Medical / Travel

Zika Virus- The Real Story

You are in a contagious area and have symptoms of Zika virus. The area is exotic and your wife, having no symptoms of Zika, wants to be romantic although she forgot her birth control pills. Should you have intercourse or let her get angry, throw things, and call you horrible names?

I can’t say I have been in this situation although I have had plenty of experience with Dengue and occasionally West Nile virus. The Aedes species mosquito is the vector in all of these viruses classified as flaviviruses.

Zika virus was discovered in 1947 in the Zika Forest of Uganda. Imagine that! As of February, 2016, the Zika virus is thought to have spread to 26, primarily tropical and sub-tropical countries, including a huge outbreak in Brazil where the upcoming 2016 Olympics will be held. Of greatest concern is the effect of this virus on unborn children.

Symptoms are similar in infants, adults, and children and include two or more of the following:

  • Rapid onset of fever. Usually not greater than 101° F as with most viruses.
  • A maculopapular (flatten or raised red) rash.
  • Joint pain.
  • Eye redness.
  • A mother can pass this virus to an unborn fetus possibly causing severe neurological effects and microcephaly (small head size).
  • Another neurological disorder, Guillain-Barre, is thought to be a possible sequelae (after effect). Therefore any numbness or weakness, particularly ascending i.e. from feet to waist or hands to shoulders, and any other neurological symptoms in children or adults should be taken very seriously.

Time from bite to infection is thought to be 3 days to 2 weeks.

Treatment:

  • Generally supportive.
  • Aspirin should be avoided until Dengue fever has been ruled out due to hemorrhage risk.
  • There is no vaccine currently.

Intercourse:

This virus can be transmitted by an infected male through vaginal, oral, and anal routes, although, according to the CDC, it cannot be transmitted via deep oral kissing. Therefore, infected males should abstain from any intercourse or use condoms for at least 6 months after an infection. The contrary is not true i.e. females do not seem to pass Zika to males and according to the CDC, do not pass it on through breast milk. The CDC further states that the benefits of breast feeding definitely outweighs the risks of Zika infected females not breast feeding.

Prevention:

  • Avoid known mosquito breeding areas. Typically around stagnant water.
  • Empty water sitting in containers, old tires, and cover garbage bins, etc.
  • Use air conditioning indoors and screen windows.
  • Wear lose fitting, long sleeve shirts and pants. Clothing is now available with sunscreen ratings up to SPF 50 and some impregnated with insect repellent.
  • Mosquito netting. This is the only safe prevention that I know of for infants ≤2 mos.
  • Insect repellents containing DEET (30% preferably), picaridin (20%), IR3535 (sounds real healthy doesn’t it?), and some oil of eucalyptus (this should not be used on any child ≤ 3 y.o. according to the CDC) as always, follow the manufactures directions and test a small amount on the skin first for about one hour to assure there is no allergic response.

Note: You can use sunscreen and insect repellent together. Put the sunscreen on first.

Note: Media sources suggest that a pesticide called pyriproxyfen may be the source of microcephaly instead of Zika as it is used in mosquito endemic areas. The CDC seems to strongly disagree, saying this pesticide has been used for years without seeing any Zika microcephaly outbreaks.

Note: Some repellents damage plastics or poly-carbonates so avoid getting on your eye glasses; tableware; and flashlights, headlights, or torch lenses, etc.

 

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