mosquitoIt’s January, 2016. News stories have inspired significant anxiety about Zika virus. It’s a scary topic because news about the outbreaks are just unfolding and this affects an already anxious group, PREGNANT mamas and expecting families. I want to share with you real time information and data to try to alleviate anxiety and educate the best I can. I suspect with time some of this will change. I’ve curated the most common questions and answers directly from the Centers for Disease Control (CDC) below. The most alarming information coming from these outbreaks are the effects of Zika on pregnant women and their babies. First things first, Zika virus will only affect an unborn baby who is exposed to Zika in utero if mom is infected WHILE she is pregnant. Meaning, women not pregnant who get Zika can have Zika virus, clear the virus from her bloodstream (typically about 1 week after illness resolves) and not transmit Zika to future babies. If you are pregnant, there is no question it makes sense to think carefully about travel. That babymoon just can’t be the priority if it will put you at risk. Zika is potentially dangerous to a baby during any trimester or pregnancy or at the time of delivery.

Zika virus is unusual in a couple ways: only 20% of people who get it know it — meaning most people infected won’t develop any symptoms. Secondly, we don’t have a vaccine and we don’t yet have an anti-viral to protect pregnant moms and their babies from side effects. So, unlike infections caused by influenza and polio, or rubella or mumps, we have to change our social determinants of health — basically pregnant moms have to take precautions with where they go and how they expose themselves. I’ve found this CDC Q/A extremely helpful.

What Is Zika Virus Disease?

CDC: “Zika is a disease caused by Zika virus that is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week.”

Like mosquitoes all over the world, the mosquitoes that carry the virus and spread it to people breed in open ponds/pools of water. The ones that carry Zika tend to bite and infect primates and humans during the day. These little buggers can get the virus from an infected person and then bite another person and transmit it during outbreaks.

What Are The Symptoms Of Zika?

CDC: “About one in five people infected with Zika will get sick — symptoms from being ill. For people who get sick, the illness is usually mild. For this reason, many people might not realize they have been infected. The most common symptoms of Zika virus disease are fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin 2 to 7 days after being bitten by an infected mosquito.”

Remember, 80% of people who get Zika won’t have any symptoms. So heading off to a country with an outbreak and coming home feeling fine doesn’t ensure you haven’t been exposed. This is key in protecting those at risk. We can’t make a lot of assumptions of who has it and who doesn’t.

How Is Zika Transmitted?

CDC: “Zika is primarily transmitted through the bite of infected Aedes mosquitoes. Aedes mosquitoes, which spread the virus, live in every Western hemisphere country but Canada and Chile. It can also be transmitted from a pregnant mother to her baby during pregnancy or around the time of birth. We do not know how often Zika is transmitted from mother to baby during pregnancy or around the time of birth.”

Research will likely evolve through these outbreaks. What we know is that unborn babies are at most risk for serious complications. They are dependent on their moms making great decisions during pregnancy. Holy moly, it’s always a lot of pressure but this sure is another one for us to bear.

More on who is at risk, what to do if you’re planning a trip to Mexico for a babymoon, and ways to prevent getting Zika:

Who Is At Risk Of Being Infected?

CDC: “Anyone who is living in or traveling to an area where Zika virus is found who has not already been infected with Zika virus is at risk for infection, including pregnant women.”

In addition, because mosquitoes that live in the US are capable of carrying the Zika virus, it is possible that a traveler could get infected, come home, and spread Zika in areas with mosquitoes. This hasn’t happened. However, CDC is working to understand more with studies starting this month. Protecting yourself from mosquito bites if mosquitoes are active where you live now, especially if pregnant, makes sense.

What Countries Have Zika?

As of today (January 27th) CDC reports, “specific areas where Zika virus transmission is ongoing are often difficult to determine and are likely to change (increase) over time. Please visit the CDC Travelers’ Health site for the most updated information.” See below, thanks to USA Today.

Image c/o USA Today based on CDC data

Image c/o USA Today based on CDC data as of 1/27/16

Zika, Microcephaly & Poor Pregnancy Outcomes Outside of US

Here’s the current theory: pregnant women are being bitten by mosquitoes who carry the Zika virus. In turn, the mothers are infected with the Zika virus and transmit it to their unborn fetus, potentially contributing to changes in development of their baby (during any trimester) including how the brain and nervous system grows. Because of the global data of increased cases of Zika concurrent to an increase in rates of microcephaly in the same region, researchers believe Zika may be the cause. This is yet to be officially linked and proven at a cellular or structural level. No one knows why Zika virus could cause this. CDC: “Some infants with possible Zika virus infection have been found to have intracranial calcifications and abnormal eye findings. It is not known if Zika virus infection caused any of these abnormalities.”

Microcephaly is a birth defect where a baby’s head is smaller than expected when compared to babies of the same sex and age (head circumference in these babies is typically at or below 3% on the growth curve). Babies with microcephaly often have smaller brains that might not have developed properly. Brazil’s Health Ministry reported Wednesday it had recorded over 4,180 suspected cases of microcephaly since October, and have confirmed a link to Zika in 270 of 700 of the 4,180 cases they have tested, the Associated Press reported. This led Brazil to announce concerns in 2015.

Dr Jeffrey Duchin at Chief at King County Public Health advised today, “Pregnant women can be infected with Zika virus in any trimester. Maternal-fetal transmission of Zika virus has been documented throughout pregnancy, and Zika virus infections have been confirmed in infants with microcephaly. Studies are ongoing to investigate the association of Zika virus infection and fetal loss or microcephaly, including the role of other contributory factors (e.g., prior or concurrent infection with other organisms, nutrition, and environment).”

I’m Pregnant. Should I Travel To A Country Where Cases Of Zika Have Been Reported?

In my opinion, long story short, no, you should not. Many airlines and cruise companies are offering refunds and allowing for travel changes without penalty. Until more is known, and out of an abundance of caution, CDC recommends special precautions for pregnant women and women trying to become pregnant:

  • Pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who do travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow steps to avoid mosquito bites during the trip.
  • Women trying to become pregnant who are thinking about becoming pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip.

What About The 2 Year Pregnancy Ban?

Some countries, where the virus is very prominent, are advising women to avoid becoming pregnant for the next two years while they work to get the virus under control. El Salvador and Columbia among them. This is controversial, of course, because women need great access to affordable pregnancy prevention, family counseling, and support. Abstinence is not being pitched as the method to avoid pregnancy (!) but it’s unclear how women will take this recommendation. Being told to wait 2 years to have a baby is simply a horrific mandate to swallow. More research will help clarify this recommendation as time unfolds.

What About Future Pregnancy?

CDC: “If a woman who is not pregnant is bitten by a mosquito and infected with Zika virus, will her future pregnancies be at risk? No. The Zika virus usually remains in the blood of an infected person for about a week. The virus will not cause infections in a baby that is conceived after the virus is cleared from the blood.”

So, if you’re not pregnant and want to travel to Mexico, you can. It’s smart not to plan a pregnancy during or shortly after your travel. Soon-to-be-Mamas: talk with your physician for more if you remain concerned.

Preventing Zika Virus

CDC: “There is no vaccine to prevent Zika. The best way to prevent diseases spread by mosquitoes is to avoid being bitten. Protect yourself and your family from mosquito bites. Here’s a few ideas how:

  • Wear long-sleeved shirts and long pants (these mosquitoes bite during the day).
  • Stay in places with air conditioning or that use window and door screens to keep mosquitoes outside.
  • Use Environmental Protection Agency C. All EPA-registered insect repellents are evaluated for safety and effectiveness.
    • Always follow the product label instructions.
    • Reapply insect repellent every few hours.
    • Do not spray repellent on the skin under clothing.
    • If you are also using sunscreen, apply sunscreen before applying insect repellent.
    • It is safe to use EPA – registered insect repellents if pregnant and/or nursing.
  • If you have a baby or child:
    • Do not use insect repellent on babies younger than 2 months of age.
    • Dress your child in clothing that covers arms and legs, or
    • Cover crib, stroller, and baby carrier with mosquito netting.
    • Do not apply insect repellent onto a child’s hands, eyes, mouth, and cut or irritated skin.
    • Adults: Spray insect repellent onto your hands and then apply to a child’s face.
  • Sleep under a mosquito bed net if you are overseas or outside and are not able to protect yourself from mosquito bites.

Zika Virus Treatment

Remember that 80% of people with the virus won’t seek treatment because they won’t have symptoms. CDC: “If someone does come down with symptoms, there is no vaccine or specific medicine to treat Zika virus but you can treat symptoms:

  • Get plenty of rest.
  • Drink fluids to prevent dehydration.
  • Take medicines such as acetaminophen or paracetamol to reduce fever and pain.
  • Do not take aspirin or other non-steroidal anti-inflammatory drugs.
  • If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication.”