Since making headlines in 2015 when it began to spread rapidly in Brazil, the Zika virus has become a growing health care concern both in the U.S. and abroad. As the virus appears in more countries, it has become clear that without strong efforts at the national and local levels, the number of infected patients only will rise. Now that the virus is beginning to appear in the U.S., it is critical to make educational and preventive measures a priority among health care professionals.
As a nurse, you should stay up to speed on the status of Zika and the strategies being developed to combat its spread to help ensure the highest quality of patient care. Doing what you can to identify cases of the virus and to educate your patients on the risks can make a difference in preventing its prevalence in your community.
The spread of Zika
According to the World Health Organization (WHO), the Zika virus is spread to humans through the bite from an infected Aedes mosquito. From there, the virus can be spread from pregnant women to their fetuses, as well as from one partner to another via sexual activity. It still is being investigated whether or not the virus can be spread through blood transfusions. Symptoms, which are typically mild, can include a rash, muscle and joint pain, fever, headache and red eyes, though some people do not show any signs at all. Infected individuals rarely die or are hospitalized.
While the first known case of the Zika virus was identified in Uganda in 1947, according to the WHO, it was not widely spread until 2015, when the Brazilian government identified a rash of cases. From there, the virus spread through neighboring countries, and the WHO declared Zika a public health emergency in February 2016. As of July 2016, the virus had spread to the majority of countries in South America and Central America.
As of July 27, 2016, the Centers for Disease Control and Prevention (CDC) reported that 1,658 identified cases of Zika have been reported in the U.S. The vast majority have been travel-related, with people contracting the virus while abroad and bringing it with them to the states. In some cases, the virus was then spread through intercourse to sexual partners. However, on July 29, 2016, the organization reported that the first cases of the virus as the result of mosquito transmission in the U.S. were identified in southern Florida.
The response of the U.S. government
Though the instances of the virus in the U.S. were predominantly the result of travel with a few resulting from sexual transmission, it is still a concern for the public. The government already is taking action to inhibit further instances of the virus being brought from abroad by travelers. The CDC has issued a travel alert for anyone heading to areas with Zika. Airports also have signs posted with information on the virus. Ideally, spreading awareness to those individuals who are going to or coming from countries where Zika is active will encourage them to take the appropriate precautions to avoid contracting the virus.
According to a July 1, 2016, statement by the White House, the U.S. government also is focusing on improving access to — and the speed of — testing, especially for pregnant women, as well as providing resources to areas that have had problems with mosquitos in the past. The funds additionally are intended to help develop a vaccine that could prevent the contraction of Zika. Because the virus is spread by mosquitoes, it can be incredibly difficult to control. Even with proper community health measures, it is difficult to keep people from being bitten by the insects, particularly in low-income areas where the population may not be able to afford nets, repellant and other preventive tools. Because Zika does not always present with symptoms, infected persons can unknowingly pass it on to sexual partners or infected mothers can pass it on to their fetuses. According to the CDC, no vaccine currently exists to combat Zika, so environmental prevention is extremely important.
The role of the nursing professional
Nurses have an important role to play in educating patients about the risks of Zika and how to take preventive measures. The American Nurses Association compiled a list of resources with the information that nurses need to know, such as details regarding symptoms, diagnosis and treatment.
While it always is important to ask patients about their recent travel history, it is possibly even more critical at the present, particularly if your patient shows any signs of Zika. The virus only can be confirmed by a blood or urine test, according to the CDC.
Recognizing the symptoms and discussing preventive measures is especially important when working with pregnant patients. While the virus is rarely harmful to children and adults, it can have devastating effects on a fetus. Zika during pregnancy has been linked to a condition called microcephaly in fetuses. Microcephaly results in smaller than average head size and incomplete brain development. Currently, the following is known:
- Pregnant women primarily contract Zika through the bite of an infected mosquito.
- An infected pregnant woman can spread the virus to her fetus.
- Zika can be spread to the fetus during pregnancy or delivery.
- Males can give Zika to their pregnant sexual partners.
However, there is still much that is not known about Zika and pregnancy, such as how likely it is that a mother infected with Zika will pass on the virus to her unborn child and whether it is more common at a certain stage of the pregnancy. Regardless, educating both pregnant women and those who are trying to conceive about the preventive measures that they should be taking is a good place to start.