Friday, January 29, 2016

The Zika Virus

Not actually Erin.
& is used with permission.
If you're like me, you noticed that social media was talking about a new virus that was "spreading explosively" in the Americas, and you were more than a little alarmed because until that moment you'd never heard of it before. Don't feel too bad about that -- as it turns out, the Zika virus was discovered in 1947 in the Zika forest of Uganda, but it didn't leave Africa until 2014, so there was really no reason for you to know about it.

Fortunately for you, I've been doing research on Zika for you, and the good news is: You're going to be okay. It's a very mild disease, and you have a tremendous advantage known as "Living in a First World Country."

Here's some more good news: 80% of people infected with Zika don't get sick at all, and once you have it you are effectively immune to it. Those 20% who do contract it might not even realize it's Zika, as the symptoms are remarkably similar to allergies and a cold, or maybe a light case of influenza:
  • Fever
  • Rash
  • Joint pain
  • Conjunctivitis (red eyes)
  • Possibly headaches and/or muscle pain
Given that Zika is typically transmitted through insect bites (see below), it's easy to see how someone could dismiss these symptoms as an allergic reaction to the bite coupled with "the bug that's going around".

There's current no antiviral agent for Zika, so treatment consists of addressing the symptoms with pain relievers, staying hydrated and getting lots of rest. The symptoms typically last no longer than a week.

If you have these symptoms, avoid NSAIDs like Advil (ibuprofen),  Aleve (naproxen) or Aspirin until you have been seen by a doctor. This is because (DO NOT PANIC) these symptoms are also similar to the much worse disease dengue fever, and NSAIDS are blood thinners which could cause a hemorrhage in a patient with dengue. I say DO NOT PANIC because if you have dengue, you are going to feel sick: high fever, severe pain, and mild bleeding from your nose or gums. But just in case, the CDC suggests you treat your pain with Tylenol (acetaminophen).

Zika virus is primarily transmitted by mosquito bites, although it is possible to spread it via contact with blood or other bodily fluids. The current insect vector for Zika are mosquitoes from the Aedes genus, which are active in the daytime, as opposed to the more typical dusk to dawn mosquitoes.

The easiest way to avoid contracting Zika, then, is not to get bitten by mosquitoes. Do not travel to any country which is currently experiencing a Zika outbreak (see Outbreak, below). However, if you must travel, or if the virus comes to the USA, stay inside screened-in or air-conditioned buildings and use insect repellent when going outside. The CDC has PDFs with more information here and here.

If you are diagnosed with Zika, then you should also avoid being bitten by mosquitoes during the period you are symptomatic. If you are bitten, you will help spread the disease, and that's bad for everyone, so stay indoors until you are feeling better.

First of all, Zika is not prevalent in the United States. However, it is prevalent in Mexico and Puerto Rico, and southern parts of the USA might see a rise in Zika as it spreads -- and it is spreading "explosively" because we do not have natural resistance to it.
Countries experiencing local virus transmissions -- in other words, where it is spreading natively as opposed to someone contracting it elsewhere and bringing it into the country -- are as follows:

  • Barbados
  • Bolivia
  • Brazil
  • Cape Verde
  • Colombia
  • Dominican Republic
  • Ecuador
  • El Salvador
  • French Guiana
  • Guadeloupe
  • Guatemala
  • Guyana
  • Haiti
  • Honduras
  • Martinique
  • Mexico
  • Panama
  • Paraguay
  • Puerto Rico
  • Saint Martin
  • Samoa
  • Suriname
  • Venezuela
Long Term Effects
All of that said, now it's time to scare you just a little bit.

Pregnant Women Should Avoid Zika 
There is a link between Zika virus and children born with microcephaly. I say "a link" because it is not yet known if Zika infection during pregnancy definitely causes microcephaly, or if it can cause it, or if it just might cause it. What is known is that the virus is rampant in Brazil, and that the number of cases of microcephaly jumped drastically from 167 in 2013 and 147 in 2014 to 2,782 in 2015.

Furthermore, a mother in Hawaii just gave birth to a baby with microcephaly, and the mother tested positive to Zika infection -- likely contracted when she traveled to Brazil in May 2015.

In other words, it's not worth the risk if you're pregnant or trying to become pregnant. Stay out of affected reasons and avoid mosquito bites during pregnancy.

Fortunately, there appears at this time to be no evidence that contracting Zika in the past will harm future pregnancies.

For more information, see this CDC Question and Answer page.

Guillain–BarrĂ© Syndrome 
There is concern that the Brazillian outbreak is somehow linked to Guillain–BarrĂ© syndrome, as there is also an increasing number of people in Brazil suffering from GBS. The CDC and the Brazillian Ministry of Health are investigating the link. There are currently no laboratory confirmations between the two illnesses, but that could change.

In Conclusion
  1. Again, Do Not Panic. The disease has not come to mainland America, and steps are already being taken to prevent spread of it here. 
  2. Do not go to places where the disease is rampant. If you are thinking about attending the Olympic Games in Rio de Janeiro, you ought to reconsider. 
  3. Take sensible precautions to avoid being bitten by daytime mosquitoes. 
  4. If you feel sick, see the doctor. 
  5. I will update you all as I know more. 

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