By Dr. Rodney Rohde
Well Bobcats, it seems like we just moved past the Ebola stories from last year to look up and hear that another virus with another strange name is invading our shores – even right here in Texas. The World Health Organization declared the Zika (ZIKV) virus and its suspected link to birth defects an international public health emergency. The declaration signals the seriousness of the Zika outbreak and gives countries powerful new tools to fight it.
One of my primary goals as a scientist (public health and clinical microbiologist) is to deliver balanced and accurate information in regards to infectious disease outbreaks. As with any “new” emerging infectious disease, it is critical for global, national, state and local public health officials to report correct information in regards to any significant health threat to the general public. One doesn’t need to look that far back to see how the introduction of Ebola to the U.S. created unnecessary panic in many people. Zika, like other arboviruses, does pose some health threats and risks, but we should be careful to not create public health hysteria by adding any material for sensationalized headlines. Facts, along with common sense advice and concern, are all that is needed in this latest “threat” to our shores. Those of us in the realm of the medical laboratory, public health and healthcare should offer a consistent message, one of instruction and caution, but not of panic.
Zika – Who are you and What Should I Know?
ZIKV is in the Flavivirus genus of viruses in the family Flaviviridae. This genus includes the West Nile Virus, dengue virus, tick-borne encephalitis virus, yellow fever virus, zika virus and several other viruses which may cause encephalitis. The virus was first documented in the late 1940s, and outbreaks of Zika previously have been reported in tropical Africa, Southeast Asia and the Pacific Islands. Zika virus likely will continue to spread to new areas. In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infection in Brazil.
Signs / Symptoms
Zika fever typically presents with mild fever, rash (mostly maculo-papular), headaches, joint pain, muscle pain, lack of energy and non-purulent (no pus) pink eye, occurring about three to 12 days after the mosquito vector bite. Only one out of five people may develop symptoms, but in those who are affected, the disease is usually mild with symptoms that can last between two and seven days. It’s rare for someone infected with ZIKV to become seriously sick or die. Zika is not thought to spread through routine, direct person-to-person contact.
How is it transmitted (spread)?
Areas of Texas, like in some other states in the southern U.S., are home to two species of Aedes mosquitoes capable of transmitting ZIKV. The Zika virus is spread primarily to people through the bite of infected mosquitos. Spread of the virus through blood transfusion and sexual contact has been reported (first case occurred in Dallas, Texas, February 1, 2016). 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.
Pregnancy Connection. Rarely, ZIKV can be spread transplacentally (from mother to child). This spread during pregnancy may be linked to birth defects, such as a condition called microcephaly (when a baby’s head is smaller than expected when compared with babies of the same sex and age). Our understanding of the link between Zika and pregnancy is evolving, and to date (February 3, 2016), there is not causal effect, which means there is no direct proof that ZIKV actually causes this condition. There is correlation (or an association) of this occurrence.
Is Zika in the U.S. or Texas?
The quick answer is yes! It actually arrived in Texas first (imported case) on January 11, 2016. As of February 2, 2016, the Texas Department of State Health Services confirms there are a total of eight cases of Zika virus in Texas — six from Harris County and two in Dallas County (which includes the sexually transmitted case). Seven of the cases are all related to foreign travel. Currently, testing for Zika virus is done through the CDC, but Texas is working on the ability to test for the virus at its Austin lab. Remember, it’s always critical to have a medical laboratory confirmation of any infection. In fact, the Texas State CLS Program is in the business of producing those who conduct these important clinical laboratory tests. The virus will continue to be imported in to the U.S., and I would say the percentages are good for ZIKV to become locally transmitted since the two mosquito vectors are present here.
Should I be worried, and can I protect myself?
Currently there are no vaccines or treatment for Zika; the best way to protect yourself is to prevent mosquito bites. You can do this by wearing long-sleeved shirts and long pants and treating your clothing and other items with permethrin. Use an Environmental Protection Agency (EPA)-registered insect repellant as directed, but not on babies younger than two months of age; instead, cover your baby in clothing and cover the crib, stroller or baby carrier with mosquito netting.
If you’ve recently traveled to an area with Zika and develop signs/symptoms, tell your doctor that you traveled to a country with Zika virus. Because the symptoms of Zika are similar to dengue and chikungunya, special blood tests may be needed.
If you get sick with Zika, make sure to get plenty of rest and fluids, and take medicines like acetaminophen or paracetamol to reduce fever and pain. Don’t take aspirin or other non-steroidal anti-inflammatory drugs like ibuprofen. You can also prevent others from getting sick by avoiding mosquito bites during the first week of illness following the same steps outlined above, because Zika virus can stay in the blood during the first week of infection.
What is being done?
Recently, CDC issued travel notices for people traveling to areas where Zika virus transmission is ongoing. Specific areas where Zika virus transmission is ongoing are often difficult to determine and are likely to keep changing over time. It’s important to keep up to date on CDC’s travel notices for recommendations on what to do if you travel to an area with Zika. CDC has also provided guidance, in consultation with major medical societies, to the healthcare community. Work and research is being ramped up on possible vaccine production, blood donor screening and possible links to birth defects.
For more information, please see my article and recent radio interview. I will also be interviewed by KTSW on February 4, 2016. Remember, it’s very important to get the facts with any disease outbreak and always to keep your #perspective.
Adapted from R. Rohde article: Zika Cases Confirmed in North America: Time to Panic?Accessed February 3, 2016.
Dr. Rodney E. Rohde (@RodneyRohde) is Professor, Research Dean and Chair of the Clinical Laboratory Science Program (CLS) in the College of Health Professions of Texas State University. He has been recognized with teaching excellence at both Texas State and Austin Community College. He has published a book on MRSA stories, over 50 research articles, book chapters and abstracts and presented at more than 100 international, national and state conferences. Dr. Rohde is the current Texas Association for Clinical Laboratory Science (TACLS) President and has been involved in licensure efforts in Texas since 2007.