New Zika travel alerts especially for pregnant women

The Pediatric Insider

© 2016 Roy Benaroch, MD

What animal kills more people, year to year, than any other on the planet? The lowly, annoying mosquito. They fly around poking their snouts (I think) into person after person, spreading infections like malaria, yellow fever, and dengue. And new infections, too—like West Nile virus, which first appeared in Uganda in 1937. Infections don’t seem to recognize the borders of countries and continents, and West Nile has now become the most common mosquito-borne encephalitis in the US.

Now, the CDC is warning travelers against an even newer virus named “Zika”. Like West Nile, Zika was first found in Uganda, in a research station in the Zika rainforest (Zika means “overgrown” in the local language.) It remained an uncommon cause of human infection until the mid-2000’s, when the virus was first spotted outside of Africa and Southeast Asia. Since then, it has spread worldwide, throughout the warmer areas of the globe, leading to a large outbreak in Brazil that may have started with visitors to the 2014 Soccer World Cup. Brazil has probably had 500,000-1.5 million cases of Zika virus infection in the last few years.

Zika had been thought to cause only mild disease, with fever, rash, and joint pains. But at around the same time as the cases spiked in Brazil, health authorities there noted an alarming increase in health problems in newborns, especially a failure of brain growth called “microcephaly.” It’s since been shown that an unborn fetus can catch Zika virus across the placenta, and it’s very likely that the Zika virus infection is causing problems in the developing baby. We don’t know exactly how that’s happening, or when, or exactly when pregnant moms and babies are vulnerable.

What we do know is that like malaria, dengue, West Nile, and Chikungunya, Zika virus is spread by mosquitoes, and the best way to prevent transmission is to prevent mosquito bites. Stay inside at dusk, wear protective clothing, and use a chemical mosquito repellant containing DEET or picaridin.

The CDC has also now issued a “Level 2 Travel Alert” for areas with active Zika transmission, including Brazil, Puerto Rico, Mexico, and most of the rest of Central and South America. That means “practice enhanced precautions”, and applies especially to pregnant women.

Meanwhile, in the US, the first reported case of Zika virus infection occurred in Texas in November, 2015, in a woman who had recently traveled to El Salvador. And a resident of Puerto Rico recently developed Zika with no history of travel off the island—meaning that Zika is probably being transmitted by local mosquitos, now. It is only a matter of time for mosquitos in the rest of the warmer parts of the US to start spreading it around here.

It’s a big world, and the health problems of Africa are our health problems, too. New infections will continue to emerge. We’d better keep paying attention, and keep an eye on those mosquitoes.

Ew, Zima

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3 Comments on “New Zika travel alerts especially for pregnant women”

  1. wzrd1 Says:

    First, before any not so well knowing of various diseases, Zika virus infection is a hemorrhagic fever, even money, it’s actually one of the most mild versions, if not the mildest.
    The issue here is, Zika infection crossing the placental barrier and wreaking harm on a developing fetus. If I miss my guess, either brain tissue, which is slightly different from other central nervous system tissue, but I doubt it.
    I suspect it’s more damaging the blood-brain barrier and then wreaking harm to tissue that would otherwise be protected against nearly anything.
    That said, it’s a guess. Educatedish, but one usually more accurate than not.
    The fact is, *all* hemorrhagic fevers aren’t a welcome thing. Ebola is pretty much the nastiest one, hantavirus, here in the US, is another, Zika is a novel one.

    So, for schmidsts and giggles, what happens if it came here, to the southern US.
    OK, one major and newer issue, as mosquito abatement used to be a thing US wide, but now has faded…
    Notice mosquito abatement?
    Have something with standing water, drain it. If it can’t be drained, introduce a predator of mosquito larvae.
    Vietnam did it with shrimp eggs, Australia followed, it worked.
    Or, we ignore it and welcome back Yellow Fever, which was the start of our main effort of mosquito abatement.
    Otherwise, we’ll see DDT enter into common use, which still is an emergency measure to control mosquitoes.

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  2. Sarah Says:

    I saw on the Today Show this morning that there are a few cases of Zika virus in Florida and they expect it to spread in the Southeast. Any advice what my pregnant sister who lives in Savannah can do do help avoid being bitten?

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  3. Dr. Roy Says:

    Sarah, I wrote about mosquito bite prevention previously: https://pediatricinsider.wordpress.com/2013/06/13/mosquito-prevention-and-treatment-updated/

    Though no transmission of Zika has been reported in Florida, the mosquitoes that can carry the virus do live there. When (and it will be when, not if) a person with Zika infection travels to Florida and gets bitten, transmission will occur.

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