Protecting Yourself From Zika

If you turned on the news over the weekend, you probably heard the warnings about Zika virus, a mosquito-borne illness that can cause serious brain damage to developing fetuses.

U.S. Centers for Disease Control and Prevention (CDC) officials are warning women who are pregnant or thinking of having a baby to delay travel to 38 places in Latin America,  the Caribbean and Pacific Islands where Zika is more common. We’re already hearing from pregnant women worried about the reports or others have just returned from Brazil, Mexico or Puerto Rico or other places with active cases of Zika.

It’s true health officials in Brazil are seeing a surge in cases of women with Zika delivering babies with microcephaly, a rare birth defect that causes a baby to have a small head and underdeveloped brain. For context, in the United States, microcephaly affects approximately 0.12 percent of pregnancies.  While that’s a scary and sad possibility, the chances of having a pregnancy complication due to Zika are very, very small.

Even in Brazil, the absolute number of microcephaly cases is still very low. We’re not seeing that everyone who gets bitten will have a baby with microcephaly.

Right now, the best course for a pregnant woman is talk to her prenatal health care provider to learn more about Zika, understand the risks and what to do next. Since there’s no vaccine or treatment for Zika, prevention is the best measure. If possible, avoid travel to the affected countries, use condoms during sex with a man who’s travelled to one of the affected areas and take steps to prevent mosquito bites.

Just the other day, one of my colleagues on the virtual care team received a call from a worried woman who just learned she was expecting.

“She had just taken a pregnancy test Friday morning and it was positive,” says Meg Scott, a family nurse practitioner on our virtual care team. “She said I’m pretty sure I conceived while I was in Puerto Rico. I had a ton of mosquito bites and now I’m freaked out.”

We’re following the CDC Zika care guidelines to ask all pregnant women about recent travel and to follow up with blood tests for any women with at least two symptoms. Since the woman didn’t have a sudden high fever, extreme joint pain, conjunctivitis, a rash or any Zika virus symptoms, we advised “watchful waiting” — trying to relax and see if any reasons for concern develop.

In suspected cases of Zika in patients with clear symptoms, blood samples are sent to the CDC or health centers in several states for analysis. For exposed pregnant women, an ultrasound can be considered beginning late in the second trimester or third trimester of pregnancy to evaluate aspects of brain development. However, ultrasound has limits for diagnosis and a pregnant patient should speak with her prenatal provider and high risk pregnancy specialists if needed before pursuing this option.

Zika virus is in the same family as illnesses like Dengue fever, West Nile virus and yellow fever.  Humans catch them from infected mosquitos and ticks, though they also can be passed from mother to fetus, or through blood transfusion.

Zika was discovered in the late 1940s by researchers studying yellow fever in Uganda. The rhesus monkey that developed symptoms was in a test cage in the Zika Forest, lending the virus its name.

A 28-year-old researcher was one of the first well-documented human cases of Zika in 1964. He described having a mild headache, followed by a bumpy rash on his face, chest and arms that spread to his palms and soles of his feet. Then he got a fever, back pain and felt sick. By the next night, the fever was gone and he started feeling better. The rash cleared up in a few days.

The disease was pretty much limited to Africa and Asia until 2007, when cases were reported in Micronesia.  As people travel more internationally, and climate change allows tropical mosquitoes to reach new locales, it’s thought that Zika will be more common.

An ounce of prevention is worth its weight in gold. Since Zika  — and other illnesses like West Nile virus — primarily are spread by mosquitoes, it’s important to avoid getting bitten, following the Zika prevention strategies shared by the CDC.

We also now know that Zika can be sexually transmitted, so use condoms, even during pregnancy if your partner has travelled to a place where an outbreak has happened. The CDC recommends that if you’re showing symptoms or not, women wait at least eight weeks after exposure before trying to conceive. If a man has symptoms, the CDC recommends waiting at least six months before trying to conceive, or eight weeks if they don’t have signs of the virus. But data is limited, so it’s best to work with your primary care or prenatal provider to make the best choice for you.

If you’re pregnant or getting ready to conceive:

• Avoid travelling to the areas where Zika outbreaks are happening
• Check the CDC website before travelling for updated travel advisories
• Don’t have unprotected sex with a man who has travelled to one of the affected areas
• If you’re pregnant and need to postpone travel, contact your provider for a note

And anyone can cut their risk of mosquito bites by wearing light-colored long-sleeve pants and shirts outdoors, dumping out any standing water near your home, making sure windows have screens and sleeping under a mosquito net. Insect repellents are an important part of the strategy too; the safest and most effective ones include formulas with Picaridin, IR3535, DEET or lemon eucalyptus oil, according to the Environmental Working Group.