Update: USA Today reports that the CDC has linked the Zika virus with the deaths of two Brazilian babies with microcephaly. The birth defect has long been associated with the disease but this is the strongest confirmation of their connection thus far.
This article was originally published on January 27, 2016.
There’s no doubt about it: The Zika virus is sweeping through the Western Hemisphere at a rapid rate, and filling your news feed with panic in the process.
Before you freak, know that the only people in the United States who have the virus have caught it while traveling abroad. But it is true that the Pan American Health Organization (a regional office of the World Health Organization) anticipates that the virus will spread to every country in the Americas, except Canada and continental Chile. How worried should you be? And what is Zika, anyway? Here’s everything you should know.
First things first: What exactly is Zika?
It’s a virus that’s related to other mosquito-borne diseases like dengue and chikungunya. People can become infected with Zika after being bitten by a certain mosquito (the Aedes species to be exact — more on that later). The virus isn’t new — at least, not to many around the world. Zika was first discovered in Uganda in 1947, and up until last year, the virus mainly hung out in parts of Africa, Southeast Asia, and the Pacific Islands. Then, sometime around May 2015, the virus hopped over to the Americas. Since it’s just recently arrived in the Western Hemisphere, those of us on this side of the world haven’t built up an immunity to Zika yet, and we might be particularly sensitive — in fact, experts say that’s one possible reason why it’s spreading so rapidly. What are the symptoms?
About 80% of people who catch the Zika virus won’t show any symptoms at all; the other 20% might have a mild fever, a rash, some joint pain, or conjunctivitis. (Muscle pain and headaches can occur too.) Whatever the symptoms, they’ll likely only last for a few days, probably a week at most. In most cases, the symptoms are manageable, and don’t require hospitalization. After that, it clears out of your system, and that’s the end of it, says Daniel Lucey, MD, MPH, an adjunct professor of microbiology and immunology at Georgetown University Medical Center.
That doesn't sound so bad. Why all the commotion?
The reason so many people are talking about this right now is because experts are worried about a possible link between the Zika virus and a birth defect called microcephaly. (We say “possible,” as according to the Centers for Disease Control and Prevention (CDC), it’s still just an “association” — albeit one that’s looking more and more certain every day.) Microcephaly is characterized by a smaller-than-average head, and usually indicates an underdeveloped brain as well. This can set these babies up for a lifetime of problems, including vision loss, seizures, learning disabilities, and more. This is a BFD considering that previously, experts thought that Zika mostly caused minor symptoms, rarely required hospitalization, and ultimately resolved itself on its own. Brazil has been dealing with a Zika virus outbreak since early 2015, and in September of last year, there was a huge jump in the number of reported cases of microcephaly — possibly an increase of 20 times the average amount. Further testing revealed that the virus was found in the amniotic fluid of two women whose fetuses had microcephaly, and another report on 35 women showed that all of them had either lived in or visited regions that were known to be affected with Zika. Given the growing certainty about the link to birth defects, and the spread of the virus, experts are rightfully flagging Zika as a huge concern for everyone right now. Governments in El Salvador, Colombia, and Ecuador are going so far as to urge women to put off getting pregnant completely for months — even years in El Salvador’s case, in an effort to prevent potential birth defects.
So where is Zika currently spreading?
With the disclaimer that it’s changing fast (Puerto Rico just reported its first locally acquired case), just know the CDC has issued a travel alert for 22 countries and territories in the Americas. An “alert” from the CDC means certain people (in this case, pregnant women) should avoid traveling there, and anyone should take “enhanced precautions.” It’s one step below a travel “warning,” which means the risk is high enough that the best advice is to completely avoid a trip there. As of now, the list of countries with a CDC alert for Zika includes: Cape Verde, Samoa, Barbados, Bolivia, Brazil, Colombia, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, U.S. Virgin Islands, and Venezuela. The CDC says that pregnant women should delay visiting those areas if possible. (Some airlines are reportedly offering refunds on tickets to Zika-affected countries if you’ve already booked.) If you’re currently trying to get pregnant, the CDC says to talk with your doctor before finalizing your travel plans. And if you’re pregnant and you must travel, take precautions against mosquitoes and watch for symptoms. If you start to feel sick within two weeks upon your return, you'll need a Zika virus test. As for all nonpregnant travelers to these countries, the best thing you can do is try to avoid being bit by a mosquito. That’s easier said than done, of course, but you might have more options that you think: Wear long sleeves, use EPA-registered insect repellent, and get rid of (or stay away from) any standing pools of water, which are fertile breeding grounds for mosquitoes. And finally, if you’ve recently been traveling to any of the countries on the CDC’s list and you start feeling sick, definitely see a doctor.
It’s a virus that’s related to other mosquito-borne diseases like dengue and chikungunya. People can become infected with Zika after being bitten by a certain mosquito (the Aedes species to be exact — more on that later). The virus isn’t new — at least, not to many around the world. Zika was first discovered in Uganda in 1947, and up until last year, the virus mainly hung out in parts of Africa, Southeast Asia, and the Pacific Islands. Then, sometime around May 2015, the virus hopped over to the Americas. Since it’s just recently arrived in the Western Hemisphere, those of us on this side of the world haven’t built up an immunity to Zika yet, and we might be particularly sensitive — in fact, experts say that’s one possible reason why it’s spreading so rapidly. What are the symptoms?
About 80% of people who catch the Zika virus won’t show any symptoms at all; the other 20% might have a mild fever, a rash, some joint pain, or conjunctivitis. (Muscle pain and headaches can occur too.) Whatever the symptoms, they’ll likely only last for a few days, probably a week at most. In most cases, the symptoms are manageable, and don’t require hospitalization. After that, it clears out of your system, and that’s the end of it, says Daniel Lucey, MD, MPH, an adjunct professor of microbiology and immunology at Georgetown University Medical Center.
That doesn't sound so bad. Why all the commotion?
The reason so many people are talking about this right now is because experts are worried about a possible link between the Zika virus and a birth defect called microcephaly. (We say “possible,” as according to the Centers for Disease Control and Prevention (CDC), it’s still just an “association” — albeit one that’s looking more and more certain every day.) Microcephaly is characterized by a smaller-than-average head, and usually indicates an underdeveloped brain as well. This can set these babies up for a lifetime of problems, including vision loss, seizures, learning disabilities, and more. This is a BFD considering that previously, experts thought that Zika mostly caused minor symptoms, rarely required hospitalization, and ultimately resolved itself on its own. Brazil has been dealing with a Zika virus outbreak since early 2015, and in September of last year, there was a huge jump in the number of reported cases of microcephaly — possibly an increase of 20 times the average amount. Further testing revealed that the virus was found in the amniotic fluid of two women whose fetuses had microcephaly, and another report on 35 women showed that all of them had either lived in or visited regions that were known to be affected with Zika. Given the growing certainty about the link to birth defects, and the spread of the virus, experts are rightfully flagging Zika as a huge concern for everyone right now. Governments in El Salvador, Colombia, and Ecuador are going so far as to urge women to put off getting pregnant completely for months — even years in El Salvador’s case, in an effort to prevent potential birth defects.
So where is Zika currently spreading?
With the disclaimer that it’s changing fast (Puerto Rico just reported its first locally acquired case), just know the CDC has issued a travel alert for 22 countries and territories in the Americas. An “alert” from the CDC means certain people (in this case, pregnant women) should avoid traveling there, and anyone should take “enhanced precautions.” It’s one step below a travel “warning,” which means the risk is high enough that the best advice is to completely avoid a trip there. As of now, the list of countries with a CDC alert for Zika includes: Cape Verde, Samoa, Barbados, Bolivia, Brazil, Colombia, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, U.S. Virgin Islands, and Venezuela. The CDC says that pregnant women should delay visiting those areas if possible. (Some airlines are reportedly offering refunds on tickets to Zika-affected countries if you’ve already booked.) If you’re currently trying to get pregnant, the CDC says to talk with your doctor before finalizing your travel plans. And if you’re pregnant and you must travel, take precautions against mosquitoes and watch for symptoms. If you start to feel sick within two weeks upon your return, you'll need a Zika virus test. As for all nonpregnant travelers to these countries, the best thing you can do is try to avoid being bit by a mosquito. That’s easier said than done, of course, but you might have more options that you think: Wear long sleeves, use EPA-registered insect repellent, and get rid of (or stay away from) any standing pools of water, which are fertile breeding grounds for mosquitoes. And finally, if you’ve recently been traveling to any of the countries on the CDC’s list and you start feeling sick, definitely see a doctor.
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Is it really only spread by mosquitoes?
Based on the available evidence right now, experts say that this is how the virus spreads: An infected person gets bitten by an Aedes mosquito, which then goes on to feed on another person, passing the virus to him or her in the process. In medical parlance, the mosquito is the most likely vector — a bug that spreads the disease.
That said, Zika remains a rare virus, and since there aren’t a ton of cases to study, questions remain about how it spreads. For example, there is some research that suggests the Zika virus might be able to reside in a man’s semen — and if that’s the case, it might be possible to contract the infection through sex. Another long shot possibility: It might be able to spread via a blood transfusion. However, these things remain extremely unlikely at this point, especially considering that very few people in the U.S. have the virus. The bigger concern right now is the threat posed by Zika-carrying mosquitoes.
How bad could it get in the U.S.?
Since the United States is home to two species of mosquitos that can spread the virus, Aedes aegypti and Aedes albopictus, experts expect that Zika will eventually migrate stateside. However, people from the U.S. have returned home with Zika viral souvenirs in the past — according to one press briefing, CDC officials said that 14 travelers tested positive for Zika between 2007-14. Plus, there have been outbreaks of dengue and chikungunya in the U.S. as well, and neither of these viruses have run rampant over the countryside. (Though perhaps it’s worth pointing out that the Zika virus is the fourth unexpected infection to reach the Western Hemisphere in the past 20 years, according to a 2016 article in The New England Journal of Medicine.) While experts seem to be cautiously optimistic, they’re also taking it seriously. Neither the CDC or the American College of Obstetricians and Gynecologists have suggested that women put off trying to conceive for any amount of time. However, if you’re pregnant or trying, avoid Zika-affected areas when possible.
How is Zika treated?
Since there’s no medication designed to target Zika specifically, the most doctors can do is manage symptoms. “The overwhelming majority of people get better on their own,” Dr. Lucey says. The CDC recommends rest and fluids, and treating any joint pain with medicines like acetaminophen. No one has developed a vaccine yet. And since the symptoms seemed pretty mild (and the link to microcephaly wasn’t previously known), a Zika virus vaccine hasn’t been a top priority for experts and pharmaceutical companies. While recent events will probably change this, it takes years to develop a vaccine. If we were to see a Zika vaccine, it’s unlikely that it would be developed in under three years, Dr. Lucey says.