Medical ALERT: Texas Medical Association Issues Zika Alert to Physicians

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Courtesy Mega Doctor News website under renovation:

Even as new Zika virus cases have been reported this week in Texas, the Texas Medical Association (TMA) and the Texas Association of Obstetricians and Gynecologists (TAOG) sent an alert this week to OB-Gyns and family physicians to watch for patients infected with the virus, and take action.

“Ideally, what we’re trying to do is control the situation to prevent as many Zika virus cases as we can, to prevent further spread and infection,” said Phil Huang, MD, chair of TMA’s Committee on Infectious Diseases. “It’s important for physicians and health care providers across Texas to be aware of the latest information – which continues to evolve – to stay on top of the situation.”

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While many people who contract Zika experience relatively mild symptoms, pregnant women who contract the disease pose the biggest concern. “Serious birth defects including congenital microcephaly [infants born with an undersized head] have been reported in babies of mothers who were infected with Zika virus while pregnant,” the advisory to doctors reads. The physician advisory discourages women who are pregnant from visiting a country where mosquito transmission of the disease occurs.

The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). Symptoms typically begin two to seven days after being bitten by an infected mosquito.

Though only about 1 in 5 people infected with Zika virus become ill, and for many people symptoms resolve in a short time, “Most concerning are the complications of Zika; the risk of the birth defect, the microcephaly among pregnant women who are infected; and also the possibility of Guillain-Barre syndrome,” said Dr. Huang. Guillain-Barre syndrome is a disorder in which a person’s immune system attacks his or her nerves, which often begins with tingling and weakness starting in the feet and legs, spreading to the upper body and arms.

Zika is transmitted primarily through the bite of infected Aedes aegypti mosquitoes, the same mosquitoes that spread chikungunya and dengue. While that type of mosquito exists in Texas, no mosquitoes are believed to carry the virus here. So the greatest threat now is to people who go where the infected mosquitoes are prevalent, including Central and South America and the Caribbean. That’s why doctors are advised to first ask about patients’ recent travel history; then screen the patients for signs they might have been exposed or for symptoms; and if present, get them tested for the virus.

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The TMA/TAOG letter recommends physicians report suspected Zika virus disease cases to their regional or local health department to facilitate diagnosis and mitigate the risk of local transmission.

While mosquitoes are the common culprit, unprotected sex can spread the virus. One case diagnosed in the United States, involving a patient in Dallas, is believed to have been sexually transmitted. A man who recently returned from Latin America passed the virus along. That is why the Centers for Disease Control and Prevention (CDC) advises pregnant women to abstain from sex or use protection if their partner has been in an area with Zika virus transmission. CDC also recommends that men who reside in or have traveled to an area of active Zika virus transmission – and their pregnant sex partners – should consistently and correctly use condoms during sex (vaginal, anal, or oral) or abstain from sexual activity for the duration of the pregnancy.

Physicians urge patients with Zika symptoms to stay indoors and avoid mosquito bites. “We recommend that because we don’t want the mosquito to get infected either,” said Dr. Huang. “If an infected person is bitten by a mosquito here, that mosquito could become the carrier to pass the virus along to another person. Then we start getting local transmissions.”

He added the universal message is to avoid mosquito bites. “If you’re not infected, it’ll help you avoid becoming infected, and if you’re infected, it’ll help prevent the mosquitoes from getting it and passing it along to someone else,” said Dr. Huang. He suggested people wear long sleeves and use EPA-approved mosquito repellent like DEET. He added that the mosquitoes that transmit Zika bite people during the daytime, unlike other common mosquitoes.

Public health experts also urge people to control mosquitoes. Pour out standing water around the house because that’s a potential mosquito breeding ground.

“These mosquitoes do exist in Texas but they aren’t carrying the virus here,” said Dr. Huang. “But it’s early in the season and cooler, so there’s less mosquito activity now… but it’ll increase.”

Here are the countries where mosquitoes currently transmit the Zika virus:

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