Thursday, February 4, 2016

Health Care and Zika

A new virus has reared its ugly head. Just when you think SARS, MERSA, Ebola, Chikengunya, Swine and Bird Flus, and a host of other recent critical diseases have been contained, a new bug goes rogue. Currently the World Health Organization and other agencies are tracking the movement of the disease with various mechanisms and reporting.  Zika is primarily a threat to pregnant women due to the potential harm to unborn children.

Zika virus is not new. Outbreaks have occurred in areas of Africa, Southeast Asia and the Pacific Islands. It is new in the Americas, however. Brazil reported the first case in May 2015, and since then, infections have occurred in at least 20 countries in the Americas. Puerto Rico reported the first locally transmitted infection in December 2015, and Zika cases are now being reported in the United States, all from returning travelers, reported CNN earlier last week. The first case of sexually transmitted Zika was reported in Dallas, Texas, this month from a traveler who returned from Venezuela.

Zika has been called a milder form of dengue fever. The most common symptoms of Zika virus disease are fever, rash, joint pain and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon, says the CDC.

It is spread to people through the bite of infected Aedes mosquitoes. Although it can also be transmitted from a pregnant mother to her baby during pregnancy, it is not otherwise transmitted person to person. People are contracting Zika in areas where those Aedes mosquitoes are present. This includes South America, Central America, the Caribbean and the U.S. mainland. For more information, visit this website: http://qz.com/601302/zika-what-is-it-and-should-you-be-worried-about-it/ .

According to the CDC, there is no vaccine to prevent infection or medicine to treat Zika. CDC has issued a travel notice (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing. This notice follows reports in Brazil of microcephaly(http://www.cdc.gov/ncbddd/birthdefects/microcephaly.html) and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant. However, additional studies are needed to further characterize this relationship. More studies are planned to learn more about the risks of Zika virus infection during pregnancy.

Until more is known, CDC recommends special precautions for pregnant women and women trying to become pregnant: Pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who do travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow steps to avoid mosquito bites during the trip. Women trying to become pregnant should consult with their healthcare provider before traveling to these areas and strictly follow those same steps.

Because specific areas where Zika virus transmission is ongoing are difficult to determine and likely to change over time, CDC will update this travel notice as information becomes available. Check CDC's Zika Travel Information website frequently for the most up-to-date recommendations. More info is located at this site: http://www.cdc.gov/zika/pregnancy/question-answers.html .

The NY Times reports that health officials in the United States, however, say the risk of a major homegrown outbreak is low because mosquito control programs are systematic and effective. They cite a related virus, dengue, which is also transmitted by mosquitoes but has not spread very much since first appearing locally a few years ago.

The current outbreak of Zika has taken the world by surprise. The virus was first identified in 1947 in Uganda, and for years lived mostly in monkeys. But last May in Brazil, cases began increasing drastically. The W.H.O. has estimated that four million people could be infected by the end of the year. The rapid spread is because people in the Americas have not developed immunity, public health experts say. More info is available at this site: http://www.nytimes.com/2016/02/02/health/zika-virus-world-health-organization.html .

CNN has reported an update about the current view of the potential threat of Zika. See their report here: http://www.cnn.com/2016/02/02/health/zika-virus-sexual-contact-texas/index.html . In addition, the CDC said there have been documented cases of virus transmission during labor, blood transfusion, and laboratory exposure. While Zika has been found in breast milk, it's not yet confirmed it can be passed to a baby through nursing.

According to PAHO, the Pan American Health Organization, In most people, diagnosis is based on clinical symptoms and epidemiological circumstances (such as Zika outbreak in the patient’s area or trips to areas where the virus is circulating). Blood tests can help to confirm the diagnosis. Some (virological PCR tests) are useful in the first 3-5 days after the onset of symptoms, while others (serological tests) detect the presence of antibodies but are useful only after five days. 

Once it has been demonstrated that the virus is present in a given area or territory, confirmation of all cases is not necessary, and laboratory testing will be adjusted to routine virological surveillance of the disease. Prevention involves reducing mosquito populations and avoiding bites, which occur mainly during the day. Eliminating and controlling Aedes aegypti mosquito breeding sites reduces the chances that Zika, chikungunya, and dengue will be transmitted.

An integrated response is required, involving action in several areas, including health, education, and the environment. To eliminate and control the mosquito, it is recommended to:
·         Avoid allowing standing water in outdoor containers (flower pots, bottles, and containers that collect water) so that they do not become mosquito breeding sites. 
·         Cover domestic water tanks so that mosquitoes cannot get in. 
·         Avoid accumulating garbage: Put it in closed plastic bags and keep it in closed containers. 
·         Unblock drains that could accumulate standing water. 
·         Use screens and mosquito nets in windows and doors to reduce contact between mosquitoes and people. 

To prevent mosquito bites, it is recommended that people who live in areas where there are cases of the disease, as well as travelers and, especially, pregnant women should:  
  • Cover exposed skin with long-sleeved shirts, trousers, and hats.
  • Use repellents recommended by the health authorities (and apply them as indicated on the label).
  • Sleep under mosquito nets. 

People with symptoms of Zika, dengue, or chikungunya should visit a health center. More information is available at this site: http://www.paho.org/hq/index.php?option=com_content&view=article&id=9183%3A2015-preguntas-frecuentes-virus-fiebre-zika&catid=3986%3Azika-virus-infection&Itemid=41463&lang=en

The Zika virus is no doubt a major health problem, and steps are being taken globally to help prevent and reduce the potential outbreak. For your own sake, practice common sense solutions to this health care issue. If you or someone you know may be symptomatic, see a doctor right away.

Until next time.  

1 comment:

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