Australian GPs to Assist Zika Surveillance
TESTING for the mosquito-borne Zika virus will be ramped up as Australian GPs are recruited to help combat the global threat from infection which has been linked to microcephaly.
GPs working in areas where the prime Zika vector, Aedes aegypti is found — a swathe of central and northern Queensland — are due to receive updated advice on who and how to test as early as this week, a spokesman for Queensland Health says.
Townsville public health medical officer Dr Steven Donohue says these GPs are on the front line of preventing local outbreaks, which could be triggered by a returning traveller.
“In previous years Zika was always thought of as a bit of an also-ran because it’s a milder illness and we were not as concerned as if we had dengue or chikungunya,” he told MO.
“But that’s all been turned on its head now there’s suspicion that Zika is causing very severe clinical outcomes, and so we need to focus more on that.”
Dr Donohue says north Queensland GPs would be called upon to not only test symptomatic patients but to assist with broader surveillance.
As 80% of cases of Zika are asymptomatic, the early stages of an outbreak could easily be missed, he says. “We will be providing further guidance on testing methods and testing criteria to our local doctors as soon as we have settled on some algorithms,” he says.
“We are very keen to bump up the vigilance and screening for Zika in people who may have travelled [to a dengue area] or who have a dengue-like illness, particularly if they might be pregnant.”
Patients who have a typical arboviral syndrome but who test negative for dengue may also need to be tested for Zika, even if they haven’t travelled.
The World Health Organization (WHO) last week declared the “explosive” spread of Zika virus a global public health emergency, noting an apparent upsurge in cases of microcephaly in Brazil and links to Guillain-Barré syndrome.
Australia has had 23 cases of Zika since its first in 2012, including two this year from Haiti. All have been acquired overseas.
Health authorities have advised pregnant women to postpone travel to Zika-affected areas, and have advised meticulous mosquito avoidance measures for all travellers.
Infectious diseases specialists say Australia is in a strong position to control any local outbreak of the disease, in part due to experience and success in containing dengue fever outbreaks in northern Queensland.
“We are all over this — we are ready,” Dr Donohue says.
Queensland has announced its second imported case of Zika so far this year, a child recently returned from Samoa.
The first case, a woman from the Gold Coast who fell ill after returning from El Salvador, is recovering well, Health Minister Cameron Dick says.
Mr Dick has announced the state will spend $400,000 to boost laboratory capacity in Townsville, where Zika testing will be available for the first time from 1 March.
Waiting for Zika
ONE of the GPs on the front line of detecting outbreaks of dengue fever says he expects to eventually see cases of Zika virus in his north Queensland practice.
Townsville GP, Dr Kevin Arlett, says he and his colleagues are already on the lookout for dengue, Ross River and chikungunya viruses, and now Zika infection will also be on their radar. ”I don’t expect lots and lots of Zika, but I am afraid I probably will see it,” says Dr Arlett, who runs a travel clinic.
“We don’t see many people who travel to South America but there are some, and I’m sure that some of them will come back with Zika virus.”
At the time of going to press, Zika transmission was being reported from 23 countries in Central and South America as well as the Caribbean.
Dr Arlett says he and colleagues have known about Zika for a few years but haven’t been actively testing for it, except as a second line of investigation.
His advice to travel patients is that these types of diseases have no treatment or vaccine and the only way to prevent them is to avoid being bitten by mosquitoes.
If a patient was pregnant and had plans to travel to South America, Dr Arlett would advise against that. However, for travel to South-East Asia and the Pacific Islands where Zika is more sporadic, he would offer mosquito-avoidance advice.
“Zika is on the horizon. It hasn’t hit Australia at this stage, but certainly anyone travelling overseas needs to be aware of it, especially to tropical areas,” Dr Arlett says.
“We have managed to avoid malaria for quite a long time, so hopefully we can avoid this one as well.”
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