Mothers and mothers-to-be assess the risk from Zika, take precautions – Baltimore Sun

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After marrying six months ago in Aruba, Laura and Rob Cancelliere planned to return for their first anniversary, but the Severna Park couple canceled the trip and even put thoughts of a baby on hold after learning about the emerging threat of the Zika virus.

Transmitted through mosquito bites and spreading rapidly through South and Central America, Zika in pregnant women has been linked to the devastating birth defect microcephaly, which stunts the brains and skulls of their fetuses.

“Sadly, will be holding off our plans for a family until we are certain that neither of us have any reason to believe we contracted or carry the virus,” Rob said.

With warm weather mosquito season on the horizon and expectations for Zika to spread into the United States, many local couples who already are pregnant or who want to be are scrapping travel plans, scouring the Internet for medical advice and stocking up on repellent to stave off a disease few heard of before this year. Doctors meanwhile are racing to understand the disease and develop a vaccine to prevent the infection.

So far there have been 426 confirmed U.S. cases of Zika, 12 of them in Maryland. All were determined to be travel related and included 36 pregnant women, at least one of them from the state. Ten cases nationally were sexually transmitted.

“Zika is the first vector-borne virus that appears to cause infection in fetuses, the first reliably spread by sexual transmission and now is a widespread epidemic,” said Dr. Lyle R. Petersen, director of the CDC‘s division of vector-borne diseases. “We must move extremely quickly. We have thousands of infections every single day in the Americas and we must be prepared.”

As fears rise, public health officials at all levels are trying to provide consumers with as much information as possible about the danger posed by Zika and how it spreads. Some local health departments are offering repellent and condoms, while mosquito control plans are being developed. In Maryland, state agricultural officials plan to treat any area where a case of Zika is recorded.

At the same time informal efforts targeting pregnant women have sprung up on social media and online as health columnists and mommy bloggers weigh in on Zika and try to provide helpful information.

Local women who are pregnant or want to become pregnant say the information has helped quell some anxiety but they note there is a lot the experts don’t know.

“When I first heard about Zika probably five or six months ago in countries to the south, it wasn’t really a concern,” said Kaysha Curro of Edgewater, who is eight months pregnant. “When I started hearing about cases in the United States, it really started to hit home. All of a sudden it was here and present and the questions started coming.”

Because the virus is expected to spread more actively in the United States during the summer, many women are looking for information and talking to their doctors about all things Zika.

“We aren’t specifically getting a lot more calls into the office from our patients but more women who are seeing us for prenatal care are asking us while they are there for their appointment — main concerns are travel to the South and should they postpone,” said Dr. Jeanne S. Sheffield, director of the division of maternal-fetal medicine at Johns Hopkins Medicine.

“I am also getting more calls from private physicians about how they should counsel the patients regarding summer travel,” she said.

The U.S. Centers for Disease Control and Prevention says the first line of defense is avoiding travel to places where Zika is actively spreading, a list that includes about three dozen countries mostly in South and Central America and the Caribbean, including the U.S. territory of Puerto Rico.

Women of child-bearing age, or who are pregnant, who travel to these areas should avoid going outside, and cover their skin and use repellent if they do to avoid mosquitos. They also should refrain from sex or use contraception during the trip and for two months after. They should also avoid sex or use contraception with men who have traveled to these areas for six months.

Even with the precautions, Zika “is something of a moving target,” said Dr. Roberta DeBiasi, chief of the division of infectious disease for the Washington-based Children’s National Health System.

“When advice changes, people may say the CDC doesn’t know what it’s doing, but the advice changes because we analyze more cases and update recommendations,” she said. “This is not a disease like malaria were we have 100 years of experience.”

DeBiasi points to CDC advice to cover up this summer, stay in air conditioned or screened rooms and use repellent approved by the Environmental Protection Agency. Products with DEET and picaridin are safe for pregnant and breast feeding women and children older than two months. Oil of lemon eucalyptus or PMD is an alternative to conventional repellent but not recommended for children under three. The CDC advises applying sunscreen and then repellent.

Health officials also advise clearing standing water where mosquitoes can breed in trash, flower pots and other containers every five days. Cover drains and rain barrels with netting or even stockings.

DeBiasi added that border states like Florida are likely to have the first cases of locally transmitted Zika, so it’s “reasonable” to avoid them too.

Aedes aegypti mosquitoes, the main carrier of Zika in affected countries, have not been found yet in Maryland this year, according to state agriculture officials. But the Aedes albopictus, or tiger mosquitoes, are more common in the state. They are considered less efficient Zika carriers, “but there’s no reason we could not have spread in the U.S. from them,” DeBiasi said.

Dr. Leana Wen, the Baltimore health commissioner, is more pointed, saying the Aedes albopictus poses a real threat because it needs so little water to breed and pools can form in trash as small as a bottle cap or vacant buildings. Baltimore, which sees 9,000 pregnancies a year, could be hard hit, she said.

“It’s not the Eastern Shore that will really be affected when it comes to Maryland,” Wen said of Zika, “it’s going to be Baltimore.”

For now, Zika infections are limited to people who have traveled who may or may not have symptoms, but guidelines would change if locally transmitted cases were found. Most people don’t even realize they are infected, but in some cases Zika symptoms include rash, fever, red eyes and joint pain.

Mothers and mothers-to-be assess the risk from Zika, take precautions – Baltimore Sun