News of the Zika virus has exploded internationally, specifically in the past two weeks with the Centers for Disease Control and Prevention (CDC) issuing a warning to pregnant women visiting areas where the virus has spread. The CDC has now issued a travel alert that includes some 24 regions outside the U.S., where the Aedes aegypti mosquito (and possibly the Aedes albopictus) carries and transmits the virus. While both of these mosquitoes can be found in the South and other parts of the United States, it is not spreading in this country. However, it has been reported that 31 travelers have returned to the U.S. infected with the virus since 2015.
(Note: Public health officials confirmed the first case of the Zika virus in Massachusetts on Thursday night, Jan. 28 – someone who had traveled to an area where the virus is being transmitted.)
Dr. Andrew Healy in Maternal Fetal Medicine offers answers to important questions about Zika virus you need to know.
Q. What is the Zika virus and how is it transmitted?
A. The Zika virus is a mosquito-borne illness, and it is only spread by mosquitoes. While it is generally believed that it cannot be transmitted from person to person, observational evidence in some small studies suggest those infected with Zika can pass the virus to others through sexual intercourse. While most people will have no symptoms, some may experience fever, joint and muscle pain, rash, headache, and conjunctivitis. There is no vaccine or medication to treat the virus, but reports say that researchers are working on both.
Q. Who is at risk and should people be concerned about traveling to Zika-affected areas?
A. Everyone is at risk for contracting the Zika virus simply be mosquito bite when traveling in the alert areas. However, people in general should not be concerned about traveling to Zika-affected areas, with the great exception of pregnant women or women who are trying to become pregnant. The virus has been associated with an alarming rise in the number of babies in Brazil being born with a birth defect known as microcephaly – where babies are born with small, underdeveloped skulls – as well as Guillain-Barre syndrome – characterized by paralysis caused by the immune system attacking the nervous system – and other poor pregnancy outcomes. If you are pregnant and have plans to travel to regions where the Zika virus has spread, contact your doctor beforehand. While a direct causal link between Zika virus and birth defects has not been established, and more research is needed, the large increase in cases of microcephaly was enough of a reason for the CDC to issue a travel alert.
Q. What should a woman do if she was pregnant while visiting one of the infected areas, or became pregnant shortly after?
A. Pregnant women with a history of concerning symptoms (as noted above) during their trip or within two weeks of travel are candidates for laboratory tests. Patients with a history of travel to at-risk areas, but no history of symptoms, should be offered a serial fetal ultrasound to detect microcephaly and/or intracranial calcifications. Amniocentesis may be also be considered depending on the results. Pregnant women should contact their obstetric provide if they have a history of recent travel to at-risk areas.
Q. How can you prevent being infected with the Zika virus?
A. The best way to prevent being infected with the Zika virus is to avoid being bitten by a mosquito in the affected areas. Insect repellents, especially those containing DEET, should be used. Also, wear protective clothing like long-sleeved shirts and pants, and avoid freestanding water (near places where you are staying while outside the U.S., including around flowerpots), which are breeding grounds for mosquitoes. Keep windows closed and use air-conditioning, if needed, in these area. Clothing should also be treated with permethrin prior to travel.
Q. What countries are included in the current CDC advisory?
A. Countries and territories with Zika virus transmission included in the current CDC advisory are in the Americas – Barbados, Bolivia, Brazil, Columbia, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, U.S. Virgin Islands, and Venezuela, as well as Cape Verde in Africa and Samoa in Oceania/Pacific Islands. For the latest CDC travel advisories visit: http://wwwnc.cdc.gov/travel/notices/
Q. Is there any risk that the virus might spread in the United States?
A. Scientists are divided as to how big an outbreak could occur in the U.S., but experts are predicting that the virus will eventually spread to the United States, as well as other countries in the Western hemisphere.