With Zika Virus in the U.S., Baystate Experts Stress Prevention

SPRINGFIELD — The Olympic Games are well underway in Rio de Janeiro, and amid all the excitement and expectations are concerns about the Zika virus and how it may impact the athletes, their families, and fans. Perhaps just as concerning is the news that the virus has now been spread by mosquitoes in the United States, in a neighborhood in Miami.

Dr. Jose Martagon-Villamil from Baystate Infectious Diseases calls Zika “an extremely interesting organism, part of the flavivirus family, which also includes dengue and West Nile viruses. When a typical person gets infected with Zika virus, the acute disease is not, in general, very aggressive. We know that up to 80{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of infections are asymptomatic — that is, they have no symptoms. In the 20{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of people who do develop symptoms, they tend to start within a few days of infection, and usually include fever, a rash all over the body, generalized aches and pains, and sometime conjunctivitis (pink eye). A small percentage of infected people — less than 1{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} — can go on to develop Guillain-Barre syndrome a few weeks after infection. This is a form of weakness and paralysis in the arms and legs. It is scary, but treatable, and rare.”

Dr. Fadi Bsat, chief of Baystate Maternal Fetal Medicine, explains that the effect of the virus is of increased concern for pregnant women, or women who may become pregnant.

“The primary way that pregnant women get Zika virus is through the bite of an infected mosquito,” Bsat said. “However, Zika virus can also be sexually transmitted, and a pregnant woman can pass Zika virus to her fetus at any time during pregnancy or at delivery.”

In pregnancy, Zika virus has been associated with pregnancy loss, brain and eye abnormalities, and fetal growth delays. Microcephaly (small head size) is the most common brain abnormality associated with Zika.

Martagon-Villamil added, “it is important to emphasize that not every pregnant woman infected with Zika will have a bad outcome. The experts estimate the risk of microcephaly to be between 1{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} and 13{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} when infection happens in the first trimester.

Both specialists stress that prevention is key. Women who are pregnant or thinking about getting pregnant should not travel to a Zika-affected area. The Centers for Disease Control and the Pan American Health Organization websites identify these areas and are updated regularly.

This warning applies to both men and women contemplating pregnancy, according to Bsat, because Zika has been found in bodily fluids and can remain in semen for weeks or months after an infection. Barrier or other forms of contraception should be used between couples when at least one of the individuals has traveled to a Zika-affected area.

People traveling to a Zika-affected area should avoid mosquito bites by using EPA-approved insect repellents containing DEET, covering exposed skin, staying in screened or air-conditioned areas, treating clothing with permethrin, and avoiding stagnant water or other environments where mosquitoes are more likely to be found.

The doctors note that recommendations are constantly being updated. If you have questions about Zika-virus risk, talk to your healthcare provider.

So far in the U.S., transmission of the Zika virus by mosquitoes has been limited to a relatively small area in northern Miami.

“We are seeing isolated cases of Zika virus infection in Massachusetts, but it’s been in returning travelers,” Martagon-Villamil said. “In the next few weeks and months, we may hear that local mosquito transmission extends to other areas in Florida, and within a few years, it might be established further. It’s impossible to predict with any certainty at this point, but the possibility exists because some of the mosquito vectors of Zika do have range into southern New England. It may take years to become endemic here, though.”