By Dan Wright, JD, RN, vice president of patient safety, The Doctors Company
Physicians should practice vigilance to ensure patient safety and reduce risk of potential adverse events as we continue to learn more about the Zika virus. As of August 2, the Florida Department of Health has reported that there have been 14 confirmed Zika infections from mosquitoes in Southern Florida, and this number continues to grow.
- Stay informed. Ensure you are staying abreast of Centers for Disease Control advisories. They are frequently updated, and you want to provide your patients with the most current information. Diagnosis of Zika is based on a person’s recent travel history, symptoms, and test results.
- Watch for the symptoms. Tell-tale signs of Zika virus are an acute onset of fever, maculopapular rash, joint pain, and conjunctivitis. For symptomatic pregnant women with exposure to Zika virus, testing of blood and urine is recommended up to 2 weeks after symptom onset. In addition, asymptomatic pregnant women should be tested if they have traveled to an area with Zika, live in an area with Zika, or have had sex without a condom with a man confirmed to have Zika virus infection. Document if the testing is declined.
- Ask pregnant patients about travel history at every visit. Ensure that patients are asked at the time of intake about their travel history, especially in high-risk areas. Ensure that travel history is available to all practitioners involved in the patient’s care. Pregnant women should not travel to areas with Zika. If they must travel, tell pregnant patients to protect themselves from mosquito bites and to take steps to prevent sexual transmission during and after travel.
- Provide specialized care for pregnant patients. Consider amniocentesis for pregnant women who have traveled recently to an area with Zika virus transmission and have ultrasound findings of microcephaly or intracranial calcifications. Consultation with a maternal-fetal medicine specialist should be considered. Report laboratory-confirmed and probable Zika diagnoses to local, state, and federal agencies.
- At birth, test and document. Test for Zika virus infection in babies:
- Born to women with possible travel-associated or sexual exposure to Zika.
- Born to women who lived in an area with ongoing Zika virus transmission during pregnancy.
- Diagnosed with microcephaly or intracranial calcifications detected prenatally or at birth.
- Born to women with positive or inconclusive test results for Zika virus infection.