More than 200,000 Americans were planning to attend the Olympic Games in Rio this summer. That number dropped to under 100,000 when concerns about the Zika virus began to spread.

As locally transmitted cases cropped up in Florida, the Centers for Disease Control and Prevention issued a remarkable travel alert, warning pregnant women and their partners not to travel to the Miami area. It was the first time the CDC warned people away from an American neighborhood because of an infectious disease.

Only 20 percent of infected patients ever exhibit symptoms. And those who carry Zika as a silent “hitchhiker” can still pass on the virus.

The outcome from all the travel to and from the Olympics has yet to be determined. Despite the risks of widespread outbreak, the U.S. government took no precautions to quarantine or monitor travelers returning from Brazil or other countries with high Zika numbers. The system currently relies on self-reporting by patients to a doctor — but only 20 percent of infected patients ever exhibit symptoms. And those who carry Zika as a silent “hitchhiker” can still pass on the virus through sexual transmission.

A number of the 15 locally transmitted cases in southern Florida were not actually discovered through self-reporting. Instead, public health officials conducted door-to-door surveys of 200 people in their homes who agreed to give blood and urine samples.

Zika has been tied to birth defects such as microcephaly and cataracts. Pregnant women and infants with Zika need a multitude of resources — especially since the long-term consequences of the birth defects are not fully understood yet.

Related: The Zika Zeitgeist: What You Must Know

The increasing number of patients with Zika has prompted hospitals to create specialized centers that focus solely on treating patients with the virus. These centers include medical professionals from numerous fields — infectious diseases, maternal-fetal medicine, neonatology, neurology and neurosciences, and ophthalmology, to name just a few. Johns Hopkins, Baylor College of Medicine, and Texas Children’s Hospital are among those who have established the centers.

One program, at the Children’s National Health System in Washington, D.C., has proven especially robust. Since its inception in May, doctors have consulted on 30 pregnancies or births with potential Zika virus exposure or infection. At the end of last month, eight were Zika-positive or probable. The system has a large neonatal intensive care unit (NICU), with 54 beds.

Children’s National specialists are able to guide Zika-affected pregnancies through the fetal period and can oversee the care of Zika-affected infants after delivery. Care and clinical support is provided by a multidisciplinary team of pediatric neurologists, physical therapists, infectious disease experts, and neurodevelopmental physicians.
Adre du Plessis, MBChB, director of the Fetal Medicine Institute and chief of the Fetal and Transitional Medicine Division, and Roberta DeBiasi, MD, MS, chief of the Division of Infectious Disease, co-lead the Congenital Zika Virus Program at Children’s National Health System.

Children’s National has used its extensive experience with other neurological disorders, such as cerebral palsy, to create their team. “Before Zika, we’ve always had a fetal medicine program that has been multidisciplinary like this. We have addressed other anatomic structural defects, so we have a long track record. It’s not new as far as how we handle a child like this,” said Dr. Roberta DeBiasi, chief of infectious disease and congenital Zika virus program co-leader.

There’s no way to prevent Zika symptoms, she said, but early intervention for newborns can still make a big difference. For example, Dr. DeBiasi explains that children with undetected hearing loss often struggle with developmental delays. But if that hearing loss is detected earlier, the child can receive hearing aids, get help from a speech-language pathologist, and have a better chance at normal development.

Children’s National specialists are able to guide Zika-affected pregnancies through the fetal period and can oversee the care of Zika-affected infants after delivery. Care and clinical support is provided by a multidisciplinary team of pediatric neurologists, physical therapists, infectious disease experts, and neurodevelopmental physicians. As one of the leads for this program, Dr. DeBiasi is fielding a number of inquiries from peers. We capture those exchanges during an upcoming speech.
Roberta DeBiasi, MD, MS, chief of the Division of Infectious Disease and Congenital Zika Virus Program co-leader, speaks with community clinicians about Zika.

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Children born with Zika-related defects gain similar advantages from a diversified team of medical professionals — neurologists, ophthalmologists, audiologists, etc. — who are equipped to help them.

“We have all that expertise here,” Dr. DeBiasi told LifeZette. Pregnant women who come to Children’s National find a medical team ready to interface with the health department on accurate testing. The center is also one of only a few places in the world that can perform a fetal MRI.

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Dr. DeBiasi also said it was important for people to remember that the mosquito vectors potentially carrying Zika cover about two-thirds of the country. The risk is not isolated to Florida or Latin America.

Dr. Martha Rac, a maternal-fetal medicine specialist at Texas Children’s Pavilion for Women, said the hospital system recognized that risk when they set up the Zika Clinic at Baylor. “Houston is a major international travel hub, with more than 30 million people traveling yearly to and from countries in Latin America where Zika is locally transmitted,” she said. “If you observe the patterns of confirmed cases of Zika virus in the United States up until this point, it parallels travel patterns, making travel probably one of the most influential factors in the spread of this pandemic.”

Related: Looming Zika Infant Epidemic

But teaming up with other doctors in Zika centers allows researchers and clinicians to give patients the best options currently available. “Our knowledge regarding its pathophysiology, effects on pregnancy, and testing options is constantly evolving at a speed that is difficult to maintain even for the seasoned infectious disease expert,” Dr. Rac said. “Our team approach allows for the joining of more than one mind to form evidence-based guidelines and management plans that ultimately provide the best care for our patient population.”