Zika Virus

There has been a lot of media coverage and panic over the Zika virus. Kaiser Permanente even called their pregnant mamas in California and played a prerecorded message about the Zika virus, A lot of the information was from the media and not really helpful. Where do you turn when there is so much panic about this seemingly new virus? Are you parents, friends, or family calling you and freaking out? Have you cancelled any and all trips? 

I have some good news. The Zika virus has been around for 70 years and has never thought to be a public health risk. Most people who contract the Zika virus have no symptoms, or think they have a mild case of the flu. Over the decades it has infected tens of thousands of people without any cases of  microcephaly (babies born with abnormally small heads and corresponding learning and developmental problems) being reported.

Rebekah Wheeler, RN, CNM, MPH puts together a great article on the Zika Virus combining all the science and facts that we know this far. In it, she explains why there is a sudden link between Zika and microcephaly. 

"There was a Zika outbreak in Brazil in 2015, with between 500,000 and 1,500,000 Brazilians getting the virus (FRAMEWORK, S. R. 2016).  At the same time, local health officials in northern Brazil noticed that there was a sharp increase in rates of microcephaly. Brazil usually sees about 150 cases of microcephaly each year, but in 2015 that number was above 3,000, a massive increase (FRAMEWORK, S. R. 2016).  Researchers began to suspect, due to the fact that the Zika outbreak happened at the same time as the increase in microcephaly cases, that perhaps contracting Zika during pregnancy might be the cause of microcephaly in the fetus. What they don’t know, and may never know, is how many of the babies with microcephaly were exposed to Zika in utero.  This may never be possible to measure, as Zika does not stay in the bloodstream for more than about 12 weeks (FRAMEWORK, S. R. 2016).

Regarding the suspected link between Zika infection and microcephaly, it is very important to know that this is a suspected link, not a proven one. In fact, experts from the World Health Organization are being very careful to say that the link between Zika virus and microcephaly is a suspected one, but has not been confirmed in any scientific study.  Microcephaly has historically been known to have multiple non-Zika causes, including Down Syndrome and other genetic disorders, exposure to toxic chemicals, smoking in pregnancy, maternal malnutrition and some severe maternal infections. Further cause for caution in assuming a causative link comes from Colombia, where they have had more than 3,000 cases of Zika but no increase in microcephaly rates." 

We do not know that Zika causes microcephaly. There have not been conclusive studies or evidence found that actually prove that Zika causes microcephaly. Studies are being done by the CDC. Scientists are working to discover the link, if any, between the two. As of right now, pregnant women and women trying to get pregnant should be careful, but there is no need to stay inside and cancel all travel plans. 

Reasonable Steps to Avoid Zika
(from Rebekah Wheeler, RN, CNM, MPH)

• Consider using mosquito repellents that are effective against aedes aegypti. Per the EPA, it is safe to use insect repellents containing DEET, picaridin, and IR3535 in pregnancy.  NPR recently published an article summarizing research on which repellents most effectively keep aedes aegypti away. For complete list of products and their EPA ratings, check out this article. ·         
• Cover up or stay inside. The aedes aegypti species typically bites during the day and at dusk.  Because of this, mosquito nets for sleeping aren’t useful.
• Use air conditioners and window screens to keep mosquitoes out of the home. Sleep in an air-conditioned room (mosquitoes hate cold).
• Try to eliminate mosquito-breeding grounds near the home.  Mosquitoes breed in standing water, even tiny puddles like the dish under a house plant.  Get rid of this standing water and there will be fewer mosquitoes around, period.
• Those who are pregnant or considering pregnancy should consider postponing travel to areas with Zika virus transmission.

Further info on avoiding mosquito bites is available at this CDC web page.

Rebecca Wheeler goes on to say in Part 2 that she does not think it likely that the Zika Virus and microcephaly will be found to be linked. She says "there are factors about Zika that make it unlikely to be a frequent risk, and that also point to a very small likelihood of it causing microcephaly in most cases:

• Zika has been around for a long time without migrating to the US.
• We have a great public health infrastructure well-equipped at handling cases of very similar diseases, such as Dengue and Chikungunya.
• We haven’t seen microcephaly in any of the other countries where there have been outbreaks.  This suggests that there are other or additional factors that led to the cases in Brazil.
• There are effective ways to avoid getting exposed to bites from mosquitoes that carry the virus.
• There is only one mosquito species confirmed to carry the virus, and their geographical scope is limited."

I hope this has helped to put your mind at ease. While pregnant women have to be careful about and avoid so many things, I do not think the Zika Virus should not be at the top of the list, especially for women in the US. 

To read the full articles by Rebekah Wheeler, RN, CNM, MPH, visit Science & Sensibility - Part 1 and Part 2.  

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