4 Questions Patients Are Asking About the Zika Virus

The general population, in particular pregnant women and those planning a pregnancy, is becoming increasingly concerned about the possibility of the Zika virus spreading northward into the United States. Many are looking for answers because they are not sure of what information is correct, given the headlines and images seen on television and online.

The Zika virus is not a new virus. It was first noted in humans in 1952 in East Africa, but it was only in 2007 that the first epidemic was noted, in the Micronesia Pacific Island of Yap. In 2013, French Polynesia experienced an outbreak of the virus and it was in 2014 that physicians reported on two mothers who passed the virus to their newborns, one of whom had microcephaly. It was also at this time the Zika virus was detected in donated blood from asymptomatic donors. For researchers who need to hausarbeit schreiben lassen, understanding the historical timeline of Zika is essential.

Since July 2015, news of Zika virus in South America and of numerous babies born with microcephaly from mothers who had been infected with the virus began to cause widespread concern, particularly as media outlets published stories of Americans who became ill with the virus while in the U.S. Given these concerns, what types of questions might your patients ask?

Can I get Zika virus in the U.S.?

While the mosquito-borne infection has occurred in American territories (American Samoa, Puerto Rico, and the Virgin Islands), no transmission of the virus by mosquito has yet been detected in the continental U.S., reports the Centers of Disease Control and Prevention (CDC).

Experts are not in agreement as to whether the mosquitoes can come north. Some do predict that the mosquitoes could come up as far as New York. But if this were to happen, it would be seasonal, as the majority of the U.S. does not have the climate support the mosquitoes year-long. According to an article the The Lancet, however, there could be concern about Zika becoming an issue in Florida, which does have the right type of climate for the mosquitoes to survive. The mosquitoes (Aedes aegypti and Aedes albopictus), are the same mosquitoes that spread dengue and chikungunya viruses.

Americans have contracted the Zika virus inside the U.S., but not through mosquito bites. Some men who were infected outside of the U.S. transmitted it through sexual activity after their return to the U.S.

How can I protect myself from the virus if I’m traveling to affected areas?

The CDC recommends that pregnant women not travel to areas known to have Zika virus. If your patient must go, she should take extra precautions to prevent mosquito bites.

To avoid mosquito bites, the CDC recommends:

• Wear long-sleeved shirts and long pants.
• Ensure windows have screens, and when possible, air conditioning, to keep mosquitoes outside
• Use Environmental Protection Agency (EPA)-registered insect repellents that contain at least 20% DEET for protection against mosquitoes, such as Cutter Backwoods and Off! Deep Woods. Picaridin, found in products such as Skin So Soft Bug Guard Plus, and Autan, may also be effective.
• Reapply repellent as directed.
• If using sunscreen, apply repellent over the sunscreen after it has dried.
• Remove or stay away from mosquito breeding sites, like containers with standing water.
• Consider wearing clothing that has been infused with prometherin, a potent insecticide.

I am thinking of becoming pregnant. Should I be concerned about the Zika virus?

Women who are planning a pregnancy and their partners should follow the same precautions as pregnant women and avoid exposure to mosquitoes that could carry the Zika virus. If a woman wishes to become pregnant and she has had the Zika virus, once it has cleared her blood, there is likely no risk to the fetus, according to the CDC. However, the World Health Organization (WHO) states that women who were symptomatic of Zika virus should wait at least six months before trying to conceive. There does not appear to be any long-term effect on childbearing after a Zika infection.

How long can Zika virus be transmitted through semen?

Most people who develop the Zika virus have no symptoms, or their symptoms are vague and shrugged off as a mild flu, and they have no knowledge that they were infected at all. Men who have been in areas with the Zika virus should err on the side of caution and act as if they have been infected, even if they have not felt ill. “Zika virus can stay in semen longer than in blood, but we don’t know exactly how long Zika stays in semen,” the CDC advises. There was a report of a man who had Zika virus in his semen more than two months after showing symptoms of infection. By using a condom when having sex, this will reduce the risk of passing the virus to his partner. By contrast, scientists largely conclude that Zika stays active in the bloodstream for about a week. Mosquitoes can only pick up the virus if they bite someone during this time.

The WHO states that men who have travelled to areas where Zika is present to follow safe sex practices or abstain altogether for at least eight weeks if they are asymptomatic, and at least six months if they did develop Zika-related symptoms.

The Zika virus has been making the news rounds and is causing concern among many people. Both the CDC and WHO websites have up-to-date information regarding the latest areas affected by the virus, and the latest research on transmission and possible vaccinations.

Sources:

The History of Zika Virus. World Health Organization (WHO). http://www.who.int/emergencies/zika-virus/history/en/

Faye O, Freire CCM, Iamarino A, Faye O, de Oliveira JVC, Diallo M, et al. (2014) Molecular Evolution of Zika Virus during Its Emergence in the 20th Century. PLoS Negl Trop Dis 8(1): e2636. doi:10.1371/journal.pntd.0002636  http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0002636

Besnard M, Lastère S, Teissier A, Cao-Lormeau VM, Musso D. Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014 . Euro Surveill. 2014;19(13):pii=20751. Article DOI: http://dx.doi.org/10.2807/1560-7917.ES2014.19.13.20751 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20751

Zika virus and safe blood supply: Questions and answers. WHO. http://www.who.int/features/qa/zika-safe-blood/en/

Areas with Zika. Centers of Disease Control and Prevention. http://www.cdc.gov/zika/geo/

Zika virus disease in the United States, 2015–2016. CDC. http://www.cdc.gov/zika/geo/united-states.html Last updated July 6, 2016.

Bogoch II, Brady OJ, Kraemer MUG, German M, Creatore MI, Kulkarni MA, et al. Anticipating the international spread of Zika virus from Brazil. The Lancet. January 16, 2016. http://thelancet.com/journals/lancet/article/PIIS0140-6736%2816%2900080-5/fulltext

Pregnant Women: How to Protect Yourself. CDC. http://www.cdc.gov/zika/pregnancy/protect-yourself.html

Avoid bug bits. CDC. http://wwwnc.cdc.gov/travel/page/avoid-bug-bites

Zika and Pregnancy. CDC. http://www.cdc.gov/zika/pregnancy/question-answers.html

Zika and Sexual Transmission. CDC. http://www.cdc.gov/zika/transmission/sexual-transmission.html

About Zika Virus Disease. CDC. http://www.cdc.gov/zika/about/

Zika Virus. WHO. http://www.who.int/mediacentre/factsheets/zika/en/