(Editor's Note: The release of this webinar has been postponed to Aug. 10 from 11 a.m. to noon CDT. We apologize for any inconvenience.)
Zika virus infection and its associated devastating birth defects may not be garnering headlines the way they did in 2016, but Zika is still a threat that all family physicians should discuss with their patients -- and not just female patients who are or want to become pregnant.
AAFP members can learn the latest about Zika by attending the free webinar Zika Virus: Updated Guidance and Recommendations for Family Physicians on July 20 from 11 a.m. to noon CDT. This is a members-only event, so be sure to have your Academy login information handy.
Elizabeth Rosenblum, M.D., professor of clinical medicine in the Department of Family Medicine and Public Health and the Department of Reproductive Medicine at the University of California, San Diego, will present the webinar.
"Even if you attended a Zika presentation a year ago, so much has changed in the past year," says Rosenblum. "Family physicians play an important role in the prevention and management of Zika infection. Prevention can be invisible. It's not ‘sexy’ and may not produce headlines. But I think it is heroic to prevent tragedy."
- AAFP members can learn the latest information about Zika virus infection during a free AAFP webinar July 20 from 11 a.m. to noon CDT.
- Webinar topics will include testing for Zika, sexual transmission of Zika, management of pregnant women and children with Zika infection, and use of the CDC's Zika Pregnancy Registry.
- Patients are at risk for Zika infection if they travel to areas with active Zika transmission, if they have unprotected sex with someone who has been exposed to the virus, or if they are bitten by a vector mosquito that has bitten an infected person.
The CDC in 2016 reported mosquito-borne Zika virus transmission in Miami, Fla., and Brownsville, Texas, as well as in U.S. territories. Two types of mosquito, Aedes aegypti and Aedes albopictus, carry Zika. The range of A. albopictus reaches as far north as Maine and Minnesota, while the range of both types reaches as far west as Southern California, according to the CDC.
Still a Risk
"Even if you live in an area where you think Zika is not a problem, in this day and age of relatively easy travel, we're all global citizens," says Rosenblum. "Your patients will be at risk if they travel to areas with active Zika transmission or if they have unprotected sex with someone who has been exposed to the virus."
Some of Rosenblum's pregnant patients tell her they plan to take a "baby vacation" before the baby comes, perhaps relaxing on a beach somewhere. "I tell them that if they vacation in a place with mosquito-borne Zika transmission, it could lead to significant consequences for the developing fetus," she says.
But even if they don't travel to such areas and don't have unprotected sex, there's still a risk, says Rosenblum. "If one of their neighbors becomes infected with Zika on a trip, and then comes home and gets bitten by a mosquito while viremic, that mosquito may turn around and bite your patient, infecting them with Zika."
That's why avoiding mosquito bites is critically important. "One thing I was surprised to learn is that the Aedes aegypti and Aedes albopictus mosquitoes primarily bite during the day rather than at night," says Rosenblum. "If these mosquitoes live in your area, it is important to use insect repellent and wear long sleeves and pants when you go outside, doing everything you can to prevent mosquito bites."
Zika Case Counts
According to the CDC, so far this year, 148 symptomatic Zika virus disease cases have been reported(www.cdc.gov) in the United States. One was acquired through sexual transmission; the rest were in travelers returning from affected areas.
Since Jan. 1, 2015, 5,365 symptomatic cases have been reported(www.cdc.gov) in the United States. Of these, 5,093 were in travelers returning from affected areas, 224 were acquired through presumed local mosquito-borne transmission, and 48 were acquired through other routes (46 through sexual transmission, one through laboratory transmission, and one person-to-person via an unknown route).
These statistics exclude congenital disease cases.
One key area Rosenblum will cover during the webinar is testing for Zika virus. "This area is really changing, and it can be confusing for frontline physicians -- knowing who to test, when to test, which tests to order, and who doesn't need testing even if they ask about it," she says.
She'll also discuss updated guidelines on sexual transmission of Zika. "We know that all forms of sexual activity can spread Zika, and it can be passed from a man or a woman," Rosenblum says. "But there's still a lot we don't know. For example, we don't know how long Zika remains infectious in semen. If a male partner develops Zika or simply travels to an area with risk of Zika, the current guideline recommends that couples use a condom or abstain from sex for at least six months after symptom onset or time of travel."
Rosenblum also will talk about the importance of the CDC's U.S. Zika Pregnancy Registry and the management of pregnant women and children who are infected with Zika.
Physicians should notify their local health department when they have a pregnant patient who tests positive for Zika, Rosenblum says. The health department will enter the information in the Zika Pregnancy Registry. "This registry will help us learn more about Zika and get answers to questions about timing and risk," Rosenblum says. "It will help us understand why some pregnant women who test positive for Zika have babies with microcephaly, while others don't."
Rosenblum says she hopes her webinar reaches a wide audience. "In early 2016, the information coming out of Brazil led the medical community to treat Zika as an international medical emergency. In 2017, Zika remains an enduring and significant risk to the health of people and communities. We want to encourage continued vigilance so as to prevent any further babies being born with congenital Zika infection."
The webinar will be archived on the AAFP website after July 20 for future reference. No CME credit is available for the webinar.
Related AAFP News Coverage
Birth Defects Seen in One in 10 Zika-infected Pregnancies
CDC Officials Call for Physicians to Remain Vigilant
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Zika Virus Outbreak
CDC Zika Virus Update(www.cdc.gov)