In February, the World Health Organization (WHO) took the rare step of declaring an international public health emergency in connection with the spread of the Zika virus. Over the last year, the mosquito-borne illness has become endemic throughout the Caribbean and in many parts of Latin America. The Zika virus which is spread primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes).
Zika virus infection during pregnancy can cause a serious birth defect called microcephaly, as well as other severe fetal brain defects.
Dr. Matthew J. Gettings, DO, is here today to discuss the Zika virus and what you need to know about your risk and to prevent the spread of this virus.
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What You Should Know About The Zika Virus
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Learn more about Matthew J. Gettings, DO
Matthew J. Gettings, DO
Matthew J. Gettings, DO, is a family medicine doctor at Lourdes Health Systems.Learn more about Matthew J. Gettings, DO
Transcription:
Melanie: In February, the world health organization to the rare step of declaring an international public health emergency in connection with the spread of the Zika virus. Over the last year, the mosquito-borne illness has become endemic through the Caribbean and in many parts of Latin America. My guest today is Dr. Matthew Gettings. He's a primary care physician with Lourdes Health System. Tell us a little bit about the Zika virus: what is it? How is it contracted and who needs to be concerned?
Dr. Gettings: Thanks for having me on, Melanie . The Zika virus is getting a lot of play on television lately and my patients are starting to come in with mosquito bites and wondering if they should be concerned. Well, I guess the good news is that, so far, there is no mosquito-borne transmission within the United States, so most of our screening efforts are looking to see if a patient has traveled to an area where it is endemic. We’re seeing most folks from Puerto Rico, from Central and South America coming in with some questions. It’s contracted by mosquitos in those places. So, we’re really screening when folks come in to see if they or a sexual partner has been in one of these territories. The tricky part is that the incubation time of the virus is between 3 and 7 days. So, you might come back from a vacation or a conference and show no signs yet.
Melanie: So, we’re going to talk about pregnant women, Dr. Gettings, but before we do that, for the average citizen, what is the risk of getting infected with the Zika virus and what symptoms might they recognize?
Dr. Gettings: Oh, sure. For the average citizen, the risk is very, very low. In fact, many people who contract the disease may not even realize it. The most common symptoms are fever and it’s usually low-grade fever, 99 – 100 or 101; some muscle aches; some joint pain and conjunctivitis or red eye. And, if we’re talking about a child or adult, the disease is very self-limiting. They’ll have symptoms for 3-7 days and we’ll take a little Tylenol, stay well hydrated and get better just like that. Most folks likely, would, rarely miss a day or two of school. It’s really the symptoms we’re worrying about –the mom carrying baby.
Melanie: So, tell us about the pregnant women and what is the risk to them?
Dr. Gettings: The risk is, essentially, that the child could born with defects. In April of this year, the CDC confirmed that the microcephaly suspicion—babies with very small heads and other brain defects—was strongly, strongly linked to the disease where it was past conjecture. Now, it seems that the evidence really bears this out. That those are the vulnerable group of patients and the efforts to contain this disease involves screening all people that travel but particularly pregnant women, women trying to become pregnant and their sexual partners as well.
Melanie: What’s the screen involved and who should get screened? You said people who have been to those areas or their sexual partners have been to that area. So, what do you want them to know about getting screened?
Dr. Gettings: Well, the screening typically happens as the patient interfaces with the healthcare system. So, particularly with ob/gyn practices looking at new pregnant moms, one of the first questions their being asked as they walk in the door is, “Have you traveled recently?” or, “Has your sexual partner traveled recently?” That opens up a bit of a can of worms if mom’s pregnant. Then, usually testing begins at that time. But, frankly, even in the family practice setting where I am, I don’t manage pregnant women myself, but ever patient coming in is asked if they travel and if they do travel, is it in one of these endemic areas? Not only did they travel but did their sexual partner travel? Every patient is asked that in many family practices. Larger health systems, in particular, are coordinating these screenings across the country.
Melanie: So, can the screenings be done at a local office or do you send it somewhere else? How long does that take?
Dr. Gettings: Oh, yes. If any of these screenings comes back positive—and when I say “screening”, I’m typically meaning just our staff asking the patient a couple of questions. Most patients screen normal because they haven’t traveled within the last couple weeks or a month to an area where it’s endemic. But, if the answer is “yes” ,then there are follow up questions related to symptoms. So, if the patient was in an endemic area and then comes back with red eyes and joint pain, then we’re contacting the Board of Health in the county that I practice and arranging for blood or urine samples to be taken and all the more rush if it’s a pregnant mom that we’re talking about.
Melanie: So, what are they telling women who want to become pregnant or whose sexual partners have traveled to these areas? Are they telling them, still, to delay pregnancy?
Dr. Gettings: There’s so much unknown right now and most advice coming from the health care system is very conservative. If you’re actively trying to become pregnant, we’re hoping that folks will postpone vacation and, if you’re in a situation where you can’t postpone a trip for some reason—if it’s a business trip that you can’t get out of, we’re hoping that these high risk individuals would take all the proper precautions to avoid being bitten by the mosquito or, if a sexual partner’s involved, if you’re pregnant or trying to become pregnant—if you’re pregnant, specifically—we’re hoping that a condom is used every time throughout the entire pregnancy, even if the exposure was months ago. And, if you’re just going for travel, we’re hoping that folks will wear long-sleeved shirts, long pants, use an EPA-approved mosquito repellant to help avoid the spread. We’re starting to become at-risk for folks coming back to the United States and, even though there has not yet been mosquito-borne illness, we’re heading into summer and mosquito populations are on the rise here. The United States does have the same types of mosquitos that transmit the disease so, truthfully, it’s only a matter of time before someone coming back from Puerto Rico is at a backyard barbeque and gets bit by a mosquito and then someone at the same party could contract the disease in that way. So far, there’ve been none of those cases but it’s only a matter of time.
Melanie: So, what would you like listeners to know about preventing the spread of this disease? You mentioned wearing mosquito repellant. Is that enough?
Dr. Gettings: Well, it’s a security system of a lot of layers. First, we want to avoid exposure if there’s a high risk individual. So, someone comes back from a trip and they could have been exposed. They either have a mosquito bite or they have classic symptoms. We want those people returning to be quarantined. We want them to stay indoors. The CDC recommends for about 3 weeks to take as much precaution as they can to avoid getting other people sick. While most of the time, the virus is at its peak levels in the blood for about 1 week, for 3 weeks, if those folks can avoid crowded outdoor settings and mosquito-laden areas, all the better. Just stay indoors with good screens or air conditioning and when you must go out, to wear some mosquito repellant and long sleeves. If you’re a homeowner, avoid keeping standing water around areas around your house that could serve as breeding pools for mosquitos.
Melanie: Dr. Gettings, is there any treatment for Zika?
Dr. Gettings: So far, there is no treatment. The CDC calls this a bit of an epidemic on the same level as that of Ebola. It’s in the categories they use. Because of this, there’s a lot of money being poured into quick research on vaccines and treatment options. So far, none are commercially available.
Melanie: So, in just the last few minutes, here, give your best advice for sorting through all this confusing information that’s coming at us from the media about the Zika virus and what you really tell people every single day about this.
Dr. Gettings: Oh, sure. When folks come in to me with concerns about Zika virus, I try to see what type of person they are. Are they a pregnant woman? If so, they’re at the highest risk and have to take the most precautions. If they are not in this group, we just counsel about the type of symptoms that could occur and how to protect themselves from travel or coming from overseas which might have the virus. We’re talking about prevention, prevention. Since there’s no vaccine and no cure, being in a place where there is fewer mosquitos, wearing insect repellant and wearing the long clothes makes all the difference in the world if there’s potential risk out there. We’re hoping that folks stay vigilant on the news to be wary about the first couple of cases of mosquito-borne illness in the United States which is likely inevitable over the news few months. Since we’re in summer, we often get questions like, “Well, if I have to wear mosquito repellant and sunscreen, how do I work that?” The answer is always, “Sunscreen first and repellant on top of that.” There’s also a little bit of chance of being a little too cautious with this. Some people, for fear of Zika, with all the headlines, may be a little bit over aggressive with mosquito treatment and I guess I should mention that the CDC recommends that no repellant be placed on infants under 2 months old. That could pose a safety concern and, also, for children under 3 years old, no oil of lemon, eucalyptus or PMD—which is another type of active ingredient in mosquito repellant. You’re generally safe with a DEET-containing product. You’re generally safe with a DEET-containing product, even if pregnant or breastfeeding.
Melanie: It’s great information. Thank you so much, Dr. Gettings, for being with us. It’s very important that people listen to this segment. You’re listening to Lourdes Health Talk. For more information, you can go to lourdesnet.org. That’s lourdesnet.org. This is Melanie Cole. Thanks so much for listening.
Melanie: In February, the world health organization to the rare step of declaring an international public health emergency in connection with the spread of the Zika virus. Over the last year, the mosquito-borne illness has become endemic through the Caribbean and in many parts of Latin America. My guest today is Dr. Matthew Gettings. He's a primary care physician with Lourdes Health System. Tell us a little bit about the Zika virus: what is it? How is it contracted and who needs to be concerned?
Dr. Gettings: Thanks for having me on, Melanie . The Zika virus is getting a lot of play on television lately and my patients are starting to come in with mosquito bites and wondering if they should be concerned. Well, I guess the good news is that, so far, there is no mosquito-borne transmission within the United States, so most of our screening efforts are looking to see if a patient has traveled to an area where it is endemic. We’re seeing most folks from Puerto Rico, from Central and South America coming in with some questions. It’s contracted by mosquitos in those places. So, we’re really screening when folks come in to see if they or a sexual partner has been in one of these territories. The tricky part is that the incubation time of the virus is between 3 and 7 days. So, you might come back from a vacation or a conference and show no signs yet.
Melanie: So, we’re going to talk about pregnant women, Dr. Gettings, but before we do that, for the average citizen, what is the risk of getting infected with the Zika virus and what symptoms might they recognize?
Dr. Gettings: Oh, sure. For the average citizen, the risk is very, very low. In fact, many people who contract the disease may not even realize it. The most common symptoms are fever and it’s usually low-grade fever, 99 – 100 or 101; some muscle aches; some joint pain and conjunctivitis or red eye. And, if we’re talking about a child or adult, the disease is very self-limiting. They’ll have symptoms for 3-7 days and we’ll take a little Tylenol, stay well hydrated and get better just like that. Most folks likely, would, rarely miss a day or two of school. It’s really the symptoms we’re worrying about –the mom carrying baby.
Melanie: So, tell us about the pregnant women and what is the risk to them?
Dr. Gettings: The risk is, essentially, that the child could born with defects. In April of this year, the CDC confirmed that the microcephaly suspicion—babies with very small heads and other brain defects—was strongly, strongly linked to the disease where it was past conjecture. Now, it seems that the evidence really bears this out. That those are the vulnerable group of patients and the efforts to contain this disease involves screening all people that travel but particularly pregnant women, women trying to become pregnant and their sexual partners as well.
Melanie: What’s the screen involved and who should get screened? You said people who have been to those areas or their sexual partners have been to that area. So, what do you want them to know about getting screened?
Dr. Gettings: Well, the screening typically happens as the patient interfaces with the healthcare system. So, particularly with ob/gyn practices looking at new pregnant moms, one of the first questions their being asked as they walk in the door is, “Have you traveled recently?” or, “Has your sexual partner traveled recently?” That opens up a bit of a can of worms if mom’s pregnant. Then, usually testing begins at that time. But, frankly, even in the family practice setting where I am, I don’t manage pregnant women myself, but ever patient coming in is asked if they travel and if they do travel, is it in one of these endemic areas? Not only did they travel but did their sexual partner travel? Every patient is asked that in many family practices. Larger health systems, in particular, are coordinating these screenings across the country.
Melanie: So, can the screenings be done at a local office or do you send it somewhere else? How long does that take?
Dr. Gettings: Oh, yes. If any of these screenings comes back positive—and when I say “screening”, I’m typically meaning just our staff asking the patient a couple of questions. Most patients screen normal because they haven’t traveled within the last couple weeks or a month to an area where it’s endemic. But, if the answer is “yes” ,then there are follow up questions related to symptoms. So, if the patient was in an endemic area and then comes back with red eyes and joint pain, then we’re contacting the Board of Health in the county that I practice and arranging for blood or urine samples to be taken and all the more rush if it’s a pregnant mom that we’re talking about.
Melanie: So, what are they telling women who want to become pregnant or whose sexual partners have traveled to these areas? Are they telling them, still, to delay pregnancy?
Dr. Gettings: There’s so much unknown right now and most advice coming from the health care system is very conservative. If you’re actively trying to become pregnant, we’re hoping that folks will postpone vacation and, if you’re in a situation where you can’t postpone a trip for some reason—if it’s a business trip that you can’t get out of, we’re hoping that these high risk individuals would take all the proper precautions to avoid being bitten by the mosquito or, if a sexual partner’s involved, if you’re pregnant or trying to become pregnant—if you’re pregnant, specifically—we’re hoping that a condom is used every time throughout the entire pregnancy, even if the exposure was months ago. And, if you’re just going for travel, we’re hoping that folks will wear long-sleeved shirts, long pants, use an EPA-approved mosquito repellant to help avoid the spread. We’re starting to become at-risk for folks coming back to the United States and, even though there has not yet been mosquito-borne illness, we’re heading into summer and mosquito populations are on the rise here. The United States does have the same types of mosquitos that transmit the disease so, truthfully, it’s only a matter of time before someone coming back from Puerto Rico is at a backyard barbeque and gets bit by a mosquito and then someone at the same party could contract the disease in that way. So far, there’ve been none of those cases but it’s only a matter of time.
Melanie: So, what would you like listeners to know about preventing the spread of this disease? You mentioned wearing mosquito repellant. Is that enough?
Dr. Gettings: Well, it’s a security system of a lot of layers. First, we want to avoid exposure if there’s a high risk individual. So, someone comes back from a trip and they could have been exposed. They either have a mosquito bite or they have classic symptoms. We want those people returning to be quarantined. We want them to stay indoors. The CDC recommends for about 3 weeks to take as much precaution as they can to avoid getting other people sick. While most of the time, the virus is at its peak levels in the blood for about 1 week, for 3 weeks, if those folks can avoid crowded outdoor settings and mosquito-laden areas, all the better. Just stay indoors with good screens or air conditioning and when you must go out, to wear some mosquito repellant and long sleeves. If you’re a homeowner, avoid keeping standing water around areas around your house that could serve as breeding pools for mosquitos.
Melanie: Dr. Gettings, is there any treatment for Zika?
Dr. Gettings: So far, there is no treatment. The CDC calls this a bit of an epidemic on the same level as that of Ebola. It’s in the categories they use. Because of this, there’s a lot of money being poured into quick research on vaccines and treatment options. So far, none are commercially available.
Melanie: So, in just the last few minutes, here, give your best advice for sorting through all this confusing information that’s coming at us from the media about the Zika virus and what you really tell people every single day about this.
Dr. Gettings: Oh, sure. When folks come in to me with concerns about Zika virus, I try to see what type of person they are. Are they a pregnant woman? If so, they’re at the highest risk and have to take the most precautions. If they are not in this group, we just counsel about the type of symptoms that could occur and how to protect themselves from travel or coming from overseas which might have the virus. We’re talking about prevention, prevention. Since there’s no vaccine and no cure, being in a place where there is fewer mosquitos, wearing insect repellant and wearing the long clothes makes all the difference in the world if there’s potential risk out there. We’re hoping that folks stay vigilant on the news to be wary about the first couple of cases of mosquito-borne illness in the United States which is likely inevitable over the news few months. Since we’re in summer, we often get questions like, “Well, if I have to wear mosquito repellant and sunscreen, how do I work that?” The answer is always, “Sunscreen first and repellant on top of that.” There’s also a little bit of chance of being a little too cautious with this. Some people, for fear of Zika, with all the headlines, may be a little bit over aggressive with mosquito treatment and I guess I should mention that the CDC recommends that no repellant be placed on infants under 2 months old. That could pose a safety concern and, also, for children under 3 years old, no oil of lemon, eucalyptus or PMD—which is another type of active ingredient in mosquito repellant. You’re generally safe with a DEET-containing product. You’re generally safe with a DEET-containing product, even if pregnant or breastfeeding.
Melanie: It’s great information. Thank you so much, Dr. Gettings, for being with us. It’s very important that people listen to this segment. You’re listening to Lourdes Health Talk. For more information, you can go to lourdesnet.org. That’s lourdesnet.org. This is Melanie Cole. Thanks so much for listening.
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