Unless you don't own a television and don't read newspapers, let alone medical journals, you are aware that a major epidemic of Zika virus disease is occurring in Latin America and the Caribbean.  Currently over 2000 cases have been diagnosed in the U.S., including a quarter in pregnant women, with the vast majority being travelers returning from endemic countries who have been bitten by the aggressive Aedes mosquito.  About a dozen cases have been reported from Delaware.  In the last several weeks, a number of cases have been diagnosed in Miami, Florida resulting from mosquito bites in a section of that city.  Only 20% of Zika virus infections are symptomatic, usually with fever, rash and conjunctivitis lasting about a week.  The greatest danger posed by Zika virus is to the fetus; particularly in early pregnancy, the infection can cause severe damage to the central nervous system and eyes and may result in arthrogryposis as well.  Because of this, the CDC has recommended that women who are pregnant or trying to become pregnant should not travel to endemic countries or to the section of Miami where locally transmitted Zika virus infection is occurring.  Also, because Zika virus can be transmitted sexually, CDC has issued guidance for safer sexual practices for persons with Zika virus infection and for returning travelers, with emphasis on preventing infection during pregnancy.

Up to date information can be found on CDC's website ( www.cdc.gov/zika ) and on Delaware's DPH website ( http://dhss.delaware.gov/dhss/dph/zika.html ).  Pediatricians should be familiar with current recommendations for protecting travelers, avoiding mosquito bites, and evaluating and managing infants with potential Zika virus infection.

Advise families traveling to the > 50 countries with ongoing Zika virus transmission to check travel notices on CDC's website.  (Visiting areas > 2000 feet above sea level is not considered to be at risk.)  Travelers should protect themselves from mosquitos by using lodging with screened windows and doors, air conditioning if possible, and using insect repellents.

The most widely used and studied insect repellent is DEET. Other products that are approved by the Environmental Protection Agency and recommended by the CDC include picaridin, oil of lemon eucalyptus, and IR3535.  Higher concentrations of all of these agents provide better and longer protection.  Reapplication should be done according to product labelling.  If sunscreen is being used simultaneously, apply that first, followed by insect repellent.  Oil of lemon eucalyptus is not recommended in children under 3 years of age.  While DEET is highly effective, it can be absorbed systemically by infants and very young children and result in CNS toxicity, so it should be used cautiously in this population.  Permethrin-treated clothing is very safe and may confer additional protection.  Families in the United States should also reduce their risk of mosquito bites around their residence by dumping standing water (e.g. flower pots, pet watering dishes, discarded tires, even bottle caps) which may serve as a breeding place for mosquitos. 

 CDC has recently updated its guidance for evaluation and management of infants with possible congenital Zika virus infection.  Pediatricians should know if a mother tested positive for Zika virus during pregnancy and follow recommendations for brain imaging, ophthalmologic and hearing evaluation, appropriate consultations, and Zika virus testing.  If an infant has a pattern of abnormalities consistent with congenital Zika (e.g. microcephaly, intracranial calcifications, arthrogryposis) even with unknown maternal Zika virus status, appropriate evaluation should also be performed.  Of course, a pediatric infectious diseases specialist would be happy to help.

        

                

I am a Pediatric pulmonary attending at Nemours, and a Clinical Associate Professor at the Sidney Kimmel School of Medicine with a research interest regarding pediatric asthma outcomes and asthma advocacy.

My special interests for my role as the DE-AAP President is to advocate for pediatricians and children's health in regard to the legislation related to the implementation of Affordable Care Act and the Medical Home requirements and to form partnerships between the Delaware social advocacy organizations and interested pediatricians and health providers for children.

I am a general pediatrician and serve as the Chief Pediatric Hospitalist for Christiana Care Health System.  In that role, I am the director of Christiana Pediatric Hospitalists, a 20 person practice providing 24/7 coverage to Christiana Hospital and Kent General Hospital.  I have been at Christiana since completing my residency training at duPont Hospital for Children in 2004, which followed medical school training at nearby Jefferson Medical College.  As a pediatric hospitalist in the two largest delivering hospitals in the state, I have a strong interest in newborn care and Maternal/Child health, including focus on breastfeeding, sleep safety and maternal addiction / Neonatal Abstinence Syndrome.  As an inpatient provider only, I also have strong interest in transitions of care, information technology, patient safety and practice management. I have served on the Delaware AAP Board of Directors for the past two years as a Board Member at Large.  That role has grown new areas of interest in advocacy, health policy and medicine and social media.  I am excited to serve as VP for our chapter and look forward to serving the pediatricians, medical community, and most of all children of our wonderful state. 

I am originally from Delaware and have lived here almost my whole life.  So being able to serve my state in this way is an unexpected opportunity that I'm truly enjoying.  I live with my husband and dog in Rockland, Delaware, which is just off Rockland, Rd. near duPont Children's Hospital.  I enjoy music, reading and travelling, especially to the Delaware beaches.

Sara Slovin, MD, MSPH, FAAP - Secretary

I am a general academic pediatrician at Nemours/A.I. duPont Hospital for Children. I primarily work in our hospital-based academic primary care clinic, where I have the privilege of teaching medical students and residents. I completed my residency at the University of Florida and a General Academic Pediatric Fellowship at Johns Hopkins Children's Center. Advocating for children and families on an individual and public health level, working with students and residents and traveling with my family are some of my passions. My research interests focus on how we can leverage health information technology to improve risk assessment screening during preventive care visits and facilitate family-centered care. I enjoyed being involved in the Academy through residency and fellowship as an Executive Committee Member of the Section on Medical Students, Residents and Fellowship Trainees (now the Section on Pediatric Trainees) and I look forward to engaging more residents and early career physicians in our chapter.