Before you panic, read this.
So you’ve probably heard of Zika, the mosquito-borne virus turned epidemic in Latin America.
The Zika virus is transmitted to people primarily through infected mosquitoes in tropical regions — there is no vaccine or cure. The first outbreak happened last May in Brazil, and now there are epidemics in 22 other countries in Central and South America. The CDC has also confirmed over 30 travel-acquired cases in the United States, and it’s estimated that 3 to 4 million people in the Americas could become infected with Zika in the next year.
Even though Zika is generally a mild virus, it was recently declared a global health emergency as the epidemic coincides with a rise in babies born with birth defects. In Brazil, the prevalence of Microcephaly (a condition where a fetus’ brain stops growing so the baby is born with an abnormally small head and brain damage) during the second half of 2015 was over 10 times higher than the historical prevalence. And experts believe that Zika infections during pregnancy may be to blame.
All this news can be pretty terrifying for anyone who’s pregnant or thinking of becoming pregnant — so how worried do you actually need to be about Zika?
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We reached out to two experts currently studying pregnancy and Zika: Dr. Amanpreet Bhullar and Dr. Ricardo Lopez, both OB/GYNs at Orlando Health Physician Associates, to find out more about the risks for pregnant women. So here’s what you need to know about Zika if you’re currently pregnant and living in the U.S.
Worth noting: These are not the same as the guidelines for women living in areas where Zika is endemic, but rather suggestions from American doctors for women living in the United States.
1. First of all, health officials still don’t know how likely it is to have a baby with microcephaly if you’re infected with Zika during your pregnancy.
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According to the CDC, the increased reports of microcephaly from congenital infections in Zika virus-affected babies suggests a possible causal relationship, but additional studies are needed to confirm an association. There isn’t enough data yet to calculate a statistical risk to women, says Bhullar, but the World Health Organization (WHO), Center for Disease Control (CDC), and ministries of health in affected countries are all working to increase surveillance and update registries for Zika and microcephalic babies.
2. But if you are currently pregnant, just avoid travel to countries where Zika is endemic.
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The CDC has issued a level 2 alert for people traveling to 28 regions in Latin America with special precautions for pregnant women. “The worst countries right now are Brazil and Venezuela, but I’d say you should avoid all of Latin America and the Caribbean,” says Lopez. The same goes for women who are actively trying to get pregnant in the next six months or year. “You might be on vacation and not even know you’re pregnant yet then get Zika early in the pregnancy which could put the fetus at risk,” Lopez says. It might suck to cancel plane tickets, but it’s for the best. Colombia, Ecuador, El Salvador, and Jamaica have advised women to delay pregnancy.
If you are pregnant and absolutely need to travel to affected regions, you should talk to your doctor about ways to minimize your risk, says Bhullar. The best prevention for pregnant women traveling to endemic areas is staying indoors, wearing long sleeves and pants, covering yourself in insect repellant approved by the EPA for use during pregnancy, and using screens and mosquito nets. The CDC has also issued guidelines with more precautions.
3. If you don’t have any travel plans and Zika isn’t an issue where you live, you don’t need to worry.
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If you aren’t pregnant and don’t plan to be pregnant anytime soon, you are totally fine (yes that’s you, irrationally paranoid college kids going on Spring break). And because mosquitos are an insect of the tropics, says Lopez, people in the United States aren’t at risk for contracting Zika for the next few months. However, there are some places in the South where Zika is more likely to spread first such as Texas, Florida, and Georgia. However, both experts agree that it isn’t worth panicking because you will receive detailed updates from local and state health departments if Zika does become an issue where you live.
4. Zika is actually a very mild infection that usually doesn’t have any symptoms.
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Zika has been around since 1947, when it was found in Uganda in the Zika forests. Up until 2015, outbreaks mostly occurred in Africa, Southeast Asia, and the Pacific Islands. Why haven’t we heard about those outbreaks? For starters, the infection is very mild. “Only 1 in 5 people have symptoms, so the vast majority don’t even notice that they got infected,” says Bhullar. However, up until now the Zika virus hasn’t been associated with any rise in birth defects. “It could be another factor specific to the environment or the mosquitos in Brazil which is causing this, but we don’t know yet,” says Bhullar.
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These symptoms will last about one week and the only treatment is rest and hydration. Generally speaking, if you have any concern about the health of your baby, you should see your OB/GYN, says Bhullar. But the official recommendation for pregnant women is to see their physician if they have at least two classic Zika symptoms and have either traveled to endemic countries or otherwise been exposed to Zika.
Tests for Zika are not commercially available, so you have to see a doctor if you want to find out. “If your doctor feels you need to get tested for Zika, they have to refer you to a local or state health department with tests available and they’ll take it from there to the CDC,” says Lopez.
6. Researchers aren’t sure when in the pregnancy a Zika infection is most risky, but it’s most likely earlier in the pregnancy when the fetus’ organs are forming.
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In theory, Lopez says an infection during the first or early second trimester probably has the highest risk because this is the organogenesis period, meaning all the fetus’ bodily tissues are still developing and forming organs. A problem or disruption in this process from an infection could then have devastating effects on the development of major organs, like the brain. That being said,
“there’s not enough information to say this definitively and you should still avoid exposure to viruses during your entire pregnancy,” says Bhullar.
7. The Zika virus should clear your system in about two weeks, so it shouldn’t affect a future pregnancy if you were exposed before you got pregnant.
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During the first week of infection, the Zika virus can be detected in the blood and it can passed from the infected person to a new mosquito. “But sometimes it can take up to 12 days after being bitten by an infected mosquito to develop symptoms,” says Lopez. So it’s safest to wait at least two weeks after traveling to an affected area where you might’ve been exposed to Zika before you try to get pregnant.
8. New evidence shows that Zika can be sexually transmitted, so if you’re pregnant, it’s best to avoid unprotected sex with someone who may have been exposed — at least for about two weeks.
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Texas health officials recently confirmed that a patient was infected with Zika after having unprotected sexual contact with an infected person who had just traveled to an affected country. “The danger of spreading through sexual contact is that pregnant women may have unprotected sex with their partner who has returned from traveling and didn’t have any symptoms, says Lopez. If the woman is in her first trimester, this is especially risky, says Lopez. The best precautions are abstaining from sex for several weeks after your partner may have had exposure to Zika or using condoms to reduce the risk of infection, says Lopez.
9. You don’t need to run to a doctor every time you get a mosquito bite — even if you are pregnant.
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“If you’re pregnant and you get bitten, don’t panic,” says Lopez. Unless it’s an epidemic where you live (and you’ll know long before it gets that bad), it’s probably a bite from a regular mosquito and you’re fine. “The main concern is whether you get bitten and you have symptoms of Zika,” says Lopez. Otherwise, just try to chill out — the experts agree that irrational panic and stress over Zika will probably do more harm than good.
10. But it’s still a good idea to avoid mosquitos and protect yourself from bites.
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In addition to the previously mentioned precautions, if you live in the South it’s probably smart to remove and treat areas of standing water near your home. The mosquitos which carry Zika can lay eggs and breed in bodies of water as big as a swamp or as small as a soda bottle, the experts say. If you don’t allow a breeding source, you’re reducing the risk of mosquitoes entering your home.
11. Try not to freak out about warmer weather bringing more mosquitos — that doesn’t mean that they’ll all be carrying Zika.
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It’s inevitable that there will be mosquitos in the United States in several months. But not every mosquito carries Zika — in fact it’s only one particular species (aedes aegypti) which also carries Dengue fever and it already exists in the United States. “Mosquitos don’t just have Zika; they need to bite an infected person and ingest their blood before the mosquitos can become infectious and spread Zika to other people,” says Bhuller. So it’s actually the traveling back and forth from Zika-affected countries that’s going to cause a spike in the virus in the U.S. “Infected mosquitoes won’t just migrate up from South America,” says Lopez, because they’d die first. So try not to panic and stay tuned in with your local health department for updates come summer.
12. If your doctor believes you’re at risk or you test positive for Zika, they’ll work with you to monitor brain growth.
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Depending on the discussion with your physician, you may get referred to a maternal-fetal medicine expert, Bhullar says. These specialists can do further tests such as amniocentesis and conduct frequent ultrasounds to monitor the fetus’ brain growth after 20 weeks and look for calcifications or abnormal head size, which can both signal microcephaly. There is no treatment or cure for microcephaly, but you can work with your doctor to make sure your pregnancy and birth is as low-risk as possible. The CDC has also published guidelines for evaluation and testing of infants with possible congenital Zika virus infection.
13. Seriously, don’t panic.
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“First of all, the risk is really limited to women who are already pregnant so if you aren’t please do not freak out,” says Lopez. Again, the infection is very mild, it usually has no symptoms at all, and it’s out of your system for good in a week or two. “If cases are imported into the U.S. and they go up dramatically, things might change, but we still need a better understanding of the specifics and nature of the disease in the first place,” says Bhullar. Information could change in the next weeks or months as new information is discovered. But right now, the experts agree that pregnant women in the U.S. and other countries where Zika has not been detected should feel comfortable that their risk is very low.
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— Center for Disease Control (CDC)
— World Health Organization (WHO)
— Pan American Health Organization (PAHO)
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