Zika Virus, One Year Later

It’s been just over a year since King County had its first diagnosed case of Zika virus infection. We caught up with medical epidemiologist Dr. Meagan Kay, DVM, to find out what we’ve learned about Zika virus since then, and what concerns health experts have now.

At this time last year, Meagan, you were expecting a child yourself. What concerns did you have about Zika when you were pregnant?

Information was just starting to emerge about the risk of Zika to pregnant women and their babies. As a public health professional, I was alarmed about the early reports of microcephaly in some Zika-infected newborns and what it would mean for families. Microcephaly is a birth defect resulting in an abnormally small head. Babies with microcephaly often have smaller brains that might not have developed properly.

I knew my personal risk in Washington state was low because we don’t have the mosquito that can transmit Zika here, but it did affect where I chose to go for vacation. My husband and I love international travel, but I knew I could prevent a Zika infection if we avoided those countries where Zika was circulating. It just wasn’t worth the risk of becoming infected and potentially having a miscarriage or poor outcome for my baby.

Have there been any cases among pregnant women, and what have been the outcomes for their babies?

Yes, we’ve had thousands of people diagnosed with Zika virus infection in the U.S. in the past year, and over 1,845 have occurred in pregnant women. In 2016, about 1 in 10 pregnant women with confirmed Zika had a fetus or baby with birth defects. And there’s still much we don’t know about Zika, so it’s possible that there may be developmental delays or other health problems in children born infected with Zika that have yet to be identified.

What have health experts learned about the possible health outcomes from Zika?

Many people who are infected with Zika virus, won’t have symptoms, or will only have mild symptoms like fever, rash, red eyes, and joint pain. The main concern is still for pregnant women and their babies.

Medical researchers have identified a pattern of birth defects among fetuses and babies infected with Zika during pregnancy that includes microcephaly and can also include decreased brain tissue, damage to the eyes, and a limited range of motion. Not every pregnant woman infected with Zika will have a baby with a birth defect. And some defects may not show up right away, including slowed head growth after a baby is born.

However, pregnant women are not the only people who should be concerned about infection.  Zika can be passed through sex, so men and women can pass it to their sex partners if they get infected.

CDC’s current research suggests that Zika is also linked to Guillian-Barre syndrome (GBS), a condition in which someone’s own immune system damages their nerve cells, causing muscle weakness, and sometimes paralysis. However, it’s rare, even among people infected with Zika, and most people recover from it.

If you travel to an area that has Zika, what’s the current guidance?

First, if you’re pregnant or want to start a family, avoid areas that have Zika if at all possible. This is the best way to prevent Zika infection!

Anyone going to an area that has Zika should protect themselves from mosquito bites by using insect repellant (the EPA has a helpful tool to help you find a repellant that’s right for you), wearing long-sleeves and pants, and staying in places with screens or air-conditioning. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women.

After your trip, you can protect yourself and your partner during sex by using condoms or refraining from sex for a period of time after travel, especially if you are considering getting pregnant. This is important to do even if you don’t feel sick because many people who are infected don’t have any symptoms.  For men, use condoms (or refrain from sex) for at least six months after traveling to a Zika-affected area. If only the female partner in a relationship traveled, follow these precautions for at least 8 weeks.

When should you get tested for Zika?

Consult a doctor or other healthcare provider about possibly getting a Zika test if:

  • You have symptoms of Zika and you’ve recently traveled to an area with Zika or had sex without a condom with a person who has been to an area with Zika in the last six months.
  • You are pregnant and you have Zika symptoms.
  • You are pregnant and you’ve recently traveled to an area with Zika or had sex without a condom with a person who has been to an area with Zika in the last six months, even if you don’t have symptoms.

Originally posted June 1, 2017.

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I am a risk communications specialist at Public Health - Seattle & King County.

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