Zika out of the headlines for now, but the danger still looms

Paul Basilio, MDLinx | January 17, 2017

Coverage of the Zika virus has waned after its long reign as one of the top medical news stories of 2016. While the absence of daily headlines may be good news for travel agencies, the virus remains a serious concern, according to the Penn State Health Milton S. Hershey Medical Center.

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Zika virus still cause for concern

The most marked is the increased likelihood of fetal birth defects, such as microcephaly and neurologic complications.

“People think it is not a problem anymore, but it is,” according to Wallace H. Greene, PhD, D(ABMM), director of the diagnostic virology laboratory at the Hershey Medical Center. “Those mosquitoes are alive and well.”

In early 2016, the World Health Organization (WHO) declared the Zika outbreak to be a Public Health Emergency of International Concern. While news of the outbreak spread in the mass media, travel concerns culminated as the world gathered in Rio de Janeiro for the Olympic Games.

The international response to the outbreak led scientists to a greater understanding of the virus. In November, WHO ended Zika’s status as a public health emergency and moved to a long-term response plan for the virus, but the problem is not going away. Concern is growing that the virus could even return to the US this summer.

“[The WHO] felt it had escalated in importance,” said George McSherry, MD, chief of the Division of Pediatric Infectious Diseases at the Penn State Children’s Hospital. “That allows for a more sustained focus and more dedicated resources.”

Although most patients with Zika infection are asymptomatic, some may develop a mild fever, rash, or joint pain—symptoms that often resolve without treatment. The most marked concern is the increased likelihood of fetal birth defects, such as microcephaly and neurologic complications. Guillain-Barre syndrome has been associated with Zika infection in adults.

Current tests can detect the virus in blood or urine, but no treatment is available. A number of Zika vaccines are currently being developed, but they are still in the early stages.

“Some of them look hopeful, but they are at least two years away,” Dr. Greene said. “That isn't going to help anyone who wants to travel this winter."

The Zika virus is transmitted primarily by the Aedes mosquito, but sexual transmission is also possible. The virus has been detected in semen, blood, urine, amniotic fluids, saliva, and fluids found in the brain and spinal cord. Most cases in the US have involved patients who have traveled to the Caribbean or Latin America, where the virus is prevalent.

“If you’re not pregnant or you’re not planning to become pregnant, it doesn’t seem to be a big issue,” Dr. McSherry said. He also notes that the public should follow the Centers for Disease Control and Prevention (CDC) to help guide decisions about travel plans.

Enlisting protection against mosquitoes in the Mexico, Central and South America, and the Caribbean can also help in prevention of other mosquito-borne disease such as Dengue and Chikungunya.

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