Urgent care operators, especially in the southern U.S., need to be tuned in to the latest news and information about the Zika virus.
The World Health Organization declared a “public health emergency of international concern” over Zika, a virus transmitted by the Aedes mosquito. Though typically non-lethal, the virus appears to be linked to a significant increase in fetal deformity. Microcephalic babies, those with tiny heads and developmental delays, are being born to women who are infected. There has also been a reported increase in Guillain Barre Syndrome in infected individuals, though a scientific link has not yet proven this, according to the Urgent Care Association of America.
Florida’s governor declared a health emergency in four counties today after at least nine cases were confirmed there. Health officials believe all the cases were contracted while the people were traveling in other countries, according to the Associated Press.
Don’t panic, advises William Gluckman, DO, MBA, FACEP, President and CEO of FastER Urgent Care in New Jersey. “Zika is not endemic to the U.S., so the chances an urgent care provider here will see a case is relatively small at this time.”
Here are four things to know about the virus.
How it spreads
Zika is spreading rapidly in many Latin American and Caribbean nations, and the first case of local transmission in the U.S. was reported this week. The patient in Texas acquired the virus through sexual contact with a person infected while traveling outside of the U.S., the Dallas County Health and Human Services department reported. This raised additional concerns about spread of the disease, and public health officials are urging people to use condoms to block potential disease transmission. Additionally, people traveling to any of the countries with higher rates of Zika—especially pregnant women or those of child-bearing age—need to take extra precaution against mosquito bites, using repellant and sleeping in a screened-in room or under a mosquito bed net.
Symptoms and treatment
Only one in five people infected with the virus develop symptoms, which are usually mild. Because of this many people may not realize if they’ve been infected. Symptoms include fever, joint and muscle pains, rash, conjunctivitis, and headache, which begin to show up 2 to 7 days after being bitten by an infected mosquito. While the Pan American Health Organization (PAHO) reports more than 16,000 Zika illnesses since the first cases were confirmed in Brazil in October 2015, the real number is likely much higher.
“The number of cases being reported is significantly lower than the actual number of cases.” says Candice Burns Hoffmann, a CDC spokeswoman. “Many countries do not regularly test for Zika virus. Also, once the outbreak becomes common in an area, most people will not go to the doctor or get tested for the virus.”
There is no vaccine and treatment is purely supportive care.
Urgent care providers should inquire about travel to any of the endemic regions when presented with a patient with these symptoms. Acetaminophen, not NSAIDs or aspirin, are recommended for pain and fever until Dengue is ruled out as this can increase the bleeding risk, according to the UCAOA.
Testing is not readily available, so providers should contact their state health department for guidance. The CDC and a few state health department labs are able to perform testing on serum.
Advice for providers and patients
Women who are pregnant, or trying to become pregnant, should consider postponing travel to any area where Zika transmission is ongoing, the CDC says. Find more info about those areas here.
The World Health Organization estimates between three and four million people across the Americas will be infected with the virus in the next year. The CDC is asking ob/gyns to review fetal ultrasounds and do maternal testing for any pregnant women who has traveled to a country where Zika is currently active.
Zika can mimic other viral infections, such as influence, parvovirus, enterovirus, and disease cause by other agents such as malaria and strep. “So urgent care providers should consider more common entities in patients presenting with febrile illness,” Gluckman said. “Additionally, this infection is self limiting and not considered fatal.”
Suspected patients should be directed to stay home and rest, keeping well hydrated and take Acetominophen for aches and fever.