Although the Centers for Disease Control and Prevention (CDC) has confirmed just four cases of Zika virus in Michigan—none of which have been transmitted by local mosquitoes—the arrival of warm weather and the uptick in summer-related travel increases the likelihood that Family Physicians will be faced with potential exposures. As with other public health crises, Family Physicians are integral to the surveillance of the Zika virus. Knowing the symptoms to watch for and what to do should you suspect a patient has the virus is critical to the health of that patient and your community.
Zika Virus is a Reportable Condition in Michigan
Recent guidance issued by Michigan's Chief Medical Executive, Dr. Eden Wells, explains the symptoms of Zika and the critera for when testing is required. Physicians who identify that a patient meets any of the criteria are required to contact their local health department or Michigan Department of Health and Human Services (MDHHS) epidemiologists at 517.335.8165 to request Zika testing.
In early May 2016, the MDHHS laboratory added capacity to test for Zika, and it continues to work with the CDC for confirmatory testing. MDHHS requires pre-approval of testing to ensure the appropriate tests are ordered and specimens are correctly collected, labeled, processed, packaged and transported. MDHHS guidance includes the information you should have available when calling to request testing, and the follow-up steps you should take.
During testimony presented before the Michigan House Health Policy Committee on May 24, Dr. Wells and Medical Entomologist, Erik Foster, MS underscored that while the mosquitos identified as carriers of Zika—Aedes albopictus (Asian tiger mosquito) and Aedes aegypti (Yellow fever mosquito)—have been found in parts of the United States, including Ohio and Indiana, no locally transmitted cases have been documented. Dr. Wells also pointed out that because the CDC has deemed Michigan a low-risk state, it has not received federal funding to augment surveillance or other public health emergency preparedness efforts to combat any potential outbreaks. New York has the most confirmed cases with 114, followed by Florida with 109. (Click here for Dr. Wells and Mr. Foster's full presentation.)
Last week, President Obama reiterated his call for Congress to send him a bill funding Zika response efforts. In February he requested $1.9 billion in emergency funding to combat the virus, but the U.S. House and Senate have yet to come to an agreement, with the House approving just $622 million and the Senate passing a $1.1 billion appropriation.
Physicians Are Encouraged to Participate in the U.S. Zika Pregnancy Registry
Dr. Wells and Mr. Foster also spoke about the U.S. Zika Pregnancy Registry, which the CDC developed as a tool for obtaining a more complete picture of Zika's impact during pregnancy. They strongly encourage physicians and other healthcare professionals to participate in the registry. People who are eligible for inclusion in the registry include pregnant women in the U.S. with laboratory evidence of Zika virus infection (positive or inconclusive test results, regardless of whether they have symptoms) and prenatally or perinatally exposed infants born to these women, as well as infants with laboratory evidence of congenital Zika virus infection and their mothers. Click here to learn more about the registry and how the information you report to your local health department per the MDHHS guidance is then incorporated into the registry.
Physicians are also encouraged to consult the CDC website for resources and information designed specifically for healthcare professionals, and for free fact sheets, posters, and other educational materials to share with their patients.
To arm Family Physicians with the latest evidence-based information, AAFP hosted a members-only webinar on May 24 highlighting transmission, symptoms, diagnosis and prevention of Zika. A link to that webinar recording should be available soon.