It’s been over a year since the World Health Organization declared the association of Zika infection with microcephaly and other neurological disorders as a “Public Health Emergency of International Concern.” A lot has happened since then including several confirmed cases in the United States. In April 2017, the Centers for Disease Control and Prevention published a report of babies born in the US whose mothers possibly had been infected with Zika virus.
Dr. Meiling Parker, maternal-fetal medicine specialist with Minnesota Perinatal Physicians, a part of Allina Health, is here to give the latest update on Zika virus and what women and men who are planning for a family should know.
Recent Zika Virus Updates 2017
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Learn more about Meiling Parker, MD
Meiling Parker, MD
Meiling Parker, MD is a board-certified maternal-fetal medicine specialist with Minnesota Perinatal Physicians, part of Allina Health. Minnesota Perinatal Physicians offers expert and personalized high-risk obstetrical care for all maternal health concerns, pregnancy complications and fetal abnormalities.Learn more about Meiling Parker, MD
Transcription:
Recent Zika Virus Updates 2017
Melanie Cole (Host): It's been over a year since the World Health Organization declared the Association of Zika Infection with microcephaly and other neurological disorders as a public health emergency of international concern. A lot has happened since then, including several confirmed cases in the United States. My guest today is Dr. Meiling Parker. She's a maternal fetal medicine specialist with Minnesota Perinatal Physicians, a part of Allina Health. So, Dr. Parker, welcome to the show. We’re here to do some updates on the Zika virus and what women and men who are planning for a family need to know. So, what has changed? We're into 2017 now, and what is the Centers for Disease Control and Prevention speaking about now?
Dr. Meiling Parker (Guest): Hi, good morning, Melanie. Thanks for having me back. In the last year, scientists have been able to now detect Zika virus in brains, amniotic fluid and placentas of affected babies, and they have also been able to isolate Zika virus in specific areas of injured brain cells. So, using these studies as well as others, the CDC has now concluded that there is enough evidence to support the Zika virus is a cause of microcephaly and other severe brain anomalies. In addition, using what we know about the current outbreak in Brazil, scientists have estimated that the risk of microcephaly with a first trimester infection is between 1% and 13%. There's not enough data at this point to estimate what the risk is when the parent is infected in the second and third trimester, but scientists think it's probably a little bit less than infection in the first trimester.
Melanie: So, what does this mean for women who are planning a family or for the men involved in the situation as far as travel? I mean, we've come up to the summer, people want to travel plus in certain parts of the United States it's been identified. What do we need to know about this upcoming summer?
Dr. Parker: Well, it's important to check the CDC website for recent updates regarding areas with local transmission, and it's really important for pregnant women and those who are trying to become pregnant to avoid traveling to those areas with active transmission because it's important to know that there's still no cure for Zika virus or for congenital Zika virus.
Melanie: So, can you give us an update, Dr. Parker, on where the Zika virus is currently found or if it's active in parts of the United States?
Dr. Parker: So, there have been over 5,000 cases total reported in the US, and these are contained within every state except for Alaska. There are now cases of local mosquito-borne transmission in Florida and Texas and those counties and areas are on the CDC website, but the main areas to avoid in Florida would be Miami, Dade County and then Brownsville, Texas.
Melanie: Wow, so a question that I have heard people ask is if this is being spotted in Florida or in Texas, can the mosquitos carrying this virus -- can they travel? Can they fly to other parts or is it being transmitted by somebody in that area coming into this area and brining it that way?
Dr. Parker: Well, the range of the mosquito is pretty short, so it's unlikely for a mosquito in Texas to make its way up to for example, Minnesota, but people who are infected in Texas who then travel to other states, and who are bitten by a mosquito while they still have virus in their blood have the potential for infecting mosquitos in that local area, so that's mostly how the infection was spread across the US.
Melanie: So then speak about how it is spread person to person? What are the modes of transportation?
Dr. Parker: Well, we do know that Zika is sexually transmitted so it can be passed through secretions during intercourse. There are also cases of Zika identified in donor blood as well as, you know, one or two cases of laboratory transmission. There has been a case where two people living in the same household transmitted Zika virus to each other, but it's not known at this point what that specific route of transmission was.
Melanie: Is there any new news about diagnosing Zika if you are a pregnant woman, and you think you might have been exposed to this virus, what do you do?
Dr. Parker: Well, the first thing is to notify your OB/GYN provider so that testing can be done. Even women without symptoms who suspect that they were exposed either by travel or by an infected partner can be tested and so the testing modalities are still the same. It will involve a blood sample and a urine sample as well as ultrasounds during pregnancy.
Melanie: And then is this something that if they detect it, this is reported?
Dr. Parker: Yes.
Melanie: --I mean this is something that gets reported to the CDC and then what's a woman to do about that? How does her OB/GYN and Dr. Parker, you know, you're a maternal fetal medicine specialist so what would you do with the woman if you have discovered that she has Zika? How do you help her through that pregnancy?
Dr. Parker: So, keeping in mind that even with confirmed Zika infection, a minority of women will go onto have congenital Zika infection or babies affected by Zika; however, every woman with confirmed infection needs to be followed closely throughout pregnancy, and that's mostly by following the growth of the baby with ultrasound and using ultrasound to look for Zika specific birth defects as well. These babies after birth will also have blood testing done in order to confirm congenital Zika infection.
Melanie: So, women should stay away from these certain areas -- kind of wrap it up for us with some updates for women and men who are planning a family, and what they should take into account in regards to the Zika virus this year and what it means for pregnant women and those trying to become pregnant.
Dr. Parker: So, there is still no cure for Zika virus so the most important thing is preventing Zika infection, and the easiest way to do that is to avoid traveling to areas with active Zika transmission, and those areas are all outlined on the CDC website so before traveling to other countries, or to the southern United States, women and their partners should check the CDC website for the most up-to- date guidelines. If travel is absolutely necessary, they should make every attempt to avoid being bitten by a mosquito, so that means using mosquito repellent with DEET, using mosquito netting at night, staying away from outdoor areas and staying in lodgings that has air conditioning rather than opening windows.
If a woman has to travel to these areas, they should notify their OB/GYN so that testing can be done when they return and so that their babies can be followed with ultrasound. If their partner has suspected or known infection, they should abstain from intercourse for the remainder of pregnancy or use condoms every time.
Melanie: It's really important information, and thank you so much Dr. Parker for being with us again. You're listening to the Wellcast with Allina Health and for more information, you can go to allinahealth.org. That's allinahealth.org. This is Melanie Cole. Thanks so much for listening.
Recent Zika Virus Updates 2017
Melanie Cole (Host): It's been over a year since the World Health Organization declared the Association of Zika Infection with microcephaly and other neurological disorders as a public health emergency of international concern. A lot has happened since then, including several confirmed cases in the United States. My guest today is Dr. Meiling Parker. She's a maternal fetal medicine specialist with Minnesota Perinatal Physicians, a part of Allina Health. So, Dr. Parker, welcome to the show. We’re here to do some updates on the Zika virus and what women and men who are planning for a family need to know. So, what has changed? We're into 2017 now, and what is the Centers for Disease Control and Prevention speaking about now?
Dr. Meiling Parker (Guest): Hi, good morning, Melanie. Thanks for having me back. In the last year, scientists have been able to now detect Zika virus in brains, amniotic fluid and placentas of affected babies, and they have also been able to isolate Zika virus in specific areas of injured brain cells. So, using these studies as well as others, the CDC has now concluded that there is enough evidence to support the Zika virus is a cause of microcephaly and other severe brain anomalies. In addition, using what we know about the current outbreak in Brazil, scientists have estimated that the risk of microcephaly with a first trimester infection is between 1% and 13%. There's not enough data at this point to estimate what the risk is when the parent is infected in the second and third trimester, but scientists think it's probably a little bit less than infection in the first trimester.
Melanie: So, what does this mean for women who are planning a family or for the men involved in the situation as far as travel? I mean, we've come up to the summer, people want to travel plus in certain parts of the United States it's been identified. What do we need to know about this upcoming summer?
Dr. Parker: Well, it's important to check the CDC website for recent updates regarding areas with local transmission, and it's really important for pregnant women and those who are trying to become pregnant to avoid traveling to those areas with active transmission because it's important to know that there's still no cure for Zika virus or for congenital Zika virus.
Melanie: So, can you give us an update, Dr. Parker, on where the Zika virus is currently found or if it's active in parts of the United States?
Dr. Parker: So, there have been over 5,000 cases total reported in the US, and these are contained within every state except for Alaska. There are now cases of local mosquito-borne transmission in Florida and Texas and those counties and areas are on the CDC website, but the main areas to avoid in Florida would be Miami, Dade County and then Brownsville, Texas.
Melanie: Wow, so a question that I have heard people ask is if this is being spotted in Florida or in Texas, can the mosquitos carrying this virus -- can they travel? Can they fly to other parts or is it being transmitted by somebody in that area coming into this area and brining it that way?
Dr. Parker: Well, the range of the mosquito is pretty short, so it's unlikely for a mosquito in Texas to make its way up to for example, Minnesota, but people who are infected in Texas who then travel to other states, and who are bitten by a mosquito while they still have virus in their blood have the potential for infecting mosquitos in that local area, so that's mostly how the infection was spread across the US.
Melanie: So then speak about how it is spread person to person? What are the modes of transportation?
Dr. Parker: Well, we do know that Zika is sexually transmitted so it can be passed through secretions during intercourse. There are also cases of Zika identified in donor blood as well as, you know, one or two cases of laboratory transmission. There has been a case where two people living in the same household transmitted Zika virus to each other, but it's not known at this point what that specific route of transmission was.
Melanie: Is there any new news about diagnosing Zika if you are a pregnant woman, and you think you might have been exposed to this virus, what do you do?
Dr. Parker: Well, the first thing is to notify your OB/GYN provider so that testing can be done. Even women without symptoms who suspect that they were exposed either by travel or by an infected partner can be tested and so the testing modalities are still the same. It will involve a blood sample and a urine sample as well as ultrasounds during pregnancy.
Melanie: And then is this something that if they detect it, this is reported?
Dr. Parker: Yes.
Melanie: --I mean this is something that gets reported to the CDC and then what's a woman to do about that? How does her OB/GYN and Dr. Parker, you know, you're a maternal fetal medicine specialist so what would you do with the woman if you have discovered that she has Zika? How do you help her through that pregnancy?
Dr. Parker: So, keeping in mind that even with confirmed Zika infection, a minority of women will go onto have congenital Zika infection or babies affected by Zika; however, every woman with confirmed infection needs to be followed closely throughout pregnancy, and that's mostly by following the growth of the baby with ultrasound and using ultrasound to look for Zika specific birth defects as well. These babies after birth will also have blood testing done in order to confirm congenital Zika infection.
Melanie: So, women should stay away from these certain areas -- kind of wrap it up for us with some updates for women and men who are planning a family, and what they should take into account in regards to the Zika virus this year and what it means for pregnant women and those trying to become pregnant.
Dr. Parker: So, there is still no cure for Zika virus so the most important thing is preventing Zika infection, and the easiest way to do that is to avoid traveling to areas with active Zika transmission, and those areas are all outlined on the CDC website so before traveling to other countries, or to the southern United States, women and their partners should check the CDC website for the most up-to- date guidelines. If travel is absolutely necessary, they should make every attempt to avoid being bitten by a mosquito, so that means using mosquito repellent with DEET, using mosquito netting at night, staying away from outdoor areas and staying in lodgings that has air conditioning rather than opening windows.
If a woman has to travel to these areas, they should notify their OB/GYN so that testing can be done when they return and so that their babies can be followed with ultrasound. If their partner has suspected or known infection, they should abstain from intercourse for the remainder of pregnancy or use condoms every time.
Melanie: It's really important information, and thank you so much Dr. Parker for being with us again. You're listening to the Wellcast with Allina Health and for more information, you can go to allinahealth.org. That's allinahealth.org. This is Melanie Cole. Thanks so much for listening.