Dear Doc:
My husband and I are planning on starting a family. With all the news about the Zika Virus and birth defects, am I am at risk for the virus here in Upstate New York?
Dear Reader:
The Zika Virus was first discovered in Uganda’s Zika Forest in 1947. The virus was initially thought to be a relatively benign mosquito borne disease. There are over 3,500 species of mosquitoes with about 175 species in the United States. Mosquito is Spanish for “little fly.” These little flies can fly at speeds up to 1.5 miles per hour, beat their wings 500 times per second, and live an average of two months.
Only female mosquitoes bite humans and animals. The females need protein for their eggs and must take a blood meal in order to reproduce. A female mosquito can drink up to three times her weight in blood! Don’t worry if you are a sanguivoriphobe (one who fears vampires or other blood eaters), it would take 1.2 million mosquito bites to drain the five liters of circulating blood from your body.
What we should worry about is being bitten by a mosquito that is carrying a parasite or virus that can be transmitted to us. In fact, mosquitoes are the deadliest animal on the planet! More than 200 million cases and 500,000 deaths are attributed to malaria each year. The parasite that causes malaria is transmitted to humans by mosquito bites. Mosquitoes are also responsible for transmitting dengue fever, yellow fever and viruses that may cause encephalitis (inflammation of the lining of the brain.)
Your skin and sweat produce more than 340 chemicals odors and some of them smell like lunch to mosquitoes. If your skin has higher amounts of cholesterol, folic acid, and certain bacteria you may be a preferred target for a bite. Mosquitoes can detect carbon dioxide (C02) up to 75 feet away and use this as a guide to their next feeding. Humans breathe in oxygen and exhale C02. Larger individuals, produce more C02, which is why mosquitoes are more attracted to biting adults over smaller children. Pregnant woman are at a higher “bite risk” as they produce and exhale a higher level of C02. After your exercise routine, the panting out of C02 may inadvertently alert the mosquito of a nearby meal.
Zika has been found in 44 countries. Outbreaks have occurred in Africa, Asia, and most recently in Latin and South America. Most that are infected with Zika are completely asymptomatic. If symptoms should develop they are mild, including fever, rash, joint pain, headache and/or conjunctivitis. However, Zika infections of pregnant women have been associated with the birth defect microcephaly, where the brain does not develop properly resulting in smaller head size and intellectual disability. Because of this risk to pregnancies, some countries have urged their citizens to avoid starting families until the Zika outbreak is controlled. Zika Virus may also cause Guillain-Barre Syndrome, a neurologic disorder resulting in muscle weakness and paralysis.
Zika is spread through the bite of the Aedes agegypti species of mosquitoes. These bugs are aggressive daytime biters (but they can bite at night as well.) The good news for us is that these mosquitoes are not yet in New York. However, Aedes albopictus, a related species is active downstate, and may be able to effectively transmit the virus if the mosquito becomes a carrier of Zika.
So far, more than 400 Americans have contracted the virus while overseas. It is estimated that 40 million Americans, 500,000 of them pregnant woman, will travel to Zika affected countries in the next year. Experts predict that many will unknowingly bring the virus home, leading to an increase of Zika in the United States. Zika has also been determined to be transmitted during sex, a first for a mosquito borne illness. It is recommended that women who have had possible Zika Virus exposure should wait at least eight weeks before attempting conception. Men who have had possible Zika exposure should use condoms or abstain from sexual activity for at least eight weeks in order to prevent disease transmission. If one has confirmed Zika, consider delaying conception for at least six months. If you have traveled to a Zika affected area or believe you may have contracted Zika from someone who has traveled, discuss testing options with your doctor. All testing in New York State needs prior authorization from your local health department. Currently there are no treatments or vaccines for Zika (but scientists are working on some now).
For now, as long as you are not planning any travel to Zika affected countries, Zika should not be a major concern for your family plans. However, to avoid possible mosquito borne diseases there are a number of things that can always be done to avoid mosquito bites. Staying indoors with screened or air conditioned rooms, wearing long sleeved shirts and long pants when outdoors, and the use of EPA registered insect repellent will reduce the risk of bites. (Insect repellent is not recommended for use in children under the age of 2-months-old). In addition, eliminating areas of standing water and trash will decrease breeding grounds for mosquitoes decreasing their numbers.
Stay healthy, and remember the quote by Christine Todd Whitman, “Anyone who thinks that they are too small to make a difference has never tried to fall asleep with a mosquito in the room!”
Dr. Nagpaul is a medical doctor and is board certified in Internal Medicine. He currently is the Medical Director at Newark-Wayne Community Hospital, DeMay Living Center and Wayne County Public Health. This column is meant to be educational and not intended to be used to make individual treatment decisions. Prior to starting or stopping any treatment, please confer with your own health care provider. To send questions to our medical providers, please email Dr. Nagpaul at Arun.Nagpaul@rochesterregional.org and put “Ask a Doc” in the subject line.
