VCU news

By Anne Dreyfuss
C. Kenneth and Dianne Wright Center for Clinical and Translational Research

For an updated Q&A from April 2016 with Gonzalo Bearman, M.D., please click here. 

With the head of the World Health Organization saying that Zika virus “is now spreading explosively” in the Americas, people around the world are turning to infectious disease experts at institutions such as Virginia Commonwealth University Medical Center to learn more about the mosquito-borne illness. Categorized in the same family of viruses as dengue, Zika causes no more than mild discomfort in most people, but there is mounting evidence suggesting that the disease is linked to birth defects such as abnormally small heads and Guillain-Barre Syndrome, a rare autoimmune disorder that can lead to life-threatening paralysis. Having small heads can cause severe developmental issues and sometimes death.

The infection is active in 29 countries and territories in the Americas, according to the Centers for Disease Control and Prevention. The national public health institute has recommended that women who are pregnant or who are trying to become pregnant consider postponing trips to countries in the Caribbean, as well as Central and South America where there are ongoing Zika virus outbreaks. The CDC is also recommending that men who have been in risk areas use condoms in order to prevent the spread of the virus.

As an academic medical center with a staff that includes experts in infectious disease, infection control and epidemiology, VCU is prepared for the unlikely case that Zika virus reaches Central Virginia. Gonzalo Bearman, M.D., chairman of infectious diseases and hospital epidemiologist at VCU Medical Center, has been monitoring the rise of the virus. He recently answered questions about the disease and how VCU is equipped to confront it.

Can you briefly explain what the Zika virus is?

Zika virus is a viral infection that is generally very mild. Eighty percent of those infected with the virus have no symptoms. Historically it has been found in Africa, but cases have developed in Brazil and up through South and Central America. The concern for Zika virus is primarily for pregnant women because it can have an impact on the fetus.

What are symptoms of the Zika virus?

Symptoms are a mild fever, some joint pain, a rash, and redness of the eyes.

How long do symptoms last?

The clinical illness usually lasts for two-to-seven days and patients with prior confirmed infections are not believed to be at risk with pregnancy after symptoms have ceased.

How is Zika detected in an infected person?

There are two blood tests that screen for Zika virus, but there is no commercially available test in the United States. All testing here has to be coordinated through the Virginia Department of Health.

How is the disease contracted?

The disease is primarily spread through the bite of an infected mosquito, and that mosquito has to pick it up from an infected person. While there have been three reported cases of sexual transmission of Zika virus, possibly via infected semen, the vast majority of cases to date are related to mosquito-borne transmission.

How does it spread?

It is via a vector in the vast majority of cases, and that vector is mosquitoes.

How is VCU Health prepared to treat the disease if we start seeing cases here?

There is no treatment for Zika virus, so we are here to provide consultations related to it and to assist in diagnosing the disease if a patient has the travel history and the clinical symptoms that are potentially suggestive of Zika.

What would VCU do if a patient who was being treated here tested positive for Zika virus?

We would give the patient supportive care and give them medications to make them more comfortable.

What is the likelihood of Zika virus spreading to Central Virginia?

It is not likely that the virus will spread to Central Virginia. We likely will continue to see cases in Virginia that are imported from tropical and sub-tropical areas in Latin America and the Caribbean. The majority of these cases will likely be due to mosquito bites that occurred while in those areas. At this point it seems highly unlikely that we will see local sexually transmitted Zika virus infections in Virginia. As far as we know now – although our knowledge of this is evolving – sexually transmitted infections appear to be relatively rare events with only three instances of sexual transmission documented to date. Although local mosquito-based transmission is theoretically possible in Virginia, it is highly unlikely based on our environment and the types of mosquitoes we have here.

What is the best way to control the spread of the disease?

The best way to control the spread of Zika virus anywhere is to use mosquito repellent and for local health authorities to embark on mosquito-reduction practices.

How serious is the Zika virus?

Zika virus is a credible public health threat; however, there are other infectious disease concerns that are more pressing. Diseases like malaria and influenza are more concerning as a public health threat than Zika virus at the present moment.

* Editor’s Note: This article originally posted to the VCU News site on Monday. On Tuesday, Dallas County, Texas, health officials announced a case of transmission involving a patient who had sex with someone who had recently returned from Venezuela and was infected with the virus. The CDC on Wednesday updated its Zika virus guidance for pregnant women, advising them to protect themselves if their male sexual partner has traveled to or lives in an area where Zika virus is circulating. VCU has updated the article to reflect the new information. As information continues to arise in this evolving public health issue, VCU will update the news site accordingly. Michael Stevens, M.D., assistant professor of internal medicine at VCU and associate hospital epidemiologist, contributed to the updates as Dr. Bearman had limited availability.

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