Abstract
To the Editor:
T
The first consideration should be the risk to the patient undergoing surgery. Because many cases of Zika virus infection are asymptomatic [2] and might not detectable before surgery, the risk of profuse bleeding is an issue. For the symptomatic cases, if they need emergency surgery, “can the surgery be done or not?” is the big question. The similar situation, dengue fever, might be used as reference. Indeed, conservative non-surgical management is suggested as the first option for patients with this disease [3]. However, emergency surgery under good anesthesiology and resuscitation is possible in the cases in which emergency surgery truly is needed [4].
Second, the risk of a surgeon contracting the infection from contact with the blood and body fluids of the infected patient has to be discussed. Although the main mode of contagion of Zika virus is vector-borne transmission, many new transmission methods (such as sexual contact and blood transfusion) have been documented recently [5]. However, Zika virus has not been proved to be a blood-borne pathogen as yet. However, dengue fever has already been proved to have a potential as a blood-borne pathogen [6], so the risk of similar transmission of Zika virus has to be of concern. Indeed, viremia in cases with Zika virus infection can be observed [2], and the blood of the patients in that stage can be infectious.
Last, an important but usually forgotten issue is the control of transmission of infection to other the patients in the wards. This can be a problem in any surgical ward in a tropical country, where mosquitoes can be detected readily. Because the patients in the ward usually have limitations in movement and might not protect themselves from mosquito bites, it is possible that an arboviral disease outbreak on the ward can occur if there is not a good system for mosquito control.