The Scoop on the Zika Virus

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The Scoop on the Zika Virus
News about the Zika virus has flooded the television and newspaper headlines in the last few months leading to many questions and concerns from people in the United States and all over the world.  The big concern regarding the virus seems to be the possible link between it and microcephaly in newborns.  You may already be getting questions from patients including what areas are currently affected by the Zika virus and whether or not they need to be concerned.
 
The purpose of this article is to give you a summary of the high points regarding the Zika virus to help you as a healthcare provider and to also provide concerned patients answers to questions they may have.
 
The Zika virus is primarily spread through the bite of an infected mosquito. It was first discovered in humans in 1947 in Uganda, with subsequent outbreaks being reported in Africa, Southeast Asia, and the Pacific Islands.  In May 2015, an alert was issued regarding the first confirmed case in Brazil.  On February 1st 2016, the World Health Organization (WHO) declared the Zika virus a public health emergency of international concern which is when we began seeing news of the virus start hitting the headlines. People infected with the virus typically develop very mild symptoms consisting of a fever, rash, joint pain and conjunctivitis, with the symptoms lasting for several days to a week.  Many individuals don’t even know they have the disease because they won’t have any symptoms, therefore most individuals do not seek medical treatment.  The public health emergency was issued not because of the severity of the illness associated with the virus, but because of the possible link between the virus and cases of microcephaly in newborns.  Because the symptoms can be so mild, those infected may not even know they have it and possibly spread it to other individuals.  Of particular concern is the spread of the virus to pregnant females.
 
There are three other modes of transmission of the virus in addition to transmission by mosquitos.  First, a pregnant woman can pass the Zika virus on to her fetus during pregnancy. At this time there have not been any cases reported of infants getting the Zika virus through breastfeeding. The virus can be spread via blood transfusion as well.  There have not been any confirmed cases in the United States caused by transfusion, but there have been a few cases reported in Brazil. The virus usually remains in the blood of an infected person for about a week but it can be found longer in some people.  Finally, the virus can also be spread by a man to his sexual partners.  This is still being investigated, but what the Center for Disease Control (CDC) does know is that that the virus can be spread by an infected male before, during, and even after his symptoms resolve.  This is because the virus can remain present in the semen longer than in blood.  The CDC has yet to determine a few things about sexual transmission. For example, how long the virus can stay in the semen of men who have had Zika, whether women can spread Zika to their sexual partners, and whether Zika can be spread through oral sex.
 
The Zika virus is spreading, and the CDC states it will be hard to determine how and where the virus will spread over time.  Currently, areas with outbreaks of active mosquito-borne transmission of the Zika virus have been documented in areas of Africa, Southeast Asia, the Pacific Islands, Brazil, Central America, much of Mexico, and many islands of the Caribbean. The US territories that have been affected include Puerto Rico and the US Virgin Islands.  No mosquito-borne Zika virus disease cases have been reported within the US states at this time.
 
So what can you tell patients who are concerned about travel to these areas?  First of all, prevention is the best tool to avoid contracting the disease.  Travelers should protect themselves from mosquito bites by wearing insect repellents, long sleeved shirts and pants, and trying to stay in places with air conditioning or that use window and door screens to keep mosquitos outside.  There is currently no vaccine to prevent the Zika virus, nor is there any treatment.  Remind patients, that the disease itself is very mild if they happen to contract it. The biggest concern at this point is spreading the virus to women who are pregnant or have the potential of becoming pregnant.  The CDC recommends males use a condom during sexual intercourse for as long as 8 weeks after return from an area affected by the Zika virus even if they did not develop symptoms during or after their stay.  This is because many individuals may not know they contracted the virus and there are still a lot of questions that need to be answered about the virus, its transmission, and its effect on fetal development. 
 
Information from this article was referenced from the CDC website http://www.cdc.gov/zika/ 
This is a great resource for both healthcare providers and travelers to seek the most up to date information on the Zika virus.  Recommend your patients review this website before travel to any areas affected by the Zika virus.   -submitted by Jill Jensen

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