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Sick of the Zika

As infection rates rapidly increase across the globe, the Zika virus is raising alarms in the medical community—not for its symptoms but for its link to congenital microcephaly, miscarriages and other adverse fetal outcomes for pregnant women. Orlando physicians, as well as the entire medical community, are on high alert for signs of the virus, yet they advocate calm, as there’s little risk to local residents unless they travel to infected regions.

Of course, it is possible for visitors to bring it with them. “Orlando is a major tourist destination, so we expect to see more people traveling here from areas where Zika transmission is active,” says Dr. Antonio Crespo, Orlando Health infectious disease specialist. Furthermore, a new study from the National Center for Atmospheric Research says that Orlando is one of the U.S. cities with the highest risk of an outbreak this summer

The Centers for Disease Control and Prevention (CDC) report 49 cases of Zika confirmed in travelers returning to Florida, but that number will grow. Mosquito-borne transmission of Zika virus was declared a public health emergency by the World Health Organization in February. It’s active in Central and South America, the Commonwealth of Puerto Rico, the U.S. Virgin Islands and American Samoa. Though the transmission of Zika through mosquito bites is not recorded in the continental U.S., Crespo says the risk exists in many states, including Florida.

“We have similar climates as the affected areas as well as native populations of the Aedes aegypti mosquitoes known to carry the virus,” Crespo says. “It’s possible it could happen, but it’s unlikely the virus will spread in the same fashion. Our living conditions are better compared to the countries where it’s spreading. Plus, our health departments are on high alert, and we are acting quickly to monitor and control transmission.”

An Uninvited Pest

Originally discovered in 1947 in the Zika forest of Uganda, the virus has since been reported in tropical Africa, Southeast Asia, the Pacific Islands, and Central and South America, along with Puerto Rico and parts of the Caribbean. In addition to bites, the virus can spread to women through unprotected sexual activity. The CDC issued a health advisory following the case of possible sexual transmission in Texas. As of February 23, the CDC and state public-health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several involving pregnant women.

“If one of our local residents has not traveled to any of the countries where the virus is actively spreading, it’s very unlikely that they have the virus,” Crespo says. “The only possibility is if they’ve come into close contact to someone who has been to one of those areas, either by sexual transmission or through a mosquito who bit the same person.”

The Florida Department of Health describes Zika as a mild fever with symptoms including rash, joint pain, conjunctivitis (reddening of eye), body aches, headache, eye pain and vomiting. The illness typically resolves within a week, though rare, severe cases require hospitalization. Also, treatment is symptomatic, since there is no specific cure or vaccination.

Impact on Pregnant Women—and Possibly Men

The Ministry of Health of Brazil first reported an increase in the numbers of newborns with microcephaly in areas experiencing Zika outbreaks. Now, accumulating evidence documented by the American Medical Association links maternal Zika virus infection with the aforementioned adverse fetal outcomes.

“At this point, pregnant women are the biggest group who need to take this seriously,” Crespo says. “If possible, pregnant women should avoid travel to areas where virus is spreading. If you have to go, take precaution to avoid mosquito bites, [which pose] the highest risk for complications.”

Dr. Kristina McLean, fellow of the American Congress of Obstetricians and Gynecologists and healthcare provider at Women’s Centre for Excellence in Clermont, agrees Zika’s effects on pregnancy and its lack of treatment or vaccine are the main reasons the virus is causing so much concern.

“We’ve seen the virus in placentas and amniotic fluid,” McLean says. “But if you test positive, we have no treatments available, and we’re about a year away from having a vaccine.”

A lot of unknowns surround Zika, including whether a patient is protected from reinfection. “If you were Zika-positive last year, can you get pregnant next year? Are you protected from reinfection like chicken pox? We don’t know that yet,” McLean says.

What McLean, along with the rest of the health community, does know is that infections during pregnancy increase one’s risk of miscarriage. That’s why she recommends asymptomatic screenings. “Although there isn’t a specific treatment, the earlier [a pregnant woman’s] aware of an infected pregnancy, the more options she has.”

It’s not just women who are concerned about contracting the virus, though the CDC has yet to report transmission of Zika from infected women to their sex partners. Bryan Roy, CEO of Southwest Orlando Family Medicine, says men are also conscientious of their role in the spread of Zika and want to know how they can protect their family. “We don’t have clear guidance as to what to tell men aside from using condoms or abstaining from sex,” Roy says.

Protecting Yourself

The Orlando region has a projected risk for potential spread of the virus due to large, local mosquito populations. This is the reality of living in a hot, swampy state with lots of standing water. Experts all agree the best way to protect oneself from the risk of mosquito-borne transmission is by following simple mosquito-protection precautions.

McLean says the key protective measure is one we all should be taking anyway. “The most important thing is protecting yourself from the bite,” she says. “Don’t go out at dusk when mosquitos are swarming and feeding. Wear long sleeves and pants to cover your body. Look around your property for any standing water where mosquitos might breed. Call a pest control company and have them spray for mosquitos.”

Doing so will not only protect against Zika but also the more common and more deadly mosquito-borne dengue and West Nile virus infections.

Additionally, if you travel to an infected area and experience symptoms within two weeks, visit your physician or a clinic. Pregnant women who travel to those areas should visit their physician upon return even if they don’t have any symptoms. “They’ll test you for Zika and prescribe monthly growth ultrasounds to specifically monitor head size and brain tissue of the fetus,” McLean says.

To put Greater Orlando’s risk in perspective, Dr. Crespo says local residents should be just as worried, if not more, about the recent significant increase in flu activity. “It’s much more likely for someone to get influenza, which has just as serious consequences, and it can be prevented with a vaccine.”

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