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Zika Virus and the Lung Transplant Patient

It is important for people with compromised immune systems, such as pre- and post-lung transplant patients, to be aware of possible exposure to the Zika Virus. With the current emphasis on the potential risks to pregnant women and their unborn babies, there has been very little guidance provided about Zika and the immunocompromised patient.

Basic precautions should be taken by lung transplant recipients and others with compromised immune systems to avoid possible exposure to Zika.  If you have concerns, talk with your healthcare provider about your specific risks.

KEY POINTS

  • Zika virus is transmitted by the bite of an infected Aedes species mosquito
  • Mosquitoes that spread Zika virus also spread dengue and chikungunya viruses
  • Many patients will have minimal symptoms and may not realize they are infected. The most commonly reported symptoms include fever, rash, joint pain and reddening of the eyes.
  • The current outbreak is affecting countries in Central and South America as well as the Caribbean
  • However it is very likely that the virus will spread to other areas, including parts of the United States
  • Consider whether travel to a Zika-affected area is absolutely necessary. Your transplant providers or ID specialists can help with assessing the potential risk of Zika virus exposure and other infections associated with travel.
  • Female sexual partners of males who have travelled to Zika-affected areas should consult with their healthcare providers to minimize their risk.
  • The best protection is to protect yourself from mosquito bites.
  • These particular mosquitoes primarily bite during the daytime.
  • If think you may have been exposed to Zika, see your healthcare provider as soon as possible.

The Centers for Disease Control (CDC) recommends these Steps to Prevent Mosquito Bites:

When in areas with Zika and other diseases spread by mosquitoes, take the following steps:

  • Wear long-sleeved shirts and long pants.
  • Stay in places with air conditioning and window and door screens to keep mosquitoes  outside.
  •  Take steps to control mosquitoes inside and outside your home.
  •  Sleep under a mosquito bed net if you are overseas or outside and are not able to protect yourself from mosquito bites.
  • Use Environmental Protection Agency (EPA)-registered insect repellents with one of the following active ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. Choosing an EPA-registered repellent ensures the EPA has evaluated the product for effectiveness. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breast-feeding women.
  •  Always follow the product label instructions.
  • Reapply insect repellent as directed.
  • Do not spray repellent on the skin under clothing.
  • If you are also using sunscreen, apply sunscreen before applying insect repellent.
  • To protect your child from mosquito bites:
  • Do not use insect repellent on babies younger than 2 months old.
  • Do not use products containing oil of lemon eucalyptus or para-menthane-diol on children younger than 3 years old.
  • Dress your child in clothing that covers arms and legs.
  •  Cover crib, stroller, and baby carrier with mosquito netting.
  • Do not apply insect repellent onto a child’s hands, eyes, mouth, and cut or irritated skin.
  • Adults: Spray insect repellent onto your hands and then apply to a child’s face.
  • Treat clothing and gear with permethrin or purchase permethrin-treated items.
  • Treated clothing remains protective after multiple washings. See product information to learn how long the protection will last.
  • If treating items yourself, follow the product instructions carefully.
  • Do NOT use permethrin products directly on skin. They are intended to treat clothing.
  • Even if they do not feel sick, travelers returning to the United States from an area with Zika should take steps to prevent mosquito bites for 3 weeks so they do not spread Zika to mosquitoes that could spread the virus to other people.

Additional Resources that may be helpful:

Practical advice that could be offered to immunocompromised patients

Consumer Reports Mosquito Repellents That Best Protect Against Zika

Build Your Own Zika Prevention Kit

Controlling Mosquitoes at Home

 

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