What Not to Worry About :: Zika Virus

At 22 weeks into my third pregnancy, I thought I had worried about and read up on everything possible thing to think about while pregnant. And then I started hearing about the Zika virus affecting in utero babies around the world, mostly in South American and Africa.

According to the Centers for Disease Control and Prevention (CDC), “Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon.” So if you aren’t pregnant, zika can be uncomfortable but not always dangerous.

However, if you are pregnant or trying to get pregnant, Zika is something you definitely need to be aware of. Why? Because while no direct cause and effect has been established, it is possible that contacting the Zika virus while pregnant may cause congenital microcephaly in the baby.  (There are multiple reports in Brazil of microcephaly in babies of mothers who were infected with Zika virus while pregnant.)

Microcephaly is a birth defect where a baby’s head is smaller than expected when compared to babies of the same sex and age. Babies with microcephaly often have smaller brains that might not have developed properly. (CDC)

Florida Gov. Rick Scott recently declared a state of emergency in several counties in our state where about a dozen people have been diagnosed with the Zika virus, even though all of them contracted it while outside the United States. However, the state of emergency declaration allows the state to be prepared should the virus start spreading through mosquitos to others. Closer to the First Coast, the virus has been diagnosed in St. John’s County in a person who traveled abroad.

Fortunately for us in Northeast Florida, we have Wolfson Children’s Hospital available.  Dr. Mobeen Rathore (MD, CPE, FPIDS, FAAP, FIDSA, FACPE, FSHEA, Professor and Director, University of Florida Center for HIV/AIDS, Research, Education & Service) answered questions about Zika for me through Wolfson’s Children’s Hospital, clarifying any need for concern and explaining what pregnant women need to be aware of and concerned about.

Please explain how Zika virus spreads:  Zika spreads when the mosquito bites and takes a blood meal from someone who is infected with Zika virus and the virus is still circulating in their blood (which is usually for seven days). This mosquito can then take another blood meal from someone not infected with Zika virus and transfer the virus to this individual who will then get infected with Zika virus.

Are the kinds of mosquitoes that carry it in Florida and do they live in Northeast Florida specifically? Zika is spread by the mosquito of the aedes species. In Africa, it is the aedes africanus. It is also spread by aedes aegypti which is the mosquito present in Florida.

What can happen to pregnant women/their babies if they are bitten by a mosquito carrying Zika? If a pregnant woman gets Zika virus infection there is compelling epidemiological evidence that her baby is at risk for developing microcephaly (small head) which may not allow the brain to develop normally.

Does it matter at what point in your pregnancy you contract the disease? (For example, if you got Zika at 14 weeks vs. getting it at 36 weeks, does that matter in the baby’s development?)
It is not clear what the risk is for each trimester of pregnancy. Babies with microcephaly were born to mothers who got Zika virus infection all through the pregnancy. In general it is believed that infection earlier in pregnancy poses a higher risk.

I have read that mosquito repellent with DEET is what you should use, but is DEET safe to use during pregnancy? Or is it in this case a lesser of two evils, so to speak?
Any EPA approved repellent is safe in pregnancy and during breastfeeding.

A Zika virus case has been diagnosed in St. John’s County from someone who had traveled abroad. Are there any statistical odds available about actually contracting the disease from a mosquito at this point?
At this point the risk is very minimal.

What is the difference between our living conditions here in Florida and those in the countries the World Health Organization (WHO) has put a travel restriction on that would make it easier to get Zika?
We have better dwellings. More screened doors and windows and air conditioning. In addition we do not have large numbers of standing bodies of water that can be breeding grounds for mosquitoes.

Should people who are trying to get pregnant right now wait, like is recommended for women in the WHO countries, or is it reasonably ok to go ahead to try to get pregnant?
It is recommended that pregnant women not travel to areas where there is ongoing active transmission of the Zika virus. I would recommend that if one is contemplating pregnancy they avoid travel to areas where there is ongoing active transmission of Zika virus.

How worried should pregnant women in North Florida be, on the scale of things everyone worries about while pregnant….should this be a top five worry?
Women in North Florida should not worry about Zika virus infection if they have not traveled to parts of the world where there is ongoing active Zika virus transmission. Women in North Florida should be more worried about influenza and whooping cough and should make sure that they receive the available and safe influenza and whooping cough vaccines as is recommended.

Additional Resources:

Center for Disease Control: http://www.cdc.gov/zika/pregnancy/question-answers.html
World Health Organization: http://www.who.int/emergencies/zika-virus/situation-report/en/
New York Times Q&A and maps: http://www.nytimes.com/interactive/2016/health/what-is-zika-virus.html?_r=0