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October 30, 2018

Zika publicity has faded, but the health threat remains real

CDC still says to avoid certain areas if you are expecting or trying to get pregnant

Adult Health Maternity
10292018_Zika_Puerto_Rico_USAT Matias J. Ocner, File/Miami Herald/TNS

Yessica Flores, 38, talks to a reporter after an October 24 news conference at Jackson Memorial Hospital's Ira Clark Diagnostic Treatment Center in Allapattah, Florida. She had tested positive for the Zika virus and was 24 weeks pregnant. The Zika threat remains real for pregnant women in 2018, the CDC warns.

At a recent visit to my obstetrician, my doctor gave me a stern warning: avoid traveling to areas where the Zika virus is active or I will need to wait six months to try to get pregnant. If my husband and I go to a country where this virus is still posing a threat to expecting mothers and their babies, we would have to use birth control to ensure I do not get pregnant after the possibility of exposure.

I was surprised to hear her caution. Zika was something I worried about when I was pregnant with my first child back in 2016. At the time, there were frequent news stories about the virus and its devastating effects on babies in utero. But I could not remember the last time I had heard about the virus. It is no longer a topic of conversation among my friends, nor has it been on my radar in years. Is it still really a problem?

Yes it is, according to the Centers for Disease Control and Prevention. The good news is that in 2018, no local mosquito-borne Zika transmission and infection has been reported in the United States. But it is still a threat internationally in Mexico, Africa, Asia, the Caribbean, Central America, South America and some Pacific Islands. There is currently an outbreak in India. (A complete list of the countries that post a risk of Zika infection is below; some have a low likelihood of infection but are still listed with a travel caution by the CDC, the World Health Organization and the European CDC.)

As the weather grows colder and the days get shorter, many of us in the Greater Philadelphia region are already longing for a getaway to someplace warm this winter. For those of us who are expecting or hoping to become pregnant, it is important to understand why the CDC recommends that we take special precautions by altering or canceling travel plans to avoid areas with a known Zika risk. It is simply too dangerous for your baby.

Zika spreads through infected mosquitoes and by unprotected sex with someone infected by the virus. It can be passed from a pregnant woman to her fetus, which can result in severe birth defects including microcephaly. A study released in August by the CDC said that infants who seem fine at birth may develop issues related to Zika exposure over the first year of life. After studying nearly 1,500 babies exposed to Zika, six percent were born with birth defects like microcephaly and vision damage but 14 percent developed problems related to the virus before their first birthday, including cognitive problems, difficulties walking, moving and swallowing, as well as seizures. Parents are advised to have their children evaluated if they could have been exposed to the Zika virus up to six months before conception and present any of these issues. The CDC is continuing to study how Zika exposure affects toddlers and children.

NO VACCINE

There is neither a preventative vaccination nor medication to treat Zika. Many people infected with the virus do not present symptoms which is why it is really important to use birth control to protect yourself if you or your partner has traveled to an area where the virus is currently active. If you are currently expecting a child and have traveled to an area where there is a known Zika threat or if you experience fever, rash, headache, joint pain, conjunctivitis or muscle pain, call your doctor so you can be tested right away.

The CDC says that the Zika virus can stay active in a male up to three months after exposure and in a female up to two months after exposure or the date of diagnosis, which is why couples are advised to use condoms to prevent pregnancy during this time. My obstetrician offers a more cautious timeline, advising that couples use condoms for six months either after chance of exposure or from the date of diagnosis. Even couples who are not trying to get pregnant should take precautions and use birth control for the recommended period of time if either partner has visited an area with Zika. Remember, though there are symptoms associated with the virus , many people do not present any and have no idea that they have the virus. If you travel to an area with Zika and you come home feeling fine, you still need to err on the side of caution to protect your future child.

If you need to visit an area with Zika, the CDC recommends protecting yourself against mosquito bites since that is the most common mode of virus transmission. There are a number of ways to shield yourself including using EPA-registered insect repellents , wearing long sleeves and pants to cover your skin, ensuring there are screens in open windows to keep bugs outside, removing standing water from properties or avoid being near standing water, and using a bed net. But even if you take these precautions, you should use condoms to avoid getting pregnant for at least three months if you’ve visited one of the countries at risk.

For every woman’s general health and wellness, it is important to visit a gynecologist annually for routine check-ups and screenings. It is even more important to see your obstetrician regularly for prenatal care if you are expecting. For more information about the Zika virus, talk to your doctor and visit the CDC website for continued updates.

AT-RISK COUNTRIES FOR ZIKA

Countries with Zika virus risk, according to the CDC:

Africa: Angola, Benin, Burkina-Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Congo (Congo-Brazzaville), Côte d’Ivoire, Democratic Republic of the Congo (Congo-Kinshasa), Equatorial Guinea, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mal, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, South Sudan, Sudan, Tanzania, Togo and Uganda
Asia: Bangladesh, Burma(Myanmar), Cambodia, India, Indonesia, Laos, Malaysia, Maldives, Pakistan, Philippines, Singapore, Thailand, Timor-Leste (East Timor) and Vietnam
The Caribbean: AnguillaAntigua and BarbudaArubaBarbadosBonaireBritish Virgin IslandsCubaCuraçaoDominicaDominican RepublicGrenadaHaitiJamaicaMontserratthe Commonwealth of Puerto Rico (a U.S. territory), SabaSaint Kitts and NevisSaint LuciaSaint MartinSaint Vincent and the GrenadinesSint EustatiusSint MaartenTrinidad and TobagoTurks and Caicos Islands and the US Virgin Islands
Central America: Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama
North America: Mexico
The Pacific Islands: Fiji, Papua New Guinea, Samoa, Solomon Islands and Tonga
South America: Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Paraguay, Peru, Suriname and Venezuela

Have you delayed a trip or have concerns about traveling to a country where Zika is still a threat? Share your thoughts with me and other parents in the comments section below or Tweet me @ThePhillyVoice and @KathleenEGagnon.

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