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Zika Virus

Thursday, June 23, 2016

According to the World Health Organization (WHO), the Zika virus is spreading and with it concern for the public’s health.   Zika was discovered in the 1950s and for many decades outbreaks were small and sporadic.  The first large outbreak of disease was not reported until 2007 when there was a rise in cases on the Island of Yap.  Fast forward to 2016 and the scenario has changed dramatically. Today, WHO states that 60 countries and territories report continuing mosquito borne transmissions of the virus; the most serious outbreak occurring in Brazil. The CDC indicates that the Zika virus will continue to spread.   

Zika virus spreads to people primarily through the bite of an infected Aedes species mosquito (Ae.aegypti or Ae. Albopictus).  This species is aggressive and primarily a daytime biter but can also bite at night.  The Ae. Aegypti is the mosquito that most efficiently transmits the Zika virus.  At this point in time, the Ae. Aegypti is found in the Deep South and Southwest United States.  The Ae. Albopictus mosquito on the other hand is more prevalent.  Its territory extends to portions of the Midwest and mid-Atlantic including the New York City and surrounding areas.  According to the NY Department of Health, it is not clear if the albopictus is transmitting the virus to humans.  Basically this means, we know for sure Ae. Aegypti is the more efficient vector (transmitter) and that type of mosquito does live in the southern regions of the U.S.  We don’t know if albopictus will do the same – it may since it has been implicated in other virus outbreaks such as a recent Dengue outbreak in Hawaii.

All that being said, it is very important to note that there have been zero cases of locally acquired mosquito borne cases in the U.S.  All 755 U.S. cases to date have been travel associated cases.  The NY Department of Health states “In the U.S., no mosquitos have yet been found carrying the virus.  The only cases in the U.S. are in people who got the virus while traveling to Zika affected areas or through sexual transmission from someone who traveled there.”

As noted, Zika spreads when a mosquito bites an infected person.  That mosquito can then spread the virus by biting more people.  There are three other ways Zika can spread:  1) during sex with a man infected with Zika; 2) from a pregnant woman to her fetus during pregnancy or around the time of birth; or 3) through blood transfusion (likely but not yet confirmed by the CDC).   The good news is that for the vast majority of people, the virus is mild.  In fact, the CDC reports that many won’t have symptoms or will only have mild symptoms.  The most common symptoms are fever, rash, joint pain, or red eyes. Other symptoms may include muscle pain or headache.   Symptoms can last for several days to a week.   Overall, the symptoms and effects are mild for the majority of people; however, there is scientific consensus that Zika virus is a cause of microcephaly and Guillain-Barre syndrome.  

The biggest concern regarding Zika is its effect on fetuses.  Contracting the virus during pregnancy can cause a serious birth defect called microcephaly which translates to ‘small head’.  The baby’s brain does not grow at the expected rate during pregnancy and as a result major defects can occur. Microcephaly has been linked with the following problems:  seizures, developmental delays, intellectual disability, problems with movement and balance, feeding problems, hearing loss, or vision problems.  For this reason, women who are pregnant or may become pregnant and their partners need to exercise extra caution to avoid the virus.

In addition to the effect on fetuses, Zika is also causing Guillain-Barre syndrome in a small number of people.  In Guillain-Barre syndrome, the body's immune system attacks part of the nervous system causing muscle weakness and loss of sensation in the legs and/or arms.  For some people, these symptoms can lead to paralysis of the legs, arms, chest, or facial muscles.  At this point, only 3 cases of Zika related Guillain-Barre syndrome have been identified in the U.S.  Once again, those cases were not contracted by mosquito bites here in the U.S.  

The best way to prevent Zika as well as other mosquito bite transmitted viruses such as West Nile and Eastern Equine Encephalitis is to protect yourself and your family from mosquito bites.  The New York Department of Health and the CDC offer the following advice:

  • Wear long-sleeved shirts and long pants.

  • Stay in places with air conditioning and window and door screens to keep mosquitos outside.

  • Treat your clothing and gear with permethrin or buy pre-treated items.

  • Use EPA registered insect repellents.  Follow directions carefully and never use insect repellent on babies younger than 2 months old.  Do not use products containing oil of lemon eucalyptus or para-menthane-diol on children younger than 3 years old.

  • Mosquito netting can be used to cover babies younger than 2 months old in carriers, strollers, or cribs to protect them from mosquito bites.

  • Sleep under a mosquito net if air conditioning or screened rooms are not available or if sleeping outdoors.

  • Prevent sexual transmission of Zika by using condoms or abstaining from sex.  

  • Reduce the mosquito population near your home by reducing or eliminating standing water and debris.  Dispose of cans, containers, pots or other water holding containers.  Dispose of used tires which are a significant breeding ground for mosquitos.

  • Turn over plastic wading pools and wheelbarrows when not in use.

  • Change water in birdbaths twice weekly.

  • Clean and chlorinate pools and hot tubs on a regular basis.

  • Drain water from pool covers.

  • Pregnant women should not travel to Zika areas.  If you must travel, take extra precautions.

Wear long-sleeved shirts and long pants.

Stay in places with air conditioning and window and door screens to keep mosquitos outside.

Treat your clothing and gear with permethrin or buy pre-treated items.

Use EPA registered insect repellents.  Follow directions carefully and never use insect repellent on babies younger than 2 months old.  Do not use products containing oil of lemon eucalyptus or para-menthane-diol on children younger than 3 years old.

Mosquito netting can be used to cover babies younger than 2 months old in carriers, strollers, or cribs to protect them from mosquito bites.

Sleep under a mosquito net if air conditioning or screened rooms are not available or if sleeping outdoors.

Prevent sexual transmission of Zika by using condoms or abstaining from sex.  

Reduce the mosquito population near your home by reducing or eliminating standing water and debris.  Dispose of cans, containers, pots or other water holding containers.  Dispose of used tires which are a significant breeding ground for mosquitos.

Turn over plastic wading pools and wheelbarrows when not in use.

Change water in birdbaths twice weekly.

Clean and chlorinate pools and hot tubs on a regular basis.

Drain water from pool covers.

Pregnant women should not travel to Zika areas.  If you must travel, take extra precautions.

For more information about travel advisories or what to do if you believe you have the Zika virus, visit the following websites:

New York Department of Health – https://www.health.ny.gov/diseases/zika_virus/

The NY Department of Health also has a toll free line for Zika questions - 1-888-364-4723.

CDC - http://www.cdc.gov/zika/

World Health Organization - http://www.who.int/topics/zika/en/

Lorraine Wichtowski is a community health educator at Noyes Health in Dansville.  If you have questions or suggestions for future articles she can be reached at lwichtowski@noyeshealth.org or 585-335-4327.  

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