As Zika virus spreads, so do concerns

While doctors have been aware of the Zika virus since the 1940s, for many years it was considered a mild infection. The recent link that has emerged in Brazil between the disease and an increase in a birth defect called microcephaly has people – particularly expectant mothers – worried about its spread.

“There’s no major panic at this point,” said Dr. Patrick Ramsey, a maternal/fetal medicine specialist and clinical professor at the UT Health Science Center. “We’re dealing with a lot of unknowns. In the coming months we will learn a lot more about the virus and the real risks.”

A number of cases have been reported in the United States, including three in San Antonio, according to the San Antonio Metropolitan Health District. Almost all of them were people who had recently traveled to a country with high rates of Zika — but we may just know it now because we’re looking for it, Dr. Ramsey said.

“It may be that Zika was already here and we didn’t know it because it causes such a mild illness,” he said.

President Barak Obama is requesting $1.8 billion in emergency funding to fight the Zika virus through vaccine research, mosquito control programs and other initiatives.

The Zika virus normally appears as a fever, rash, aching joints and/or conjunctivitis, but many people do not experience symptoms at all. It is normally transmitted by the Aedes aegypti mosquito in tropical regions – the same mosquito that transmits dengue, chikungunya and yellow fever. There have been reports of spread through blood transfusion and sexual contact from male to female.

As more information becomes available, the CDC is updating its Zika pages, including precautions and lists of countries where the virus is being transmitted.

While the primary concern is for pregnant women to avoid infection, one of the questions still being examined is how Zika could affect a woman’s future pregnancies.

At this time there are no CDC guidelines that provide guidance on how long a woman should wait to get pregnant after a Zika infection or travel to affected countries, Dr. Ramsey said.

“We do know a few things today,” he said. “First, Zika virus is cleared from the bloodstream within a week of infection. In semen, we know that Zika virus can be isolated from 2-11 weeks post infection.” We don’t yet know how long the virus may be harbored in other tissues, he said.

“I have suggested to patients that have asked me that question to wait at least three months between Zika infection or travel to affected countries and attempted pregnancy. This would allow for the patient to be over 12 weeks post infection, and longer than the time that we know virus can be isolated from semen. There is precedent for a 3-month interval for pregnancy after measles, mumps, rubella (MMR) vaccination and varicella vaccination.”

If you’re traveling to one of the affected countries, use preventive measures like DEET, permethrin, mosquito netting and screens to avoid mosquito bites. Practice abstinence or protected sex with partners who’ve recently traveled to areas with Zika. If you’re planning to give blood, wait 28 days after your return from an affected area to do so.

Mosquito control at home is an important part of preventing the disease’s spread. Keep grasses and plantings trimmed and empty all standing water that can collect in planters, buckets or other open containers.

Photo by Mark Greenberg Photography

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