Zika (19 page)

Q. If my husband has been to a place with Zika, what are the chances that he got it?

A. Unfortunately, that is just not knowable. The risk varies not just by country but by region as well. A buggy lowland area of Mexico can be dangerous, while Mexico City may be perfectly safe because it's located too high for mosquitoes.

Q. Can my husband/boyfriend get it from sex with another woman who has Zika?

A. Probably not. As of this writing, there have been no documented cases of female-to-male human transmission. So if he says, “I swear, dear, I got it from a mosquito bite,” he's probably telling the truth.

Q. Can my husband/boyfriend get it from sex with another man who has Zika?

A. Yes. But if your husband or boyfriend is bisexual, you may face other risks, including HIV, syphilis, gonorrhea, and chlamydia, which are more common among gay and bisexual men.

Q. Can my husband or boyfriend give me Zika even though he never felt sick?

A. Possibly. Men have definitely transmitted Zika to their wives
before
falling ill. Whether a man can have no symptoms at all and still transmit the infection is unknown.

Q. Should men who have returned from a Zika area be sperm donors?

A. There have been no known cases of transmission that way, but since it's a sexually transmitted disease, sperm banks should take the same precautions against it that they do against other STI's.

Q. If I get inseminated with sperm from a sperm bank, what are the chances it has Zika virus in it?

A. This is a new area. But in theory at least, the chances should be low. Sperm banks should screen donors and sperm should be tested for virus. However, no test is perfect.

Q. Can I get Zika from anal sex, oral sex, or any other form of sex?

A. Definitely from anal sex. Transmission by oral sex is suspected but not proven. The virus has been found at high levels in semen, blood, and urine, and at low levels in saliva. Transmission by kissing has not been documented and is thought to be unlikely. Contact between infectious fluids and mucus membranes like the insides of vaginas, rectums, and mouths, or with the eyes or nose, is not considered safe. Contact with hands, breasts, or any part of the body covered by intact skin probably is.

Q. I'm a gay man. Can I get Zika from anal sex from my boyfriend?

A. Absolutely, yes. It has happened.

Q. If I'm pregnant, and have had Zika, how soon will I be able to tell whether my baby has been hurt?

A. If you had a positive Zika test, your doctor should schedule ultrasounds and MRIs as often as every three weeks. They may suggest amniocentesis, to look for virus in the fluid around the baby. No one knows how long from the date of infection it takes for damage to show up on an ultrasound, but changes indicating brain damage have been detected as early as week 19 of pregnancy, in the second trimester.

Q. If I have had Zika, what are the chances that my baby has been hurt?

A. No one knows. The majority of babies whose mothers had Zika appear normal at birth. Very early studies suggested the chances of brain damage are somewhere between 1 percent and 29 percent, which is a very wide margin. A CDC-sponsored study published May 25 found the risk of microcephaly to be as high as 13 percent. It did not make estimates for other types of fetal brain damage. Bigger studies that should answer the question more accurately are now underway.

Q. If I have Zika, can I safely breastfeed my child?

A. Although the virus has been found in breast milk, breastfeeding has has never been proven to transmit it, so the WHO and CDC recommend that women with Zika continue to breastfeed. They believe the benefits greatly outweigh the risks.

Q. Is there a Zika vaccine? Will there be?

A. No, not yet. Nearly 20 laboratories are working on them, but lengthy testing is mandatory. The most optimistic scenarios hope for one by late 2018. Sometime before 2021 is considered more realistic. Some pessimists fear the risk of triggering Guillain-Barré paralysis will make a vaccine impossible.

Notes

Note: Page numbers listed correspond to the print edition of this book. You can use your device's search function to locate particular terms in the text.

CHAPTER 1

15
“Zika doesn't worry us”
: Donald G. McNeil Jr., Simon Romero, and Sabrina Tavernise, “How a Medical Mystery in Brazil Led Doctors to Zika,”
New York Times
, Feb. 6, 2016, http://www.nytimes.com/2016/02/07/health/zika-virus-brazil-how-it-spread-explained.html.

CHAPTER 2

18
“Ziika”—the spelling was shortened
: Josh Kron, “In a Remote Ugandan Lab, Encounters with the Zika Virus and Mosquitoes Decades Ago,”
New York Times
, April 5, 2016, http://www.nytimes.com/2016/04/06/world/africa/uganda-zika-forest-mosquitoes.html.

19
On April 19, 1947
: Jon Cohen, “Zika's Long Strange Trip into the Limelight,”
Science
, Feb. 8, 2016, http://www.sciencemag.org/news/2016/02/zika-s-long-strange-trip-limelight.

20
a “filterable, transmissible agent”
: G. W. A. Dick, S. F. Kitchen, and A. J. Haddow, “Zika Virus (I). Isolations and Serological Specificity”
Transactions of the Royal Society of Tropical Medicine and Hygiene
, Sept. 1952, p. 509, http://trstmh.oxfordjournals.org/content/46/5/509.full.pdf+html.

25
“an African female aged 10”
: F. N. Macnamara, “Zika Virus: A Report on Three Cases of Human Infection during an Epidemic of Jaundice in Nigeria,”
Transactions of the Royal Society of Tropical Medicine and Hygiene
, March 1954, p. 139, http://trstmh.oxfordjournals.org/content/48/2/139.full.pdf+html?sid=864a5093-2f7f-4f0b-ba6d-30030da79028.

27
After marking the spot
: W. G. C. Bearcroft, “Zika Virus Infection Experimentally Induced in a Human Volunteer,”
Transactions of the Royal Society of Tropical Medicine and Hygiene
, Sept. 1956, p. 442, http://trstmh.oxfordjournals.org/content/50/5/442.full.pdf+html?sid=ad409066-59d5-4ef4-a3a7-29dd4a149ae1.

28
In 1964, another researcher
: D. I. H. Simpson, “Zika Virus Infection in Man,”
Transactions of the Royal Society of Tropical Medicine and Hygiene
, July 1964, p. 335, http://linkinghub.elsevier.com/retrieve/pii/0035920364902007?showall=true.

32
In March 2016, researchers
: Shannan L. Rossi et al., “Characterization of a Novel Murine Model to Study Zika Virus,”
American Journal of Tropical Medicine and Hygiene
, March 28, 2016, doi:10.4269/ajtmh.16-0111.

CHAPTER 3

37
The first time Zika was noticed
: Mark R. Duffy et al., “Zika Virus Outbreak on Yap Island, Federated States of Micronesia,”
New England Journal of Medicine
, June 11, 2009, doi:10.1056/NEJMoa0805715.

38
Dengue kept looking
: Austin Ramzy, “Experts Study Zika's Path from First Outbreak in Pacific,”
New York Times
, Feb. 10, 2016, http://www.nytimes.com/2016/02/11/world/asia/zika-virus-yap-island.html.

39
“We worked through hot”
: Tai-Ho Chen et al., “Zika Virus Outbreak—Yap, Micronesia, June 2007,”
EIS e-Bulletin
, March 2008.

40
“Our health care system”
: Reuters Health E-Line, “Little Known Virus Causes Outbreak in Pacific Isles,” Reuters, July 10, 2007, http://www.reuters.com/article/us-virus-mosquito-zika-idUSHKG4179220070710.

41
On October 7, 2013
: Henri-Pierre Mallet et al., “Epidémie de virus Zika en Polynésie française” (PowerPoint presentation at interregional conference on public health surveillance, Fort de France, Martinique, Nov. 5–7, 2015).

41
“Tahiti is a small island”
: Jason Beaubien, “Zika in French Polynesia: It Struck Hard in 2013, Then Disappeared,” NPR News, Feb. 9, 2016, http://www.npr.org/sections/goatsandsoda/2016/02/09/466152313/zika-in-french-polynesia-it-struck-hard-in-2013-then-disappeared.

41
The first household
: Van-Mai Cao-Lormeau et al., “Zika Virus, French Polynesia, South Pacific, 2013” (letter),
Emerging Infectious Diseases
, June 1, 2014, doi:10.3201/eid2006.140138.

42
The first was a woman
: E. Oehler et al., “Zika Virus Infection Complicated by Guillain-Barré Syndrome—Case Report, French Polynesia, December 2013,”
Eurosurveillance
, March 6, 2014, doi:http://dx.doi.org/10.2807/1560-7917.ES2014.19.9.20720.

43
“Up till then, everyone”
: Damien Mascret, “Interview with Dr. Sandrine Mons,”
Le Figaro
, Feb. 18, 2016, http://sante.lefigaro.fr/actualite/2016/02/18/24642-tahiti-zika-etait-considere-comme-benin.

44
Four cases of “immune”
: “Surveillance de la dengue et du zika en Polynésie française,”
Centre d'Hygiène et du Salubrité Publique
, Feb. 7, 2014, http://www.hygiene-publique.gov.pf/IMG/pdf/bulletin_dengue_07-02-14.pdf.

44
The worst-off was Larry Ly
: Karen Weintraub, “Scientists Link Zika Firmly to Paralysis, as Patients in Tahiti Know Too Well,”
STAT News
, Feb. 29, 2016, https://www.statnews.com/2016/02/29/zika-guillain-barre-tahiti/.

44
As fear of the disease
: “Epidémie de Zika: La ministre de la santé au chevet des malades,”
Tahiti Infos
, Feb. 22, 2014, http://www.tahiti-infos.com/forum/Epidemie-de-Zika-La-ministre-de-la-sante-au-chevet-des-malades_m195232.html.

45
Finally, the French high commissioner
: “Les maires résistants aux pulvérizations d'insecticide rappelés à l'ordre,”
Tahiti Infos
, Feb. 19, 2014, http://www.tahiti-infos.com/L-epidemie-de-zika-recule-mais-la-situation-sanitaire-reste-tendue_a95004.html.

45
By April 2014, when
: Henri-Pierre Mallet, “Emergence du virus Zika en Polynésie française” (PowerPoint presentation at national infectious disease conference, Bordeaux, France, June 11–13, 2014).

46
The Guillain-Barré “attack”
: Van-Mai Cao-Lormeau et al., “Guillain-Barré Syndrome Outbreak Associated with Zika Virus Infection in French Polynesia: A Case-Control Study,”
Lancet
, Feb. 29, 2016, http://dx.doi.org/10.1016/S0140-6736(16)00562-6.

46
In an interview
: Gwendoline Dos Santos and Frédéric Lewino, “Scandal: Health Authorities Ignore a Leading Zika Specialist,”
Le Point
, Feb. 3, 2016, http://www.lepoint.fr/sante/zika-la-propagation-de-l-epidemie-etait-previsible-depuis-2014-03-02-2016-2014974_40.php.

46
In 2015, when France's High Council
: Dos Santos and Lewino, “Scandal.”

47
From Tahiti, the virus
: “L'épidémie de zika en phase terminale en Polynésie française,”
Tahiti Infos
, April 9, 2014, http://www.tahiti-infos.com/L-epidemie-de-zika-en-phase-terminale-en-Polynesie-francaise_a98643.html.

48
Dr. Musso then
: Didier Musso, “Zika Virus Transmission from French Polynesia to Brazil,”
Emerging Infectious Diseases
, Oct. 2015, http://dx.doi.org/10.3201/eid2110.151125.

48
But in March 2016
: Nuno Rodrigues Faria et al., “Zika Virus in the Americas: Early Epidemiological and Genetic Findings,”
Science
, March 24, 2016, http://science.sciencemag.org/content/early/2016/03/23/science.aaf5036.

48
In April, researchers
: John Lednicky et al., “Zika Virus Outbreak in Haiti in 2014: Molecular and Clinical Data,”
PLOS Neglected Tropical Diseases
, April 25, 2016, http://dx.doi.org/10.1371/journal.pntd.0004687.

49
This was not the first
: “L'origine de l'épidémie de zika en Polynésie restera un mystère,”
Tahiti Infos
, Dec. 9, 2013, http://www.tahiti-infos.com/Dengue-Zika-la-chasse-aux-moustiques-doit-etre-totale_a89989.html.

CHAPTER 4

52
Hospital hallways
: Donald G. McNeil Jr., Simon Romero, and Sabrina Tavernise, “How a Medical Mystery in Brazil Led Doctors to Zika,”
New York Times
, Feb. 6, 2016, http://www.nytimes.com/2016/02/07/health/zika-virus-brazil-how-it-spread-explained.html.

53
As well they might
: J. P. Messina et al., “Mapping Global Environmental Suitability for Zika Virus,”
eLife Sciences
, Jan. 18, 2016, http://simonhay.well.ox.ac.uk/uploads/publications/309/Messina_MappingGlobalEnvSuitZikaVirus_2016_provis_SI.pdf.

54
After that, the greatest
: Van-Mai Cao-Lormeau et al., “Guillain-Barré Syndrome Outbreak Associated with Zika Virus Infection in French Polynesia: A Case-control Study,”
Lancet
, Feb. 29, 2016, http://dx.doi.org/10.1016/S0140-6736(16)00562-6.

CHAPTER 5

59
He forwarded me
: S. C. Weaver and W. K. Reisen, “Present and Future Arboviral Threats,”
Antiviral Research
, Oct. 24, 2009, doi:10.1016/j.antiviral.2009.10.008.

61
On Google News
: Shasta Darlington, “Brazil Warns against Pregnancy Due to Spreading Virus,” CNN News, Dec. 24, 2015, http://www.cnn.com/2015/12/23/health/brazil-zika-pregnancy-warning/.

62
A few years earlier
: Donald G. McNeil Jr., “Fast New Test Could Find Leprosy before Damage Is Lasting,”
New York Times
, Feb. 19, 2013, http://www.nytimes.com/2013/02/20/health/fast-new-test-could-help-nip-leprosy-in-the-bud.html.