Dear Alice,
I read that Zika is now in the U.S. Should I be afraid? Do I need to wear bug spray all the time now? I heard it may be spread by more than mosquitoes. The media reports are all over the place. What's the real deal, Alice?

Dear Reader,

All the buzz about a mosquito-borne disease can definitely feel confusing. To clear the air, here's the just-the-facts version of the Zika virus outbreak: Originally occurring in Africa, Asia, and the Pacific Islands, Zika virus arrived as the new kid on the block in the Americas in spring 2015. While the vast majority of these new cases are currently in South America, Central America, and the Caribbean, there have been cases reported in the United States primarly from people who contracted the virus while traveling to the U.S.'s southern neighbors.

  • The not-so-great news is that there will likely be more and more cases coming into the U.S. from travelers returning from affected areas, thus increasing the number of people becoming ill and the risk of person-to-person transmission in the U.S.
  • The good news is that Zika virus is a reportable disease in the U.S., which facilitates the ability to diagnose it and helps health experts track the transmission of the virus. This, in turn, helps decrease the chances of it spreading further. What's more, the Centers for Disease Control and Prevention (CDC) does not anticipate widespread transmission in the continental U.S.

Kudos to you for asking for more info and clarity; it’s wise to learn more and to be prepared with prevention methods (which do include, but aren’t limited to, insect repellant). And, you’re right that mosquitoes are the most common vector (i.e., an organism that transmits disease) for Zika virus, but there are other ways it may be passed from person-to-person, so keep reading for more details. Beyond the news reports and what’s shared here though, there are some other great go-to resources when it comes to reliable information on infectious diseases.

Time to talk transmission: The primary way the virus is transmitted from one human to another is through bites from an aedes aegypti and albopictus mosquitos. But, that’s not the only way; it may also be passed from mothers to babies through pregnancy and birth, through semen during sex, and via blood transfusions (though a self-deferral process is being implemented for blood donors who have recently traveled to affected areas). In general, the groups at highest risk for contracting the virus are those who live in affected areas and those who frequently travel to areas where the virus is most common. Those who live in areas in the U.S. with lots of mosquitos and those whose (male) sexual partners may have been exposed to the virus are also at a higher risk of becoming infected.

For those who become infected, it's been noted that only about one in five people will actually develop symptoms. They are typically mild and include a fever, rash, conjunctivitis, muscle pain, or headaches that last about a week. Hospitalizations and deaths from Zika virus are rare. Interestingly, because symptoms might appear similar to other conditions, such as dengue fever, a diagnosis via blood test is necessary to rule out any other conditions. To muddy the waters even more, there are a number of unknowns about the virus' potential links to complications, such as Guillian-Barre syndrome, and the association of babies with unusually small heads (a condition called microcephaly) born to mothers who were infected with the virus while pregnant. As such, if any symptoms associated with Zika virus are suspected, it’s a good idea to consult with a health care provider. Most folks who are infected and experience symptoms, will recover in about a week with rest, fluids, and the use of over-the-counter pain relievers such as acetaminophen to relieve pain and fever (avoiding the use of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) is recommended, particularly before dengue fever can be ruled out, due to potential hemorrhaging risk).

When it comes to prevention, you’re off to a good start with the use of insect repellent, as one of the most critical prevention strategies is to keep those mosquitos at bay. Here are a few more details and ways to ward off these buggers:

  • Use insect repellent that is approved by the Environmental Protection Agency (EPA).
  • In hot and humid weather, stay indoors in air-conditioned spaces or put screens in the windows and entryways to the outdoors to keep those pesky buggers out.
  • Wear long sleeves and pants, or consider buying permethrin-treated clothing (fabric that is treated with insect repellent) if you'll be in a mosquito-riddled area.
  • Avoid areas where there's standing water, such as puddles, swamps, or clogged drains, and keep garbage tied up in bags to fend off mosquito breeding grounds.

There are a few additional actions that may be appropriate to take to further reduce transmission risk:

  • If you’re a male (or have a male sex partner) that lives in or has traveled to an affected area, practicing sexual abstinence or correct and consistent condom use is recommended.
  • Because of the potential effect on fetuses, those who are currently pregnant are advised to speak with a health care provider if symptoms associated with the virus are present or if a male sex partner has been exposed.
  • If you're planning to travel, the Centers for Disease Control and Prevention (CDC) has a map of affected areas and travelers’ health information that may be useful to consult prior to departure. The U.S. Department of State also issues travel health advisories that you can check out before you go.

It’s great that you’re looking for out for reliable information on this outbreak, because knowing the facts can help you make decisions on how to protect yourself and your loved ones. It’s also good to know that researchers around the world are already hard at work learning more about links to potential complications, developing a vaccine, and specific treatment for the virus — so keep your eyes peeled for more news on that. One final tip as you continue to stay informed about Zika virus: while the news media is great for keeping you in the loop about day-to-day events, turning to a few trusted resources as more is discovered on this topic, such as the World Health Organization (WHO), the CDC, and even your state and local health departments, will help you sort the out the facts!

Alice!

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