The Zika epidemic: UPDATE July 29, 2016
The big news today is that 4 cases of Zika virus infection now appear to be caught here in the United States. http://nyti.ms/2aPyj88
There are about 1600 Americans in the 50 states who are known to have Zika virus infection, but until now, all caught it outside the country.
There are about 5000 Americans in Puerto Rica who have Zika virus infection, but some got it from local mosquitoes.
This is big news because prior to this development, you could not possibly get the Zika virus unless one of two events occurred:
- You left the 50 states to go to a place where the mosquitoes spread it
- You had sex with someone infected from outside the US
So, prior to this week, someone living in Ohio could go to any of the 50 states and as long as they did not have sex with an infected partner, they could be sure they were not going to catch Zika infections. This may soon not be true.
Where are the four cases?
All four cases are from a small area just north of Miami in a neighborhood called Wynwood- http://nyti.ms/2aPyj88
No mosquitoes trapped in this area have Zika virus in them, but the studies of these 4 cases strongly suggests that all 4 people got it from local mosquitoes, not somewhere else, not from each other.
The CDC has stated this is a local outbreak, not a widespread outbreak. The cases are so few in number and limited to such a small few blocks, that issuing warnings to stay away is not helpful.
What to worry about?
At this time, only future possibilities.
If the Zika virus actually starts spreading across mosquitoes in a wider area, then the whole question about the risk of being in or visiting this area begin to arise. The greatest risk would be to pregnant women as the damage to the fetal brain is the worst impact of this virus.
So, this news really serves as a warning to stay tuned, let’s see if the Zika virus starts spreading by mosquito across a small region or state.
If not, fine.
If so, then precautions to avoid a pregnant woman getting infected, by mosquito, or by human partner, will need to be discussed.
Past Updates on the Zika virus have concluded:
- It is now confirmed that the Zika virus grave harm the developing brain of the embryo and fetus, at anytime during pregnancy, not just the first trimester.
- There are Americans who have traveled to areas where Zika have spread and have come home to the US infected with Zika virus. Over 1600 such cases now have been reported in nearly every state, including Ohio.
- Men seem to harbor the living virus in their reproductive fluids longer than women. For men with the virus, therefore, it can be transmitted for over a month after the man gets infected, whereas once the woman recovers from the infection, typically a week or so after the mosquito bite, she is no longer able to pass the virus along to a partner or baby.
The Zika virus continues to erupt across the tropical Americas.
A great resource as this epidemic unfolds will always be the CDC at: http://www.cdc.gov/zika/index.html
It still remains the case that by far the gravest danger posed by the Zika virus may be to developing babies.
But some deaths have been reported from people infected with Zika, so the risk is no longer considered solely born by the fetus. But the infection in anyone from childhood through adulthood is very unlikely to cause harm, 80% of all people infected, at any age, have no symptoms.
The bottom line at this time is that if you want to avoid getting infected by the Zika virus, you and your family need to stay out of areas where it is now very active, namely the tropical Americas [Mexico, Central America, Northern half of South America, the Caribbean], Samoa, and the Cape Verde Islands. Men who travel there should abstain from sexual contact or practice completely safe use of condoms for an indeterminate number of months. If their wives are or may become pregnant, the precautions must be taken for the duration of the pregnancy.
Given the emergence of these four cases of local transmission, stay tuned for indications that areas of the US will be added to this list.
- A virus long dormant in Africa spread to French Polynesia in 2007, and now is exploding across the tropical Americas, the Zika virus.
- In adults, the vast majority of infected people either don’t get sick at all or have mild symptoms.
- Less commonly, adults can get significant pain in muscles and joints.
- Adults with the infection can have the neurologic complication of Guillan-Barre syndrome which is typically transient. Now some have died from the infection.
- A very disturbing aspect of the Zika virus is its ability to infect babies of pregnant women and that it is now known to cause damage to brain development at any time during pregnancy.
- Adults and children need to weigh the risk of serious infection if they plan to travel to tropical Americas, Samoa, and Cape Verde Islands. The risk of getting infected is real. There are neurologic complications and now even death reported.
- Pregnant women should know that traveling to tropical Americas, Samoa, and Cape Verde Islands could be catastrophic for their developing baby.
- If a woman who even may become pregnant has a partner who has traveled to the tropical Americas, Samoa, or Cape Verde Islands, she should abstain from sexual contact during the entire pregnancy.
The main point now is that we need to be kept up to date for when (if?) Zika virus begins to be spread by mosquito in identifiable regions of the United States.
To your health,
Dr. Arthur Lavin