Response to: Zika Virus

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Dear Editor,
The role of plastic surgeons in treating neonates affected by congenital Zika virus infection continues to evolve as basic scientists, clinicians, and epidemiologists expand our understanding of this teratogen. Our colleagues in otolaryngology—head and neck surgery have also embraced this epidemic as a call to action.1 Since submission, there has been important research aimed at understanding how the timing of intrauterine infection affects the risk of delivering a microcephalic baby.2 There appears to be a tendency for first-trimester maternal infection to produce more serious defects with some data also indicating that second-trimester infection can predispose to specific cranial abnormalities. For the plastic surgeon, these data imply that identifying women who test positive for Zika virus earlier in pregnancy is important; such identification may warrant early presentation to the plastic surgery clinic for preemptive counseling regarding possible congenital defects and surgical treatment options.
With regard to Zika virus as a hazard in the clinic and operating room, the risk from blood products is real.3 Despite direct evidence, infected needles and other sharps remain a legitimate source of possible nonvector transmission too. Finally, there has been new attention paid to a forgotten report of a Zika virus researcher becoming infected due to exposure in the laboratory.4 Given the risk of exposure across several environments germane to plastic surgery practice and research, the best strategy to prevent accidental transmission is diligent avoidance of infected blood and sharps. In the near future, there is hope for translating promising vaccine candidates into useful clinical options.
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