The Zika virus epidemic in Brazil is causing concern not only among pregnant women, but among all Brazilians. Today we summarise basic facts about this serious public health situation.
What it the Zika virus
Zika is a virus in the same family of viruses that cause dengue and yellow fever, and is spread by bites from the Aedes mosquito, just like those other diseases. Zika was discovered in the Zita forest of Uganda in 1947, and the first outbreak outside of Africa only occurred in 2007. Only in the past year has it been seen in Brazil and Columbia.
The risk for babies and others
The Zika virus appears to be the cause of the epidemic of microcephalous that has been seen in the past several months in the Northeast of Brazil. So far over 1700 cases have been reported, which is over 10 times the normal rate. Microcephalous is a condition where the baby is born with a smaller than normal head size and brain, accompanied by an inflammatory process in the nervous system, causing various degrees of mental retardation. There is no cure, and the children need a lifetime of supportive care.
If a pregnant women is bitten by an infected mosquito, particularly in the first and perhaps second trimester, the virus could attack the nervous system of her fetus.
The other serious consequence of Zika is that is there has also been a sharp increase in a neurologic disorder, Guillan-Bare disease, which occurs in children or adults. The symptoms are weakness or paralysis that starts in the legs and moves upwards. If it affects the breathing muscles, artificial ventilation is required, but fortunately, most cases resolve over time. It is not certain, but it is likely, that the Zika virus in some cases triggers Guillan-Bare disease, an autoimmune problem where the body makes antibodies against the nervous system.
Probably 80% of people infected by Zika have no symptoms, but the remaining 20% suffer from headache, rash, fever, conjunctivitis, weakness, and joint pains. The symptoms appear 3 to 12 days after the bite of an infected mosquito, and the symptoms last up to a week. Unlike dengue, bleeding is not part of the disease, and most people recover without problem. Hospitalization is rarely needed, and deaths have not been reported. The disease only acts cruelly if it strikes certain pregnant women.
Similar to dengue and chikugunya, there is no specific treatment besides supportive care. Non-aspirin pain relievers such as paracetamol are recommended, as the symptoms can be confused with dengue, where bleeding is a real risk and any aspirin products should be avoided.
What should women of child-bearing age do
While the Brazilian Health Authority has not yet recommended women avoid pregnancy, but many leading infectious disease experts recommend women throughout Brazil (not just in the Northeast) should absolutely avoid getting pregnant until the situation is clarified. The risk appears too great, and the consequences are so severe.
What about women already pregnant
See your obstetrician for orientation and maximize all mosquito prevention measures.
Use insect repellent at least 3 times per day, and re-apply more often if you sweat a lot or get wet. Note that home-type or “natural” repellents such as citronella are unfortunately not nearly as effective as commercial products.. The Aedes mosquito bites throughout the day and into evening. If you use a sunscreen, use that first, then the repellent. Use long sleeves and long pants if you can tolerate that.
Clean up any standing water (where the mosquitos breed) at home and work, use screens on windows and doors, and preferably maximize your time in air conditioned environments, Finally, you might avoid traveling to areas of particularly high risk.
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