Zika virus: Should we be alarmed?

Zika has been getting a lot of press lately. Our patients, especially women of child-bearing age, have a lot of good questions about the virus, the risk it poses and what they can do to protect themselves.

Let’s start with a brief summary of the facts.

Zika and fears of birth defects

This past October, doctors in northern Brazil began noticing a rise in the number of cases of infants born with small heads (microcephaly) and some other abnormalities of the central nervous system. This upward trend in birth defects occurred shortly after Zika arrived in Brazil; previously the virus was mostly located in Africa and Asia.

This strong association led officials to conclude that there was a tentative causal connection between the two, but the exact mechanism has yet to be identified. However, the evidence is strong enough that the World Health Organization (WHO) designated the infection a "public health emergency of international concern."

For men and non-pregnant women, the virus appears to be a self-limited infection without significant long-term effects.  To date there is no vaccine or treatment available for Zika. Testing for the virus currently is confined to select laboratories and is being coordinated by regional health departments.

Here are some thoughts on common questions our patients have.

Do I need to be tested?

Yes, if:

• You traveled to an affected area (see link to country list below) and have symptoms such as a rash or a viral-like illness.
• You are pregnant and have traveled to an affected area. Testing is advised two to 12 weeks after you return from your trip.

If you have any concern that you might have been exposed to Zika, call your doctor's office to discuss whether you should be tested.

What will be done to prevent the spread of this virus to the US?

Researchers have begun working on a vaccine, but this process likely will take years. In the short term, the government likely will use mosquito-control strategies to further prevent the spread of Zika.

President Obama has asked Congress for almost $2 billion for the federal Centers for Disease Control and Protection (CDC), the National Institutes of Health (NIH) and other scientific partners to learn more about the specifics of the virus and how to protect individuals.

It is possible that Zika eventually will spread in the US. The main carriers are yellow fever mosquitoes, which are more typical of tropical areas, but researchers are concerned that the virus may also be spread by Asian tiger mosquitoes, which are more prevalent in cooler climates.

Why is this happening?

Viral infections have been with us since the dawn of time.  Recent increases in global travel and population density, as well as climate change, are likely playing a role in the rapid emergence and spread of viruses like Zika.

Where can I get the most up-to-date information about which areas to avoid travel to?

I recommend checking the CDC website frequently, as information on travel is changing rapidly. The virus may eventually spread to most of the Western Hemisphere, including the US.

My husband just got back from Thailand; will he infect me and hurt my pregnancy?

The predominant mechanism of transmission is through mosquito bites.  That being said, there have been a few cases of documented sexual transmission, but it appears to be very rare. The safest thing to do would be to use barrier protection or abstinence for two to four weeks after a male has returned from an affected area.

My sister's wedding is in Mexico and it’s too late to change the location. Should I miss her wedding?

A friend of mine actually asked this question. Certainly for women who are already pregnant, especially in the first trimester, it would be safest to avoid travel to affected areas.

For women not yet pregnant, I recommend talking to your primary care or gynecology provider to make sure you are able to plan a pregnancy when intended. I would recommend delaying pregnancy until travel to affected areas is completed (the virus only appears to stay in the blood of an adult for about one week after infection).

It is also reasonable to keep travel plans because the risk of individual infection is low overall. Use strict mosquito precautions, including wearing long-sleeve shirts, pants and permethrin-treated clothing, and using insect repellents registered by the Environmental Protection Agency (EPA). Insect repellents that contain ingredients such as DEET, picaridin and IR3535 are safe for pregnant women when used in accordance with the product label.

Keeping perspective

In summary then, people are wise to be concerned about new emerging infections. We all should think carefully about travel and follow CDC recommendations regarding Zika, especially if pregnant or planning a pregnancy.

With so many new infectious disease concerns, some may feel that the world is increasingly precarious and doomed to be overrun by disease. On the contrary, I think we have a much greater awareness of risks and infectious agents like Zika than we did at other times in history. We should view this increased access to information as a benefit that improves our lives and helps us prevent infections – and not let the buzz around Zika and other infections paralyze us with fear.

From a statistical perspective, the everyday choices we make when we put on our seat belts, drive safely, get preventive vaccines, make healthy food choices, exercise and engage lovingly in our community are much more likely to positively affect our well-being than Zika ever will.

If you have questions or concerns about the Zika virus, find a Providence health care provider near you.