Zika Q&A: Miami infectious disease expert shares his thoughts

As of April 29, there were 426 cases of travel-related Zika reported in the U.S., 90 of those cases — more than any other state — were found in Florida.

The Zika virus has been a prominent fixture in recent news. The link between the virus and the debilitating birth defect microcephaly, which causes babies to be born with abnormally small heads, has been confirmed by the CDC. As cities like Miami prepare for local Zika transmission, debates over funding to combat the virus continue in Washington.

In an interview, infectious disease expert Kenneth Ratzan, MD, of Mount Sinai Medical Center in Miami, shared his thoughts about Zika with Becker's.

Note: Responses have been lightly edited for length and clarity.

Question: What is Mount Sinai Medical Center in Miami doing to assist with Zika prevention and awareness?

Dr. Kenneth Ratzan: We're taking steps to let the medical staff know what to look for [regarding Zika detection in patients], sending out notices to OB-GYNs and the emergency room as to how to make the diagnosis and take the blood and how to make sure the blood makes it to the laboratory and that the testing is done appropriately. We then send the blood to the health department and continue to moderate the environment of the patient in regards to mosquito exposure.

Q: Zika has become highly politicized in recent months — what are your thoughts about this politicization and the funding disputes in Washington?

KR: We need funds allocated with respect to Zika, not only to make sure vector control is being appropriately funded, but to assist health departments in maintaining sufficient manpower. We need help with contraception, prevention and educating patients and those at risk. The need for access to contraception will be great once mosquito transmission occurs. We also need to be able to expand testing capabilities. The CDC has sent testing kits to Southern states at risk — we need more of that.

Q: What is unique about the challenges presented by the Zika virus?

KR: Only 20 percent of patients infected display symptoms of infection. There's a lot of potential for asymptomatic patients to spread the virus. The risk to the fetus is real but unknown [regarding the likelihood of complications]. There's a misperception that it's greater than it is, but it's real and it's devastating. It affects the fetus and that creates a lot of anxiety, which it should — it can cause fetal wastage, microcephaly, eye deficits, intracranial calcifications and we don't really know what trimester complications are most likely to occur.

Q: What misperceptions about Zika in the continental U.S. do you find most troublesome? Do you feel the people of Miami are well enough informed?

KR: I don't know. I think the medical profession is pretty well-informed. I can't speak to the general public. I know that the media will be running stories on the Zika virus. Things have been quiet so far in Miami because no cases have been transmitted here. I'm sure it will be in the news and on the front page when it [local transmission] happens.

Q: By August, what do you imagine the state of Zika transmission will be in Miami?

KR: It's hard to say. First of all, travel will continue between Latin America and Florida. The Olympics will increase travel to Miami and the rest of the world. It's easy to think there will be infected mosquitoes spreading Zika [in Miami]. We've see dengue and chikungunya transmitted [locally] by the mosquito, but we haven't seen hundreds. We will have cases [of locally transmitted Zika]. I don't want use the word epidemic, because technically one case over what is typically seen constitutes an epidemic, but I don't think we'll have an "epidemic" proportion of locally transmitted cases, I don't know how many, but I think we will be prepared not only in Florida but in the U.S.

More articles on the Zika virus: 
First US Zika-related death reported in Puerto Rico 
FDA approves Quest Diagnostics' Zika test for emergency use  
Infographic: Where in the US have Zika cases been reported? [April 29 update] 

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