The Summer of Zika

By J. Ron Eaker, M.D.

I am not an alarmist. In fact, I am generally just the opposite. I, like Joe Friday (there’s a reference no-one under 40 will get), want the facts and only the facts, and the fact is that while Zika virus disease is worth noting, it’s not worthy of massive hysteria.

First, of course, some facts

Zika is a virus transmitted by a mosquito in the Aedes species which is significant because this same scourge can harbor other viral illnesses such as  dengue and chikungunya. Unlike these illnesses, 80 percent of those who contract Zika have very mild, even unnoticeable symptoms.  

Common symptoms, if they appear at all, are fever, rash, joint pain, conjunctivitis, muscle pain and headache. As you can surmise, many folks will experience some or all of these symptoms and never associate them with a particular viral illness. The time from contact to symptoms for Zika virus disease is not known, but is likely to be a few days to a week, and likewise the symptoms commonly last for only a few days. 

It is vital to understand that, as opposed to dengue and some other viral illnesses, Zika is generally very mild and has only resulted in deaths when a person is infected who is severely compromised for other reasons. 

The issue is Zika during pregnancy

So why all the media attention for a viral illness that is often milder than a common cold or flu? It is because of the effect Zika has on pregnant women. Zika virus can be passed from a pregnant woman to her fetus, and infection during pregnancy can cause a serious birth defect of the brain called microcephaly and other severe brain abnormalities. 

Microcephaly is a condition where a baby’s head is much smaller than expected and is often associated with poor brain development and mental deficiencies. Other problems have been detected among fetuses and infants infected with Zika virus before birth, such as defects of the eye, hearing deficits and impaired growth.  

Not an immediate threat

Luckily for most of us in the United States, Zika doesn’t present an immediate threat, at least not yet. As of May 2016, the CDC has not reported any cases of Zika infection that were caused by a direct mosquito bite in this country.  Of the 503 reported cases in the U.S., all were contracted by people traveling outside the country. Like any vector-born disease, this could change with a change in mosquito migration or transport, yet there are other safety barriers here that may not exist in other countries where Zika is endemic.

Currently there is no vaccine against Zika, however that seems likely to change as research has ramped up in this area and funding has been massively appropriated. In addition there are public health protocols and measures that are being enacted to minimize the offending mosquito populations and testing centers for possible infections to aid in early detection and prevention.

Person-to-person transmission

Many are concerned as to whether they can transmit Zika to a family member or friend if they are infected (knowingly or unknowingly). The simple answer is no. The virus is not transmitted from human to human (with one exception, see below) and the only way a family member, especially a pregnant family member, could get Zika from another person is for a mosquito to bite the infected individual and in turn, feast on the pregnant person. This is presently unlikely in the U.S. as an Aedes aegypti or Aedes albopictus mosquito has to bite an infected person during the first week of infection when the virus can be found in the person’s blood. It must then live long enough to multiply and then bite the pregnant target. Currently the CDC states this is unlikely on a large scale.

There is some evidence that Zika can be transmitted in semen, so pregnant women whose partners have traveled to endemic countries should refrain from sexual contact or use condoms.

Detecting Zika

There are blood tests that can detect Zika and currently only those who have traveled to high impact countries should be tested. Currently those countries most affected are most of South and Central America and the Caribbean. The most current information on travel warnings can be found at www.cdc.gov.

Most pregnant women in the CSRA should only take routine precautionary measures to prevent an already unlikely infection. These include wearing long-sleeved shirts and pants, using insect repellant when outside (EPA-registered insect repellents containing ingredients such as DEET, picaridin and IR3535 are safe for use during pregnancy when used in accordance with the product label) and staying in places with air conditioning or with window and door screens—not a tough call for a pregnancy in the South!