Summer Safety Series | Should I avoid Zika areas if I want to get pregnant? 7 questions with Mark Dowell, M.D.
By Kristy Bleizeffer Jun 15, 2016
You’ve likely heard at least some of news headlines about Zika virus by now. It’s carried by a mosquito closely related to the carrier of yellow fever, and it has been shown to cause alarming birth defects in newborn babies. So far, it’s been reported in Africa, the Caribbean, and areas of South and Central America.
Do we, in the great northern state of Wyoming, have anything to worry about? We sat down with infectious disease specialist Mark Dowell, M.D., to explain the Zika basics.
1. What is Zika?
Zika is a virus that was discovered in the late 1950s. It is well described and known to cause an illness not that different from West Nile virus.
Because of changes in world travel and to the overdevelopment of well-contained areas where the virus would live and not move outside of, it has now spread. That is probably due to man I think more than anything.
2. How is it spread?
Zika is spread mainly by bites from certain types of mosquitoes — Aedes aegypti and Aedes albopictus. Aedes is the same mosquito that carries yellow fever, dengue fever and some other infectious diseases. There are many subspecies of the Aedes group of mosquitoes, and in Wyoming, we have two of those —neither of which can carry Zika.
This is not going to be like the West Nile virus that spread from east to west across the country because West Nile is able to be carried by mosquitoes that live in colder climates. This is not the case with Zika. Unless something major changes, and I’m not an expert in entomology, it should stay fairly well contained to warmer southern areas where the mosquito lives.
So we don’t anticipate having any cases that are home grown in Wyoming. I do anticipate, at some point, having some imported cases from people who traveled to affected areas. The Wyoming state lab now has the ability to test for Zika.
I don’t think the mosquito species will end up suddenly populating our environment. We really have too short of a growing season. But along the Gulf Coast, in Texas and in Florida, Zika will occur there eventually. Zika has also been shown to be sexually transmitted.
3. What countries are most affected, and is it OK to travel there?
The Caribbean, Central and South America, and Africa are the main places affected by Zika right now. I tell people that unless they are planning on conceiving, they can go on their trips.
If you want to have a baby, and you don’t want to wait several months after you get back to try to conceive, then go somewhere else where there is not Zika. It’s not worth the risk at this point. That’s true for both men and women. Men do transmit it to their sexual partners. Women, apparently, do not transmit it to men.
I don’t want to add to the hysteria around Zika, and I don’t think people should panic. With all of the mosquito bites that occur in areas where there is Zika, your chance of getting infected by a single mosquito bite is incredibly small. Not all mosquitoes in these areas are carrying Zika. But if you are in the right place at the wrong time and are bitten by a mosquito that carries it, you can get infected.
4. What are the symptoms?
Eight out of 10 people who are infected with Zika won’t get sick and won’t know they have it. It is almost never deadly. It may cause joint aches, muscle aches, fevers and other flu-like symptoms —maybe accompanied by a rash, maybe not. You are pretty sick and pretty tired, and that can last a week or two. You usually get over it.
The biggest problems occur with birth defects forming in the first and second trimester. For women in the third trimester, the danger from Zika comes in the form of premature rupture of membranes, early deliveries, that kind of thing.
There is a fairly clear link between Zika and some of the birth defects. I think the one that has reached the news the most is microcephaly, which is a horrible thing.
5. For those planning pregnancies, how long should parents wait before trying to conceive when traveling to Zika-infected areas?
Eventually we may test women before they are trying to conceive and test their partners if they’ve been into a Zika area.
The CDC recommends that women who have symptoms or tested positive wait eight weeks before trying to get pregnant. Men who have symptoms should wait up to six months before trying to conceive.
Now, if you’ve gone to a Zika area, and you wait four weeks, and nobody has gotten ill, I’d still wait. Chances are, you will be fine, but nobody wants to go through pregnancy and have your baby have microcephaly.
6. Will there be problems at the Summer Olympics in Rio de Janeiro, Brazil?
I believe that the Summer Olympics are occurring at a time when the mosquito population is not at its height. But, given the type of city that Rio is, I would think that it would be high risk. If one has seen on the news the video of the garbage all through that area, the old tires where mosquitoes love to breed the filthy sewage-laden canals. I would say that would be a significant risk. However, they claim they are going to perform incredible mosquito control and that it will not be the high season for mosquitoes. I would not move the Olympics because of Zika.
7. How can people traveling to Zika areas prevent an infection?
There is no vaccine for Zika at this time, and we just developed the tests for it. This whole area is evolving right now and every month they are coming out with new recommendations for travel and how to prevent it.
But, like so many infectious diseases, it is largely preventable. Not every time, but a lot of the time. Common sense goes a long way: Wear long-sleeve shirts, pants and the best insect repellant you can get. The higher the concentration of DEET, the better. Avoid going out at dusk and dawn when most mosquito species are most active. And don’t go into areas where it’s obvious there is standing water where mosquitoes would be multiplying. Do not count on areas in underdeveloped countries to have great mosquito control programs.
But most of all, don’t panic. I think that’s the key thing.
Dr. Dowell is board certified in infectious disease and is the medical director of Infectious Disease at Wyoming Medical Center. He practices at Rocky Mountain Infectious Diseases.