Zika different than Ebola

Area hospitals say they are not adopting new protocols to deal with virus

There is at least one major difference between Ebola and the Zika virus: Zika can’t be transmitted through “casual contact,” health officials said.

So if a patients shows signs of Zika — which include mild fever, skin rash, conjunctivitis or red eye, muscle and joint pain and fatigue — they’re treated with standard procedures like anyone with an infection, said Dr. John Kennedy, vice president of Medical Affairs at Mercy Health-Fairfield Hospital.

Still, the spread of the Zika virus outside the United States has spurred a slew of new travel guidelines and protocols at blood centers and other medical facilities across the region, where one of the four cases reported last week in Ohio was diagnosed in a 56-year-old Butler County woman returning from Guyana.

While there have been no reports of the mosquito-borne virus being transmitted by mosquitoes in the U.S., the Centers for Disease Control and Prevention (CDC) has reported 52 cases of Zika brought back to the U.S. by travelers in 16 states and the District of Columbia, in addition to the cases in Ohio.

“Given the number of travelers between Ohio and Zika virus-affected countries, it would not be a surprise to see more cases,” ODH Medical Director Dr. Mary DiOrio stated. “There is no vaccine available for Zika virus, so it’s important for Ohioans traveling to affected areas to take steps to prevent mosquito bites.”

The CDC has confirmed the person-to-person spread of the virus in the U.S. after the victim’s sexual partner returned in Texas from an affected country and developed symptoms.

About 80 percent of those who contract Zika never develop symptoms, which include fever, headache and muscle pain and are usually mild and rarely severe enough to require hospitalization, according to medical experts.

But the virus has been linked to severe birth defects, leading the Community Blood Center in Dayton and Hoxworth Blood Center in Cincinnati to step up their screening procedures. The Dayton center restricts anyone who has recently returned from travel outside the United States or Canada to the U.S. from giving blood for at least 28 days. Hoxworth requires a 30-day wait, officials said.

Because of the risk to pregnant women and women trying to get pregnant, the CDC on Monday upgraded its recommendations for travel to areas with Zika virus transmission, including the Caribbean, Mexico and Central or South America.

The CDC now recommends that pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. And that pregnant woman who must travel to one of these areas should talk to their doctor or other health care provider first and strictly follow steps to avoid mosquito bites during the trip.

Local travel agents contacted by this news agency declined to discuss the impact of the CDC’s warning on pending travel plans for spring break.

Dr. Robert Lerer, Butler County health commissioner, said as more travelers return from the infected countries, these Zika cases will be “no news.” Eventually, he said, returning to the U.S. with the Zika virus will be as common as the flu or diarrhea.

Lerer said a group of Rotarians from Fairfield is expected to travel to Haiti, an infected county, soon.

In his 4oth year as commissioner, the longest tenure in the state, Lerer said it’s “good news” that the virus is transmitted by mosquitoes because there are no mosquitoes in Ohio right now.

Dr. Madhuri Sopirala, medical director of Infection Control for UC Health, said since Zika can’t be transmitted through “casual contact,” medical facilities are treating it differently. Unlike with Ebola, medical professionals won’t wear hazardous material outfits when dealing with a Zika patient.

She said there is no cure for Zika, but the Zika-carrying mosquito doesn’t live in Ohio.

Dr. Thomas Vajen, emergency department manager at Fort Hamilton Hospital, said the virus remains active for seven to 10 days.

Tammy Lundstrom, chief medical officer for Dayton-based Premier Health, said the hospital is not making any changes to its admissions procedures in light of the reported cases of Zika in Ohio.

“We are not adopting any new protocols, except that we are sending suspected samples to the ODH (Ohio Department of Health),” Lundstrom said. “All symptomatic patients with recent travel history to an endemic Zika area will be tested utilizing the ODH protocol.

“As of today, there are no additional precautions above and beyond what we would do for a patient who has the flu. We are continuing to monitor both CDC and ODH and will evolve our protocols as more information about the virus becomes known, if warranted.”

Dr. Kennedy said it’s important to note that as few as one in five patients infected with Zika show symptoms, which include mild fever, skin rash, conjunctivitis or red eye, muscle and joint pain and fatigue.

If a patient arrives with Zika-like symptoms, he said, the hospital would follow standard precautions as it would for any patient presenting with an infection. Standard precautions are a set of infection control practices that the uses to prevent transmission of diseases that people can acquire through contact with blood, body fluids, non-intact skin (including rashes) and mucous membranes.

These precautions include:

• Exercising hand hygiene, including the use of alcohol-based hand rubs (containing 60-95 percent alcohol).

• Using personal protective equipment, based on symptoms and travel history, including gloves, gowns, facemasks and face shields.

• Following respiratory hygiene and cough etiquette

• Covering the mouth and nose with a tissue when coughing or sneezing

• Disposing of the used tissue in the nearest waste receptacle

• Performing hand hygiene after contact with respiratory secretions and contaminated objects/materials

• Masking and separating people with respiratory symptoms whenever possible

Aside from these in-hospital precautions, the hospital recommends Ohioans follow CDC Guidelines as well as those from the public health department if they are considering travel to affected areas:

• It is important to take steps to prevent mosquito bites. Prevention of mosquito-borne Zika virus transmission is the same as prevention of any other mosquito-borne diseases and includes using insect repellents, limiting exposure where and when mosquitoes are most active and removing breeding sources such as containers that collect standing water.

• To date, there have been no reported cases of Zika virus disease transmission through mosquito bites anywhere in the continental U.S. However, there have been reported instances of sexual transmission of Zika. The Centers for Disease Control and Prevention issued new recommendations that men who have lived in or have traveled to an outbreak area should abstain from sex or wear condoms if they have a pregnant sexual partner.

• Women who are pregnant or anticipating becoming pregnant to refrain from travel to affected areas.

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