Two events are taking place in Brazil right now: the 2016 Summer Olympic Games and the Zika virus outbreak. Whereas the Olympic Games are fostering a sense of national pride, the Zika outbreak is causing a state of worldwide concern.
A major fear in the run-up to the Olympics was the threat Zika would pose not only to the athletes—but also to the throngs of visitors attending the games from across the globe; most importantly, how the attendees becoming infected could potentially result in the worldwide spread of the virus.
Brazil, like the rest of Central and South America, along with the Caribbean, Oceania/Pacific Islands and, most recently, the North Miami neighborhood of Wynwood are breeding grounds for the Zika-carrying mosquito. The Aedes aegypti mosquito also carries the virus responsible for dengue, chikungunya and yellow fever. This mosquito is active in the daytime, living its 2-4 week lifespan within an extremely small range.
Zika virus symptoms not readily present
The problem is that, unlike patients presenting with seasonal flu, for example, 80 percent of people infected with Zika will be asymptomatic. For those who do develop symptoms, the illness is typically mild, lasting only up to a week. Symptoms include acute onset of fever, maculopapular rash, joint pain, or conjunctivitis. Other common symptoms consist of muscle pain and headache.
Pregnant women greatest concern
The real danger lies with pregnant mothers—particularly those who may have recently visited, or had a close contact visit, with a high-risk transmission area—due to the effect the disease could have on the fetus. In April, the CDC concluded, after careful review of the evidence, that Zika was a cause of microcephaly and other severe fetal brain defects. In fact, sadly, the U.S. just suffered its first Zika-related newborn death, a baby in Houston whose mother had visited El Salvador during her pregnancy and was likely infected there.
Unique Zika features
According to Rade Vukmir MD, JD, chief clinical officer, National Guardian Risk Retention Group and chief clinical officer, ECI Patient Safety Organization, LLC, who coauthored the infographics featured in this post, the most common mode of Zika transmission is the conventional mosquito-borne mechanism. Here, an infected individual is bitten by a mosquito, which then transmits disease to the uninfected individual.
“There are some features that should be emphasized,” Dr. Vukmir said. “Transmission by close intimate contact as a factor in transmission, was underappreciated early on; as was the length of transmissibility, which can be as long as eight weeks. After exposure, patients should abstain, use barrier protection and consult their physicians or additional guidance if contemplating a pregnancy.”
Testing pathways
“As with any new disease process, the diagnostic testing may have a delay in availability,” continued Dr. Vukmir. “Currently, there are a limited number of testing kits available, and there are send-out tests with a longer turnaround time than customary.” Testing is being performed at select local and state health departments, as well as the CDC.
The key to the testing approach is the exposure or presence of symptoms before or after two weeks, mandating different laboratory testing protocols. Currently, the public health system is developing approaches to assist asymptomatic concerned populations, especially in high-risk areas.
Zika virus triage guidelines
Whether or not you practice in a high-risk area, you need to know how to triage a patient, who may be subject to Zika virus infection. As well, the ability to screen, diagnose and refer at-risk pregnant patients is paramount.
To help, SCP and ECI Healthcare, Schumacher’s newest clinical partner, along with Dr. Vukmir, developed the following two infographics intended for use as a quick-reference guide for screening and recognizing potential cases of Zika.
The first, Screening for the Zika Virus, includes guidelines applied to the general population to prevent exposure. The second, Screening for the Zika Virus in Pregnancy, focuses on triaging women who are or may be pregnant recommending testing and guidance.
Each Zika infographic includes:
- Screening questions;
- Symptoms (including incubation period);
- Isolation and treatment procedures;
- Facts regarding human-to-human transmission;
- High-risk countries and territories.
