Zika In Perspective
Insect repellents are considered safe for use on pregnant and breastfeeding women and on children 2 months of age and older.
In February, the World Health Organization declared the Zika virus a public health emergency of international concern. That same month, the first two cases of Zika, including that of a pregnant woman, were reported in Washington state. Both individuals had traveled to affected regions abroad and contracted Zika there.
The virus isn’t new; it was first detected in Africa in the 1940s, but did not start causing outbreaks until a few years ago. Zika is spread to people through the bite of infected mosquitoes, primarily Aedes aegypti mosquitoes, which aren’t found in our state, though summer travel plans may put you in close contact.
For expectant moms and women trying to get pregnant, there is reason for concern. The Zika virus can be passed from a woman to her fetus during pregnancy or at birth.
On April 11, Dr. Anne Schuchat, the principal deputy director of the Centers for Disease Control, spoke from a press conference about Zika at the White House. “Everything we look at with this virus seems to be a bit scarier than we initially thought,” said Schuchat. In addition to microcephaly (a significantly smaller head, due to abnormal brain development), Schuchat said the virus has been linked to a broader array of birth defects throughout a longer period of pregnancy, including premature birth and blindness. The CDC advises that pregnant women avoid travel to affected areas.
“I think it is important to keep this in perspective and not panic,” says Dr. Wendy Sue Swanson, MD, aka Seattle Mama Doc at Seattle’s Children’s Hospital. “It is a really small risk.”
However, for pregnant women, women trying to get pregnant and their sexual partners, Swanson believes that playing it safe is best. “The recommendation is to avoid unnecessary travel to affected areas,” she says. “In the same way you would take a prenatal vitamin, avoid alcohol, and try to eliminate mercury in your diet, why not avoid travel to places where your risk is increased?”
Dr. Hanna Oltean, MPH, Zoonotic Disease Epidemiologist with the Washington State Department of Health, agrees: “I would caution that a pregnant woman not travel to affected areas at any point during their pregnancy, even later in the pregnancy. There’s simply not enough known on outcomes of babies infected at birth. If they absolutely must travel, then they need to use really strict mosquito prevention.”
“DEET repellents tend to be the most effective,” says Swanson. While some parents worry about the safety of DEET, she points out that these insect repellents are considered safe for use on pregnant and breastfeeding women and on children 2 months of age and older by the CDC and the Food and Drug Administration.
“It’s a personal decision,” says Swanson, a mother of two. “But, for me, I am not scared of insect repellent; I am scared of infection. If I were traveling with my children to Hawaii, where cases of dengue fever — another mosquito-borne illness — are currently being reported, then I would use insect repellent. I want to keep them healthy.”
Oltean advises that the best way to ensure you have properly covered all of your child’s exposed skin is to apply the spray to your hands, then use your hands to apply it to your child.
While no insect repellent should be used on infants under 2 months of age, Oltean points out that parents can still take action to cover as much skin as possible with clothing, cover the stroller with a protective cover, keep them indoors when possible and avoid travel to areas where an outbreak of any kind of mosquito-borne illness is occurring.
This caution is just as important for soon-to-be fathers, since Zika also can be transmitted by a man to his sex partners. The CDC recommends that men who might have been exposed to the virus consider abstaining or using a condom.
“Detection of Zika in the blood is gone within about a week after it is first detected, but we don’t know if it stays longer in the body, and we do know it is sexually transmitted, so any pregnant woman should practice safe sex with a partner who could have been exposed to Zika,” says Swanson. There are several countries, including the U.S., where cases of Zika acquired by sexual transmission have been reported.
While we do not yet know all the long-term health outcomes for infants and children infected with Zika, Oltean says that as of now, “there is no evidence that Zika is more severe in children and infants than it is in adults.”
Protecting yourself and your family against mosquito bites here at home and when traveling is always important. As Oltean points out, the West Nile virus is carried by mosquitoes found in Washington state, and there is always concern for emerging infections.
“Get outside with your kids, travel, but use insect repellent,” says Swanson. “There is never a world with no risk, so we must mitigate the risk.”