As temperatures rise, so does awareness of Zika virus

As temperatures rise, so does awareness of Zika virus

One year ago, reports of the mosquito-borne Zika virus were buzzing all over the news. The disease had spread from South America and Central America to parts of the lower U.S., including Florida and Texas.

And patients of Fred Farias III, O.D., became concerned.

Dr. Farias practices in McAllen, Texas, about an 11-mile drive from the border of Mexico, where an outbreak was occurring. The World Health Organization (WHO) declared a public health emergency of international proportions in February 2016. The Centers for Disease Control and Prevention counted 5,234 cases of the Zika virus between January 1, 2015, and April 12, 2017, in the U.S.

"Being located so close to an international border, many of my patients felt concerned," recalls Dr. Farias, who was prompted to research how the disease spread might impact his community. "I was able to educate my patients based on their exposure and counsel them about their eye issues."

Among Zika's symptoms are fever, rash, headache, joint and muscle pain, and conjunctivitis (red eyes).

"My patients' questions ranged from wondering whether they had an increased level of vulnerability to asking about early symptom indicators," he adds.

Lingering concerns

Mosquito season begins in the spring. "These types of carrier mosquitoes (local mosquito-borne virus transmission) are here—and here to stay," says Sue Lowe, O.D., who practices in Laramie, Wyoming, and chairs the AOA Health Promotions Committee. "Doctors of optometry are going to have to continue to be aware of Zika. We need to keep talking to our patients about it, especially young women who become, or want to become pregnant, and young men who want to become fathers. We should keep abreast of the CDC recommendations and guidelines."

As he was last year, Dr. Farias is prepared to query his patients about their eyes and their travel plans, and he will respond to any concerns they might have. The disease can be transmitted through mosquito bites, from pregnant women to their fetus, intercourse and potentially blood transfusions (though there have been no confirmed cases of the latter in the U.S., there was a report in Brazil of transmission through platelet transfusions). A Washington University School of Medicine-St. Louis study on mice raised a potential new transmission method source: shed tears.

Being located so close to an international border, many of my patients felt concerned.

The WHO warning has expired, but the CDC remains on alert and the Texas Department of State Health Services reported 10 cases of Zika as of April 11, 2017.

Last December, the CDC declared the Texas border city of Brownsville a "cautionary" or "yellow" Zika virus zone—pregnant women or women considering having a baby were told to avoid the area if they could or take other precautions, such as wearing long-sleeved clothing, staying indoors or spraying themselves with insect repellant.

Pregnant women are at risk of giving birth to children with birth defects of the brain (microcephaly). Zika has also been linked to Guillain-Barré syndrome. In 2016, about 1 in 10 women in the U.S. with Zika had a fetus or baby born with birth defects, and the CDC continues to recommend that pregnant women not travel to areas where there is a transmission risk.

Also, the CDC has urged continued surveillance of Zika, as recently as March 31 in its Morbidity and Mortality Weekly Report (MMWR). "Because of ongoing transmission and the risk for recurrence of large outbreaks, response efforts, including surveillance for Zika virus disease and its complications, and vector control and other prevention activities, need to be maintained," the MMWR says.

"Mosquito season is basically year-round in south Texas," Dr. Farias says. "It has been on our minds since its discovery. With an increase in the rainy season and the lack of freezing temperatures, Zika is definitely on our radar."

What doctors of optometry can do

If patients present with viral conjunctivitis, joint pain, lethargy or symptoms of Guillain-Barré syndrome and they or their partner have visited a country known to have Zika virus infections, doctors should counsel them about the Zika threat. If Zika virus infection is suspected in a woman who is currently pregnant, the patient should be referred to her primary care provider for testing.

Click here for current information on Zika virus infection for health care providers, including case definitions.  

Check the CDC's Zika Virus website regularly for the most current information.

April 17, 2017

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