How Worried Should You Be About the Zika Virus?
Zika, a virus thought to cause brain defects in Brazilian babies, may begin to emerge in the southern United States this summer. This is already a concern for travelers , and the World Health Organization considers the epidemic a global emergency . Don’t worry, but stock up on insect spray.
What is Zika virus and why do people bother it?
Zika can cause brain damage in newborns if their mothers contract the virus during pregnancy. There is no Zika virus vaccine, cure, or method that we know of (yet) to prevent a child from infecting a Zika virus. The good news is that Zika and its complications are rare.
Pregnant or not, if you contract the virus, you may develop annoying but not life-threatening symptoms. Zika virus causes fever, rashes, joint pain, and bloodshot eyes in about 20% of people who get it, and does not cause any symptoms in the remaining 80%. It is a member of the Flavivirus genus, making it a relative of the yellow fever , chikungunya and dengue viruses. Like them, it is transmitted through mosquito bites. Zika can also be sexually transmitted.
Until recently, no one cared about the Zika virus. This was rare and was not accompanied by serious complications. But in Brazil, the Zika virus appears to be causing an epidemic of birth defects, which means the disease is now a serious problem for pregnant women.
What does Zika do with babies?
Zika has been linked to birth defects, especially underdeveloped brain, which makes babies very small heads. This condition is called microcephaly and it is the main reason people are concerned about the Zika virus now. The idea that Zika virus causes microcephaly has yet to be fully proven, but the case for the link is very strong and grows stronger with every study that looks at it .
Babies infected with the virus have other problems besides a small head . These include problems with vision and hearing, as well as damaged areas of the brain, even if they are of normal size. Zika can also cause problems with the baby’s placenta and can lead to miscarriage or stillbirth.
The authorities are still trying to figure out how serious the problem is. Early reports said there were 4,000 cases of “suspected microcephaly,” but there were many babies among them whose heads were slightly smaller than normal. So far, the Brazilian government has investigated about 2,500 cases, of which 907 are definitely small brains. Officials say “most” of them are associated with the Zika virus, and 122 of them have tested positive for the virus . This still leaves a lot of room for it.
If you are pregnant and have contracted the Zika virus, we do not know how likely your child is to get sick. In 2013 and 2014, there was an outbreak of the Zika virus in French Polynesia. Researchers looked at medical records and found that about 1% of pregnant women with Zika virus symptoms gave birth to babies with microcephaly . The current outbreak in South America appears to have a higher complication rate. One small study at a clinic in Rio de Janeiro found that of 42 women infected with the Zika virus, 12 (29%) had babies with birth defects or died in the womb .
One thing we know does not cause microcephaly is the Monsanto conspiracy. There are rumors on social media that the birth defect is related to pesticides or genetically modified mosquitoes. Neither is true or even plausible.
While it may sound daunting, GM mosquitoes are actually a good thing: mosquitoes are non-biting males that are designed to mate and die, leaving sterile offspring. If you are not a mosquito, this should not bother you .
Concerns about pesticides are also clearly false. A group of doctors opposed to Monsanto has published a report that blames a chemical related to Monsanto for birth defects, but the chemical (which kills mosquito larvae) has been widely used for a long time and there is no plausible way to link it to Brazilian infections. … a spike in cases of microcephaly. Consider this another dead end .
I am not a pregnant woman. Should I worry?
If you are a man who has sex with women, especially if you know your partner is pregnant or planning a pregnancy, you need to be careful. The Zika virus is sexually transmitted .
We know that men can transmit the virus to women through vaginal intercourse, but we do not know if it can be transmitted sexually by other routes (for example, from men to men, from women to men, or through oral sex). We also don’t know if men who have never had symptoms can transmit the virus. If you have contracted the Zika virus or have been in an area where you might have been infected without knowing it, it is best to talk to your partner about it. Dating tip: “Have you had any interesting vacations lately?” is a great way to start a conversation.
You don’t have to be pregnant to experience another possible complication of the virus, Guillain-Barré Syndrome (GBS). It is a rare condition in which a person’s immune system attacks nerve cells. This can lead to paralysis. It can be caused by an infection, includingCampylobacter (a form of food poisoning), or even the flu.
How can I avoid the Zika virus?
The CDC has advised pregnant women or women who may become pregnant not to travel to countries where the Zika virus is spreading . However, if you can’t help living in an area affected by the Zika virus, stock up on condoms and insect spray.
If you are a woman who has no intention of getting pregnant, make sure you are at the top of your birth control game . An unplanned pregnancy is stressful; An unplanned pregnancy, possibly related to the Zika virus, is not a fun travel souvenir.
To avoid sexual transmission of the Zika virus, the CDC recommends that men use condoms (or not have sex) for eight weeks after returning from an area with Zika travel advice, or for six months if you know you are infected with Zika. Women who have Zika symptoms should wait at least eight weeks before trying to conceive.
Mosquitoes are the most common source of Zika virus infection. You cannot guarantee that you will not be bitten, but insect repellents containing DEET are very effective at repelling mosquitoes. Some brands with picaridin or lemon eucalyptus oil also work well.
DEET is safe if you’re wondering, and the CDC travel guidelines explicitly include a statement that all three repellents are safe during pregnancy. Be sure to reapply frequently; Here are the test results of how popular brands look on the skin after a few hours of use.
Where am I most at risk? Is Zika moving to the USA?
A list of CDC areas affected by the Zika virus can be found here . It currently includes 25 countries and territories in the Americas, as well as several islands in other parts of the world. Mexico and much of South America are included.
Suspected cases of microcephaly are listed below. (This is just a screenshot of a really awesome interactive map – check it out to learn more about each country.) The northeastern corner of the country is where the problem seems to be centered. Other areas were less affected.
The Zika virus was first detected in Africa, but there have been only a few outbreaks so far (including in French Polynesia in 2013 ).
Zika virus and its relatives are transmitted by mosquitoes , mainly by the speciesAedes aegypti . It has small white spots and bites throughout the day. Concerns about the spread of the Zika virus (as well as dengue and chikungunya ) are based on the range of these mosquitoes that extend to the southern United States – see map below. Note that viruses are not yet widespread in all of these areas, but if they do appear, mosquitoes will appear and carry the disease.
So it is entirely possible that Zika and other viruses could enter the United States. Mosquitoes also move northward as temperate regions get warmer and stay warm longer due to climate change. The National Center for Atmospheric Research has predicted that some areas of the US will have large populations of Zika mosquitoes this summer , with the most dangerous zones in and around Florida.
But the likelihood of a major Zika virus outbreak in the United States is rather low because most people in the United States spend indoors with air conditioning, install window screens, use repellents, and keep standing water out of their yards. (If you don’t have standing water in your yard, go out and empty the birdbath. You breed mosquitoes for the entire area.)
How do I know if my child has Zika?
Be sure to tell your doctor if you have been to a country with Zika virus during pregnancy, especially if you have had a rash, fever, or something that looks like a pink eye . CDC has issued guidelines for appropriate testing and treatment ; you can bring a copy to your document. ( Vox has translated them here as a flowchart .) Suggestions include:
- Sending a blood sample to the State Healthcare and Social Development for analysis. This works best within a week of infection. If you have had Zika in the past, the health department may do an antibody test, but the result will be less accurate.
- Consideration of amniocentesis, which means taking a sample of the amniotic fluid around the baby. This test itself is dangerous: there is a 0.1% chance of miscarriage if done before 24 weeks. The liquid can then be tested for the Zika virus.
- Have an ultrasound scan every 3-4 weeks to monitor your child’s brain development if a blood test or amniocentesis is positive.
There is a serious caveat here: we do not know how the test results compare with the chances of a baby being born with microcephaly or other complications. Microcephaly is also often undetectable with ultrasound until 24 weeks or later – after legal abortion is prohibited in most states .
If it turns out that you may have contracted the Zika virus, you are in a very difficult situation with many unknown factors. We don’t know how likely microcephaly is in someone with a positive blood test or amnio, and we don’t know exactly how children with Zika virus microcephaly will be harmed throughout their lives.
How will Zika virus affect children when they grow up?
“Microcephaly is a box of surprises,” journalist Ana Kacheras writes for the BBC . The doctors told her mother that she would never walk or talk, but they were wrong. On the other hand, many children with microcephaly do justify these harsh and dramatic claims. Brazilian cases appear to include many of the more severe cases .
Microcephaly from Zika is new, so speculations about the future of babies are based on what we know about microcephaly from other causes, including infections from other viruses. Cytomegalovirus, for example, also appears to destroy stem cells in the developing brain , leaving less tissue to work. Zika can do the same.
Affected Brazilian babies receive treatment, which may include physical therapy to help strengthen muscles that may also be affected by microcephaly, and medications for seizures. There is no way to reverse it, which is why healthcare providers try to manage symptoms and work to understand the condition as best they can.
What are governments and scientists planning to do?
Without a vaccine or reliable treatment, there is little they can do in the short term. Countries like the United States are advising pregnant women to reconsider their travel plans , and governments in countries with the Zika virus are telling women they may not want to get pregnant anytime soon.
Brazil and El Salvador have recommended that women living there postpone pregnancy – in the case of El Salvador – until 2018. But this is not easy advice for residents. In El Salvador, for example, condoms are expensive, pills are difficult to obtain, and the most popular form of birth control is sterilization surgery, which is not suitable for temporarily delaying pregnancy.
The World Health Organization, in declaring the Zika virus outbreak a public health emergency of international concern , has named a number of actions, including the following:
- The WHO says the development of better tests is a top priority for researchers, even more important than the development of vaccines and treatments. Without a good test, it’s hard to know who needs treatment and how big the problem is.
- Mosquito control is also very important, and people, especially pregnant women, should have the tools they need to protect themselves from mosquitoes to reduce their risk of contracting the Zika virus.
- Health services in the affected countries must be ready to provide more assistance to people affected by the virus, such as neurologists and physical therapists, to support babies as they develop.
The most effective ways to combat Zika in the short term are likely to be those that keep mosquitoes away from humans, even killing mosquitoes or killing the species Aedes aegypti , which is not native to America anyway. The first step is to get rid of obvious sources of standing water, as mosquitoes can breed in potholed puddles and buckets of rain.
In addition, there are many possible strategies for mosquito control, including mass spraying of insecticides (which sounds intimidating, but the same with microcephaly); the release of genetically modified male mosquitoes that mate with females but cannot produce fertile offspring , which reduces the number of mosquitoes in the next generation; and the release of mosquitoes infected with Wolbachia , a mosquito-only infection that also renders them infertile . Mosquito control will not only reduce the spread of the Zika virus. The same mosquitoes carry other viruses such as dengue, so this is a good public health measure.
Zika virus vaccines are in development and may be ready for the first human trials by the end of the year . With some luck, in the coming years we will have more accurate answers to all the unknown facts related to the Zika virus. Babies with microcephaly will start to grow and we will know how seriously they are affected. Over time, therapists working with these babies will find the best ways to help them.
It’s hard to say at this point how serious Zeke’s problem is, but we’re learning. Since this is so rare, you don’t need to worry. But since complications can be serious, it is wise to take extra precautions.
Updated 02/03/2016 to reflect new data on sexual transmission of Zika virus in Texas.
Updated March 28, 2016 with more information on the strength of the association with microcephaly, past outbreaks that could spread to the United States, and sexual transmission.