Fighting an epidemic

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Texas Children’s Hospital leads anti-Zika efforts

When the Zika virus epidemic erupted in South America in early 2015, Texas Children’s went on alert. And when the virus began to spread north—with cases arriving in the Houston area in early 2016—Texas Children’s put into action a plan that helped make the hospital one of the nation’s leading fronts in the fight against the epidemic.

Transmitted largely through bites from infected mosquitoes, Zika mainly causes mild, flu-like symptoms which resolve on their own. In pregnant women, however, the disease poses significant risks through “vertical transmission.” The disease is passed from mother to child in the womb, leading to significant birth defects in up to 42 percent of live births.

Texas Children’s Zika clinic

Texas Children’s Pavilion for Women served as the focus of the hospital’s clinical response. Texas Children’s opened a Zika clinic within the Baylor OB/GYN clinic at the Pavilion, focusing on pregnant women who have traveled to countries affected by the Zika outbreak; have shown symptoms of the virus; and who have partners who have traveled to Zika-affected countries.

“It’s very important to have a resource here at the Pavilion for Women for mothers-to-be who are worried they might have been exposed to Zika,” said Dr. Kjersti Aagaard, a maternal-fetal medicine physician and vice chair for Research in the Department of Obstetrics and Gynecology at Texas Children’s and Baylor College of Medicine.

The clinic provides these women with care, including blood, urine and amniotic fluid testing, and counseling about the disease and its risks. The clinic also offers a targeted diagnostic ultrasound that can help determine if there are any signs of Zika-related developmental issues in a fetus. This test can be performed as early as 15 weeks into pregnancy.

“In an emerging disease, where new evidence arises daily, having a dedicated group of providers who can keep up with large amounts of crucial information, understand what testing to perform, and discern clinically important information and how to readily apply it are critically important,” Aagaard said.

Testing innovation

Texas Children’s also was a key player in the development of the nation’s first hospital-based rapid test for the Zika virus. Conducted in collaboration with Houston Methodist Hospital through the L.E. and Virginia Simmons Collaborative in Virus Detection and Surveillance, the accelerated development process was completed in a matter of weeks and was put into clinical use in February 2016. Texas Children’s Pathologist-in-Chief Dr. James Versalovic and Dr. James Dunn, director of Medical Microbiology and Virology, led the Texas Children’s team.

The new hospital-based test provides results in only a few hours—a significant improvement over the existing system, in which Zika tests were performed at local and state public health laboratories or at the Centers for Disease Control, taking several days. In addition, the new test can clearly distinguish between Zika virus and other viral infections such as Dengue, West Nile and Chikungunya.