At the 2016 Illinois Self Insurers’ Association 38th Annual Educational Seminar and Membership Meeting, Christopher Dea, MD, Assistant Corporate Medical Director with Caterpillar, gave an update on Zika.
In the United States, most confirmed cases of Zika have been travel related. There were some very-isolated cases of non-travel-related Zika in a section of Miami-Dade County, but that appears to have been eradicated. There has a small number of cases that appear to have been sexually transmitted.
The primary transmission method of Zika is through one particular species of mosquito. They can be found in many states in the U.S., including the entire Southeast and upward into the Midwest. Pregnant women can transmit Zika to the fetus during pregnancy and the virus can cause birth defects, so this is a huge area of concern.
The main method to diagnose Zika is based on symptoms and recent travel history, but it is confirmed by a blood or urine test. Zika causes symptoms that are similar to many other viruses, including fever, rash, joint pain or red eyes in addition to fatigue, chills, loss of appetite and sweating. Unfortunately, a negative blood/urine test does not necessarily mean the person does not have Zika because the virus could be present in low levels at first onset.
Zika tests are primarily performed by the CDC and state health departments. There are also commercial tests available, but none of these are currently FDA approved. Testing is recommended for a person showing symptoms with a possible exposure within two weeks of symptoms developing. The only treatment is supportive care such as rest, staying hydrated, and taking Tylenol.
From a prevention standpoint, pregnant women are advised to avoid Zika-affected areas. People are also told to try and avoid mosquito bites by using insect repellent. There is no vaccine for Zika.
There are many unanswered questions, including:
- How likely are you to get Zika if you travel to an affected area?
- What is the maximum duration of infection after symptom onset?
- How long can a person remain asymptomatic while still carrying the virus?
- How likely is transmission from a pregnant woman to a fetus and does the trimester of the infection matter?
Case scenarios seen in the workplace:
- Worker travels to South America and demands to be tested upon returning to the United States because he is concerned about contracting Zika. This person does not meet CDC guidelines for testing because the person does not have symptoms.
- Worker travels to Brazil for a meeting and is concerned about catching the disease and transmitting it to his pregnant wife via sexual transmission. Worker was advised to use a condom for protection or abstain from sexual relations until after several weeks had passed.