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Zika virus: Should EMS responders be worried about this viral illness?

EMS organizations and personnel should use this as an opportunity to review infection control and ambulance disinfection procedures

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Zika is spread from the bite of an Aedes mosquito, yet many people infected may not even realize they are infected.

AP photo/Felipe Dana

As health care providers and infectious disease experts learn more about the Zika virus and information becomes available that is relevant to EMS providers Dr. Tan will update this article.

Updated February 4, 2016

Zika, a virus that’s been around for decades without much fanfare, is suddenly getting a lot of media attention due to its recent appearance in more populated areas and its association with birth defects. It is important to understand the difference between causality and association because they are not the same thing. Scientists can only say there is an association of Zika-infected mothers who have given birth to babies with microcephaly, but there is yet no definitive causal link.

Zika is spread from the bite of an Aedes mosquito, yet many people infected may not even realize they are infected since only about 1 in 5 people infected with the virus will actually fall ill with a vague viral syndrome of fever, rash, myalgias, and maybe mild conjunctivitis. The illness goes away in a few days, but the worry ensues if the victim is pregnant.

No reason for panic
Zika is not contagious like influenza. Transmission from person to person, such as a sexually transmitted case in Texas, is relatively rare.

There is no widespread outbreak in the United States, and if it does appear on our shores, treatment is supportive and prevention strategies are identical to current recommendations for the mitigation of mosquito populations and use of widely available repellants.

For the EMS provider, it is virtually impossible to differentiate one virus from another when treating a patient presenting with vague viral illness syndrome and symptoms, so good history-taking skills remain essential. Inquiring about recent travel to endemic areas will be important if the disease becomes identified in a U.S. state or urban area.

Health care providers should avoid giving non-steroidal anti-inflammatory drugs (NSAIDs) since their use with other indistinguishable viruses may cause hemorrhage.

EMS personnel should also strive to stay current in the ever-changing world of medicine since, undoubtedly, we will learn more and more about the disease, its presentation, and emerging threats as the epidemiology unfolds and more information is gleaned about this virus. As more information becomes available, practice recommendations may change to meet the evolving threat.

Use this current media frenzy about Zika as an opportunity to review basic infection control procedures, proper body substance isolation, disinfection procedures for your ambulance’s patient care compartment, and the importance of updated vaccinations. In addition employ common sense mosquito control strategies around your home and work environment to counteract the much greater threat of other and more common mosquito and vector-borne diseases endemic to your area.

David K. Tan, MD, EMT-T, FAEMS, is associate professor and chief of EMS in the division of emergency medicine at Washington University School of Medicine in St. Louis. He is double board-certified in Emergency Medicine and EMS Medicine by the American Board of Emergency Medicine. Dr. Tan remains very active in EMS at the local, state and national levels as an operational medical director for local police, fire and EMS agencies. He is chairman of the Metropolitan St. Louis Emergency Transport Oversight Commission, vice-chairman of the Missouri State Advisory Council on EMS, and president of the National Association of EMS Physicians. Dr. Tan is a member of the EMS1 Editorial Advisory Board. He also provides medical direction to EMS1.com and the EMS1 Academy.

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