By now, many of you have heard about the Zika virus and may be concerned about the risk here in Texas. Zika virus is a mosquito borne virus that generally produces non-specific influenza-like symptoms such as fever, rash, conjunctivitis, muscle aches, and joint pain. Symptoms generally appear 2-12 days after a bite by an affected mosquito and typically resolve in about a week. Only 25% of people who acquire the virus have symptoms. This is generally a self-limiting virus that does not require hospitalization. The problem, however, is that if a pregnant woman acquires the infection the virus may cause microcephaly in her infant. Infants with microcephaly have a small head and may be born without a fully developed brain. This may lead to very significant neurological problems and can even be fatal.
The Zika virus has primarily been identified in countries and territories in Central and South America and the Caribbean including Puerto Rico. The most alarming number of Zika related microcephaly has occurred in Brazil where the number of cases surged from an average of 150 to nearly 4,000 in 2015. This is especially worrisome that the summer Olympics are scheduled to be held in Brazil this summer.
Last week the CDC issued a Travel Advisory recommending women who are pregnant, or may become pregnant, NOT travel to 14 countries where the virus is spreading. *See CDC Travel Health Notices webpage for current updates.
On January, 11 2016 the first case of Zika was confirmed in Texas. A traveler who had recently returned from El Salvador to Houston tested positive for the virus. She contracted the virus not in Houston, but in El Salvador. Local transmission in the US has not yet been reported. Southwestern Texas, however, does have 2 species of Aedes mosquitos that are known to transmit the virus. The CDC expects to see more Zika cases among travelers visiting or returning to the US. This is likely to increase the chance for localized spreading in areas such as the Gulf Coast of Texas and Florida.
The best way to prevent infection is, of course, to avoid mosquitos. As we move into spring and summer months we need to implement aggressive mosquito control measures. This would include emptying any outdoor containers that hold water, repairing septic tank leaks and using window screens. People that are likely to be exposed to mosquitos should wear protective clothing and use one of the CDC recommended insect repellents such as DEET, picaridin, oil of lemon eucalyptus or IR3535. These are all compatible with use during pregnancy. When used with sunscreen, apply the repellant after the sunscreen. There is currently no vaccine for the virus.
The current recommendation for testing is to test pregnant women who have travelled to a country where Zika transmission is ongoing, and who develop symptoms within 2 weeks of their travel. There is no currently available commercial test, but testing can be done at the CDC and several state labs.
For now, the bottom line is not to panic. Do not plan to travel to the affected countries if you are pregnant or planning pregnancy. When warmer weather arrives avoid mosquito breeding areas, wear sleeves outdoors, and use insect repellant.