What Happened to the Zika Virus? And Can I Take My Baby to Latin America?

Mosquito
Zika virus is spread by two types of mosquitos.

Last year, it seemed like the Zika virus was in the news daily.  At least it seemed that way to me, as I was pregnant and thus at risk for having a baby with birth defects if I contracted it.  Luckily, the virus did not hit the United States the way some models predicted it might.  And while I don’t want to belittle the experience of those who did contract it, most US mamas and babies survived the scare without incident save for a few areas of Florida and Texas.  But since then, we haven’t heard much about Zika.  Is the epidemic over?  Should pregnant women still avoid travel to Zika areas? What about young children?  In this article I will bring you up to speed on the latest regarding this somewhat unusual epidemic.

THE ZIKA VIRUS SCOUTING REPORT

Chicen Itza Pyramid
If you are actively growing your family, many Latin American destinations may be best avoided in the near term.

To start I should point out that I am not a doctor or medical professional, and none of the following should be considered medical advice.  I am just a mom who wants to start traveling to Latin America and the Caribbean again!   I am summarizing what I have found on the internet.  Please consult your doctor for detailed professional advice!

In short, there are still a lot of unknowns about the Zika virus, and those being prudent would do best to avoid Zika areas.  Some destinations in countries that do have local transmission might be just fine, so careful research is advised if you’re considering a trip.

IN CASE YOU MISSED IT

In case you missed the hubbub last summer, Zika is a virus carried by the Ae. aegypti and Ae. albopictus mosquitos, and thus its reach is largely determined by the range of those species of mosquitos.  For example, since these mosquitos don’t live at elevation, locations such as Mexico City are generally considered to be safe from Zika.  It can also be transmitted sexually.  One in five infected shows symptoms, such as fever, rash, headache, joint pain, conjunctivitis (pink eye), and muscle pain.  Severe complications, such as Guillain-Barré syndrome, are rare.

Conventional wisdom, such as reported here by NPR, suggests the main concern about Zika is that two key studies have found a causal relationship between contracting Zika while pregnant and having a child with microcephaly, a severe brain defect.  Other defects have also been observed, such as vision and hearing issues as well as fetal growth restriction.  That said, there is a lot we don’t know about this virus, and this article, for example, suggests that it may not be as innocent to non-pregnant adults as originally thought.  Alternatively, there are also many conspiracy theories floating about suggesting that the increase in microcephaly cases wasn’t caused by Zika.

DOES ZIKA REALLY CAUSE MICROCEPHALY?

According to the New England Journal of Medicine, a causal relationship does exist.  However, there are many questions about this relationship.  For example, the extremely high incidence of microcephaly in northeast Brazil was not seen elsewhere.  Other areas of Brazil, as well as Colombia, had similarly high incidence of Zika transmission, but comparatively much lower numbers of microcephaly.  Even the Brazilian government has suggested that a second factor was likely in play in the northeast of the country.  So, in short, we’re not sure.  This article suggests that in some of these other areas, babies may have been damaged by their mothers’ exposure to the virus, but not to the point of having the noticeably small head size.  Others wonder if certain pesticides or GMO mosquito breeding programs may have been at fault in northeast Brazil.

WHERE IS ZIKA NOW?

Map
Many high elevation areas are considered minimal risk (light purple).

According to this CDC map, Zika is endemic to the vast majority of Latin American countries and the Caribbean, as well as sub-Saharan Africa, India, and southeast Asia.  In the US, local mosquito-borne transmission occurred in Florida and Texas.  Based on the range of the mosquitos, the virus could reach as far north as New York.  Thankfully, that didn’t happen last summer, but the epidemic doesn’t appear to be over, either.

According to the CDC, since the outbreak began in 2015, there have been 224 cases in US states that are presumed to be from local mosquito borne transmission, primarily in Florida.  In 2017 (through June 14), there have been 136 symptomatic cases of Zika, but none in the continental United States were assessed to be from local mosquito borne transmission.  In other words, those affected either travelled to a Zika area or had sex with someone who did.  There is local transmission in US territories in 2017, with over 90% of those cases occurring in Puerto Rico.  But beyond those statistics, the threat varies by whom you talk to.  Some experts state that Zika will again threaten those in warmer areas this summer as it did last year, while others suggest the whole ordeal is on its way out.

ZIKA VIRUS AND YOUNG CHILDREN

Toddler and baby
While the data is far from conclusive, there are fears that the brain development of babies and toddlers could be adversely affected if they contract the virus as small children.

Despite extensive online research, I have not been able to find good information on the risk of Zika for infants and young children.  This source suggests once a child is 18 months their risk is reduced because their brain is sufficiently developed to avoid some of the worst complications, but that’s about all I could find.  Many experts admit they’re not sure.  I spoke with our pediatrician about the matter and he said that the older the child if they were to contract the virus, the better.  However, he didn’t have a lot of additional details regarding the impact on children.  If you have young children, proceed with caution!

SO WHAT DOES THAT MEAN FOR TRAVEL?

With all that, here’s a quick summary:

If you’re pregnant or hoping to get pregnant soon, you should still avoid areas that are considered Zika hot spots.  Some high elevation areas such as Mexico City and parts of the Andes should be okay if you can get there directly.  If your partner travels to a Zika area, use condoms.

If you have a baby or infant, it may be advisable to wait until they’re 18 months old to reduce the risk of the worst adverse affects to their developing brain.  Keep in mind that there is no official agreement on 18 months being the threshold.  If you’re considering a trip with your young children, it is advisable to do your own additional research and talk to your doctor.  Again, Mexico City and few other high elevation destinations should be just fine.  We felt comfortable taking our then-2.5-year-old son and 4-month-old baby to Mexico City last winter.

Have you learned anything else about the Zika Virus that helped you make travel decisions?  Please comment and share!

SOURCES

“Brazil Asks Whether Zika Acts Alone to Cause Birth Defects,” Nature — http://www.nature.com/news/brazil-asks-whether-zika-acts-alone-to-cause-birth-defects-1.20309

“Zika Virus and and Birth Defects — Reviewing the Evidence for Causality,” New England Journal of Medicine — http://www.nejm.org/doi/10.1056/NEJMsr1604338

“A Clue to the Mystery of Colombia’s Missing Zika Cases,” Wired.com — https://www.wired.com/2017/01/clue-mystery-colombias-missing-zika-cases/

“How Does Zika Affect the Toddler Brain?” The Atlantic — https://www.theatlantic.com/health/archive/2016/09/how-does-zika-affect-the-toddler-brain/498578/

“How Dangerous is Zika for Babies, Really?” NPR — http://www.npr.org/sections/goatsandsoda/2016/12/28/506727887/how-dangerous-really-is-zika-for-babies

“Can Zika Virus Damage an Infected Infant’s Brain After Birth?” Stat News — https://www.statnews.com/2016/08/24/zika-virus-infant-brain/

“Questions and Answers:  Zika Risk at High Elevation,” CDC — https://wwwnc.cdc.gov/travel/page/q-a-zika-risk-high-elevations

“World Map of Areas With Risk of Zika,” CDC — https://wwwnc.cdc.gov/travel/page/world-map-areas-with-zika

“2017 Case Counts in the US,” CDC — https://www.cdc.gov/zika/reporting/2017-case-counts.html

“Zika Might Have More Health Risks In Adults Than We Thought,” Shape Magazine — http://www.shape.com/lifestyle/mind-and-body/zika-might-have-more-health-risks-adults-we-thought

“The Race Is On to Stop A Zika Virus Epidemic in the US,” CNBC — http://www.cnbc.com/2017/04/11/the-race-is-on-to-stop-a-zika-virus-epidemic-in-the-us.html

“Do You Still Have to Worry About the Zika Virus?” Shape Magazine — http://www.shape.com/lifestyle/mind-and-body/do-you-still-have-worry-about-zika-virus

“Zika Thoughts:  No Panic Needed,” Dr. Brownstein’s Holistic Medicine — http://blog.drbrownstein.com/zika-thoughts-no-panic-needed/

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