An interview with Dr. Lark Coffey, an expert in mosquito-borne viruses, for women trying to conceive.
If you are trying to get pregnant this summer, you are probably like every other woman trying to conceive and highly concerned about the Zika virus. All the news channels, big and small, have covered Zika virus, but there are still so many unanswered questions. Now that summer has arrived and mosquito season has started, we met with Dr. Lark Coffey who is an expert on mosquito-borne viruses to see if we can get to the bottom of some these questions.
Q: If I’m pregnant and get mosquito bites, what do I do?
A: If you get mosquito bites in the Continental U.S., do not worry about Zika virus infections since the virus has not established mosquito-borne transmission here.
If neither you or your partner have traveled to South or Central America or the Caribbean since mid-2015 or had sexual intercourse with someone who returned from one of those areas, the risk of either of you having had Zika virus is zero.
Q: But I heard that there have been cases in the U.S.? Do I need to be worried?
A: Not yet since the virus has not established local transmission between mosquitoes and people in the Continental U.S.
Q: My partner and I traveled to a Zika virus endemic area a couple months ago and now trying to conceive. Do I need to worry?
A: Even if you were infected with Zika virus during your travels, the virus will not cause infections in a baby that is conceived after the virus has been cleared from your blood, a period that has long since passed.
Q: My husband and I are trying to get pregnant and I want to understand how long the virus is a threat if he gets infected with it.
A: Zika virus can be found in semen for 2 months or longer and in men who are not ill, so if your husband has been to South or Central America or the Caribbean (the endemic areas) where Zika virus outbreaks are ongoing, it is best for him to get tested for evidence of recent infection. If laboratory tests show that he has been infected, use condoms for at least 2 months to reduce the risk of transmission to you via intercourse.
Q: I keep reading about if my husband travels to the location to wear condoms, but we are trying to get pregnant! What are our options if he (or we) have traveled to a Zika infected area?
A: I understand your conundrum. Given that Zika virus causes severe neurologic outcomes in some babies born to infected mothers, it is best to be extra careful. If your husband has to travel to a Zika virus endemic area, use condoms until he can get tested to make sure that he did not get infected during his travels. If he did not get infected, it is safe to have intercourse without risk of transmission without condoms. Here are CDC recommendations to reduce your risk of getting bitten.
Q: Is the Zika virus really as scary as the media is making it out to be?
A: Zika virus causes microcephaly, abnormally small brains, in a small fraction of infants born to mothers who were infected during their pregnancy, an outcome that makes the virus very scary and has probably led to media attention. In South and Central America and the Caribbean, where the virus has been recently introduced and is spreading and since relatively little is known about Zika virus, clinicians and scientists are all very concerned because so many questions about Zika virus and pregnancy are unknown. For example, we don’t know if there is a safe time to travel during pregnancy. Maybe if a woman is further along in the pregnancy their baby is not at risk for severe disease, but we simply don't have that information yet.
Q: If I’m trying to conceive and want to travel to Zika virus endemic areas, what do I need to know?
A: The Centers for Disease Control advises women trying to conceive not to travel to endemic areas. Follow the CDC travel recommendations and plan your trip in safe areas that have no local transmission, if possible.
Q: I’m trying to get pregnant now, so what exactly do I need to know to protect myself?
A: Trying not to get infected is the only way to currently protect yourself. For a person in the U.S., this means not traveling to an endemic area.
Q: What is being done about this problem? Will they have a vaccine soon?
A: Scientists in the medical and research communities are working together to contribute their expertise towards developing therapies or vaccines against Zika virus. Although there are vaccine candidates in development, a safe vaccine approved for use in people requires extensive testing, which takes time. Another approach is to eliminate the species of mosquitoes that transmit Zika virus. Even EO Wilson, an ecologist who favors biodiversity, said he would be happy if mosquito vectors of human pathogens were eliminated from earth. Click here to read more about eradicating the killer-mosqitoes.
Q: Is every pregnant woman bit by a mosquito carrying the Zika virus going to have a baby with birth defects?
A: No, probably a very small fraction of infants born to infected mothers will develop microcephaly or other birth defects. The reasons for different outcomes in different mothers are not known.
Q: Will the Olympics increase the risk for it to become a problem?
A: Increased travel out of Brazil during the Olympics does have the potential to increase the spread of Zika virus internationally, especially since about 80% of infected people who are capable of transmitting to mosquitoes do not get sick and would therefore not change their travel plans due to illness.
Q. Can you share with us what you personally are currently working on?
A: I study viral genetics with a goal of understanding whether Zika virus has changed since invading the Americas. There have been Zika outbreaks in Africa and Asia for over 70 years without massive outbreaks on the scale of what is now occurring in the Americas. One possible explanation for this increase in disease is that the virus in the Americas has mutated to be more efficiently transmitted by mosquitoes or cause more severe disease in people.
In summary, if you live in the U.S., for the time being you have nothing to worry about but you should plan your summer vacations in areas that have not been affected by the Zika virus. While it's best to mitigate getting bitten by following the CDC guidelines even if you live in the U.S., try and relax. Enjoy the process of getting pregnant if you can- it is one of the most exciting times in your life. We hope this interview helps to relieve you of some questions and confusion.
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For more resources:
The New York Times has a great article for more information
The CDC is your most reliable resource for information regarding the virus
Time Magazine for updated coverage
A special thank you to Lark L. Coffey from Davis Arbovirus Research and Training Center for Vectorborne Diseases Department of Pathology, Microbiology and Immunology University of California, Davis.