Running head: ZIKA VIRUS 1

Health Impact Framework- Research Paper

Zika Virus

Delaware Technical Community College

NUR 310 Global Health

Jessica Elliott

April 25th, 2019

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Abstract

The zika virus was originally detected in Uganda in 1947. Since then, the disease has rapidly

spread to other developing and developed countries. The disease has impacted hundreds of

thousands of ignorant people. The disease is mainly spread through mosquito bites and sexual

activity. It is important to note that it can also be transmitted from mother to fetus and can lead to

birth defects, such as microcephaly. Prevention and education are the leading way to stop the

spread of the zika virus.

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Zika Virus

The zika virus was first discovered in Uganda in 1947. This virus is typically transmitted

by a mosquito bite and can cause anything from flu-like symptoms and a rash, to microcephaly.

While the disease may not always have lasting impacts in adults, it can cause severe brain

defects in fetuses. The specific mosquito that transmits the disease is called the Aedes mosquito

and also transmits yellow fever, chikungunya, dengue fever, and many other serious diseases. In

addition to mosquitos, the virus can be transmitted through sexual contact. Since it was first

discovered, the virus has spread from Uganda to the Federated States of Micronesia, to Oceania,

and then to Brazil. Once the disease reached Brazil, it spread like wildfire to the surrounding

countries. (Messina et al., 2016)

Socioeconomic Factors

While lower income countries typically have a higher rate of communicable disease, this

particular disease is more climate based, rather than socially or economically based. The virus

spreads where the climate can maintain the mosquitos- it is most definitely a geographical

incidence. The main locations impacted are South America, United States, Mexico, India, and

select African countries. The zika virus has been reported in eighty countries worldwide (WHO,

2019) Many of these countries are along the coastlines and near the equator with warm, humid

climates and/ or sitting bodies of water; the perfect mosquito breading grounds. Socioeconomic

factors may not necessarily determine who is more likely to contract the zika disease, however, it

can determine who can afford to prevent or treat the disease.

In the US territories in 2018 (American Samoa, Guam, Puerto Rico, and the US Virgin

Islands), there was 1 reported case from a traveler and 147 from local mosquitos. However, in
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the US in 2016 there were 5,168 cases from travelers and 224 from local mosquitos (Texas and

Florida coastlines). In the US territories in 2016, there were 145 cases from travelers and 36,367

cases from local mosquitos. ("Zika in the US," 2019) It is important to note that many cases in

the US are from people traveling to other countries during an outbreak. While not all parts of the

US have the infected mosquito, almost all of the US has someone who has traveled out of the

country and could potentially transmit the disease. Based on a study by Baylor in Houston, TX,

“It is estimated that approximately 500,000 cases of Zika virus infection have occurred in Brazil,

although exact numbers are not known because of the difficulty in keeping track of the large

number of cases and the fact that many infections go unnoticed. After Brazil, Columbia has been

the most affected country with around 20,000 estimated cases.” (Baylor, 2018) According the

World Health Organization, "In a rich country, like the US, the costs of caring for a single child

with microcephaly have been estimated to be as high as $10 million." ("Zika outbreak," 2019)

While this may be the case in the US, it is even harder to imagine the cost of care in developing

countries.

While the mosquitos may not choose who to bite based on the person’s socioeconomic

factors, the prevention of the bite may be impacted by this. It is recommended to wear mosquito

repellant and dress in light colored clothing to prevent bites. However, the supply of the repellant

is limited in developing countries and if supplied, can be extremely costly. (Moore et al., 2018)

In addition, it is also recommended to use physical barriers, such as screens and closed windows/

doors. (“Zika outbreak,” 2019) In many regions impacted by the zika virus, many people do not

own air conditioners and rely on open windows to cool their houses. Therefore, these people are

placing themselves at a greater risk of contracting the Zika virus. In 2016, the Zika virus

outbreak was classified as a “public health emergency.” (“Zika outbreak,” 2019)

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Clinical Interventions

As part of the healthcare field, nurses are part of both preventing and treating

communicable diseases, such as the zika virus. In order to determine if a patient was exposed to

the virus, it is important to ask the patient about any travel history- if not normally from the

“hotspot” zika locations. It is especially important to screen for this in pregnant women. If the

patient is pregnant and has symptoms, it is crucial to screen the fetus for microcephaly or

intracranial calcifications as soon as possible. These are both signs of zika transmission to the

fetus. (“Zika virus,” 2018) Once the child is born, it is also important to continue to screen the

child for zika related complications. Newborns who do not appear to have microcephaly, but

who were still exposed to the zika virus, may still develop microcephaly within the first few

months to years of life. (“Zika virus,” 2018)

Counseling and Education

In order to prevent the spread of the zika virus, it is important to understand how it is

spread. While the zika virus is transmitted by mosquito bite, there are many other ways it can be

spread. It is known that zika can be spread from mother to fetus and while not confirmed, it is

thought to be possibly transmitted through breast milk as well. (“Zika in the US,” 2019)

Additionally, zika is transmitted though sexual contact. Even if the infected person does not have

symptoms, it can still be transmitted sexually. It is recommended to abstain from unprotected

sexual relations with someone who lives in or who has visited an infected area. Females who

have potentially been exposed should use condoms or abstain from sex for two months. Males

should the same guidelines for a three-month time frame. If both male and female have been

exposed, the couple should wait at least three months before having unprotected sex. (“Zika

virus,” 2018) It is also important to give counseling to parents who have a child with
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microcephaly due to the zika virus. Not only is this treatment costly, but it can cause an

emotional toll on caregivers as well.

Protective Interventions

While it is important to educate those exposed to the zika virus about the modes of

transmission, it is also important to educate them on how to prevent acquiring the disease in the

first place. Insect repellant and light-colored clothing are ways to repel the mosquitos. However,

not all people in developing countries can afford these protective interventions. (Moore et al.,

2018) Closing windows and doors, or adding screens to them, can help to stop mosquitos from

infecting people in their homes. An intervention that all people in zika regions can easily

participate in is dumping stagnant water. Often times, rainfall collects in buckets or on tarps.

These places create the perfect breeding ground for mosquitos. By dumping this water, it

eliminates a new population of mosquitos. (“Zika outbreak,”2019) The people impacted by the

zika virus do not want to contract the disease. However, they do not always have the resources or

education needed on the subject. They do not mean to contract the virus, however, they are also

not doing anything to prevent it.

Future Interventions

The biggest intervention that can be implemented towards reducing the spread of the zika

virus is education. It is important to teach people, specifically in active zika areas, about how the

virus is spread and what can be due to prevent to spread of the virus. By doing this, both humans

and fetuses would have less risk of disease. It is also important that those at risk for zika,

especially those who plan to become pregnant, are screened from the disease. Blood, tissue, or

body fluid samples can detect whether a person is infected with the zika virus or not. Preventing
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the spread of the disease is the biggest way to stop the zika outbreak. As nurses, it is our job to

educate patients about the risks of the zika virus. It is especially important that pregnant women

are screened and given the appropriate care as soon as possible. There are currently no global

health jobs for the zika virus, however, there are opportunities for other communicable and

noncommunicable diseases.

Conclusion

The zika virus is a communicable disease that is transmitted through both mosquito bites

and sexual activity. This disease has made its impact in both developing and developed

countries. Taking protective measures is the best way to avoid contracting the virus. If a person

is planning to have a child and lives in or has recently visited a zika area, it is highly important to

be screened for the disease to prevent fetal defects.

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References

Baylor College of Medicine. (2018). Zika virus. Retrieved from https://www.bcm.edu/

departments/molecular-virology-and-microbiology/emerging-infections-and-

biodefense/zika

Centers for Disease Control and Prevention. (2019). Zika in the US. Retrieved from https://

www.cdc.gov/zika/geo/index.html

Lippincott Nursing Center. (2018). Zika virus. Retrieved from https://www.nursingcenter.com/

resources/clinical-topics/zika-virus

Messina, JP, Kraemer, MUG, Brady, OJ, Pigott, DM, Shearer, FM, Weiss, DJ, Golding, N,

Ruktanonchai, W, Gething, PW, Cohn, E, Brownstein, JS, Khan, K, Tatem, AJ, Jaenisch,

T, Murray, CJL, Marinho, F, Scott, TW, & Hay, SI. (2016, April 19). Mapping global

environmental suitability for Zika virus. eLife. doi: 10.7554/eLife.15272.

Moore, E.L., Scott, M.A., Rodriquez, S.D., Mitra, S., Vulcan, J., … Hansen, I.A. (2018, July 3).

An online survey of personal mosquito repellant-strategies. PeerJ. doi:

10.7717/peerj.5151

World Health Organization. (2019). One year into the Zika outbreak: how an obscure disease

became a global health emergency. Retrieved from https://www.who.int/emergencies/

zika-virus/articles/one-year-outbreak/en/index4.html