Becker's Clinical Quality & Infection Control

21 SPOTLIGHT ON ZIKA Zika Q&A: Miami Infectious Disease Expert Shares Thoughts on the Virus By Brian Zimmerman T he CDC is closely monitoring six states for local Zika trans- mission, including Florida. In an interview in late April, infec- tious 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 do- ing 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 depart- ment and continue to moderate the environment of the patient in regard 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. e need for access to contraception will be great once mosquito transmission occurs. We also need to be able to expand testing capa- bilities. e 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 [re- garding 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 calcifi- cations 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 peo- ple of Miami are well enough informed? KR: I don't know. I think the medical profession is pretty well-in- formed. I can't speak to the general public. I know that the media will be running stories on the Zika virus. ings 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 transmis- sion] 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 seen dengue and chikungunya transmitted [locally] by the mosquito, but we haven't seen hundreds [of cases]. We will have cases [of locally transmit- ted 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. n WHO Doubles Suggested Abstinence Period After Traveling to Active Zika Zones By Shannon Barnet T he World Organization has upped the recom- mended number of weeks people should follow safe sex practices or abstain from sex after return- ing from active Zika areas from four to eight, according to Reuters Health. WHO updated the suggested abstinence period after scientists discovered the virus can linger in blood lon- ger than previously thought, WHO spokesman Christian Lindmeier said in a news briefing, according to the Reu- ters Health report. Mr. Lindmeier also said scientists are still trying to determine how long the virus can be detected in saliva, but tests have been inconclusive thus far, according to Reuters Health. n "There's a lot of potential for as- ymptomatic patients to spread the virus." — Dr. Kenneth Ratzan

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