Infection prevention has become a hot topic again in the past few months, due in large part to daily news reports about the spread of the Zika virus, while memories of the Ebola outbreak remain fresh. Previous recent outbreaks such as dengue fever and chikungunya increased awareness of vector-borne illnesses, but Zika raised additional concerns about potential serious outcomes for babies of infected women.
“We’ve learned a lot from past [vector-borne] outbreaks,” said Maria Eckart, BSN, RN, CIC, SD-CLTC, a clinical education specialist/corporate infection control and prevention specialist for Genesis HealthCare in Towson, Md. “Mosquitoes have been a problem off and on in our country’s history.”
Ebola changes outlook
Healthcare workers ardently pursued pertinent information about infection prevention and monitoring during the Ebola outbreak, she said. As a result of that illness, agencies such as city and state health departments, aided by global networks such as the World Health Organization and the CDC, now have in place an infrastructure to confront disease outbreaks such as Zika at the local level. This existing infrastructure boosts the ability of local entities to look at prevention from the start. “Prevention is not just looking at the organism and the illness,” Eckart said. “It’s a multifaceted process. We’re looking at the mode of transmission, which is challenging in that the host travels, so the disease has potential to move far from the country of origin.”
These kinds of vector-borne infections are becoming increasingly endemic, and prevention is exceedingly difficult, said Patrice Nicholas, DNSc, RN, MPH, MS, ANP, FAAN, director of Global Health and Academic Partnerships at Brigham and Women’s Hospital in Boston and a professor at the MGH Institute of Health Professions. “Prevention in the U.S. territories where the Zika virus has emerged is about trying to avoid getting mosquito bites,” Nicholas said. The mosquito that transmits Zika is active most frequently during the day, so she recommends that individuals living in or traveling to areas with mosquitoes use insect repellents recommended by the EPA.
Nicholas said the Zika infection is similar in some ways to diseases such as HIV, since it can be sexually transmitted. “It raises issues that were raised during the HIV epidemic,” she said. “For example, it’s unknown if the Zika virus has lifelong potential. How long can the virus be harbored in the male reproductive system?”
The Zika outbreak also resembles the urgency seen with the Ebola infection, she said, in the rapid CDC and WHO involvement. “They consider it an enormous problem globally, like Ebola.”
Funding important in stopping spread
As Zika spreads to new areas, including resource-rich countries such as the U.S. and Australia, it’s apparent funding is needed to foster public health approaches. Nicholas said these approaches include prevention of mosquito bites by using appropriate mosquito repellents as well as education about how infection occurs and may affect fetal development. It also is important for the future of vaccine development against the Zika virus.
Eckart pointed out that Zika differs from some similar diseases, which are spread person to person by droplet or secretion. “Then it can be easier to figure out who is sick,” she said. “When you have someone infected with Zika, however, you can take the symptoms — fever, rash, joint pain, conjunctivitis — and it could be a number of other illnesses.”
In this recent Zika outbreak it was important to ask those with possible Zika infection about risk factors: Have they traveled to an affected country or had sexual contact with someone who has?
Eckart said media reporting can be both helpful and hurtful. She said information that is properly, appropriately and tactfully reported can give the public facts needed to slow the spread of infection. “If the public doesn’t receive accurate information, they end up with misconceptions and this can create hysteria,” Eckart said.
Nicholas agreed that the wide public dissemination of information can benefit prevention and monitoring. “It increased awareness,” she said, “leading to increased screening and education efforts.” She said the media ultimately can spur better testing methods and remedies such as involvement by biotechnology companies that may advance Zika vaccine development.
With any outbreak, promoting better understanding of the disease starts with healthcare workers being properly educated, Eckart and Nicholas said. Eckart pointed to the plentiful resources available from the CDC website with “fantastic downloadable resources about preventing mosquito bites. These resources are easy to understand and include plenty of pictures.”
Eckart recommended nurses ask patients and families what they know about the virus, then provide proper information. “And encourage people to stay off Wikipedia or other websites that can spread misinformation.”
Eckart urged nurses to have the facts to share with other healthcare workers, keeping down the panic factor. Eckart said in any outbreak “we’re obligated to understand what we’re dealing with so we can accurately relay information and allay fears, and help co-workers know how to respond.” •
Freelance writer Karen Schmidt, RN, contributed to the writing and research of this article.
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