By now, you’ve probably seen news reports about Zika, a virus that most U.S. nurses haven’t encountered or even heard of until recently. The following is meant to provide you with basic information, based on CDC resources. You can find more comprehensive information on the CDC’s Zika web page.
Is Zika a new, emerging virus?
Yes and no. The virus was named after the Zika Forest in Uganda in 1947, when it was first isolated from monkeys. Human Zika infections were first documented in 1952. Since then there have been reports of human cases in Africa, Southeast Asia, and various Pacific islands, with the first large outbreak occurring in 2007 in Micronesia, on an island where residents apparently lacked any type of immunity. In 2015, it became apparent that Zika had arrived in the Western Hemisphere when Brazil began noting illness stemming from Zika virus. New cases are now popping up in the Americas, including the Caribbean. (For more information: See the World Health Organization’s Zika timeline.)
Which areas of the U.S. are affected?
- According to the CDC, 48 states have had at least one laboratory-confirmed case of Zika-related illness, as of September 7, 2016. (For updated information: See the CDC map of U.S. cases.)
- However, as of September 7, there have only been 43 cases of locally acquired, mosquito-borne illness. Most confirmed cases here have been travel-related. (For updated numbers by state: See the CDC case-count page.)
- Currently, South Florida is the area of most concern here in the U.S., as mosquitoes have been found to be carrying the virus in some neighborhoods. The CDC has specific advice for people living in or traveling to South Florida, and you should stay current on these guidelines, particularly if you are a nurse in this area. The CDC advises that pregnant women and their partners should avoid travel to South Florida, and that those living in the area should take precautions to prevent mosquito bites, and be tested for Zika virus according to the most recent recommendations available.
What are the signs and symptoms?
Zika is in Flavivirus family, so it is related to dengue, yellow fever, and West Nile virus. Most people infected with Zika remain asymptomatic or have only mild symptoms. Some will have flu-like symptoms that include headache, fever, body aches, conjunctivitis, or skin rash. Because these symptoms are vague and common, it can be hard to identify a patient with Zika. This is why asking your patients about recent travel while you’re taking a medical history is more important than ever.
How is it transmitted?
The CDC has identified four methods of transmission:
- Mosquitoes. This is the number one risk factor for travelers to areas of the world where Zika is endemic. The virus is carried by infected Aedes species mosquitoes and transmitted by their bite.
- Sex. Pregnant women in particular are urged to abstain or use a condom at all times.
- Vertical transmission. The virus can be passed from a pregnant woman to her fetus.
- Blood transfusion. There are no documented cases of transmission through blood products at this time, but health officials are alert to the possibility. We know that the virus is present in blood. The Red Cross is currently screening out donors who say they have recently traveled to affected areas. A method of testing donated blood for the virus is in development.
Who is most at risk?
Concerns have emerged that the virus causes poor outcomes in pregnancy, including still births, congenital defects, and miscarriage. Nurses who work with pregnant patients or women who are trying to become pregnant should stay current on guidelines for Zika testing during pregnancy, and should be ready to advise patients on how to avoid Zika infection.
What is my role as a nurse?
Stay alert and stay informed. Review the CDC’s guidelines for clinicians, regarding testing, treatment, and clinical guidance. Know that Zika is a notifiable condition and suspected cases should be reported to a state or local health department, which reports to the CDC. Be ready to recognize the signs of Zika illness and to get a travel history from patients who present with symptoms. Likewise, be ready to counsel patients who plan to travel outside the country regarding how to prevent mosquito bites and sexual transmission of the virus. Patient education and support is particularly important with pregnant women and those who are trying to conceive.