What Boston women need to know about Zika virus

zika virus mosquito bite

By Matthias Muenzer, M.D.
Ob/Gyn and Women’s Health in Medford & Melrose, MA

Sept. 6, 2016 update:

A few things have developed with Zika virus in the United States and Massachusetts since I shared my original blog post below in July 2016.

Massachusetts has the fifth highest number of Zika cases in the nation. And while that can sound alarming, I haven’t seen any patients in my clinic who have tested positive. In the last few months, I’ve sent three patients’ Zika virus tests to the state lab, and all three tested negative. Their recent travel to areas with high infection rates prompted me to recommend and perform these tests.

There is a small risk in the Boston area (and anywhere really) to get Zika virus by having sex with a person who has been infected. But most Zika cases involve people who had themselves traveled to areas outside the country. However, the CDC has identified two areas of Miami-Dade County in Florida where mosquitos are spreading Zika virus.

My original post below outlines some preventative measures to consider to protect yourself from mosquitos. To prevent person-to-person transmission of Zika virus, use protection during sex with somebody who has or may have the virus.

Long story short, your risk to get Zika virus here in the Boston area is small. That said, it’s important to follow the tips outlined to keep yourself — and your baby-to-be — safe from Zika virus.

Feel free to set up an appointment if you have questions about Zika virus or any women’s health issues.

July 12, 2016 post:

zika virus mosquito bite

Zika virus can be spread through bites from infected Aedes genus mosquitoes and sexual contact with infected people.

Since early 2016, the news has been full of stories about Zika virus and its link to serious birth defects in babies whose mothers had it. While the focus primarily has been on South America and the Caribbean, Boston-area residents have not been immune to Zika virus fears.

I’ve gotten questions about Zika over the past months, primarily from women who had travel plans in areas known to have the virus. Many have canceled trips to South America, the Caribbean, and even Florida. I even had a patient who moved her wedding from Mexico because of the risk. Concern about possible Zika infection led me to send one pregnant patient for advanced testing. Luckily, she and her baby were fine.

While there is very little risk of contracting Zika in Massachusetts, it’s important that local residents — especially women who are pregnant or planning to become pregnant — are aware of this disease and know how to protect themselves.

What is Zika virus, and what are its symptoms?

Zika virus is primarily spread through the bite of an infected Aedes genus mosquito, but it also can be contracted through sexual contact with an infected person.

The symptoms of the virus are mild. In fact, 80 percent of people who have Zika will not experience any symptoms. Those who do may get a low-grade fever (less than 101 degrees), rash, joint pain (especially in the small joints, such as the hands and feet), or conjunctivitis (red eyes).

There is no vaccine to prevent Zika, nor is there medicine to treat it. Zika patients should get rest, drink plenty of fluids, and take medication such as acetaminophen to reduce fever or pain. There is a blood test to confirm Zika virus, but you can’t just go to your doctor and ask for it. Because this test is so new, only a few labs in Massachusetts right now can detect it, so patients are screened before being approved for testing.

Most people with Zika virus will not get sick enough to go to a hospital. While Zika has been linked to rare cases of Guillain-Barre syndrome, a severe neurological disorder that causes temporary paralysis, we are most concerned about its link to birth defects in unborn babies.

How can Zika virus affect pregnancy?

There is much we don’t yet understand about how Zika virus affects an unborn baby, although quite a few studies are currently being conducted. We do know that a mother with Zika can pass the virus to her baby during pregnancy or delivery.

Since 2015, a startling number of babies in Brazil have been born with microcephaly, a birth defect marked by smaller heads and brains that may not have developed properly. Possible causes of microcephaly include changes in the baby’s genes, certain infections during pregnancy, or a mother encountering toxins during pregnancy. In April 2016, the Centers for Disease Control and Prevention (CDC) confirmed that Zika can cause microcephaly and other serious defects in babies, such as damaging calcium buildups in the brain.

We don’t know how likely it is for a woman to pass Zika on to her baby, how likely it is the baby would develop birth defects if infected, or when in pregnancy the virus could cause the most harm to the baby. A few cases also have pointed to a possible link between Zika virus and miscarriage, and researchers are studying that as well.

Where is Zika virus found?

Zika was first detected in Uganda in the 1940s. Since then, it has been reported across Africa, Southeast Asia, and the Pacific Islands. It was detected in Brazil in 2015 and has moved into a handful of South and Central American countries, the Caribbean, and Mexico.

While the type of mosquito capable of carrying Zika is found in the United States, it doesn’t appear that any have been infected yet. Aedes egypti, the mosquito known to transmit the virus, is found mainly in the southern states, although Aedes albopictus, which may potentially transmit it, is found as far north as Massachusetts in the summer.

How can I protect myself from contracting Zika virus?

The No. 1 way to protect yourself and your unborn child is not to travel to areas where Zika virus is known to be spreading. These regions are changing all the time, but the CDC provides updated travel advisories for Zika. If you are pregnant, or there is a chance you could become pregnant, I advise you not to chance it. Stay home, or find a new place to visit.

The CDC advises women who have been diagnosed with Zika or were possibly exposed to the virus to wait at least eight weeks before trying to become pregnant. It also advises that men who were diagnosed or experienced symptoms to wait at least six months before having unprotected sex, as the virus has been found to linger longer in semen.

Take precautions to prevent mosquito bites, whether you are traveling to an area known to have Zika or if you are staying home in Massachusetts. While mosquitoes here may not yet be infected with Zika, they can still cause illnesses such as West Nile virus.

  • Wear protective clothing, such as long sleeves, long pants, and a hat. During a trip to Morocco, I was struck by how residents’ billowing sleeves and pants appeared to chase away the relentless mosquitoes there.
  • Avoid going outside at sunset, when mosquitoes are most active.
  • Sleep in areas that have screens on the windows and have air conditioning. This keeps mosquitoes from coming in or wanting to come in, as they don’t like cold air. If this isn’t possible, sleep under a mosquito net.
  • Use Environmental Protection Agency-registered insect repellents. When used as directed, they are safe and effective, even for pregnant or breastfeeding women.
  • Eliminate standing water such as buckets, gutters, or other containers where mosquitoes can breed.

If you are pregnant or are planning to become pregnant, there is no reason locally to panic about Zika. However, if you plan to travel, it’s important to be aware of the risk. If you want to talk to a physician about your travel plans, schedule an appointment online or call 855-446-2362.

Tags: children's health, family health, family medicine, internal medicine, OB/GYN, women's health

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