With mosquito season now under way, that also means mosquitoes that could potentially transmit the Zika virus. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. However, pregnant women — and those who are trying to get pregnant — face the biggest danger with Zika since the virus can cause brain damage in a fetus. If you’re not pregnant, the disease affects you differently. Typically, you would see mild symptoms such as acute fever (often low grade), rash, joint pains, “pink” eyes, or redness of eyes.
“About one in five people infected with Zika virus are symptomatic,” says Abdul M. Memon, M.D., Chief Medical Officer for Disaster & Emergency Preparedness at Jackson Health System. “They can also get generalized aches and pains, headache, pain behind the eyes and vomiting. The way we know if somebody is infected is to suspect the infection, based on the travel history and/or presenting symptoms, and then do the appropriate laboratory test for Zika Virus Disease, after consultation with Health Department.”In February, the World Health Organization declared the mosquito-borne illness a public health emergency of international concern. According to entomologist Chalmers Vasquez, who is also the Mosquito Control Operations Manager with the Miami-Dade County Solid Waste Management Department, Aedes aegypti, the main vector of the Zika virus, is a mosquito species that has been associated with human habitation for thousands of years.
“This mosquito completes its life cycle in water-holding containers – manmade and natural – found in and around residences,” Vasquez explains. “The mosquito lay her eggs on the walls of the containers and the eggs hatch into larvae within hours after getting flooded by rainfall or irrigation.”
This mosquito completes the larval and pupal stage in approximately one week, and two days later emerges as an adult. Adult mosquitoes actively fly for a short time at dawn and dusk and harbor in cool dark areas outside and inside homes.
“Aedes aegypti mosquitoes have a flight range of approximately two city blocks and show a strong preference for biting humans,” says Vasquez. “Aedes aegypti easily adapts to environmental change and is distributed in tropical areas around the world.”
Jackson Health System has decided to tackle this concerning health issue head on by creating a Zika work group. The work group developed the Health System Protocol for Zika Virus Infection which is updated every two weeks based on the guidance that comes out of Centers for Disease Control and Prevention/Federal Department of Health. This group has a representation from Obstetrics, Pediatrics, Infectious Disease, Infection Control, Emergency Department, Ambulatory Care/Primary Care Clinics, Laboratory, Occupational Health, Health Department, Public Relations, Disaster & Emergency Preparedness, selected hospital leadership and others.
The biggest concern regarding the virus, notes Dr. Memon, is the adverse pregnancy and birth outcomes most notably microcephaly (small head and small brain) and other serious brain abnormalities, other nervous system abnormalities, developmental abnormalities in the babies including seizures, visual and hearing abnormalities and intrauterine fetal death. There is also the risk of sexual transmission from male to female and from male to male from vaginal, anal or oral sex.. Guillain-Barre Syndrome (weakness of arms and legs and in some cases weakness of muscles of face, weakness or limitation of eye movements, weakness of swallowing and breathing muscles etc) is very likely triggered by Zika in a small proportions of infection much as it is triggered by and after a variety of other infections, he adds.
Miami-Dade County has launched an aggressive trilingual “Drain and Cover” public education and outreach campaign in conjunction with the Miami-Dade Office of the Florida Department of Health to increase public awareness of simple steps that residents can take to prevent mosquito breeding and mosquito bites. The campaign includes radio, television and newspaper ads; outdoor and transit advertising; social media messaging through Facebook and Twitter; online display ads and search engine marketing; and production and distribution of “Drain and Cover” door hangers and information cards through County personnel, the Health Department and the Healthy Start Coalition – a state-funded agency providing health services to pregnant women and their families.
“The public’s involvement is critical to our efforts to prevent mosquito breeding,” says Gayle R. Love, Division Director for Solid Waste Management’s Public Information and Outreach Division. “Residents should inspect their property at least once each week to drain any sources of standing water no matter how small.”
This includes planters, kiddy pools, bird baths, buckets, pails, boat tarps, and BBQ grills. Residents should pay special attention to bromeliads and other container plants by flushing them weekly to prevent mosquito breeding.
“Be sure to apply mosquito repellent and cover skin with long-sleeved shirts and pants while outdoors to prevent mosquito bites,” says Love.
If you plan to travel out of the country this year to areas where the virus is already prevalent, Dr. Memon recommends adhering to the CDC’s travel advisories: www.cdc.gov/zika/prevention/ wwwnc.cdc.gov/travel/page/zika-travel-information.
“CDC recommends that travelers to Zika areas, even if they do not get sick during travel, should avoid mosquito bites after returning to the U.S. for three weeks so they can avoid transmission, by mosquito bites, to others in this country,” says Dr. Memon.
The CDC also recommends that women who have the Zika virus should wait at least eight weeks after symptom onset to attempt conception. Men with the Zika virus should wait at least six months after symptom onset to attempt conception.
“Potentially infected men with pregnant partners should either abstain from sex or use condoms consistently and correctly during intercourse for the duration of pregnancy,” says Dr. Memon. “Pregnant women in any trimester should postpone travel to Zika affected areas while all pregnant women who decide to travel to areas with Zika virus activity should take appropriate precautions to avoid mosquito bites.”
In addition, men and women with possible exposure to the Zika virus – who are not experiencing the signs and symptoms of the Zika virus – should wait at least eight weeks after exposure to attempt conception.
“Healthcare providers should ensure that women who want to delay or avoid pregnancy have access to safe and effective contraceptive methods that best meet their needs,” adds Dr. Memon. “All pregnant or potentially pregnant women should let their healthcare provider know if they have travelled to a Zika area, or had unprotected sex with somebody who may have travelled to a Zika area or are having any one or more symptoms of Zika virus disease so that appropriate lab tests, and other tests as needed to evaluate status of pregnancy and fetus, can be performed.”
