Zika and Holiday Travel: Should You Delay Your Holiday Trip?

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Depending where you're going, the answer is likely yes. Snow approaches and people leave. Winter holidays are, for many of us, travel times – we run to warmer weather, or to the warmth of our families and loved ones to celebrate the holidays. But this year, there's a reason to stay home, one that has nothing to do with ticket prices or airline delays. As I often tell patients in my obstetric practice at Montefiore Health System in Bronx, New York, Zika is still a major cause for concern in certain areas around the world. Here's the thing about Zika: It's a potent combination of terrifying and unknown, it infects many people and, while most get better without ever having symptoms, if you're a pregnant woman, the Zika virus can be a never-ending nightmare. Zika has a tremendous affinity for developing neurons, the building blocks of our nervous system. The virus also has tricks for sneaking past the placenta – the organ grown during pregnancy that connects mom to the baby and generally protects the growing fetus from infection. The Zika virus, however, knows how to get past the the placenta. Once it does, it targets fetal neurons and can cause extensive brain damage to the fetus, including an irreversible condition known as "microcephaly," where the baby's head does not fully develop. One of the hard things about Zika is how much we don't know. Even with state-of-the-art ultrasound, we can't see the effects of a Zika infection right away – or sometimes at all. Zika-infected fetuses can look completely normal in the 20-week scan, and only in the third trimester can we detect that the head has stopped growing. Blood tests are similarly limited. We can test for the virus and for an immune reaction against the virus, but if those are negative, it still doesn't tell the full story. Maybe you had Zika, but just too recently for us to see it, or too long ago for our blood tests to detect it. While the majority of Zika virus comes from a mosquito bite, it can also be sexually transmitted if someone with the active infection has sex with someone who has never been exposed. There is no treatment or vaccine for Zika, leaving very little options after exposure. Once exposed, it becomes hard to feel safe. This is why prevention is the leading strategy for public health experts, including recommendations from most public health organizations for pregnant women to avoid travel to Zika-affected areas. It is also the reason that I have conversations with women at my clinic daily about travel risks. The map of countries with active Zika transmission has expanded over the past few months. The Centers for Disease Control and Prevention, plus other public health agencies, strongly recommend that women who are pregnant or are planning to become pregnant – and their sexual partners – avoid traveling to impacted areas. Women who are excited to travel to the Bahamas, Puerto Rico or even parts of South Florida, for example, come to me for what was intended to be a routine prenatal visit, and I have to tell them about the realities of Zika today. I tell them I don't think this vacation is a great idea for now, and we highly recommend they reschedule the trip for after the pregnancy. I try not to frighten them, but the idea of brain damage in a baby is scary. Women tend to agree that postponing travel is worth the peace of mind that accompanies an informed decision. If my patients still have to go on their trip – and sometimes they do because life is complicated – there are ways to reduce the risk of contracting Zika. For example, at-risk travelers can wear clothing that will protect them from mosquito bites, including long pants and long-sleeved shirts; they can also wear clothing and gear sprayed with the anti-mosquito agent permethrin. Pregnant women should also use insect repellant with DEET (an EPA-approved bug spray which research shows to be safe in pregnancy if used as directed) or other recommended agents. A bed net might be useful if sleeping in a room with open windows. Since Zika can be sexually transmitted, we recommend using condoms with a partner who has traveled to those Zika-epidemic areas for the rest of the pregnancy to protect the pregnant woman and the fetus.  The medical community is working round-the-clock to develop a vaccine, but until we reach a breakthrough, unfortunately pregnant couples have one more thing to consider. If you can post-pone your trip to a Zika-affected area, please do; instead, perhaps you can plan a doubly fantastic trip in a year or two. You will deserve it.

source : U.S. News & World Report - Health (http://www.usnews.com/)
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