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Northwell Health to open Zika-in-pregnancy program today

Dr. Burt Rochelson, chief of maternal fetal medicine

Dr. Burt Rochelson, chief of maternal fetal medicine at Northwell Health and director of obstetrics at North Shore University Hospital in Manhasset, appears with nurse Barbara Miller on March 8, 2016, in his Manhasset office. Credit: Northwell Health / Adam Cooper

A Zika-in-pregnancy program with its own specialized team of medical professionals opens Wednesday at Northwell Health, the second medical service on Long Island in less than a month dedicated to concerns involving the emerging pathogen.

Medical personnel at the local health care giant have been fielding calls for weeks from worried women and even obstetricians in private practice who have fears and questions about the virus, said Dr. Burt Rochelson, chief of maternal fetal medicine at Northwell and director of obstetrics at North Shore University Hospital in Manhasset.

“We have been getting calls daily from doctors asking us to start something because their phones were ringing off the hook. So we are providing this as a service to patients as well as to the physicians,” Rochelson said. He estimates that Northwell receives anywhere from 10 to 15 phone inquiries a day.

Rochelson said Northwell clinicians assured all who inquired that there was no evidence of Zika virus on Long Island, but he emphasized that the health system, and particularly the new clinic, was concerned about women who had recently traveled to Zika virus hot zones, vast swaths of Latin America and the Caribbean where mosquitoes are carrying the pathogen.

Although the virus, which is carried by the Aedes mosquito species, can result in zero to relatively mild symptoms in some people, it underlies a range of flulike maladies, reddened eyes and skin rash in others. One concern is its association with Guillain-Barré syndrome, a rare form of muscle weakness and paralysis.

For pregnant women, the virus can underlie a breathtaking range of birth defects, according to an increasing number of studies.

It is therefore no surprise, Rochelson said, that the pathogen is fueling fears among pregnant women who have traveled to endemic countries.

On Tuesday, in a sweeping statement, Dr. Margaret Chan, director general of the World Health Organization, advised pregnant women not to travel to regions of the world where the viral infection is flourishing.

Freeport resident Andrea Osbourne, 42, said she was bitten frequently by the insects while visiting Jamaica last month. She is eight weeks pregnant but didn’t know while on vacation that she was expecting her third child.

“It was all over TV down there. You couldn’t avoid it,” said Osbourne whose parents are from Jamaica. She was born in Brooklyn.

Upon her return to Long Island, Osbourne said her doctors at North Shore University Hospital in Manhasset ordered special testing that would reveal whether she had been exposed to Zika-carrying mosquitoes. She found out Monday that her test was negative.

“I was very relieved,” Osbourne said. “Before that, I was terrified.”

Zika testing is not a simple task, Rochelson said Tuesday, noting that it requires special paperwork and approval by the New York State Department of Health for each patient. Experts at Wadsworth Center, the state laboratory, run PCR — polymerase chain reaction — testing on patients’ blood samples. PCR is capable of detecting the presence of viral DNA, and then amplifying the specimen by several orders of magnitude for further study.

Rochelson said Northwell’s new program would complete all necessary state paperwork so that patients received proper testing. Doctors at Nassau University Medical Center in East Meadow unveiled a similar program devoted to Zika virus testing for people of both genders last month.

Testing is important because the virus can trigger devastating problems during pregnancy.

Although global public health experts for weeks said evidence was persuasive but not yet confirmatory that the pathogen causes severe birth defects, Chan said Tuesday there now seems to be no doubt.

Cases of microcephaly — small head and brain size — appear to be inextricably linked to the pathogen in Brazil, she said, where more than 4,000 instances of the birth defect have been tallied.

She also said other birth defects have been associated with Zika infections.

“Zika has been detected in the blood, brain tissue, and cerebrospinal fluid of fetuses following miscarriage, stillbirth, or termination of pregnancy,” Chan said Tuesday. “Microcephaly is now only one of several documented birth abnormalities associated with Zika infection during pregnancy. “Grave outcomes include fetal death, placental insufficiency, fetal growth retardation, and injury to the central nervous system,” she said.

A study in the New England Journal of Medicine last week drew the same conclusions.

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