Doctors prepare for potential Zika virus outbreak


Although there are no confirmed cases of Zika virus originating in the continental United States, local health care professionals are preparing for potential cases originating from travel to affected areas outside the United States, and possible local outbreaks in South Texas. Some cases have already been diagnosed in the United States, including Texas, Hawaii, Illinois, and Florida, but all of these cases have been acquired during travel outside of the United States.

Patrick S. Ramsey, M.D., M.S.P.H., said the public―especially pregnant women―should be informed about the virus and take precautions to control mosquitoes and avoid exposure when traveling to affected countries. Dr. Ramsey is a maternal–fetal medicine specialist at UT Medicine San Antonio, the faculty practice of the School of Medicine at the UT Health Science Center San Antonio. He cares for women with complicated high-risk pregnancies and delivers babies at University Hospital, the Health Science Center’s clinical partner.

“The virus is benign in most people, but in pregnant women the virus is associated with birth defects, especially microcephaly―a congenital condition in which an unborn baby’s brain stops developing and its head is much smaller than usual,” Dr. Ramsey said. “There have also been cases of miscarriage and stillbirth associated with the infection.”

In adults Guillain-Barre syndrome, a rare disorder in which the immune system attacks the nervous system, has been associated with Zika virus infection.

Symptoms can include a fever, rash, joint pain and conjunctivitis, often called pink eye. About 1 in 5 individuals who have the virus will exhibit these symptoms, he said, and they are usually mild. There are no specific treatments or vaccines for Zika.

Transmitted by Aedes mosquitoes primarily in tropical regions, the Zika virus was first discovered in Africa. It spread to parts of Asia, and now there are thousands of active cases in Central and South America, including Mexico. “We are being cautious because the virus can spread through mosquito bites,” Dr. Ramsey said.

The Aedes mosquito is found in Texas and throughout much of the United States. The Pan American Health Organization has warned that Zika virus could continue to spread throughout the Americas, and potentially to local areas in the United States. Dr. Ramsey noted that the U.S. Centers for Disease Control and Prevention (CDC) has issued travel advisories related to Zika virus infection for pregnant women traveling to or from Mexico and certain countries in South America, Central America and the Caribbean.

Dr. Ramsey urge pregnant women traveling to countries with reported Zika virus infection to avoid contact with mosquitoes by staying inside or in a screened-in area. “Spray all exposed skin with mosquito repellent with DEET and treat clothing with permethrin, which can be used safely during pregnancy,” he added.

Pregnant women who have traveled recently to one of the countries with a travel advisory for Zika infection should notify their obstetrician, especially if they have any symptoms associated with the virus. Dr. Ramsey said that in these situations, even if no symptoms are present, close ultrasound evaluation of their baby may be needed. Testing for Zika is being coordinated through the CDC and state and local health departments.

This month, the CDC updated its guidance on Zika virus and issued a warning for nonessential travel to regions where there is an outbreak.

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