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How Can You Outsmart Zika?

Ten Facts to Know About the Zika Virus
By Dr. Mia Taormina

Besides the limited research surrounding this epidemic, there are many reasons the disease is commanding more attention than other types of tropical mosquito-borne viruses. Arm yourself with the facts to keep your family safe.

1. What is Zika and Why Do I Need to be Concerned?
Zika is a virus that is most commonly spread by infected mosquitoes living in tropical climates. According to the World Health Organization, it originated in the Zika Forest of Uganda in 1947 and since that point has spread to other countries. The Aedes aegypti mosquito species primarily live near and feed on people; therefore they are the most likely type of insect to spread the Zika virus to humans. The Aedes albopictus mosquito is also able to carry Zika but is less likely to spread the virus since it prefers to feed off of animals.

Zika infection is known to be linked with birth defects of the brain (called microcephaly) and nervous system in unborn children. A woman bitten by an infected mosquito before becoming pregnant or during pregnancy is at risk for passing the virus to her fetus. At this time, we do not know the risk or frequency of transmission. Zika virus can potentially cause issues in all stages of pregnancy. It appears the greatest chance for significant birth defects occurs when the virus is acquired very early on in pregnancy or in the first trimester. Furthermore, the virus can cause significant neurologic infection in some otherwise healthy adults.

Additionally, it is important to understand that only 1 in 5 patients will experience actual symptoms once infected with the Zika virus. Therefore, without realizing it, patients can potentially spread the disease to their sexual partners and also transport the disease to non-tropical areas that would normally remain safe from risk.

2. Is There a Vaccine for the Zika Virus?
Unlike other mosquito-borne illnesses such as yellow fever or Japanese encephalitis, there is no vaccine at this time to protect against Zika.

3. Can I Recognize the Symptoms of Zika?
After exposure, patients who exhibit symptoms usually notice them between 3-7 days. Reported symptoms include body aches, fevers, bright red eyes and rashes. These symptoms are often mild and will self-resolve over the course of a week.

4. Is Future Fertility Affected for Children Who Contract Zika after Birth?
If a child is exposed to the Zika virus after birth, he or she should have no issues conceiving a child later in life. Currently, there is no evidence the Zika virus causes any residual fertility effects.

5. How Can I Avoid the Zika Virus for Myself and My Family?
Limiting your travel to environments that do not sustain the Aedes aegypti mosquito is the first line of defense against contracting this disease. The Aedes aegypti mosquito is an aggressive species that is only able to live in a specific tropical environment. Central America, South America and areas such as Aruba, Jamaica, Puerto Rico, Guam, the Caribbean and the US Virgin Islands are at risk for ongoing transmission of the virus. The Aedes aegypti mosquito is able to survive in the southern United States, outbreaks in that part of the country have been reported.

If you are traveling to or live in an area where you cannot avoid risk of being bitten, please follow the following precautions:
The CDC recommends liberal use of mosquito repellents containing at least 40% DEET, apply the repellent over sunscreen, do not apply on skin under clothing. Be certain to reapply as directed. In addition, permethrin treated clothing and footwear can be worn. Make sure to spray repellent on hands and then apply to your face or your child’s face, take care to avoid eyes, mouths or abrasions. Children under two months of age should not use repellent, cover strollers or baby carriers with mosquito netting at all times while exposed to infested areas. Children under age three should not be exposed to repellent products that contain oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD).

Aedes mosquitoes are poor fliers and bite during daytime hours. It is best to schedule wilderness activities in the early daytime hours and after dusk to limit exposure. During daytime hours, activities at altitude or in open water such as sailing or fishing may be better options. If camping, mosquito netting should be used for an additional layer of protection. When outside, wear long-sleeved shirts and pants to cover as much skin as possible. Remain in screened in areas and use air-conditioning when possible.

Do not allow any standing water to collect inside or outside where mosquitoes may lay eggs.

5. Can I Catch the Virus from my Partner?
Understand that once a person is infected, the virus can be passed through sexual activity. This is complicated since symptoms of the virus can be very subtle and an infected person may not know they have contracted the disease. While the virus rapidly clears from the bloodstream, it can linger longer in semen. Even if a man returns from travel in a tropical climate with no symptoms, it is advised he should abstain or use condoms for at least three months after travel. If he has any symptoms of Zika, he should abstain or use condoms for six months after travel and should not try to conceive before consulting with his primary care physician. Although much less common, females are also able to pass the virus to their partners. Therefore, using condoms for all sexual activity or abstinence are the best ways to avoid contracting Zika.

6. Can I be Screened or Tested for Zika Virus?
At this time, Zika virus screening is not commercially available. Patients must meet specific criteria in order to be tested. Any patient, male or female, who is exhibiting at least two of the four classic symptoms of Zika within two weeks of travel to an endemic area can be tested for Zika virus. Any pregnant woman, symptomatic or not, can be tested within 12 weeks of travel to an endemic area. Asymptomatic, non-pregnant patients cannot be tested at this time.

7. How Does an Isolated Case Lead to an Outbreak?
While not highly likely, it is possible for an outbreak of the Zika virus to occur in an area not rampant with the disease or high volumes of Aedes mosquitoes. The infection cycle arises when a person gets infected with the Zika virus from a mosquito bite (or it can be transmitted with sexual activity) and that person is then bit by an Aedes aegypti or Aedes albopictus mosquito during the first week after being infected. If they are bit by another mosquito, that insect can potentially pick up the Zika virus from the infected person’s blood and spread it to the next person it bites. If this cycle continues a viral outbreak may result. This is why precautions need to be taken for those living in areas with tropical or very warm areas of the United States where the two mosquito species can survive.

8. What Should I do if I am at High Risk for Zika and Believe I May be Pregnant?
Please contact your primary care physician immediately if you believe you have contracted the Zika virus while pregnant or if you become pregnant after recent travel to a tropical area. Your physician may refer you to an Infectious Disease specialist for further consultation, evaluation and monitoring.

9. What is the Treatment if I Contract Zika?
There is currently no treatment or vaccine for the Zika virus. For those experiencing symptoms, supportive care including rest, hydration, and Tylenol/ibuprofen are currently recommended.

10. Will Winter Weather Eradicate the Zika Virus in the US?
The anticipated change in weather will likely lead to a sharp decline in transmission of Zika. Aedes mosquitoes thrive in warm, tropical climates and will be inactive during the winter months. It is also anticipated that this entire outbreak should fade by spring/summer 2018 as so many people will have become infected that there will be a sort of herd immunity for a period of time leading to the waning of this outbreak.


Topics and Subtopics: General Health & Infectious Disease

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