THE Z WORD

Preface:

For those who don’t know, my not-so-little sister is kind of a big deal. While I was always drawn to social and creative things in my youth, my sis was busy planning to be a mad scientist. And she did just that.

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So when a few medical woes began to arise in our RM community on repeat, I thought – “Who better to ask for some advice (and serious scientific backing) than the family genius!”. Thankfully I was able to coax her into carving out time to contribute to The Rebel Mama, because that’s what older sisters do. 

Today, we’re tackling the Zika Virus since many of our fellow soon-to-be mamas are either panic stricken somewhere in the South, or completely reluctant to book anything. Hopefully, this can answer a few questions. 

xx A

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Written by: Agatha Jassem

I went to university for 10 years. 10 YEARS. Following that, I was in a fellowship program (like being a resident), and accumulated many letters that now follow my name. I got my first big girl job this past year at age 33.

While I know there is no perfect time to have kids, I wanted to wait until I got this far in my career so I could survive in North America’s most expensive city on maternity leave. So here I am, feeling like I’m 100 (because my students stay the same age) and preparing to start a family with over a decade of experience in microbiology.

Many mamas have told me that while they love their babes more than anything, life with them is full of sacrifices and I just experienced my first. I cancelled a fully booked trip to Thailand just two weeks before departure. Why? The most infamous Z word for mommy’s-to-be today: Zika.

Unfortunately, with the onslaught of information that is presented to us every day it can be hard to find quick answers your most pressing questions. So here is some simplified information on what is known about Zika virus for North Americans planning to travel (disclaimer: there is still a lot that is not known).

Where and how can I get a Zika virus infection?

1. Through a mosquito bite in an area where Zika virus is found:

Zika virus is carried by species of the Aedes mosquito (aegypti and albopictus), so you can locally-acquire an infection where the mosquitos are found. Currently: the US (some southern areas of Florida and Texas), the Caribbean, Central America, South America, the Pacific Islands, and Southeast Asia. The jist: hot and wet places.

2. Through sex, anywhere: Add Zika virus to the STI list, because it can spread through sexual exposures from someone who is infected even if they don’t have symptoms.

What are the symptoms of a Zika virus infection?

People infected with Zika virus often won’t have any symptoms or will only have mild symptoms that include fever, rash, joint pain, red eyes, muscle pain, and headache (think: a flu-like illness). Symptoms last for a couple of days up to a week.

What health problems can result from Zika virus infection?

1. Congenital abnormalities in babies born to infected moms:

Zika virus infection during pregnancy can lead to a variety of defects and disorders in babies, including microcephaly (abnormally small head size), decreased brain tissue and brain damage, mental health disorders, damage in the eyes, seizures, irritability, hearing loss, too much muscle tone that restricts movement, and joints with a limited range of motion. And the list may only with grow with information coming from the follow-up of infected children. Most birth defects are associated with infection in the late first and early second trimester, but defects have also been reported after third-trimester infections.

2. A neurological disorder in adults:

Zika virus infection is strongly associated with the development of Guillain-Barré syndrome (GBS), a rare neurological disorder characterized by muscle weakness (mostly in the limbs) and sometimes paralysis because of nerve damage. Most people recover fully from GBS but some are left with permanent damage.

How is Zika virus infection diagnosed and who should get tested?

1. Through tests that detect the virus:

In symptomatic persons Zika virus can be detected within 14 days of symptom onset by tests for viral RNA that are performed on blood and urine. A positive test result confirms Zika virus infection but a negative test result does not rule out infection. For asymptomatic pregnant women who have traveled to areas with Zika virus, this type of testing is also recommended within 2 weeks of the last possible exposure.

2. Through tests that detect antibodies to the virus:

A symptomatic person or asymptomatic pregnant woman who traveled to an area with Zika virus can also be tested for Zika virus specific IgM antibody. This antibody develops within a week of Zika virus infection and can be detected in blood up to 12 weeks later. But antibodies to other related viruses such as Dengue can also give positive results, so a positive result has to be confirmed with another antibody test and false-positive results are still possible.  

How is a Zika virus infection treated?

There is so specific drug or vaccine treatment for Zika virus infection. Symptoms of the infection can be managed like for other infections; with rest, fluids, and medications that reduce fever.

How can I prevent getting a Zika virus infection?

There is no vaccine for Zika virus at this time, but:

If you are travelling to a place where Zika virus is present, prevent mosquito bites by wearing long-sleeved shirts and long pants or clothing treated with permethrin, staying in places that are air-conditioned with window and door screens or using a bed net, and wearing insect repellent that includes specific ingredients like DEET. Mosquitos that spread Zika virus bite mostly during the day, especially around sunrise and sunset, but can also bite at night.

If  you plan to have sex with someone who may have had a Zika virus infection, prevent sexual transmission of the virus, by using condoms or abstaining from having sex. Men who traveled to an area with Zika virus or who had an infection should wait at least 6 months after travel or after symptoms started before trying to conceive with their partner. Women should wait at least 8 weeks after travel or after symptoms started before trying to get pregnant.

Finally, the ultimate question, should I go on vacation to that tropical destination?

The US CDC recommends that those who are planning to get pregnant, or already pregnant women should avoid nonessential travel to areas that may have Zika virus.

My advice: talk to a healthcare professional to get all the latest information about the specific destination you want to travel to and ultimately, travel at your own risk.

When I was planning my trip to Thailand, I went to a travel clinic and I did my reading. I bought bug spray and insect repellent clothes. For a long time I was adamant about still going to Thailand with my husband while trying to get pregnant. But as the departure day got closer and closer I became more and more anxious. 

What are the odds of getting infected? How much do preventative measures decrease these chances? How likely is it that Zika virus would affect my baby if I was infected and got pregnant at that time or shortly after? These were the questions I was asking, but these are also the questions for which there aren’t clear answers to yet, and there would always be a risk of the worst possible scenario.

In the end, just two weeks before we were to leave, I decided I couldn’t go. 

Personally, I think creating a person, pushing them out of your body and caring for them the rest of your life, is terrifying enough. Plus, I wouldn’t enjoy my vacation in an air-conditioned room wearing long pants with a swatter in my hand, and I was done with postponing pregnancy any longer.

This is an individual travel decision each of us moms-to-be have to make. On the upside though, I’ll be snowboarding in Japan instead so life is still pretty fucking awesome.

**

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Agatha Jassem, PhD, D(ABMM), FCCM, is a Clinical Microbiologist at the British Columbia Centre for Disease Control (translation: oversees a lab that diagnoses infectious diseases) and a Clinical Assistant Professor at the University of British Columbia (translation: puts on a teaching and research hat when not doing the above). She is also a proud Rebel Auntie to Aleks’ son Oscar.

Keep up with DR Ags on Twitter @agathajassem

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Featured Image: Vogue, December 1966
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One Comment Add yours

  1. MissLam says:

    Agatha, thanks for your post. I have a (nerdy) question about the zika virus. As viruses never leave your body, is it possible that a child who gets infected will carry the virus through the rest of their lives and possibly infect their own children? I know this is decades down the road but might be deduced from what we know about dengue viruses already. Thanks.

    Like

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