By Jennifer Toro-Galarza, M.D.
Internal Medicine – Munroe Regional Medical Center
Zika virus is a mosquito-borne disease that was first documented in a human in 1952. Nowadays the virus has made its way to the Caribbean, South America and now has arrived to the United States. In order for us to be prepared against it we should know how this virus spreads, its manifestations, possible complications and what to do to decrease its incidence. The first identified outbreak in United States is documented in Florida Miami Dade and Broward counties this June 2016. Recently the CDC announced advisory to people who are traveling to South Florida in regards to blooming Zika virus in the area. Florida health department has confirmed around 783 cases of this virus involving all the counties of Florida. So what should we know about zika virus in order to be prepared?
It can be transmitted due to a bite of an infected mosquito, mother to fetus transmission, sexual intercourse, blood transfusions, organ transplant and laboratory worker exposure. We need to be paying attention to the transmitter of this disease which is the Aedes species mosquito which is also known to be the vector for dengue and chikungunya which are very similar to Zika. If we all take the precautions recommended by the CDC we could limit the spread of it.
Now we know how it is transmitted, what if you have been exposed? Most people who contract Zika Virus may be asymptomatic, however carry the infection.Symptoms of Zika are very similar to those from a dengue virus, which are: low grade fever that typically lasts from 2-7 days, a rash, pain in your small joints (hands and feet) ,muscle aches, headache and red eyes. Adults and children may present with similar symptoms and immunity occurs following infection. In order to be informed we need to recognize these symptoms and seek help with our provider in order to get tested. At this moment there are no vaccines for it and to treat the condition is mainly done so through symptom relief.The FDA has approved several diagnostic tests which are based on molecular testing. Now is even recommended that all pregnant women who have recently spent any time near the Miami-
Dade county be tested for Zika virus even if asymptomatic.
The reason why this virus is worrisome is not the actual disease which is self-limited but it’s complications which can be very serious. It has been associated with a congenital malformation called microcephaly. Microcephaly means that a fetus head is not fully developed and in consequence may have smaller brain that will result in developmental delays. Other complications of microcephaly are: hearing loss, seizures, speech problems, vision problems, balance and coordination problems. Also pregnant women might be at risk of fetal loss secondary to this infection.Due to this a lot of warnings have been made in regards to pregnant females traveling on their first trimester to any area below 6500 feet which have mosquito transmission ongoing. The list of territories with warnings of Zika virus keep on growing so it is wise to visit the website of the CDC to get the full list before traveling.
A more serious complication associated to Zika virus is Guillain-Barre syndrome. This is an auto-
immune mediated neuropathy which manifests as fairly symmetric ascending muscle paralysis. The weakness that develops in Guillain-Barre can vary from leg weakness that can make it difficult to walk, to more serious extent where there is complete paralysis of our diaphragm which is one of the muscles that helps us to breathe. In other words this paralysis may lead to death or other complications. This is a medical emergency that needs to be taken promptly to an ER. Other serious conditions associated with Zika are meningoencephalitis and brain ischemia.
What should we do to prevent an epidemic? This is where we as an individual play our part to decrease its incidence. First of all, since we know this disease is mainly transmitted by a mosquito we can start by decreasing the likelihood of a mosquito bite. Use EPA (Environmental Protection Agency) registered insect repellent, when outdoors wear long sleeved shirts, use air conditioning when available, use screens on windows and doors, remove standing water container and cover tightly water storage containers. If you have to travel make sure to check for travel notices and plan ahead.Since it has been found that the virus can be transmitted through sexual intercourse it is also recommended to practice safe sex using barrier contraception which can decrease incidence of zika virus. Pregnant women should avoid traveling to areas where zika contact is a possibility and if they have to do so they should contact their healthcare provider. In conclusion, we should all be informed in the developments of these virus and how it can affect us.
Munroe Regional Medical Center
8550 NE 138th Lane, Bldg. 400
Lady Lake, FL 32159