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By Sue Hubbard, M.D.
I have been receiving a lot of phone calls from patient families, especially from mothers who are either pregnant or thinking about becoming pregnant, with their concerns and confusion over the Zika virus. Several of these women have trips scheduled to Mexico and the Caribbean in the coming weeks, and called to ask what they should do.
While I don't want to be an alarmist, I do think there is real concern that this virus is spreading amid new reports of countries that have identified the Zika virus and associated microcephaly in newborns. The list of countries grows daily, and the Centers for Disease Control and Prevention website (www.cdc.gov) has been updated with a new map showing the distribution of the virus.
The Zika virus is transmitted to humans by the bite of an infected Aedes species mosquito. There is no human to human transmission, but a mosquito could bite an infected person, become infected itself and go on to bite another human. It's a cycle.
Travelers to Zika-affected countries will ultimately bring the virus back to the United States, where it is expected to spread to states with warmer and humid climates (such as Texas, Florida, Mississippi, Louisiana and Hawaii) as summer approaches.
The CDC has already issued a warning for pregnant women and those who are planning to become pregnant to avoid travel to the 20-plus countries (and growing) that have detected the Zika virus. As I told my patients, is it worth it to go on vacation or to attend a wedding and risk (even the slightest risk) becoming infected with this virus? Is it worth having a child who is born with microcephaly (a small head) and abnormal brain growth?
Short of wearing mosquito netting to cover yourself from head to toe, spraying copious amounts of DEET insect repellent and staying inside (which is not foolproof), I think it may be time to re-think plans to travel to these areas while more research and data is being gathered. The World Health Organization and the CDC have researchers investigating all aspects of Zika virus, including trying to develop a vaccine, but all of this takes time.
While for most people the Zika virus causes a mild illness with headache, fever, pink eye and joint aches, the effects on the unborn baby may be devastating.
The CDC has issued guidelines for OB-GYNs who may see women who are pregnant that have returned from a trip to one of these areas with Zika and show signs of a "viral infection" with symptoms as noted above. In this case, the recommendation is that a blood test is done to confirm Zika virus. If the mother is positive, she should have serial ultrasounds (every three to four weeks) performed to monitor the baby's head growth.
Unfortunately, not all pregnant women who may be infected with the virus will have symptoms (up to 80 percent of people may not feel ill), and their babies could possibly be affected as well. While it seems that the virus may be more likely to affect a fetus during the first trimester, it is difficult to pick up microcephaly on ultrasound before the second trimester.
This story continues to evolve and new recommendations should be expected as more information is gathered. But my advice continues to be: Why risk it? To have any concern, doubt or worry about exposure is enough for me to advise my patients to change their travel plans.
Dr. Sue Hubbard is an award-winning pediatrician, medical editor and media host. “The Kid’s Doctor” TV feature can be seen on more than 90 stations across the U.S. Submit questions at http://www.kidsdr.com. The Kid’s Doctor e-book, “Tattoos to Texting: Parenting Today’s Teen,” is now available from Amazon and other e-book vendors.
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This article was printed in the April 3, 2016 - April 16, 2016 edition.