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Experts warn of Zika epidemic as hospitals, health departments prepare to combat spread

The American Hospital Association has already distributed guidelines created by the CDC for pregnant women and for the evaluation of infants.

Susan Morse, Senior Editor

The Aedes aegypti mosquito that carries the Zika virus lives in the warmer climates of the United States. (Wikipedia image)The Aedes aegypti mosquito that carries the Zika virus lives in the warmer climates of the United States. (Wikipedia image)

As the Zika virus begins to spread across the United States, hospitals and health departments are starting to gear up.

At least 31 cases of the Zika virus have been reported across California, Texas, Florida, Illinois, Arkansas, Minnesota, New York, New Jersey, Massachusetts, Virginia and Washington, D.C. according to the Centers for Disease Control and Prevention. And in all of the cases, those infected contracted the disease by travelling to countries where the Zika virus has been prevalent, the CDC said.

"America's hospitals are working closely with their local public health officials and with the CDC,"  American Hospital Association Chief Medical Officer John Combes said in a statement on Friday. "Important steps are being taken now by public health agencies to identify and share effective strategies for reducing the likelihood that the virus will spread to the United States and to prepare hospitals to correctly diagnose and treat any who may have become infected. Hospitals will continue to partner with public health officials to spread the word about the dangers of this virus and to share strategies individuals, particularly pregnant women, can use to avoid becoming infected."

[Also: Zika virus in Massachusetts; State health officials confirm first case]

The American Hospital Association has already distributed guidelines created by the CDC for pregnant women and for the evaluation and testing of infants.

The American Medical Association is ensuring that physicians are prepared to respond to patients concerns about this mosquito transmitted disease, the AMA said. It has created an online Zika Virus Resource Center as a clearinghouse for information from the CDC, health organizations, and The Journal of the American Medical Association at: http://www.ama-assn.org/go/zika. 

The mosquito that carries the virus, the Aedes aegypti, commonly called the yellow fever mosquito, lives in the warmer climates of the United States as far north as Washington, D.C., yet there are no known reports that Zika has infected the local population, according to Phyllis Guze, MD, chair of the Division of Clinical Sciences at the University of California Riverside.

Mosquitoes become carriers when they bite an infected person, and then can infect another person when they bite that person, Guze said.

[Also: Zika makes disease surveillance a critical IT tool]

Most people will not get sick enough to visit a hospital, Guze said, and symptoms include a rash, pain or red eye. The person remains in an infectious stage for a ranges of 3-8 days after exposure.

In Texas, where two cases have been reported in the southeastern region, the Department of State Health Services is following CDC guidelines and is speaking to providers, according spokesman Chris Van Deusen.

"Really the best thing to do is avoid mosquito bites. That's the effective way to stop infection," he said. "Our primary guidance to healthcare providers is to be aware of Zika and consider it when they're seeing patients. At this point, it's a travel-associated condition. We haven't seen any local incidents of transmission."

[Also: World Health Organization calls emergency meeting on Zika virus]

The Arizona Department of Health Services is reaching out to local doctors to ask them to monitor patients with the disease symptoms.

"Right now, as we understand it, there are no cases in Arizona. One test was negative; it was done at the CDC," said spokesman Ben Palmer. "The mosquito is in Arizona but the actual virus has not made it the mosquito population. Protect yourself from bites, take precautions, that's all we really can do at this point."

The virus causes the greatest risk to pregnant women and is  linked to a marked increase in infants born with microcephaly, a birth defect resulting in smaller-than-normal head size.

For other adults, only about one in five infected with the mosquito-borne virus will get sick, and their illness is usually mild, according to the CDC.

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While the World Health Organization has called the spread of the virus explosive, predicting that 3 to 4 million people in the Americas could become infected this year, the lack of a vaccine and of patients filling hospital rooms in the United States has not mobilized the nation's health organizations as yet for an epidemic, with the exception of preparations for expectant mothers and for babies that have been exposed to the virus.

Until more is known, the CDC strongly advises pregnant women to consider postponing travel to Zika-affected areas, or to talk to their healthcare provider before going and to follow steps to avoid mosquito bites during the trip.

"The Zika virus spreads via mosquito bites from a specific type of mosquito," Guze said. "This mosquito is found in essentially all of the Americas. The virus has been around for many decades but it is just this year that, in Brazil particularly, there has been a significant epidemic. There is no vaccine or treatment."

Guze said people should take the virus seriously, since mosquitoes are everywhere and there is no immunity for the virus.

"It's a setup for an epidemic," he said.

Twitter: @SusanJMorse

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