How Doctors’ Offices and Trained Triage Nurses Can Provide Zika Advice for Patients
Since the Zika Virus outbreak in South America last summer and the recent mosquito-borne cases in Florida, many patients will be concerned how they will be affected. Now that the CDC has established that in addition to mosquito bites, the Zika virus can be sexually transmitted and causes microcephaly and other birth defects, it is imperative that your patients understand the virus, how they can limit their risk of infection, and what steps to take if they are infected. This article provides education information for patients and pregnant women on the Zika Virus.
Zika in the U.S.
Recently the Florida Department of Health identified Wynwood, a neighborhood in Miami, as a place where Zika was being spread by mosquitoes. They are advising pregnant women to not travel to this area. Pregnant women who live in or frequently travel to Wynwood should be tested in the first and second trimester of pregnancy.
The Wall Street Journal also reports that there has now been a case of Zika not associated with the Wynwood neighborhood. A pregnant 22-year-old woman living in the Miami area, not in the “warning zone,” has been infected by Zika through a mosquito bite. This is the first mosquito-transmitted Zika case that is not associated with Wynwood. In the U.S., all other Zika cases outside of the Wynwood area have been either sexually transmitted or related to travel.
How Prevalent is the Zika Virus ?
- Zika outbreaks are occurring in 48 countries and territories
- Reported cases in the U.S.
- 6 locally acquired mosquito-borne cases
- 1,955 travel-associated cases
- 1 laboratory case
How is the Zika Virus Transmitted ?
The Zika virus is most commonly transmitted through the bite of an infected mosquito, primarily those of the Aedes genus. The virus can also be sexually transmitted, regardless of the presence of symptoms. Though there have been no confirmed cases in the U.S., the virus has been reported to have been transmitted through blood transfusions in Brazil and French Polynesia.
While Zika can only be diagnosed through lab tests, the combination of presenting symptoms and recent travel history may signal a Zika virus infection.
Zika Virus and Pregnant Women
Zika usually causes mild symptoms, including mild fever, skin rash, muscle and joint pain, and headache. Symptoms typically last two to seven days and the majority of people who contract the virus fully recover.
Though severe illness or death are rare, the virus can be especially dangerous for pregnant women. Zika can be passed to the fetus, which may cause serious birth defects. The CDC recently concluded that Zika virus infection during pregnancy could cause microcephaly and other severe fetal brain defects. Zika virus has also been linked to impaired growth and eye defects in infants. It is important to underscore that not all women infected with Zika during pregnancy will have babies with birth defects. However, their babies will be at an increased risk.
Zika Precautions for Pregnant Women :
Since there is no vaccine against Zika and no medications to protect the fetus in the event that a mosquito carrying the Zika virus does bite the mother, the best approach at this time is prevention.
Expectant patients should avoid travel to areas with Zika outbreaks, especially the Caribbean and Latin America. If travel to one of these areas cannot be avoided or if a woman lives in one of these areas, she should take steps to prevent mosquito bites, such as covering exposed skin with clothing, staying in air-conditioned or screened rooms, and applying mosquito repellent with DEET or picaridin, both of which are safe to use during pregnancy.
If her partner has recently visited an area where the Zika virus is prevalent, the couple should take precautions during sex, such as using a condom or abstaining until after the baby is born.
Suggested Medical Testing Guidelines :
Pregnant women who live in one of the Zika-affected areas should have blood tests for the virus at least twice during pregnancy, regardless of whether or not they are experiencing symptoms. If a pregnant woman visits an area with active Zika cases, a blood test for the virus should be administered, even if she is not experiencing symptoms.
All pregnant women who may have been exposed to the virus should also have at least one ultrasound to look for evidence of fetal microcephaly. If tests show that a woman is infected, she should have ultrasounds regularly.
A newborn should be tested for Zika if the mother visited or lived in any country experiencing an outbreak and the mother’s own tests are either positive or inconclusive.
Through the spread of information on how to prevent Zika and what symptoms to look for, triage nurses will be a big part of helping to control this crisis.
To keep abreast of Zika virus updates, check the CDC’s Zika virus information page regularly. Read also our full line of childbirth education materials at TriageLogic blog central.
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