproductive life plans, including pregnancy intention and timing, with women of reproductive age in the context of the potential risks associated with the Zika virus infection.
How can I keep updated on Zika?
New information on the Zika virus is continually emerging. The CDC maintains an extensive Zika virus website with ongoing updates on diagnosis, transmission and prevention.
You can also visit the Premier Safety Institute Zika website for additional resources, including on-demand educational webinars.
Still want more info on Zika? Don’t miss Premier’s Zika webinar!
Premier will be hosting an AdvisorLive webinar on Zika diagnosis, transmission and prevention with speakers from the CDC and Johns Hopkins on Friday, April 8, 2016 from 1-2 p.m. E.T. Details and registration will be posted at www.premierinc.com/advisorlive.
I’m a patient safety expert from Chicago who helps organizations promote a safe environment for patients, workers and their communities. When I’m not working, you’ll find me playing tennis, jogging on the lake front or reading. Connect with me on LinkedIn and Twitter.