‘Constantly evolving’

Zika in the US: How 2 Miami ob-gyns are advising their patients

With active Zika transmission in Miami, local DO ob-gyns are doubling down on educating, empathizing with their alarmed patients.

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Miami Beach and Wynwood are two of Miami’s hottest tourist areas. But this summer, the neighborhoods grabbed headlines for a different reason: Health officials found active transmission of the Zika virus in both locations, prompting the federal government to warn pregnant women to avoid the neighborhoods.

The Centers for Disease Control and Prevention has since changed the warning for Wynwood to reflect the fact that the area hasn’t had a recent reported transmission. As of Sept. 30, 124 people have contracted Zika in Miami, according to the Florida Department of Health.

Miami obstetrician-gynecologists Eric Runyon, DO, of Pavilion for Women’s Health and Paola Bordoni, DO, of Ob/Gyn Associates of Miami, say that while coping with the outbreak has been challenging, most patients are reassured after discussing Zika with a physician. Here’s a closer look at those conversations.

What’s it like being an ob-gyn in Miami amid the Zika outbreak?

Eric Runyon, DO

Dr. Runyon: My practice serves mostly patients in south and west Miami, so we’re not in the heart of the high-risk zone. But it’s difficult to counsel patients about the outbreak because the research is at such an early stage that we don’t always have all the answers.

Dr. Bordoni: None of my patients have tested positive, but some of my colleagues’ patients have. There’s a lot of uncertainty, and the information we have is constantly evolving.

How does a typical patient visit go these days?

Dr. Runyon: Many of my patients, whether they’re pregnant, trying to become pregnant or trying to avoid pregnancy, have the misconception that because they live in Miami, there’s a 100% chance they will get Zika and, if they’re pregnant, the baby will definitely get infected. That’s not the case.

Paola Bordoni, DO

Dr. Bordoni: We discuss Zika at every prenatal visit, and many patients are very concerned. But once I’ve discussed prevention with them, they tend to feel a little more calm.

Are you testing pregnant patients for Zika?

Dr. Runyon: We’re testing every pregnant patient. Patients who report Zika symptoms or think they’ve been exposed through a partner are also sent for testing. The Florida Department of Health offers free Zika testing for pregnant women.

Are you counseling patients to delay pregnancy or move elsewhere?

Dr. Runyon: Unless the patient is on a tight timeline, I advise holding off on pregnancy until we know whether this is an epidemic that’s worsening in Miami. That being said, if you’re pregnant but use condoms and take steps to ward off mosquito bites, there’s no reason why you should have to leave Miami.

Dr. Bordoni: I urge patients to consider the risk of being pregnant now vs. being pregnant later. This year, there have been two Zika hot spots in Miami. In the future, there might be zero—or there might be more than two. A few of my patients have considered moving elsewhere, but no one has actually relocated.

What precautions can patients take against Zika?

Dr. Bordoni: The CDC has great advice on how to avoid mosquito bites. Because Zika can also be transmitted sexually, pregnant women should use condoms or practice abstinence to ensure they don’t contract the virus from their partners. Couples who suspect they’re infected or have visited areas with Zika should wait the CDC-recommended time frame before trying to become pregnant. There’ve been no cases reported of Zika being transmitted through breastfeeding.

How are you drawing on your DO training amid the outbreak?

Dr. Runyon: Some physicians in Miami are primarily focused on getting patients in for Zika testing, but as a DO, I’m a big believer in taking the time to empathize, provide education and answer questions. Just a five-minute conversation about safe sex and mosquito spray can do a lot to set patients’ minds at ease.

One comment

  1. Jenna Dionisio

    I have heard from a non-OB/GYN attending that a pregnant woman who is even in the same vacinity as a Zika-infected patient is at risk to contract Zika. Is this true, and if so, how does that transmission work (airborne vs droplet transmission, etc?) Thank you for your information!
    Jenna, OMS-II

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