Vague Zika guidelines leave pregnant women guessing

[PHOTO COURTESY: International Business Times]

Rachel Percy faced a lot of confusing information when deciding whether to postpone a trip to Tulum because of the potential risk posed by the Zika virus that’s now affecting Latin America and the Caribbean.

“We were really frustrated with how vague the recommendations were,” Percy says, of her and her husband’s efforts to cancel their Mexican vacation, which was set to start last month when she would be about 20 weeks pregnant.

In the two weeks since the Toronto couple decided to cancel their trip, the guidelines are still vague.

“It is recommended that pregnant women and those considering becoming pregnant discuss any travel plans with their health care provider to assess their risk and consider postponing travel to areas where the Zika virus is circulating,” Health Canada spokeswoman Sylwia Krzyszton tells Yahoo Canada News.

If travel can’t be avoided, precautions to avoid mosquito bites should be taken, Krzyszton says. That includes wearing loose long-sleeved shirts tucked into long pants, and using a mosquito net while sleeping. The guidelines are similar to American recommendations for women considering travelling.

Testing guidelines for women who have recently visited a Zika-affected area are also still in development, and so far they largely apply only to women who are showing signs of infection.

Under current guidelines, pregnant Canadian women who have visited Zika-infected areas will currently only be tested for the virus if they are symptomatic. That potentially leaves some women wondering if they’ve contracted the virus, and how that could affect their developing fetuses.

“Testing for pregnant women is recommended if they have travelled to a Zika-affected country and have acute signs and symptoms compatible with Zika virus,” Krzyszton says. “If a pregnant woman is not showing symptoms but is concerned, they should speak with a physician.”

One such woman is considering terminating the pregnancy because she will not be tested for Zika due to a lack of symptoms, the National Post reported this week.

“We are going to be left with the option of terminating what could be a perfectly healthy pregnancy, because we are just completely unwilling to take the chance,” the unnamed Toronto woman told the Post.

Given the incomplete and evolving recommendations, Percy and her partner opted to cancel their trip rather than figure out the potential risk on their own.

“I did wish there was better information about how likely I would be to contract Zika, and how likely the virus was to cause birth defects, so that we could have had a better assessment of the risk,” Percy says.

From obscurity to emergency

Zika — first isolated in the forests of Uganda in 1947 — was declared a global public health emergency by the World Health Organization on Monday after rates of both infections and microcephaly cases of babies born with small heads rose quickly in Latin America. The virus is believed to be linked to the rapid increase in the number of cases of microcephaly in infants in Brazil and other Latin American countries. The condition results in a smaller-than-normal head and under-developed brain and can have serious health consequences.

Zika is contracted by bites from the Aedes aegypti mosquito, which is found in tropical and subtropical climates. If the suspected connection between the virus and microcephaly cases is legitimate, then Zika can also be transmitted in utero. A new case from Texas also indicates that Zika may be contracted through sexual contact.

One concern is that only about one in five people exhibit signs of Zika, and those symptoms are often mild: flu-like symptoms, for example, or a rash.

Testing for the previously rare virus isn’t widely available because it was previously so uncommon, and the virus itself can only be detected for up to a week after detection. Later testing looks for antibodies, but can produce in false positives in people who’ve had other infections like dengue or yellow fever, or received the yellow fever vaccine. There are no existing medicines or vaccines for Zika.

“The Public Health Agency’s National Microbiology Laboratory (NML) can perform diagnostic tests, but currently, their test can only detect the virus for approximately one week after symptom onset (molecular diagnostic test),” Krzyszton says. “A limited number of provinces also have this capacity, but for the most part, testing is being done at the NML.”

And while it seems clear that the risk to the fetus is highest when Zika is contracted early in pregnancy, and the virus seems to only stay in the system for about two weeks. But doctors don’t yet know the level of risk for pregnant women who contract Zika, or what —if anything — can be done to lower the risk.

For now, anyone who fears she has been exposed to Zika is advised to seek medical attention, whether or not she is pregnant.

“If you develop symptoms similar to Zika virus infection when you are travelling, or after you return, see a health care provider and tell them where you have been travelling or living,” Krzyszton says.