In the past few days, both the US CDC and WHO have issued guidelines for pregnant women regarding the Zika virus and I wanted to provide more information based on the research I conducted. Zika is very similar to dengue—a virus with which I am intimately familiar. I investigated two dengue fever outbreaks in Brunei back in my field-work public health days. All of the underlined text is linked to scientific articles if you want more information.
Where is Zika now?
There was an explosive pandemic in 2015 that has everyone at WHO and US CDC quite nervous, and for good reason. As of week 3 in 2016, the following countries have Zika confirmed cases: Barbados, Bolivia, Brazil, Colombia, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, US Virgin Islands, Venezuela. January 13, 2016 a case was reported in Texas, US. January 15, 2016 another case was reported in Hawaii.
What is the Zika virus?
Zika virus is a flavivirus transmitted by mosquitoes—the ubiquitous Aedes aegypti. In the insect world, this one is a jerk. Not only do they live almost everywhere but they also transmit all of the other awful diseases like dengue, yellow fever, chikungunya, and now zika. The Aedes aegypti bites mostly during the day (when you’re awake and moving around in the world, perfect), breeds in places of stagnant water like flower pots, buckets, shower floors, discarded tires—anything that collects still water. They can live and bite both indoors and outside. It’s the female mosquito who bites to feed her babies. Kind of ironic, isn’t it? One mother taking from another…anyway, I digress.
Symptoms of Zika
Symptoms include travel to a zika-affected area and two or more symtpoms of the following: acute onset of fever, maculopapular rash (a rash composed of flat, red bumps or papules), joint pain, or conjunctivitis (eye redness, eye inflammation, or eye pain).
Unfortunately, 80% of zika infections are asymptomatic, so many pregnant women may not know they were ever infected until their baby is born. This is a pandemic in progress and it is why the virus may be spreading much faster than we realize. It isn’t being detected until babies are born with microencephaly (underdeveloped brains).
Why is Zika so bad for pregnant women?
It’s not really that bad for the woman, but more for her growing fetus. Zika infection results in underdevelopment of the baby’s brain—a major birth defect. Brazil and Colombia have recommended that women delay pregnancy until they can learn more about the virus. The delay will help public health officials spread public health education about what mothers can do to prevent infection.
What can women do to prevent infection?
Currently, there is no vaccine or treatment available. Epidemiologists are still learning about the disease and practitioners are receiving guidance on how to better detect zika infections. The options for prevention aren’t that great, unfortunately. Basically, don’t get bit by a mosquito by using physical or chemical barriers.
- Delay pregnancy
- Not travel to zika-endemic countries
- Rid your area of potential mosquito breeding spots both indoors and outdoors
- Wear long-sleeved shirts and long pants (I know this is ridiculously hot in equatorial regions but it’s necessary. COVER UP that baby bump!)
- Douse your clothing in the insecticide permethrin
- Cover yourself regularly in DEET insect repellant. Chemicals picaridin, and IR3535 are deemed “safe” for pregnant women
- Stay or sleep in air-conditioned, screened-in rooms
- Purchase a insecticide bed net and sleep under it (they are CHEAP)
What does all of this mean for pregnant women?
For pregnant women in the Americas and Caribbean regions, it means that they need to take mosquito bite prevention very seriously. Eliminating breeding grounds around your house will help enormously. No more flower pots, discarded tires, buckets, anything that can collect standing water. Get rid of them.
For women in the US, this is a new virus that can easily spread. Dengue fever was once thought to be contained only to South America and SE Asia but it has spread to Texas, Florida, and other warm-climate states. Due to international travel and asymptomatic presentation, an infected person can travel to the US, be bitten by a local mosquito and begin the natural transmission cycle locally.
Like all things when you’re pregnant, be aware of the risks, take preventive measures that are within your control, and continue to live your life. Our world is highly mobile and diseases don’t recognize country borders.