What Women And Their Families Can Do About Zika Fever

Most women who are or who are planning to become pregnant who read stories about Zika fever understandably want to protect their unborns. There are some very basic steps women can take to avoid Zika virus infection.

• Pregnancy is a bad time to move to or to take a trip to northeastern Brazil, central Africa, or Micronesia. Avoid travel to these areas if at all possible.
• Women who are pregnant should avoid contact with mosquitoes. This means avoiding outdoor exposure at times mosquitoes are most likely to bite (at dawn and at dusk), wearing pants and long sleeves, and using natural mosquito repellents. When you do go outside, favor direct sunlight; mosquitoes prefer shade. 
• It's more important to avoid the infection during the first and second trimesters than the third, although women should not let up their guard until the baby is born. Once babies are born, infection even with the mutated, new form of Zika virus only causes mild-flu like symptoms.
• Since mosquitoes spread the disease from person to person, it's important that anyone in the same household with a pregnant woman who gets unidentified flu-like symptoms after travel to the tropics consult a doctor. Chances are it won't be Zika virus, but it's best to know for sure.
• If you haven't been exposed to mosquitoes in the tropic, don't panic (yet). Although some of the cases of babies born with birth defects have occurred in women who did not show symptoms of Zika fever while they were pregnant, the fact that you don't have symptoms doesn't mean you do have Zika fever.

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The whole family can get involved with keeping your environment as mosquito-free as possible.

• Change water in pet dishes at least once a day. Change water in wading pools and bird baths every other day.
• Cover trash containers so they will not collect water. Irrigate lawns and gardens with care so water does not stand for several days.
• Cover your hot tub when you are not using it. Get a friend or neighbor to take care of it if you are out of town. Use a water filter (with a safety cover) in your swimming pool to keep water agitated so it does not provide mosquitoes with a breeding ground.
• Empty or get rid of buckets, bottles, cans, old tires, pots, plant saucers and other containers that hold water.
• Fill in low areas in your lawn that catch water.
• Fill in holes in trees that catch water.
• Keep drains and ditches clear of trash and weeds to keep water from collecting.
• Keep gutters clear of areas that could collect standing water. Remove standing water around your house and from flat roofs after rains.
• Place screens over rain barrels and openings to cisterns and rain water catchments.
• Repair all leaking plumbing indoors and outdoors. Don't leave faucets dripping (except to keep pipes from freezing).
• Stock ornamental ponds in your garden with fish that eat mosquitoes.

If you think you could have Zika fever, you need to see a doctor. If you live in the United States, here are the guidelines for what your doctor will need to do.

• Your doctor will look at other concerns unless you have traveled to an area where there is currently a Zika fever outbreak. The cases in the United States have occurred in people who are returning from the tropics. They didn't catch the infection here (as of February 1, 2016).
• If you don't have any symptoms of Zika fever, the first step for your doctor is to order ultrasound of your unborn to make sure there are no indications of the disease.
• If you have possible symptoms of the disease, your doctor will order a test called reverse transcription-polymerase chain reaction (RT-PCR) testing of maternal serum. It's a blood test, of the mother's blood. Amniocentesis is not part of the protocol for diagnosing the disease, especially in the first trimester.
• If you test positive for the disease, the only treatments are those for fever and pain. Unfortunately, right now there is nothing the doctor can do for your baby except to support your health in every other way possible. Even so, the Centers for Disease Control directs doctors to collect the placenta and umbilical cord after birth for viral testing if the mother or baby shows signs of infection. (This is not required of every mother after every birth.)
• Babies born to mothers who may have been exposed to the Zika virus should be checked for eye problems before they leave the hospital, and for hearing problems in the first month, even if they display no other symptoms of the disease.
• Follow up doctors during the first year of life to make sure the baby's brain is growing normally is a must, as is repeated testing of hearing and sight.

The Centers for Disease Control are not expecting a major outbreak of Zika fever in the United States in 2016. Americans use air conditioning during the summer, and keep their windows closed. Urban areas in the United States are not as densely populated as those in Central and South America, so it will be harder for the mosquitoes to travel from person to person to spread the virus. Nonetheless, they are expected up to four million Americans to be infected with the virus over the next five years, during which there will be no vaccine.

There are many more causes of microcephaly than just Zika fever. Nonetheless, it's only prudent to be on the lookout for possible symptoms of the virus, and to work even more closely with your doctor during pregnancy.