Pediatricians should be on alert to screen for cases of congenital Zika infection in infants of symptomatic women who have lived in or traveled to areas where the virus is endemic, according to a new directive from the Centers for Disease Control and Prevention (CDC).
The Zika virus was first identified in a monkey in Uganda in 1947 and has typically been found since then along the equator throughout Africa and Asia. It is spread by the yellow fever mosquito (Aedes aegypti) and the Asian tiger mosquito (Aedes albopictus), which also transmit dengue and chikungunya viruses.
About a decade ago, cases started appearing throughout the Pacific Islands, and the case in the Americas was reported in Brazil in mid-2015. Since then, the mosquito-borne disease has spread to 22 other countries and regions in the Americas, according to the World Health Organization, and may have been the cause of at least 4000 cases of microencephaly since summer 2015.
There have also been about 30 documented cases across 12 states in the United States, as well as 19 confirmed cases in Puerto Rico and 1 in the US Virgin Islands. The states where cases have been reported to local health departments include Arkansas, California, Florida, Hawaii, Illinois, Massachusetts, Minnesota, New Jersey, New York, Oregon, Texas, Virginia, and the District of Columbia.
The CDC has created a map to track Zika outbreaks, and doesn’t believe that any cases have been contracted locally, but rather during recent travel. Still, local infections may not be far off, says CDC.
“With the recent outbreaks, the number of Zika cases among travelers visiting or returning to the United States will likely increase,” says CDC. “These imported cases could result in local spread of the virus in some areas of the United States.”
H Cody Meissner, MD, FAAP, a member of the American Academy of Pediatrics Committee on Infectious Disease and chief of the division of pediatric infectious disease at Tufts Medical Center in Boston, Massachusetts says he expects Zika virus to be endemic in the United States by summer 2016, as temperatures rise across the majority of the nation.
About 20% of individuals infected with the Zika virus develop symptoms, which can include high fever, joint pain, rash, conjunctivitis, muscle pain, and headache.
The CDC says it doesn’t know the incubation period for the virus, but it is most likely between a few days and a week. The illness is usually mild, with severe illness resulting in hospitalization and death occurring rarely. No medications or treatments are available aside from comfort care such as rest, hydration, and pain relief. However, the larger risk is to the unborn children of pregnant women.