Lopez: What Summit County residents should know about Zika (column)
May 8, 2016
When we hear about disease outbreaks arising in places like Brazil, Sierra Leone or Saudi Arabia, those of us in Summit County might be tempted to take some comfort in the fact that thousands of miles separate us from the epicenters of these public health crises.
Although we may feel concern and heartbreak for patients, families and communities affected by infectious illnesses in far-away places, we may not feel personally vulnerable in our high-alpine enclave here in the United States.
However, as Zika virus has most recently reminded us, communicable diseases in today's world do not care about political boundaries or even oceans. To these pathogens, the world's continents may as well be locked together like Pangea, as people and goods move across the globe today at unprecedented rates.
With mud season upon us, many Summit residents may be traveling outside the country, making it a good idea for all of us to take a moment to better understand Zika. Zika virus, originally identified in 1947 in rhesus monkeys from the Zika forest of Uganda, was first discovered to be infecting humans in 1952. Since then, the virus has been on a relatively slow-moving globetrotting tour, drifting through communities in Africa and Asia in small waves. In early 2015, Zika finally reached the Western Hemisphere.
The current Zika outbreak has affected multiple countries in the Americas and the Caribbean. The exact number of those infected is difficult to determine, in part because of lack of access to health care and laboratory testing. The full picture is further obscured by the fact that about four out of five infected people show no symptoms at all. The other one out of five typically falls ill with minor symptoms of fever, rash, joint pain and conjunctivitis (pink eye), which last little more than a week. So why is Zika concerning health experts across the world?
There are two reasons: Zika virus causes microcephaly, and the disease's transmission is taking place in unprecedented ways. Never before has an arbovirus (A group of viruses transmitted by mosquitoes, ticks or other arthropods) caused microcephaly (lack of brain growth, leading to an abnormally small head). And never before has an arbovirus been known to be transmissible directly from one person to another. Medical researchers have recently determined that Zika can spread from an infected man to his partner(s) through sexual contact. Available treatments are merely supportive, meaning that they address the discomfort of symptoms but not the underlying disease.
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There is no vaccine.
Zika typically spreads via mosquitoes. A mosquito bites an infected person, which then makes the mosquito an infectious agent. When it bites other people, they may also become infected. If the person is pregnant, the fetus may be exposed to the virus, which can cause an absent or poorly developed brain and other harm. If the infected person is a man, he could transmit the virus through his semen. It's not yet clear how long after the initial infection that the virus can be transmitted sexually.
It's important to note that Zika exposure does not always harm the fetus, so pregnant women who have been exposed should discuss their individual care with their medical providers. Likewise, if an infected man's partner is pregnant or planning to become pregnant, there may be a risk to the fetus, which should also be discussed with a medical provider.
There are an estimated 3,000 species of mosquito worldwide; of these, only about 176 are able to survive in the climates of the United States. Summit County's altitude and cold weather further limit the reach of many of these species.
Notably, the two mosquito species that are known to transmit Zika virus – Aedes aegypti and Aedes albopictus – are not believed to have the ability to survive here.
It is interesting, therefore, that two Coloradans have so far tested positive for Zika. How did they get it? And how is it that 426 people in the United States have contracted Zika as of April 27?
Millions of U.S. residents, including many from Colorado, regularly travel to and from countries to our south where large human populations have relatively high rates of Zika infection. All of the U.S. cases to date have been associated with travel in some way.
There are many unknowns surrounding Zika, but the medical community is quickly learning more about this troubling disease. We know that once a person is exposed to Zika, it is unlikely that he or she will contract the virus again. We don't know whether we'll begin to see spread of Zika in the United States that is not associated with international travel; however, experts believe this is likely. The mosquito species that transmit the virus are found in many U.S. states. If enough people living in the U.S. have Zika in their blood, it would be possible for the virus to spread within the country. U.S. health officials are actively preparing for this possibility.
For the majority of people in Summit County, Zika is not a serious health threat. Nevertheless, a disease outbreak taking place half-way around the world does have the potential to impact us here at home. It is important for us to understand the risks associated with Zika and to take a few simple steps, depending on your risk factors, especially as they relate to travel and pregnancy:
Pregnant women should avoid travel to any area with Zika. Check travel guidance from the U.S. Centers for Disease Control at http://www.cdc.gov/travel.
Pregnant women who must travel to an area with Zika should first meet with their medical provider(s).
Pregnant women should take measures to prevent mosquito bites, including covering up arms and legs and using EPA-registered insect repellent deemed safe for use during pregnancy.
To protect the fetus in pregnant heterosexual couples in which the male partner has been in an area with Zika, use latex condoms the right way every time, or choose not to have any type of sex for the duration of the pregnancy.
For more information on Zika virus, visit http://www.cdc.gov/zika, or call the Colorado Health Emergency Line for Public Information at 877-462-2911.
Sara Lopez, RN, BNS, is a member of the Summit County Public Health Department.
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