Zika, Our Community, and You

Michelle
Michelle Szymanowski, RNC, MSN, WHNP-BC

Zika in Our Community

As of May 2016, there have only been three identified cases of Zika in the state of Arizona. All three were acquired during travel. As of this time, there have been NO cases of transmission in Arizona. We as a community need to be diligent about keeping it out of our community and avoid any potential outbreak.

What is Zika?

Zika is a virus that has been linked to birth defects if a pregnant woman becomes infected during pregnancy. These birth defects can include microcephaly (a small head), and some sensory deficits such as eye abnormalities. At this time, we do not know the extent of the birth defects as we are still gathering information about babies born to moms who were infected with Zika. Because of both the known and the unknown birth defects that are associated with Zika, all women who are currently pregnant, as well as women who are considering pregnancy, are encouraged to speak with their health care providers to find out how to best protect themselves and their babies.

Zika Symptoms

Recent studies show 80% of people infected with Zika have no symptoms. For those who have symptoms, the symptoms can include fever, joint pain, achiness, and red eyes. Most of these are symptoms similar to many other viral infections. Therefore, it is impossible to diagnose Zika by symptoms alone. There have been no cases reported in Arizona that were acquired here. The three reported cases were all attributed to travel or from having sexual contact with a person who traveled to one of the communities known to be infected with Zika. If you have traveled to South America or the Caribbean two weeks before developing these symptoms, you should contact your healthcare provider. Also, if you have had sexual contact with someone who traveled recently to a community of known infection, you should speak with your healthcare provider.

Preventing Zika Infection

Since Zika is spread through mosquito bites, the best way to prevent infection is to avoid getting bit especially if you are traveling to a Zika infected area. Travelers should check with the Center for Disease Control (CDC) to see if the area they are traveling to is experiencing an outbreak of Zika. (Note: Visit the CDC for the most up-to-date Zika-infected communities, statistics, and information.) If traveling to Zika-infected areas, you should use an insect repellant such as DEET the entire time you are there.

Because 80% of infected individuals will never have symptoms, many people will never know they became infected while on vacation. For this reason, you need to apply insect repellant three times per day for three weeks when you return from vacation to avoid passing the infection on to our mosquitoes. The goal is to prevent transmission of Zika to our mosquitoes.

The list of recommended insect repellents are:
DEET (found in Off!, Cutter, Sawyer, Ultrathon)*
Picardin (Cutter Advanced, Skin So Soft Gug Guard Plus)*
IRS3535 (Skin So Soft Bug Guard Plus, Expedition, SkinSmart)*
Oil of Lemon Eucalyptus (Repel)*- not for use on children under the age of 3
Para-methane-dio (Repel)*- not for use on children under the age of 3
(*Name brands are provided for your information only; we do not endorse any specific products.)

Insect repellent is not safe to use on infants under the age of two months. Consider mosquito netting for infants younger than two months.

Additionally, you can protect yourself by eliminating all standing water around and in your home. The mosquito that carries Zika only needs a capful of water in which to breed. Be sure to remove objects such as children’s toys, pet food bowls, and old tires from your yard and surrounding area. Do not overwater plants in pots. The trays to catch the water can become breeding areas for mosquitoes both inside and outside your home. Protect the interior of your home by using screens on windows and doors that are free of holes and tears.

What about Pregnancy?

Pregnant women should be advised to avoid all travel to Zika-infected communities for the duration of their pregnancy. If their sexual partner travels to these areas, the recommendation is they use condoms (the entire time, every time, from start to finish) for six months. The virus lasts longer in semen than blood. For this reason, we know that men who were exposed can remain infectious for at least 62 days, and possibly longer. Because Zika may last longer and we are unsure of the effects on the fetus, the CDC recommends pregnant women use condoms for the duration of the pregnancy if their sexual partner has traveled to an infected community.

Women who are not yet pregnant and travel to these areas should avoid becoming pregnant for eight weeks even if they are asymptomatic. Men should avoid getting anyone pregnant for six months upon return. Remember, 80% of patients will never know that they were infected when traveling to Zika infected communities, so assume that all travelers were infected.

Together we can all prevent the spread of Zika into our community if we all do our part and educate those around us! For additional information, be sure to visit the CDC and the American College of Obstetricians and Gynecologists.

www.cdc.gov/zika/geo/index.html

http://www.acog.org/About-ACOG/ACOG-Departments/Zika-Virus/For-Patients

http://www.marchofdimes.org/complications/zika-virus-and-pregnancy.aspx