Zika Virus: An Ob-Gyn Answers Our Questions

Zika: There's no avoiding the topic, especially if you're pregnant, or planning to become pregnant. Parents Editor-in-Chief Dana Points sat down with; Dr. Siobhan Dolan to talk about the virus.


[BLANK_AUDIO] I am here today to talk about Zika virus
with Dr. Siobhan Dolan. Thank you for joining me. Thanks
for having me. You know there's a tremendous number of
cases of Zika virus infection right now outside the United
States. There have been 1.5 million cases in Brazil alone
in the last year. And it's obviously caused a lot
of concern around the Olympics this summer. We have some
very high profile examples of folks that were not gonna
participate or not gonna be able to travel down there.
52 countries have reported cases of locally acquired mosquito associated
Zika virus as of just last month. So that's 52
countries around the world where mosquitos are already transmitting the
virus. And to date, there's been no recorded Zika transmission
in the United States. That's correct? There have been people
who have acquired Zika Virus by traveling overseas. Right. And
where are they traveling? What are some of the countries
where this is present? Right now a little over 600
cases in the United States, Dates that were travel acquired
and actually what actually no. It's 600 cases in the
United States that were travel acquired and then 600, over
1300 cases in the US Territories. And so the US
Territories include Puerto Rico, the US Virgin Islands and American
Samoa and that's important to remember cause those Areas are
in areas where the virus is actually circulating amongst the
mosquito population. Puerto Rico has been very hard hit already.
So we want to keep, sort of, those two sets
of issues separately. If you're, as an example, where we
are, here in New York, then really the concern is
about travel related exposure. And really, the Concern is about
pregnancy related exposures, because although Zika virus does pose some
threat to regular people in terms of having a short
illness that's associated with fever. There's a conjunctivitis or a
red eye that's associated. You can have joint pain, you
can have muscle aches and so forth. Headaches. Headaches as
well for sure. It's rather self limited And so it
doesn't pose a dramatic risk. The real issue, as everyone
knows, is that when women are exposed during pregnancy, especially
early in pregnancy, the risk of the fetus being infected
and having [UNKNOWN], which is lack of development of the
brain, that's really what poses the greatest risk. So that's
really, I think we should reinforce who. When where we're
talking about, for folks in the United States thinking about
travel especially if pregnancy is part of your short term
or long term plan. That's something to really stop and
think about and contemplate. Get good advice from your doctor.
Learn lots of up to date information and then think
through what's the best plan for yourself. I think it's
a good point to make that obviously our advice [INAUDIBLE]
doesn't replace what you should be getting from your doctor.
So, use common sense and talk to your doctor. Now
they do know now that Zika virus can be transmitted
sexually. Yes. In the beginning of the reports about this
virus they thought it was just pregnant women might just
get stung by a mosquito, the virus would be transmitted
to the pregnant, Woman's blood by the mosquito but they
now know that the virus can be stored in semen
and also in saliva, is that right? Yeah. So this
saliva, yes it is have been detected, but there haven't
been cases reported, to my knowledge, through kissing, quote un-quote.
But here have been reported cases, and the cases have
been reported of transmission from a man to a woman.
So the real recommendation there is to use condoms for
sex of any variety where there could be transmission Emission
of fluid from a male partner, and that's who we
wanna really recommend. Now, if you're pregnant or planning to
become pregnant and your partner has travelled to an affected
area, the best recommendation, which is the most cautious recommendation,
is to use condoms. So that is really an important
message to get out there. If my partner travels, Go
to a place where there was Zika virus. Right. After
he came back we would want to use a condom
for how long? For, so the recommendation Suggestions for the
partner. The most conservative estimate is six months. And that's
because they've found zika virus in semen up to 62
days. Now, if your partner, your male partner, was infected,
either had symptoms or had a test that showed zika
virus infection, the recommendation then is clearly six months. If
the partner was not affected but just travelled, their recommendation
is eight weeks, but you know the Depends, the most
cautious recommendation is around six months And I think the
reason in being so cautious is that it looks like
maybe only about one in five people who are affected,
who are infected with Zica will actually show those symptoms
the doctor told them. It's like the headache, muscle aches
and all of that. Only one in five people actually
have the symptom, so there could be a risk even
if your partner is not symptomatic. And I know Dana
with us here today is moderating and she has a
question from the audience. So Dana, tell us what you
guys wanna know Yeah we have a few questions rolling
in. Right now Catherine [UNKNOWN] is worried about her risk
with Zika if she's doing IVF. So, she all ready
had her eggs frozen, is the virus in the body
going to affect the embryo? Since she- So There's a
question about who was traveling where or where does the
Zika exposure concern come up. Do you know what I'm
trying to say? Because if she's in the United States,
if she has a remote travel history like she was
In Puerto Rico, over Christmas let's say. I practice in
the Bronx. We see a lot of women who traveled
over the holiday season, very understandably. And it was actually
right before the public awareness had really grown. Right. So
we're seeing a lot of women thinking back. Now, if
it was let's say it's that scenario, the past exposure
is not gonna pose a It's a risk of Zika
Virus infection if this woman is undergoing IBF today or
next week and so forth. So no, your risk doesn't
stay with you. It's at the time of the actual
intercourse, or in the case of IBF, right, there is
exchange of body fluid. It's smaller, right? It's an egg
and a sperm, but that Could at least theoretically be
intercepted in transmission. I'm not aware of any reports associated.
So I don't think it poses a great risk. And
I also would suggest that this individual talk to her
IVF center. And really flush it out and look at
her personal circumstances to make sure she understands. But if
someone had IVF. And then traveled while in the first
trimester you would be at the same level of risk
as anyone else whose pregnant and traveling during the first
trimester. Which is the time of most concern. So if
you're gonna have a cycle of [UNKNOWN] don't then plan
a trip to an area Where Zika virus is known
and reported during- I couldn't agree with you more. Especially
during that sensitive first trimester, and I'll just stop here.
For those that just joined us,I'm Dana Points. I'm the
editor of Parents. I'm here with Dr. Siobhan Dolan from
the March of Dimes, and we are talking about Zika
virus and trying to answer some of your questions. Questions
and address you concerns. So my associate, my doppelganger, the
other Dana over there. [LAUGH] Has a question for us.
Yep, this question's coming from Kendra Murphy Burke. And she
wants to know would it be best to delay a
pregnancy until after the threat of Zika That is over.
Yes so I mean there's different answers to that certainly
there's been some public notoriety of countries and governments that
have said yes consider doing that. And that I think
again comes out of a place of caution and a
lot of uncertainty. I'd say for an individual woman, if
let's say in the next year you're thinking about pregnancy
and you're If you're planning a big trip to the
Caribbean, let's say this is just your personal goals, I'd
do the trip first and use contraception and then do
the pregnancy down the road. So absolutely to the extent
that you can be very crystal clear to not put
the pregnancy and the travel in the same equation. CDC
guide line are very clear to avoid travel to this
areas if you're pregnant or anticipating our planning pregnancy. WHC
as well so, you know, I think this organizations are
acting again out of cautions that really wanting to protect
woman and wanting to minimize risk. When you see woman
it's been and I think some of our audience maybe
in this position You're sitting with the anxiety. I want
on that truck. I'm pregnant and I don't know the
impact and the testing is a little unclear. And ultrasounds
are okay so far but I'm really not sure. That's
a lot of anxiety to carry around for 16, 18,
20 weeks by the second half of your pregnancy. So
we really wanna help women minimize that by just trying
to not themselves at risk. Rest if they can. Yeah,
one of the interesting things is that, if you're pregnant
you've probably noticed this, mosquitos like you more, right? [LAUGH]
Nobody completely knows what the reason for this is. It
might have to do with respiration and how much carbon
dioxide you exhale. There's lots of different factors that make
you attractive to mosquitos like how much you sweat and
what kind of minerals and substances are in your sweat
and what kind of bacteria live on your skin. But
they do say that pregnant women are like 20% more
likely to get bit so why put yourself in that
position. And Dana has another question. Question. Yeah. This question's
from Alison/ Moore, she's in Southern California, she's five months
pregnant. She doesn't plan to travel and neither does her
husband but should she be taking preventive measures like using
bug spray, using condoms or does she have no risk
because she's in Southern California. Yes. So, there's no such
thing as no risk. [LAUGH] Unfortunately- With anything that right.
Right, right. But I also want to suggest that Allison's
at great risk. Right? So she should follow standard precautions.
I wouldn't say she's in a risk category where condoms
are recommended if neither her partner or herself have traveled
to an infected area and their in southern California and
planning to stay there I don't think that's required for
guidelines. The mosquito issue Absolutely. The guidelines are clear. We
don't know the exact transmission patterns of the mosquitos. The
CDC and folks are watching closely, especially in the southern
part of the United States, but that's going to be
an unfolding story. So absolutely, mosquito protection in terms of
the repellents, covering your skin if you are going outside,
staying in air condition Conditioned places. Using bed netting if
you're in a place especially now if you're traveling to
an area, you really want to ramp up those mosquito
protection And if there's pretty good evidence as you probably
know, the most effective mosquito repellant Right now that's known
is DEET. Don't ask me to say what that stands
for. It's a complicated chemical name. [LAUGH] Yeah. But there's
pretty good evidence. There's not been a lot of research
on pregnant women and exposure to DEET. There were some
studies and it looks like you can go up to
about 20%. deet if you are pregnant. So look on
the label, it's always there in the super fine print
what percentage deet the product has. You want to avoid
lemon eucalyptus, is it if you're pregnant? So there are
other mosquito repellents, and one common ingredient is lemon eucalyptus.
So you want to avoid that one if you're pregnant.
Yeah. And also, with any of the repellents You wanna
use them according to guidelines, so yes use them but
don't over use them. And another piece of that with
repellents is that, you wanna put your clothing on first
and then you wanna put the repellent on exposed skin
areas. You don't wanna put your whole body with repellent
because then you'll have much more absorption in areas that
aren't actually going to do you any good. Another issue,
this is This is kind of interesting one as sun
screen and insect repellant, right? 'Cause it's like how do
you go out of the house? Because there's so many
flies these days. You wanna put your sun screen on
first. Again, in the exposed areas. And it sort of
make sense to me, right? 'Cause you're blending two type
of your skin. And then, you wanna put your bug
expire and insect repellant over your sun screen Screen because
that you want exposed to where the bugs would be
coming in. Does that make sense? Yes. So this is
sort of, you know, just a little guidance in the
back of your mind. If you can wear long sleeves
then you can again limit exposure of what your actually
putting on your skin, but use the Hands and just
use them according to guidelines. And as Dana said, up
to 20% with the DEET is safe during pregnancy. And
depending on where you live there are different kinds of
mosquitoes. So there's the Aedes aegytpi which is the one
right now that they're seeing is transmitting the Zika virus
in big numbers. There's also right here where I live
we have the Asian tiger mosquito, which is also perhaps
May eventually play a role in Zika transmission. So, you
kind of have to look a little luckily to see
what's going on. But if you're sleeping, you can use
the bed netting like you recommended but also keep a
fan blowing in the room. Because if you're blowing air
down on yourself and the mosquitoes they can't get to
you as easily So that would be another precaution. And
obviously put screens on your windows. Get rid of standing
water around your home. Report anybody, neighbors and such, who
has standing water Partner refuses to take care of it.
And Dana has another question for us. Yeah. This is
an interesting one. It's a question from Tara Paul-Peterson. So
she's breastfeeding and she's not sure if there's a concern
with that. She's not travelling, but she just wants to
know if she should consider that. Yeah. Great to consider
it but we can be very reassuring around breast feeding.
So for breast feeding, even if you've been exposed, even
if you've If you've been infected, it's safe to breastfeed.
If you think about it, in order for the viral
infection to have any impact on the baby. It has
to go through a lot of different steps and so,
there have been reported cases of transmission via breast feeding
and the benefits of breast feedings are Perception on that
at this point you can really feel reassured to keep
breastfeeding. Great. Anything else while we are with you Dana?
Yep, so we have a question in from Jolie van
Kompermill. And she's pregnant and she wants to know Do
pregnant women have anything to worry about if they live
in the US and have not travelled? Yeah so, today
on June of 2016, the answer is no. There's been
no reported cases in the United States. If her partner,
her male partner, has traveled, again, I wouldn't worry, but
I would use condoms because that's a recommendation. The story
will evolve over the summer. We don't want to be
overly concerning, but we have to be honest about what
we know and what we don't know. And I think
when I say we, the whole public health community in
the obstetrical community are going to be watching. There is
concern that the southern part of the United States will
be effected, and there will be mosquito born transmission within
the United States. So I think we have to, any
pregnant patient should keep abreast of what's going on. Keep
in touch with her doctor. And there's some good websites,
CDC.gov slash zika, MarchofDimes.org/zika, and [FOREIGN] slash zika in Spanish
and then I'm sure Parents is keeping up as well.
Keep up to date. And we'll post all of this
after our conversation today. They do think, based on the
reports that I've read, that where it will pop up
in the United States [UNKNOWN] will probably be Florida or
the Gulf Coast. Those were parts of the country that
have the conditions and type of mosquito that is most
conducive to this. The other thing I think is interesting
about if you do travel outside the United States that
was really surprising to me because I never thought of
this until I've read about it a little bit, if
you come back from a country where Zika is endemic.
Let's say you travel to Brazil for work purposes, and
you come back to the United States, you should use
mosquito repellant to keep the mosquitos here in this country
from biting you, because one way they think that transmission
might start in the United, United States is that a
mosquito in the US will bite an infected person who
maybe doesn't even know they're infected. Who's come from Brazil,
or Puerto Rico, or another country where there is Zika.
So we all sort of have a public health job
to do if you travel outside the United States to
a country that has Zika. And I think Dana has
another question for us. That we do. So this is
another good one, from Maria Celestina Knox. She wants to
know, is there a point in pregnancy where we don't
need to worry about Zika? You know, trimester versus trimester,
how it effects the foetus. Yeah it's a great question.
So for the moment we don't have all the data,
but it is It's looking like the concern is greatest
for the risk of Zika Virus infection actually causing and
contributing to microcephaly in the first trimester. And if you
think of a pregnancy, that we think of as about
40 weeks, the trimesters are the first 13 week and
the And then, 13 to 26 to 28. And then,
28 weeks to 40 weeks, which is when your due
date is. So, the first trimester, in that, the data
so far, looking at French Polynesia and Brazil, is that
about 13 Up to 13%. It may be lower but
up to 13% of women who are infected with Zika
virus during the first trimester of pregnancy will go on
to have a baby with microcephaly. So the first trimester
is the area of the greatest concern. It's tricky time
because a lot of women might not be sure quite
yet that they're pregnant. So we would definitely encourage attention
and to pregnancy desires and being really clear about travel
and pregnancy in the first trimester, because that's the time
of greatest risk. So think about that. Second and third
trimester, the data suggests are not Not as great a
risk but I don't think it's absolutely a firm conclusion
yet. But the focus on first trimester is clear. And
actually that's consistent with any [UNKNOWN] any exposure during pregnancy.
The first trimester is when the organs are forming. When
that brain, that precious brain and all that neurologic tissue
is growing. And it's just a really susceptible time. So
it isn't totally surprising that that's the great. Greatest impact,
but certainly really important for women to think about as
they think about pregnancy. And just to be clear, 50%,
I think it is, of pregnancies in the United States
are not planned. So if you are traveling somewhere where
there is Zika virus, and you're not having protected sex,
you're not using good birth control, And there's a chance
that you might become pregnant. It's important to think about
that possibility, and to take precautions, or not travel in
the first place. For sure. So, Dana has another question
for us. Yeah, so what if you actually have a
newborn and you wanna go on a vacation. Melanie Fields
wants to know, what if a zika mosquito bites my?
Six month old. Yeah, that's a good question. So it
doesn't appear, first of all six month old, is not
going to then to have microsephillie, microsephillie is a birth
defect, it's from, in-utero exposure and it has to do
with the brain development. So, a new born up to
six month old whose doing well, healthy development is not
at risk For Microsoft really. The exact exposure, again I
don't know that we know there's zero risk, but there
certainly haven't been reported dramatic effects on children throughout, the
Zika Virus has been around since the mid-1950s or so,
in Uganda and Africa is where it first started and
it's made it's way around through Asia. And it hasn't
had a huge impact on either adult health or child
health. The pregnancy-related issue they think has to do with
the fact that it moves so quickly from Polynesia over
to South America. And so the population of women had
no innate immunity cuz they hadn't been exposed. And so
it really had a dramatic affect on pregnancy in this
group of women in South and Central America who had
never have been exposed to the virus as teenagers or
And children, that make sense. Right so. Which is the
same in the United States, right? Like the women in
the United States. U.S. has never had Zika virus either
to our knowledge. So we're this kind of fresh group
of people as well. I will say though the question
about the baby, we haven't yet talked today about [INAUDIBLE]
syndrome Which is this condition that causes paralysis. It's sort
of an auto-immune response. Mm-hm, yeah. And it's a very
rare condition. And it can get very bad, isn't always
very bad, But just to be clear, it's very rare.
However, there is now A pre-established connection between Zika and
Guillain-Barré, and in countries where Zika has become endemic, the
risk of Guillain-Barré has gone up. It's been a small
risk to start, so it's still a small risk, but
we can't say with certainty that anyone Who acquire Zika
might not end up with [INAUDIBLE] syndrome. Yeah for sure
I mean that's a little, still a little bit of
a question mark but I definitely recommend that folks talk
to their pediatrician. You know travel it with a new
And a six month old you can use bug spray
right? So after the child is two months of age,
the American Academy of Pediatrics says it's okay To use
an insect repellant, right? Follow all the guidelines so you
don't spray the stuff all over the child's face. You
wanna put it only on the exposed skin, as Dr.
Dollen mentioned before. With a really little one, you don't
wanna put it on their hands, because their hands go
right in their mouth And you can use a low
concentration of DEET. So it means that you could travel
somewhere and use a bug spray. And use a mosquito
net and the baby definitely use a mosquito net. All
right and a stroller net. On a stroller. Great. Or
a bed. Dana you have another question? Yeah we definitely
we have some more questions rolling in. This one comes
from Alicia [UNKNOWN]. She was in Cancun just over a
month ago. She had zero symptoms and for both her
and her husband. But the doctor wouldn't check them. Since
he said that they have zero symptoms, should she fight
for blood work just to be sure? Is she pregnant?
She didn't say, but let's say if she was pregnant.
Okay, so if you are not pregnant, then the answer
is no. Without symptoms and without pregnancy, there's no testing
recommended. If she's pregnant, she could She would qualify for
testing and right now, testing is happening through State Department
of Health for the most part and through CTC. So,
you should and could go back to your doctor and
discuss that. But, it really has to do with pregnancy.
He's 4.5 months Pregnant. [INAUDIBLE] Yes, shes she should go
back to her doctor, and she should talk to them
about testing. She can also touch base with the State
Department of Health to find a location. Because this testing
is rather centralized, hospitals are centralized in their testing as
well to be able to offer to the appropriate women,
and then follow up the results. The testing is pretty
complicated, there's blood and urine testing. And then there's windows
of opportunity and so if you recently travelled and recently
had symptoms we do one set of tests. If it's
more remote there's a different set of tests. And it's
a rather complicated algorithm to interpret because it's a viral
illness so the early My tests are actually test for
pieces of virus in your urine or your serum. But
then the down the road tests are testing basically for
your body's immune response to the virus as a kind
of way to retrospectively think to ourselves yes, she was
exposed. So it's tricky and takes a lot of good
minds in these labs and public Health departments and these
clinical sites to put it together and access a woman's
real you know risk of exposure. The other thing that
we're doing [UNKNOWN] following women pretty closely with ultrasound and
trying to really identify any situations with [UNKNOWN] early. And
offer women you know close follow ups so they know
status. And I just to let those of you who
are just Joining us now. I'm Dana Pointes, I'm the
editor of Parents. I'm here with Dr. Shavon Dollen. She
is with both the March of Dimes, and the division
of reproductive genetics at Montfuer medical center here in New
York. She's also the author, healthy baby, the ultimate pregnancy
guide. So when's talking about testing for viruses- [LAUGH] she
knows a thing Thing or two about this topic. Thank
you so much for being with us. This is great.
I love hearing from all the Parents Magazine contributors and
the audience is wonderful to hear. Do we have any
other questions right now? We do. We have a kind
of general question from Rick [UNKNOWN]. He wants to know
well he says, if this virus has been around for
over 50 years than why is it now Become an
issue. Yeah. Do you wanna take it? No, go ahead.
[LAUGH] I think, you know what, what they believe happened.
If a virus just marches bit by bit across the
globe and that's actually what they believe it did from
Africa, to the Middle East, to South Asia So if
you are 5 years old, and you're playing outside, and
you get bit by a mosquito, and you get a
Zika Virus infection, you might have itchy eyes for a
few days, or you might have no symptoms. But now,
your body has created an antibody response. So if the
virus goes slowly, then you get an anti-body response. Then,
if you are 25 years old, and you get pregnant
Pregnant or you are pregnant, and now you get bitten,
and you're Zika virus is in your body. Your body
knows how to fight it and it doesn't pose a
great risk to your pregnancy. But what happened is, and
if you think of the Pacific Ocean, there was no,
like, step by step progression, and they believe in the
bigger picture that it maybe was some sports teams from
areas in French Polynesia and other places in the Pacific
where The virus just like came amongst folks in a
day or two with global rapid travel to the Brazil
area. So, now the virus is, the mosquitos are biting
women who have no immunity, so it's never been in
South America, no child was bitten Now has an immune
response. So if you're 25 years old and you're pregnant
woman and you've got bitten, that virus goes straight in
your bloodstream and we know about the Zika virus, it's
what they call neurotropic. It loves neurologic system. It loves
neurons and brain cells. It just gravitates right there and
the effect is devastating because the immune response Hasn't been
built up. So I know it's a long answer, and
I think it's actually quite fascinating. Makes sense to me.
Yeah. I have to say, one of the things I've
found so interesting about a lot of the reporting on
this topic has been that people often say microcephaly. So
a woman who is infected, probably in the first trimester,
Trimester. In some cases, will give birth to a baby
who has microcephaly. Which keeps getting described in the reports
I read as a small head. Uh-huh. But microcephaly actually
has developmental consequences and Sure. Brain damaging consequences. Yes. Can
you talk a little bit about that. Yeah, for sure,
and actually the basic science is supporting what we observed,
is that the virus attacks. Neurons and nerve cells and
really just destroys them, so what we see sadly in
a child that is born is that they have microcephaly,
they have a small head and it's because the brain
isn't growing. You know developmentally, the way your skull grows,
is your brain grows and pushes the bone to grow
and so there just isn't that, those cells have been
destroyed. So yes then of course once a baby's born
with a much Smaller brain with fewer cells with many
cells that have been destroyed that growth potential and developmental
potential for that child is diminished. Right. Which is, I
think to answer that earlier question and another reason that
we feel like we're hearing about it now is the
consequences are pretty devastating. For sure. And you know to
put it in context Text up to 13% who've been
infected will likely go on to have a baby with
microcephaly. So, that's a big number on the one hand,
but it's not everyone. So, we just wanna tamper the
messages, but the real message is do everything you can
for prevention because certainly When we see the stories and
when we see the babies, if you can as a
family get to a point where you don't have to
face one of those challenges. We would just love to
help provide information to help you with prevention. And there's
gonna be lots of great. Links included afterward on our
post so that you will be able to keep up
with this issue going forward. And Dana I think you
said you had another question. Yeah. We do have more
questions. Christian Caro Silva is going on a trip to
Puerto Vallarta and she is 25 weeks pregnant. Should she
cancel her trip? She should cancel her trip. Yeah. I'm
sorry and it's not my opinion. Opinion is just clear,
and every organization, the CDC, WHO, I think your doctor
would agree. The risk- Her airline would probably agree too.
Yeah. Many airlines are, depending on when you booked your
ticket, and travel suppliers, are refunding Money, if you can
document that you're pregnant and that you bought your ticket
before x point in time, so. Just think of it
as rescheduling the trip for a year from now. Right,
we don't want to squash people's fun but it's clear
that it's not an exposure that's worth introducing into the
pregnancy at this time. Right. Any other questions? We do.
We have one more We have another question from Nishi
Yu. And she wants to know, shifting over to now
if you have a child, the impact may not be
as great, but what if a child is bitten by
a mosquito with the Zika virus? Just what are the
symptoms, what are the effects, and how would you know
if your child was bitten? Well, only about 20% of
people who are Will ever show the symptoms. For starters,so
your child might not exhibit any symptoms. But the common
ones are headache, right? A sort of pink-eye like conjunctivitis,
other aches and pins. They described it almost just like
a fluish feeling If you think about what the flu
feels like. Although fever? Yeah fever. Fever too. So really
does you know I mean as a mom I can
say that sounds like just about every child with illness
you know wrapped into one. I think one of the
most distinguishing characteristics is the conjunctivitis. The eyes with discharge
And resonance. Yeah. Like Deena is saying, every viral illness
is going to give you fever, joint aches, muscle pain,
headache. But if you have eyes effected, that's something to
think about. But again, if you have a six month
old or a one year old, you're going to go
to the doctor, that's fine. You should. You should take
your doctor and be checked out. But [UNKNOWN] supportive care,
you want to break down the fever with You want
to make sure the child stays well hydrated. There isn't
you know a absolute treatment targeted at Zika and you
can't blame yourself. There's nothing you can do to prevent
it. We hope to have a vaccine down the road
but it's several years down the road at this time.
Yeah. And another question/ Yeah. We do. What is the
March Of Dimes doing to help prevent the Zika virus?
Virus from spreading. Yeah we're doing a lot of things,
one is spreading public health messages, so we're delighted and
we thank you for the invitation to do this. The
other piece is actually really trying to lead the charge
for about 80 organizations that are really working and lobbying
Congress to pass the emergency funding for Zika prevention efforts
because really now is the time and there's been a
lot written about that. Now is the time for a
mosquito eradi- education now is the time for educating women.
Now is the time for letting women know to postpone
travel. So this emergency funding is really an important step
and so we invite everybody to advocate and you know
try to get money dedicated to this cause so we
can all be healthy. Great. I will say I rode
the subway Get to work this morning and on my
train there were lots of ads about Zika and telling
you to use insect repellant and get rid of stagnant
water around your home. And I was impressed by that
because it's not here in New York yet. So Dana
another question. Yeah, so actually we are getting a few
questions in from different users about that lemon eucalypt. The
oils, so can we just revisit that and just? Yeah.
I'm gonna let everyone know what the clear, you know.
Yes. What I'll do, because there's no magic here, cdc.gov/features/stopmosquitos.
Okay, so the lemon, oil of lemon eucalyptus is in
the agent called Repel. It is an active ingredient that
is recommended but- Just to be clear there are other
Repel products that contain DEET. So it's not all Repel.
In fact there's a Repel family in a Consumer Reports
test, tested really well. We're calling mosquitoes. So not all
repel products, just some. But the recommendation is do not
use products containing oil of lemon eucalyptus or [UNKNOWN] on
children under three years of age. So that's the quick
guideline for CDC. Right, and so I think during pregnancy
also no lemon eucalyptus. I think something that's not recommended
for a child under three probably isn't going to be
recommended for a person who is pregnant either. Is that
the thinking? Yeah, I haven't actually read that, so I
don't know the answer but- Check the CDC website for
sure. But the active ingredients that are recommended are Deet,
Picaridin, the oil of lemon eucalypt Justin, then there's a
few others. So definitely take a look at what product
you're looking at using, what the active ingredient is. And
then if it's pregnancy related or child related. Put all
those pieces together and make sure you're making the best
choice. And if you're joining us late, we did say
earlier that there is some research suggesting that in pregnant
Women up to 20% concentrations of Drok. So If you're
pregnant, I can completely understand that you wouldn't want to
use deep, because it's a kind calling it's just might
make you nervous. But there is some research suggesting that
it's fine and particularly if you're an area as some
people in the U.S. might be be later this year,
or as people in Puerto Rico or Brazil are now,
where your choices, use an effective repellent or potentially be
exposed, you should use an effective repellent. Absolutely. So yeah,
go ahead Deena. Sure. We also met a few users
Just striving and wondering exactly how long does the Zika
virus stay in your system? So the exactly how long
answer, I don't think anybody knows the answer so that's
the truth of the absolute. So what has been published
and out there so far. For men, Zika virus has
been See an uptime, think 62 days after symptoms, so
you know so that's sort of a two month window
and so the guideline and recommendation is to avoid sexual
relations without a condom for six months but again to
take the two month window for data we have about
presence of the virus in semen but then be more
>Conservative so go out six months. You know, the truth
is we really, I think when I say we, the
hole community doesn't quite know the exact answer to that
yet.. For women the guidance is about 8 weeks or
two months to avoid pregnancy after an exposure, after an
infection. And so I don't think ,there haven't been a
demonstration Demonstrated cases of sort of sequestration of the virus
that could come back later as it happens with semen.
So I'd say that where we are right now which
is a little bit. We want to get conservative guidelines.
There's more to learn here, right. So it lives in
the blood for theythink maybe around 8 weeks but in
semen, it could be as long as- Longer. They don't
really know. So that's why there's that long- I don't
even think is last in the blood for that long.
Right, but that's the [CROSSTALK] Maybe about two weeks. Exactly.
And then I want to get [UNKNOWN], that's right. Chikungunya.
Yes, so, we need to ask a virologists. So, their
both RNA viruses- [CROSSTALK] And they're both what they call-
> Feel free to post. Flavi viruses. So, they're actually
pretty similar. Like cousins. They're like first cousins. So, on
some of the tests, especially the immune test, can pick
up. And they say, we know we have a plague
virus here, but we don't know which one. So there
certainly is confusion. And when you have someone like, for
instance, what we have seen in the Bronx a lot,
women who might have grown up in Puerto Rico or
grown up in Dominican Republic, and they have childhood immunity
to Dengue. [INAUDIBLE] because those are endemic, so they have
antibody to those because they grew up in countries where
they were exposed as children. And now we're trying to
discern did they have a zika virus infection, but there's
cross-reactivity because of some of the antibodies. So it kind
of confuses the test. Very much confuses the interpretation of
the test. So that's where you need now to go
from general public health Just to a specific doctor and
sometimes a higher specialist or geneticist or [UNKNOWN] just start
to tease that apart. And then you need more specialty
testing to try to pull apart which exposure was it
really. So it's really interesting, but definitely talk to your
doctor if you get to that point, right. And that's
why they're gonna take a really detailed family history. So
I think we're gonna wrap up for today. I I
wanna thank Dr. Siobhan Dolan for her time and the
March of Dimes for connecting the two of us. If
you have any more questions, I cannot recommend highly enough
that cdc.gov/zika site. And we will put on our page
That link as well as some links to articles on
https://www.parents.com. And some resources that the March of Dimes offers
in both English and Spanish. And I hope you'll join
us for the next Facebook Live next week. Thanks so
much for being here.

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