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Infectious Diseases
Keeping an eye on Zika

Jessica Fairley, an infectious disease specialist with the Emory TravelWell Center, follows news about Zika virus disease closely. She gave birth to her third child, daughter Avery, on July 25.

Since Zika was declared a public health emergency in February, Fairley and her TravelWell colleagues have advised individuals, employers, and Emory clinicians concerned about travel to and from Central and South America and the Caribbean, where Zika cases are prevalent.

As of July 20, the CDC reported 1,657 travel-associated cases of Zika in the United States, including 41 in Georgia. TravelWell director Henry Wu diagnosed four of those cases at the center, located at Emory University Hospital Midtown, in consultation with the Georgia Department of Public Health.

In addition to evaluating patients, Wu has worked with Emory GYN/OB physicians on procedures to test patients for the virus and is collaborating with colleagues in the Emory Vaccine Center's Hope Clinic to study the disease.

"For most people, the risk of complications is low," says Wu. "But it's the first disease to be linked to birth defects in 50 years. That's a big deal."

Two years ago, Wu developed protocols for possible Ebola patients who sought treatment at Emory facilities. When feasible, patients were directed to TravelWell, where strict steps were taken to minimize exposure to all patients and staff. The many patients screened by TravelWell for Ebola tested negative for the deadly virus.

Zika is a mild disease for most by comparison. Only 20% of people bitten by a mosquito carrying the virus develop symptoms—fever, rash, joint pain, and conjunctivitis—that last for a week. But Zika has been linked to Guillain-Barré syndrome and is worrisome for those expecting a baby or planning to conceive.

"We've gotten a lot of calls from women and men who have questions about sexual transmission of the virus and when it's safe to have sex or conceive, says TravelWell physician Phyllis Kozarsky. "Some have honeymoon plans in the Caribbean. Atlanta companies like Coca-Cola and Delta Air Lines are sending employees to the Olympics (in August) and Paralympics (in September) in Rio. We tell them, 'Here's what you need to think about.' "

Fairley has counseled her share of travelers about Zika virus. "We ask them specific questions about their reproductive needs, if they're trying to conceive, or if they could possibly be pregnant," she says. "We make sure they are up to date on the guidelines and advice of the CDC as to when it's safe to have unprotected sex."

That makes Zika quite personal. "When Ebola happened, there were only a few cases in the U.S. Most cases occurred 'over there' in Africa," says Kozarsky. "Zika hits closer to home because of the potential to affect many families right here. People ask, ‘Why weren't we prepared for this?' The truth is we need better public health infrastructure to deal with emerging and re-emerging diseases so we can be better prepared."

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