Zika Virus: how long should we wait to try to get pregnant?

Our understanding of Zika virus is developing daily.  As many are aware, the link between Zika virus exposure or infection and birth defects (microcephaly) is becoming stronger.

The Centers for Disease Control (CDC) has just issued recommendations on family planning and Zika.

Long story short;

1. If you are a woman who traveled to a Zika endemic area and developed symptoms, wait at least 2 months before trying to get pregnant.
2. If you are a man who traveled to a Zika endemic area and developed symptoms, wait at least 6 months before having unprotected sex.
3. If you are a man or woman who traveled to a Zika endemic area and did not develop symptoms, wait at least 2 months before trying to get pregnant.
4. If you are a man who traveled to a Zika endemic area with a pregnant partner, use condoms for any form of intercourse for the duration of the pregnancy.
5. To prevent the spread of Zika through sexual intercourse, men who have traveled to Zika endemic areas should use condoms for any form of intercourse for 2 months if they did not develop symptoms, and for 6 months if they did develop symptoms.
6. If you are a man or woman living in  a Zika endemic area, then it gets really tricky:
1. The CDC did not recommend that women delay pregnancy.
2. El Salvador has recommended that women wait until 2018 to get pregnant.
3. Brazil, Ecuador, Columbia and Jamaica have recommended that women delay pregnancy indefinitely for the time being.

Please read the link for more detail, and also my previous post on Zika for further information including a description of symptoms of Zika infection.

Zika Virus

I think we're only going to be hearing and reading more about Zika in the very near future. Spring is here, more people will be traveling on vacations, and the possibility of Zika outbreaks in the lower 48 will increase (the range of the carrier mosquitoes includes the Southeast US). This could raise issues of governmental regulation, access to abortion, climate change and immigration during a presidential election year.  I hope that any such discussions will be in the interests of the public health, and will shed more light than heat.

Zika has actually been identified in the 1950's in West Africa, then in the late 1960's in the South Pacific.  Since then, it has emerged elsewhere and most recently in South America and now Central America, including Puerto Rico which is a US territory.  It is carried by two species of Aedes mosquitoes whose effective range includes large areas of the Southeast and Atlantic Seaboard.  Aedes was responsible in the 1900's for yellow fever outbreaks in the South and as far north as Boston and New York City.  Aedes can also carry dengue hemorrhagic fever and chikungunya which are being seen in Central America and border states in the US.

 

 

At this point, Zika has been linked to a rare birth defect called microcephaly in which a baby is born with an abnormally small head and may develop lifelong developmental delays.  Happily, this appears to affect only 1% of women who were infected with Zika.  On the other hand, Zika infections are acquired through mosquito bites and are in 80% of cases without any symptoms at all.  In the other 20% of cases, the symptoms are quite mild: fever, aches, rash and reddened eyes are the most common.  Those symptoms are of course quite common to any viral illness at all, including common colds and flu.  And on top of this, Zika can be sexually transmitted for an unknown period of time after initial infection.

Due to the recent emergence of Zika in the Americas and the alarming link to microcephaly, Zika raises a lot more questions than answers at this time.  A vaccine is years away, and there are no readily available commercial lab tests for Zika.  Fluid specimens can be tested by a special division of the Centers for Disease Control (CDC) in Atlanta, but we are far from simply taking a lab slip to the lab for testing.

So, what to do at this point?

• Eliminate standing water near your home including old tires, up-turned buckets and the like.
• Use DEET-containing mosquito repellent and clothing that covers you.  If you are using it along with sunscreen, apply the sunscreen first and then the repellent.  Do not use combined sunscreen plus repellent products as this can lead to bloodstream absorption of DEET.
• Get window and door screens.  
• Use a mosquito net over your bed.
• Exercise these precautions and pack accordingly in travel to endemic areas, if you cannot avoid travel there in the first place.  (Personally, I would stay away from the Summer Olympics in Brazil.)
• If you are thinking of getting pregnant, this is a tough choice.  There are no clear choices and the best news is that even in the face of Zika infection, the odds your baby will be normal and healthy are 99% in your favor.

Here are links to some helpful information and resources on Zika Virus: 

• A Zika FAQ list from the New York Times: NYT FAQ List
• The El Dorado County Department of Public Health: County Public Health
• California Department of Public Health (having server issues at time of this writing): State Public Health 
• Centers for Disease Control, for Pregnant Women: CDC/pregnant women
• Centers for Disease Control, Zika Home Page: CDC Zika Virus

Exercise for Your Brain

This is a pretty interesting discussion of the effects on different types of exercise regimens on brain function.  Mind, it's an academic study on rats looking at the effects of different types of exercise on growing new brain cells.

If this is more broadly applicable to humans, then it suggests that distance running would be more beneficial for your brain than weight lifting or short-duration high-intensity workouts.

Please note that it's certainly possible that weight training may have other beneficial effects on the brain not looked for in this study.  As a general matter, physical exercise is not only healthy for your heart, muscles, weight and sense of balance but also good for brain function.