What North Texas Women Need to Know about Zika / Experts urge pregnant women and women trying to conceive: Donít panic

WORDS
Rachel Bronson
ILLUSTRATION
John J. Custer
PUBLISHED
April 2016 in
DallasChild, FortWorthChild, NorthTexasChild
UPDATED
March 28, 2016
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It took Lake Highlands expectant mom Lindsey Edison and her husband more than a month to plan their five-day getaway to San Miguel de Allende in Mexico. The couple was excited to visit the picturesque artist community Edison says is known for its gorgeous hotels, restaurants and beautiful churches. The trip would have been a much-deserved babymoon for the super busy business owner and mother of two boys, 5 and 2.
 
But shortly after booking the trip, Edison, who is due in June with her third son, received an alarming email from her husband about a fast-spreading, mosquito-borne virus called Zika. Edison learned that Zika infection during pregnancy appears to be associated with grave outcomes, including microcephaly (a condition resulting in an abnormally small head and brain) in unborn babies. So she and her husband heeded the U.S. Centers for Disease Control and Prevention’s warning to avoid travel to Zika-infected countries (check the CDC’s travel information site for the most-up-to-date list) and canceled their trip.
 
Edison is not normally one to panic, nor fear the adventure of international travel — in fact, her family spent part of last summer living in Chile. But the jet setter didn’t hesitate when canceling her babymoon.
 
“I made the decision for myself that it was not worth the risk for me [to go to Mexico] pretty easily,” she says. And she’s had no regrets.
 
That’s because she canceled in mid-January. Since then, the virus has spread from a handful of countries in Central and South America to Puerto Rico and the U.S. Virgin Islands, among others. The World Health Organization (WHO) declared Zika virus a global public health emergency on February 1. Government and public health officials are scrambling to find a way to treat the disease, find a vaccine and stop it from spreading. And President Obama recently requested nearly $2 billion in emergency funding, part of which is earmarked for mosquito-control programs in at-risk southern U.S. states, especially in Florida and along the Gulf Coast, where mosquitoes of the Andes genus are common, the same mosquitoes that spread Zika.
 
Zika in Texas
As warmer weather approaches, pregnant women and those trying to conceive worry about a potential outbreak here.
 
And with good reason. According to Medical City OB/GYN Kelli Culpepper, MD, Zika is spread by the same mosquitoes that carry yellow fever or dengue, mosquitoes which can be found in North Texas. Plus, recent evidence suggests that Zika isn’t just spread through an infected mosquito but may be transmitted sexually (there has been one confirmed case in Dallas where the virus was transmitted this way). And we already know that Zika can be passed from mother to baby during pregnancy since the virus has been detected in fetal tissue, amniotic fluid, full-term infants and the placenta, according to the American College of Obstetricians and Gynecologists.
 
Experts studying infectious diseases say Texas should most certainly expect Zika. Dr. Joon Lee, associate professor of environmental and occupational health at University of North Texas Health Science Center (UNTHSC) in Fort Worth and the leading scientist in the partnership program of West Nile virus surveillance and response between Fort Worth and UNTHSC, says the virus is likely to make its way here because of the proximity to Mexico, Cuba and other Caribbean regions.
 
“Weather conditions more favorable to the virus in Texas also make it more likely to gain a foothold here than areas to our north,” Lee explains.
 
Epidemic in the making?
The medical community admits that there are a lot of unknowns about the virus that continues to evolve.
 
The challenge is that Zika is hard to detect — more than 80 percent of infected persons don’t exhibit any symptoms — and those who do typically write the rash, low-grade fever, conjunctivitis (pink eye) and joint pain off as a mild case of the flu.
 
But the consequences for a pregnant woman and her unborn baby can be devastating, which is why Dr. Sheila Chhutani, an OB/GYN at Texas Health Dallas, understands the scare surrounding the virus. Yet she doesn’t want her patients — or any other pregnant or trying-to-conceive woman — to panic.
 
“The uproar over Zika is not because it’s killing people, but because of what it can do to babies,” she says.
 
Research recently published in the New England Journal of Medicine links Zika to pregnancy loss, placental insufficiency, fetal growth restrictions, central nervous system injury, microcephaly and Guillain-Barré syndrome (GBS), a condition that causes the immune system to attack the body’s nerves, sometimes leading to paralysis or disrupted breathing.
 
Advice for Local Women
Doctors like Chhutani and Culpepper are urging all women of childbearing age — especially those who are pregnant, trying to conceive, or thinking about conception — to be vigilant, cautious and educated.
 
“Look at the CDC website once a week because this is definitely an evolving story,” Chhutani advises. “We’re not at the end; we’re just at the beginning, and the more educated we are, the less fearful we can be.”
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As a certified genetic counselor and director of nonprofit MothertoBaby of North Texas, a free help service made up of experts to answer questions during pregnancy and breastfeeding, Lori Wolfe has spent the last 25 years helping to educate mothers and mothers-to-be about preventing birth defects. In that time, Wolfe says she’s never seen anything like Zika.
 
“What makes this virus different is that it’s transmitted by mosquitoes that bite aggressively during the day, not just at dawn and dusk,” she explains. She doesn’t want women to panic, but she does want women — as well as elderly people, children and babies, or anyone with a weakened or developing immune system — to take all precautions possible to prevent Zika infection. Here, her tips:
 
Avoid travel to countries where Zika is prevalent. Monitor the CDC’s website for updated travel warnings and precautions.
 
Wear DEET-based, EPA-registered insect repellent — and reapply often. Wolfe suggests looking for repellents with lower levels of DEET, which are safe for pregnant and nursing women (check the label and follow the directions carefully).
 
Dress to repel. Wear loose-fitting clothing and cover up as much as possible with long-sleeves and pants instead of shorts (yes, even on the hottest days).
Treat your clothing. Spray clothing with insect repellent or permethrin (as the CDC recommends).
 
Practice safe sex. Even if you’re not traveling to an area where Zika has spread, women need to follow precautions with their partner. Practice safe sex or abstain if your partner gets a bite (for at least six months), especially if he’s traveled to a known danger zone.
 
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