Information on the Zika Virus
Updated August 17, 2016Attention physicians:
The AMA and the Centers for Disease Control and Prevention (CDC) recently held a webinar to provide an update for physicians and other clinicians on the status of the Zika virus outbreak and the latest clinical guidance to help them diagnose and manage patients and prevent further transmission.
“As the Zika virus outbreak continues to evolve and more Americans become impacted by the virus,” said AMA President Andrew W. Gurman, MD,” we must ensure that our nation’s physicians, and all clinicians, are prepared to handle possible cases of the virus and are equipped with the most up-to-date information to answer patients’ questions.”
The webinar, “Preparing for Zika transmission in the United States,” is available online at the AMA’s Zika Virus Resource Center. Experts provided details of the latest epidemiological and clinical aspects of the current Zika outbreak, implications for pregnant women and the CDC’s most up-to-date clinical guidance to support health care professionals in combatting and preventing complications.
All pregnant women in the U.S. should be assessed for possible Zika exposure during every prenatal visit, the Centers for Disease Control and Prevention said Monday.
The advice from the CDC came as federal health officials also urged women who are pregnant or are considering becoming pregnant to avoid a Miami neighborhood that is the site of a Zika outbreak. CDC is closely coordinating with Florida officials who are leading the ongoing investigations, and at the state’s request, sent a CDC medical epidemiologist to provide additional assistance.
The Florida Department of Health has identified an area in one neighborhood of Miami where Zika is being spread by mosquitoes. This guidance is for people who live in or traveled to this area any time after June 15 (based on the earliest time symptoms can start and the maximum 2-week incubation period for Zika virus).
State officials have responded rapidly with mosquito control measures and a community-wide search for additional Zika cases.
Information on the Zika virus is being updated continually. The Centers for Disease Control and Prevention (CDC) as well as other health organizations are studying the virus. While we know much more about it than was first reported, there is still no vaccine or cure for Zika.
Symptoms and Outcomes
Zika virus symptoms are relatively mild. Many people infected with Zika virus won’t have symptoms at all. The most common symptoms of Zika are:
- Fever
- Rash
- Joint pain
- Conjunctivitis (red eyes)
- Muscle pain
- Headache
Zika is usually mild with symptoms lasting for several days to a week. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. For this reason, many people might not realize they have been infected. Symptoms of Zika are similar to other viruses spread through mosquito bites, like dengue and chikungunya.
Zika may result in severe birth defects such as microcephaly or poor pregnancy outcomes. There have also been reports of Guillain-Barré syndrome as an outcome of Zika. New studies suggest that the Zika virus hones in on brain cells and kills them. No one yet knows the long term effects of Zika.
Testing for Zika
Should you be tested for Zika? Travel history is important. New guidance suggests testing asymptomatic pregnant women within 2-12 weeks after they have returned from affected areas. Federal health officials are recommending that people suspected of having Zika infections get tested for evidence of the virus in their urine in addition to undergoing blood tests.
The Centers for Disease Control and Prevention “is urging pregnant women who may have been exposed to the Zika virus to be tested for up to 14 days after their symptoms begin — a longer period than the agency had previously recommended.” The guidance “also applies to pregnant women who have no symptoms.” The revision is based on “new research showing the virus can stay in the blood of pregnant women for longer than the previously recommended seven-day window for testing after symptoms begin.”
Margaret Honein, who chairs the CDC’s birth defects branch and was a co-author for the guidance, says that increased testing among pregnant women “will improve our ability to give definitive diagnoses of the Zika infection to those women who are at the highest risk.”
Commercial tests for Zika are not yet available. The CDC does the testing for this virus and results can take up to 2 weeks.
Zika Transmission
Both men and women can be infected by the Zika virus. It is transmitted mainly by the bite of an infected mosquito. However, it is now confirmed that the virus can also be transmitted through sexual intercourse.
The CDC also warns that Zika “can be transmitted through unprotected sex with an infected female partner.” As a result, the CDC’s revised warnings “on sexual exposure to Zika now caution against sex without a condom or other barrier method of protection with any person, male or female, who has traveled to or lives in an area with Zika, including female to female transmission with a pregnant partner.”
Mosquito Bite Prevention
The Zika virus is transmitted mostly by the mosquito Aedes aegytpi. This type of mosquito is not typically found in Illinois. At present, the DuPage County Health Department considers the possibility of a Zika virus outbreak in Illinois to be low.
However, mosquito bites from other mosquito species can transmit a variety of illnesses. Regularly taking precautions against mosquito bites is a good idea whether traveling or staying in Illinois.
Cover up. Wear long pants and long sleeves. Use mosquito repellent with DEET. For children, use a repellent with a compound called picardin. It lasts for 10 hours and is less toxic than DEET. Or use a repellent with 20 to 30 percent DEET.
Zika and Children
It has been established that the Zika virus can have serious outcomes with pregnant women being the highest risk group. But, what about your child?
So far, it appears that children infected with the Zika virus have similar outcomes as adults. There's a rash, fever, joint pain or red eyes, which go away within a week. And while many people don't get symptoms at all, some are at risk for Guillain-Barre syndrome.
For more information, visit the AMA’s Zika Virus Resource Center.