If you are currently pregnant or hope to be soon, you're probably already paying attention to the growing threat of the Zika virus, because it has been linked to major birth defects. Although I am currently not in the market for a baby (sorry, Mama!), I have been keeping up with the virus's development in Puerto Rico, where I grew up, because the island has already been flagged as a potential Zika disaster area. Local transmission of the virus was initially reported in December, and as of this writing, the CDC estimates that as many as 100,000 Puerto Ricans could be infected in this outbreak.
Growing up on a tropical island, this isn't my first rodeo with mosquito-transmitted diseases. When I was a kid, Puerto Rico had a dengue-fever epidemic, which is how I learned about the Aedes aegypti mosquito, which also carries Zika. Chikungunya infected almost everyone I grew up with in the past two years (thank you, Facebook, for keeping me updated).
But Zika is a different, potentially more frightening animal than Dengue or Chikungunya, especially for young women. Ever since it was discovered that it may cause severe birth defects in children born to infected mothers — specifically microcephaly, which is a neurological condition where a baby is born with a smaller head and often has abnormal brain development — the stakes on prevention have gotten much higher. The virus can also be sexually transmitted, which is another reason young women may be alarmed.
What seems strangest about the situation is how much is currently unknown, and how much depends on the data gleaned from the first wave of pregnant women infected with the virus after they give birth. The CDC also just announced that the virus may be in as many as 30 U.S. states by this summer, and that it's "scarier than we initially thought." Very reassuring, thanks.
We talked with Dr. Dana Thomas, a medical epidemiologist who works for the CDC and the Puerto Rico Department of Health, to get facts about the disease and its effects and to learn more about prevention.
Laia Garcia: What is the general mood in the island right now? Are people taking it seriously? Are women more afraid than men are?
Dana Thomas: We've been conducting some focus groups, both with individual women and women in small groups, to discuss what their concerns are around Zika, and what do they feel might be effective or helpful in them preventing Zika infection. What I would say is that pregnant women are anxious. There's a lot of concern, and there's a sentiment that we can't do this alone because a lot of what you have to do to prevent Zika has to do with their community behaviors. Part of our messaging is that the entire community needs to wear repellent to keep the population viremia very low. It's not just on the pregnant woman. "You need to do this, you need to do that." They don't want to be told what they need to do, they want to be supported in what is going on.
We will see larger public service announcements and campaigns that will go out to the community at large. Certainly, we have a lot of folks at the ports that are trying to do education for travelers coming in and going home, but even bigger than that.
LG: What happens when someone is diagnosed with the virus? Is it a sit-and-wait? Are there any options, even though there's currently no cure?
DT: There's no cure. Just to back up, the interim guidelines the CDC has put forward certainly involve testing all symptomatic persons. Meaning: if you have a rash or you have an unexplained illness from another source, it could be an arbovirus [virus transmitted by mosquito or tick]. You send a blood specimen in for testing at the Puerto Rico Department of Health, and we test each specimen of an acute patient for Dengue, Chikungunya, and Zika, because the arbovirus family is so difficult to differentiate and a person could have any of the three. Certainly, physicians know to, as a priority, send in and label their specimens that are coming in from pregnant women.