By Debra Anscombe Wood, RN
(Take the continuing education module “Zika: The Pandemic Threat,” today.)
Most people had never heard of the Zika virus until this past February, but now they are seeking answers from healthcare professionals about the recent outbreak and nurses are responding. “Most of the concerns are coming from our obstetrical patients,” said James Bryant, MSN, RN, CEN, CCRN, NEA-BC, associate CNO of Cleveland Clinic health system in Ohio. “Women who are currently pregnant and have traveled to those regions call in or ask during their regular appointments.”
But it’s not just expectant moms who are looking for concrete answers about the disease; the outbreak has other family members concerned. “We are seeing it across the age span — adults who have planned travel, adults who may or may not be considering starting or adding to their families in the near future,” Michelle M. Kelly, PhD, CRNP, assistant professor at Villanova (Penn.) University and a pediatric and neonatal nurse practitioner, said. “The biggest concern is what this means for themselves and their current or future families.”
Kelly and her colleagues in the NP program are staying current and informing their students, so everyone can keep patients educated about prevention measures. As with any outbreak, students are advised to spend time “focusing on travel history questions, as we did with the Ebola outbreak, and to use that opportunity to educate patients about the possible risks and realities of Zika,” said Kelly, adding they advise patients planning travel to regions where Zika is common to follow CDC guidelines.
Knowing the answers to the following frequently asked questions can help quell fears during the outbreak.
Where is the disease most prevalent?
Most cases of Zika infection have been reported in South America, where air conditioning and screens on windows are less common than in the U.S., Bryant said. “There is a higher risk there than here,” he said. “The CDC believes the risk of Zika in the U.S. is lower.”
How do you catch it?
“The virus is spread through the bite of an infected Aedes species mosquito,” said Vicki Allen, MSN, RN, CIC, vice chairwoman of the Association for Professionals in Infection Control and Epidemiology’s Communications Committee and infection prevention director at CaroMont Health in Gastonia, N.C. “Sexual transmission of the Zika virus can occur, although there is limited data about the risk.”
As of May 18, there have been 10 cases of sexual transmission, with one reported in Texas. The man had traveled in an area where the virus was active, returned to the U.S. and developed Zika symptoms, as did his sexual partner who had not traveled with him. Both tested positive for the virus, said Tom Frieden, MD, MPH, director of the Centers for Disease Control and Prevention, during a press briefing on February 5.
As of May 18, the CDC reported 544 travel-associated cases in the U.S. and 832 locally acquired cases in U.S. territories, the majority of which (803) were in Puerto Rico. Knowing that, the CDC has issued additional guidance for pregnant women, recommending “using condoms or abstaining from sex for the entire pregnancy,” said Bryant. This is recommended in cases in which the woman’s partner has traveled to areas where Zika is active.
Additionally, the CDC advises that pregnant women postpone travel to countries where Zika virus transmission is occurring. Anyone trying to become pregnant should talk with their healthcare provider before making a trip to those areas.
The reason for concern is the association found between Zika and microcephaly. “Microcephaly and all of its sequelae do not have a cure,” Kelly said. “This public health emergency is a life-long reality with the potential to devastate the child, the family, and overwhelm the health and educational resources of communities worldwide.”
The virus also has been linked to an increased number of cases of Guillain-Barre Syndrome, according to the WHO.
How long does the virus stay in your system?
Right now, no one knows how long the Zika virus stays in your system, said Bryant, but some studies have shown from a few days to a few weeks.
How do you prevent contracting the Zika virus?
Primary prevention for Zika entails avoiding mosquito bites, Allen said. Special precautions are needed when traveling to an area with Zika. “Mosquitoes that spread the Zika virus bite both indoors and outdoors, mostly during the daytime; therefore, it is important to ensure protection from mosquitoes throughout the entire day,” Allen said.
According to the CDC, when traveling to areas where Zika and other viruses spread by mosquitoes are found, take the following precautions:
• Wear long-sleeved shirts and long pants.
• Use Environmental Protection Agency-registered insect repellents, and reapply as directed.
• Do not spray repellent on the skin under clothing.
• If you are also using sunscreen, apply sunscreen before applying insect repellent.
• Do not use insect repellent on babies younger than 2 months old.
• Dress your child in clothing that covers arms and legs, or cover crib, stroller and baby carrier with mosquito netting.
• Do not apply insect repellent onto a child’s hands, eyes, mouth, and cut or irritated skin.
• Treat clothing and gear with the insecticide permethrin or purchase permethrin-treated items. Do not use permethrin products directly on skin.
What are the symptoms of Zika?
Allen said because only about 1 in 5 people with the Zika virus develops symptoms and because symptoms are usually mild, many individuals aren’t aware that they have been infected. “Symptoms are flu-like — muscle aches, a light fever, a rash or conjunctivitis,” Bryant said. “Most people never have symptoms.”
If symptoms develop, he said, they typically last three days to one week.
How can I get tested and/or treated for Zika?
The first commercial U.S. test to diagnose Zika virus won emergency use authorization from the Food and Drug Administration in April. Patients can contact their state or local health department to find out more about testing.
There is no vaccine for Zika. The CDC recommends rest, fluids and acetaminophen to relieve fever and pain. More guidelines are available at CDC’s website.
Debra Anscombe Wood, RN, is a freelance writer.
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Read more about how to keep safe while traveling in the article, “Zika-Part 1: How to keep travel safe during the health threat.”