Worried about Zika with warm weather travel on the horizon? We feel you.
It’s true: according to a case-controlled study published last month in Lancet, researchers in Brazil believe they have confirmed that microcephaly (which causes an abnormally small head at birth) is a result of a mother’s Zika exposure during her pregnancy or just prior.
Earlier this week, John’s Hopkins’ Dr. Jeanne Sheffield, Director of Maternal-Fetal Medicine, hosted a research seminar focused on Zika’s role in perinatal and neonatal medicine. After scouring publicly available data published by the Centers for Disease Control and Prevention, we caught up with Dr. Angie Jelin, Assistant Director of Prenatal Genetics at Johns Hopkins, who attended the seminar, for answers on all things Zika.
Importantly, a positive Zika test for Mom during pregnancy does not mean her child will have birth defects. However, Jelin said at least 50% of reported maternal cases have affected fetuses, and the actual number affected is likely “a lot higher.” Some infants who were affected in utero appear normal at birth but begin have neurological symptoms a few months later, Jelin said.
Unfortunately, a lot remains unknown regarding Zika, its transmission, and its effects. That being said, here are some things we do know (many of which are encouraging!), based on data from the CDC and enriched by Dr. Jelin:
Zika can be contracted the following ways, according to the CDC:
- The bite of an infected Aedes mosquito (aggressive daytime biters and also still bite at night)
- Sexual transmission from a person who has Zika (although the infected partner does not have to be symptomatic at the time)
- From mother to child, either during pregnancy or during birth.
- Blood transfusion (only in Brazil, and these cases are currently being investigated)
- Laboratory exposure (though rare and not clearly established)
Zika can be transmitted to a fetus during all trimesters of pregnancy, Jelin said. Zika RNA has been identified in breast milk, but the live virus has not been detected and the current CDC recommendation is to continue to breastfeed, even if you’re infected. There have been no reported cases of transmission through breast milk to date.
Jelin said any healthcare provider is able to send samples to the CDC for testing in patients who meet criteria. If indicated, testing is covered by insurance, she said.
There is no vaccine or medicine to treat Zika at this time. Jelin said the U.S. military has governmental funding for an initial clinical trial, but they estimate it will be three to four years before they progress to final stage trials.
The CDC now recommends women at risk for Zika infection or who traveled to an exposed area wait eight weeks to conceive. It is recommended that men who have been exposed to the virus and develop symptoms wait at least six months after symptoms begin to try to conceive to be safe. Jelin said Zika has been found in semen up to 60 days after transmission, but may remain longer.
The prevalence of Zika has quickly expanded and has reached the U.S. Locally acquired cases now total 59 (as of September 28) with travel-associated cases reaching over 3,500. All locally acquired cases have occurred in Florida and are currently relegated to Miami-Dade County.
So where to go for a safe fall or winter getaway? Check out this helpful map of countries and territories with active Zika transmission. The bad news is that most of the Americas (save Canada, Chile, and Uruguay) are affected. The good news is that most domestic travel is safe, as is travel outside of the Americas – to Europe, for example.
In the U.S., Zika-carrying mosquitos live in the Southern and Eastern parts of the country, Jelin said. Another map by the CDC shows where these mosquitos could potentially spread. Jelin said that health officials are optimistic that Zika will be contained to small areas, similar to previous outbreaks of dengue.
While it is important to be well aware of Zika risks, Jelin said, there are many prophylactic measures that can be taken to avoid mosquito bites, even in areas where one might be exposed. You might have to get a little creative with your travel – but you definitely don’t have to skip it! Whether you’re thinking of conceiving, already pregnant, or nursing, the best defense is a good offense.