The scariest thing about Zika may be the number of question marks still surrounding it. The virus has only been in the spotlight for about eight months, but hospitals are adapting quickly to the evolving Zika landscape.
Texas Children’s Pavilion for Women in Houston has opened an in-hospital Zika clinic to handle frequent travelers returning from Central and South America, and the clinic has quickly become a hub for Zika knowledge, care and testing in the region.
“We knew this was going to be arriving on our doorstep and it’s a lot for providers to understand,” says Kjersti Aagaard, M.D., maternal-fetal medicine specialist in the Zika clinic and vice chair of research in the department of obstetrics and gynecology at Texas Children’s and Baylor College of Medicine.
That’s why rotating maternal-fetal medicine specialists and physicians staff the clinic alongside full-time nursing staff and medical assistants, many of whom have worked in infectious diseases and obstetrics for years, says Aagaard. The clinic operates every Friday from 8 a.m. until noon and sees pregnant women who have traveled to Zika-affected countries, have shown symptoms of Zika, or have partners who have traveled to Zika-affected countries or have shown symptoms of the virus.
With a new virus like this, testing, ongoing monitoring and follow-up become important, so having “point people,” who can follow Zika closely, interpret recent literature and stay on top of new developments has been helpful for the region, and it is something other hospitals should consider as well, says Aagaard.
Johns Hopkins Medicine, Baltimore, also is concentrating its Zika effort. On Wednesday, it unveiled the Johns Hopkins Wilmer Zika Center, which is dedicated mainly to patients with the virus. The center is staffed by various departments and divisions of the system, including the Johns Hopkins Bloomberg School of Public Health, and the departments of epidemiology, infectious diseases, maternal-fetal medicine, ophthalmology, orthopaedics, pediatrics, physiotherapy, psychiatry and social work.
In Miami-Dade County, the front line for local transmission of Zika, Baptist Health South Florida, has seen at least two local cases, and the health system has taken steps in anticipation of local needs. Their urgent care centers have been changed to allow for testing in adjacent imaging centers to avoid a backlog for those who need urgent care as opposed to those who just need testing rather than urgent treatment, says Jack Ziffer, M.D., chief medical officer of Baptist Health South Florida.
And for Ziffer, what takes place outside the hospital has been just as important.
“As doctors in a health care system, we’re also passionate about prevention,” he says. The health system has reached out to local school board members, asking them to adopt dress codes that urge students to wear long sleeves, and allow bug repellent in schools, where it is currently banned. As Ziffer says, “We believe it’s incumbent on every person in this community to prevent [Zika].”
Florida Hospital Association President Bruce Rueben agrees that hospitals need to be working with the community to educate and prevent exposure to the virus.
“We know there’s risk when it comes to those of childbearing age; people need to be aware of that risk and what to do to minimize it. Hospitals need to be part of the education process,” he says. “This is going to be an ongoing challenge and something we have to deal with, learn about and move forward with,” he adds.