Zika: What to Expect this Year

The Zika virus, spread by the bite of infected mosquitoes and other means, is here to stay, and with it the potential for serious birth defects, public health experts warned today.

From January 2015 to May 31, 2017, 5,285 cases of Zika have been reported on the U.S. mainland, said Oscar Alleyne, PhD, senior adviser for public health programs for the National Association of County and City Health Officials. The group hosted a Zika virus update during a press conference co-sponsored by the Big Cities Health Coalition and the March of Dimes.

In addition, more than 36,000 confirmed Zika cases have happened in U.S. territories. Of the 250 pregnant U.S. women confirmed with Zika infection in 2016, 10% delivered a baby with Zika-related birth defects, Alleyne said.

With government funding possibly expiring for some Zika-related programs, consumers need to stay vigilant and educated more than ever, the experts said.

“Zika is real,” said Paul Jarris, MD, chief medical officer for the March of Dimes, at the press conference. “Protect yourself. Know before you go (if the virus is present at your destination),” he warned travelers. If it is present, travelers should consider postponing their trip, especially if you are trying to get pregnant.

Protecting Yourself From Zika: Why It Matters

Zika infection during pregnancy can cause a birth defect known as microcephaly, in which the baby is born with an abnormally small head and brain damage. The infection is also linked to miscarriage and stillbirth. Infected people can develop Guillain-Barre syndrome, in which the immune system attacks the nerves.

The virus also can be transmitted during sex and possibly through blood transfusions, although there have been no known cases spread by blood transfusion in the U.S.

In 2015, an epidemic occurred in Brazil, when thousands of babies were born with microcephaly.

“Over the past few years, we have learned much,” triggering changes to the recommended care of pregnant women and women trying to become pregnant, Jarris said.

Recommendations now include:

  • Screening tests before pregnancy
  • Postponing trying to conceive if infected
  • Testing all pregnant women at all prenatal visits

Couples should delay trying to get pregnant and use protection if either has traveled to an area where Zika is spreading, Jarris said, even if they are not infected. If a woman has been exposed, the CDC advises waiting at least 8 weeks after the possible exposure before trying to get pregnant. If a man has been exposed, the CDC advises waiting 6 months or longer before trying to get his partner pregnant.

New Developments, Resources

Recent discoveries show that even infants who are born healthy can develop microcephaly later, Jarris said. In late 2016, the CDC reported that 13 infants in Brazil with Zika virus infection did not have microcephaly at birth, but had slowed head growth later. Eleven of those developed microcephaly.

At least one case has been reported of an adolescent developing neurological changes such as problems with thinking skills after becoming infected, Jarris said.

The Zika Pregnancy Registry, set up by the CDC, provides information to doctors and researchers. Doctors report and share details of their patients. Funding for the registry is set to expire in July and again in September if Congress does not act, said Laura Hanen, interim executive director for the National Association of County and City Health Officials.

Zika Care Connect is another resource where families affected by the virus can find qualified doctors and other information. Developed and funded by the CDC, the website is maintained by the March of Dimes.

Because mosquito control programs are conducted locally, Alleyne said, coverage varies widely in the U.S. While Gulf Coast and other Southern states are higher-risk areas, medical officials warn that no one should be complacent about the risk and that no location is immune.

Zika Threat in Perspective

Two experts who reviewed the update for WebMD offered additional advice.

”Don’t assume mosquito control is going to protect you,” said Scott Weaver, PhD, mosquito biologist and virologist at the University of Texas Medical Branch, Galveston. “Many of the poorest areas, especially along the Gulf Coast, both have high risk and very limited mosquito control capabilities,” he said.

He recommends wearing insect repellent every day and wearing protective clothing, such as long sleeves and long pants. “Take personal responsibility,” he said.

Funding of ongoing Zika programs is crucial, said Dean Blumberg, MD, associate professor and chief of pediatric infectious diseases at the University of California Davis, especially because information about the virus is still developing.

If ongoing resources to study the virus are cut back, he said, ”We are going to be in a heap of trouble.”