Zika in Puerto Rico

Zika, Zika, Zika! Everyone’s talking about Zika! As you can imagine, in Puerto Rico it has been a huge topic of conversation lately. As the latest “new” mosquito-borne virus/disease there has been a lot of worry, alarm and confusion. Puerto Rico is the first place in the U.S. to face the full force of this virus. Unlike in the north where they can just simply say “avoid areas with Zika” when we live here, we are much more aware. Currently, about 700 people in PR have been confirmed with Zika and those numbers continue to grow. But what does that mean? Let’s first go over what Zika is and isn’t.

aedes
Aedes mosquitoes are large, slow and striped

Zika is a mosquito-borne virus carried by the Aedes mosquito -the same ones that carry dengue, chikungunya, and yellow fever. They are larger mosquitoes with tiger striping. They like to hide out in houses, under beds and in cabinets. Their eggs can withstand long periods of dryness and hatch in as little as a thimbleful of water. They don’t fly far, but travel widely mainly because of the movement of humans and other blood meals. Because of these factors, completely eradicating mosquitoes especially in the wet tropics can be very difficult, if not impossible. The Zika virus can also spread sexually for the approximately 10 days that it is active in the body.

The illness of Zika is actually overall much, much milder than most of the other mosquito-borne illnesses. When Britton had chikungunya/dengue (still not sure which), it laid him out flat for a week! Zika, on the other hand, is almost entirely asymptomatic meaning most people will not even know that they had Zika! Those who do get Zika symptoms have very mild symptoms such as a mild flu. Very few people, in fact much fewer than from the flu, are expected to die from Zika illness.

The main concerns for Zika are Guillain-Barré which is rare and temporarily debilitating but in most cases people will recover and microcephaly in infants born to mothers who had Zika during pregnancy. Microcephaly is basically a shrunken head/brain deformity that can cause all sorts of serious problems in the baby including seizures, vision loss, inability to walk, and other developmental abnormalities. In the general population this occurs in about 2-12 out of 10,000 births.

zika-virus-and-microcephaly-4-638

The increased number of microcephaly births in Zika exposed pregnant women, including the exact rate, is still not exactly known. Nor, is much else about it for that matter. All that is known is that there is an increased risk. Most reports show, however, that the increased numbers of microcephaly were dramatically overstated in Brazil and that of those that were accurate nearly all of the women had experienced the classic Zika symptom of a rash on the face and red eyes. Since only about 20% of people who are infected will experience any symptoms at all, the likelihood of a microcephaly birth is still very low.

The other factor to remember is that once people have been exposed to Zika, including women of childbearing years, we then have immunity! It is only during this short window of time while it spreads, perhaps a year, that we are immunologically naïve and will have this risk. Because it is already spreading so rapidly, it is estimated that 80% or more of people in Puerto Rico will have been exposed (and therefore granted future immunity) to Zika. It is estimated that at least 20-25% will have been exposed before this current year (2016) is out.

My Thoughts on Zika
To me, given all of this information about Zika, which is still frankly not much (I would like to know the exact expected rates of births with microcephaly in infected and symptomatic mothers for instance), I would say that the majority of the population doesn’t need to worry much at all! Zika is a very mild disease and most people won’t even know that they had it. And trying to fight off all the mosquitoes is a losing battle. Even in the states, West Nile Virus spread like wild fire and infected tens of thousands of people. Even though mosquitoes there are really only an issue for about 3 months out of the year and most people have screens and air conditioning, it still spread! It is nearly impossible to be completely locked away from mosquitoes, and many call the fight against mosquitoes (especially the aedes mosquitos) a lost cause.

In fact since it is estimated that most of us will get Zika anyway, I’d rather get my immunity early rather than delay it further and that way I won’t have to worry as much about questionable chemical municipal sprays, GMO mosquitoes, larvacide in the waterways and freaking out about mosquitoes (though I am certainly no fan of the little blood-suckers and have tried all I can to keep them away, given how much they love me I probably already have it).

Since the biggest issue with Zika is the increased risk of microcephaly, the group of people who I would be most concerned about are women who could become pregnant, are thinking of becoming pregnant or who are currently pregnant. For that reason some groups are recommending the delay of pregnancy until after the wet summer season (when presumably we’ll all get the chance at Zika immunity). Even still, while it is an increased risk, most babies born to women who were exposed to Zika during pregnancy will be normal.

I hope this summary of information on Zika that I have been reading up on has been helpful. In the meantime, I will be eating a lot more garlic to ward off these vampires and keep my cardiovascular/immune system strong to fight off any virus. ¡Salud!

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7 thoughts on “Zika in Puerto Rico

  1. Annie

    Thanks for the overview Cassie. As Gilda Radnor who’ve said, “It’s always something.” That phrase especially applies to life in the tropics, but we all have our challenges.

    Reply
  2. Cassie Post author

    So true, Annie. And it seems especially so with the always latest and greatest new fear-inducing illness. Don’t Feed the FEARS! And knowledge is the best way to break down fear.

    I just can’t believe they issued a warning recommending suspending travel for pregnant women or women who might become pregnant without actually saying what the increased risk is! 2 to 12 out of 10,000 is a pretty big range in and of itself. If in Brazil they had a known baseline before Zika of 150 microcephaly births and it appears that with Zika exposure it increased to 270 that could still be within the range (even if it doubled from 3/10,000 to 6/10,000 for instance). All I can assume is that it must have been outside of that range for them to issue an advisory like this, but if they don’t give us their data then we really can’t know what the truth is. And without information, we have rumors, panic and fear.

    I have a feeling that like most of these new exciting diseases (ebola, H1N1, chikungunya), it will soon all fade away into the long line of freak outs until the next one pops up.

    Reply
  3. Fran and Steve

    Nineteen women with Zika gave birth to normal babies in PR. No babies have been born with microcephaly. On the other side of the spectrum, a 70 year old man died of hemorraging in the brain and it was widely reported (even on the mainland) as the first US death due to Zika. I don’t believe it, since no reputable source has linked Zika with hemorraging.

    Good to know about immunity after infection. I had wondered about that but couldn’t find an answer — Fran

    Reply
  4. Maria Morales

    Hi Cassie
    This can destroyed the tourism during the worst financial crisis in the history of Puerto Rico.
    Jay Fonseca facebook page has an article on cancelation on reservations at the Condado Hotel because of Zika. The cancelation by a large group of tourist (who are seeking to get their money back) – The group say there IS A FEDERAL BAN AGAINST TRAVELING TO PUERTO RICO!!! THIS IS NOT TRUE!!
    THERE IS NO FEDERAL BAN!
    There have been some cases but not to the level it’s being reported IN THE UNITED STATES. Check Jay Fonseca facebook article, he is a reporter in Puerto Rico.

    Reply
    1. Cassie Post author

      The timing of this is quite strange isn’t it? There has definitely been an over-reaction. At least we are going into the summer when tourism slows anyway. Hopefully by winter there will be more known and the exact risk to pregnant women will prove to be much smaller than this unqualified “increased risk” and it will drop off the radar. This is not the only virus that can be transmitted congenitally and can have possible associated consequences to the newborn (for instance West Nile Virus http://www.ncbi.nlm.nih.gov/pubmed/16510632), but I don’t remember anyone freaking out, issuing warnings or canceling summer vacations across the US because of the WNV carrying-culex mosquitoes there…

      Reply
  5. Maria Morales

    Hi Cassie, Brazil has been very hard hit with the Zica virus, my heart goes out to them. Since people travel, It can easily go from one place to the other.
    Heard there where some cases in Florida,
    But so far in the home of my birth Puerto Rico things appeare to be in control. Hope it continues this way!!! If you have a chance check Jay Fonseca facebook page, you can use the translation since articles are written in both English and Spanish.
    There was this incident I mention, in the Condado Hotel in the Condado area of Puerto Rico, the tourist canceled their trip , they claim there was a federal Ban (to get their money back!) This is not true there is no federal ban! The Condado Hotel is one of the must exclusive and must beautiful area of Puerto Rico! – The beaches white sands and the coral reef are clear blue- green water. Was born several block from there.

    Reply
  6. Reinaldo

    Anybody heard the Pittsburg Pirates cancel a couple of exhibitions games vs the Miami Marlins in San Juan because the Zica.The Pirates have forgot that in 1972they had a player called Roberto Clemente lost his life on New Yeaar Eve representing the Pirates traveling to Nicaraguaa to help victims of an earth wake on a plane accident and these Pirates are afraid of a mosquito what a bunch of hypocrites

    Reply

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