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Travel warning considered as Zika virus spreads

The Zika virus, which is spread by mosquitoes, has been linked to birth defects and is rapidly spreading across Latin America and the Caribbean.
/ Source: NBC News

U.S. health officials are considering a travel warning about Zika virus — the once-obscure virus that’s rapidly spreading across Latin America and the Caribbean and that people increasingly fear may cause birth defects.

It’s not clear what they’ll tell people just yet, because so little is known about the virus, which is spread by mosquitoes. But evidence is growing that it may cause a catastrophic birth defect called microcephaly, and doctors always says it’s better to be safe than sorry when pregnancy dangers are concerned.

“We are in the process of developing a travel warning not only for pregnant women but for everybody,” said Dr. Lyle Petersen, who heads the Center for Disease Control and Prevention’s division on diseases carried by mosquitoes and other insects and animals.

What is clear is that it’s likely to spread much more widely. It’s also clear that it will take weeks, if not months, to get all the answers. In the meantime, there’s no vaccine against Zika, a viral cousin of dengue fever, and no treatment for it.

Baby in Brazil born with microcephaly
In this Dec. 22, 2015 photo, Luiza has her head measured by a neurologist at the Mestre Vitalino Hospital in Caruaru, Pernambuco state, Brazil. Luiza was born in October with a head that was just 11.4 inches (29 centimeters) in diameter, more than an inch (3 centimeters) below the range defined as healthy by doctors. Her rare condition, known as microcephaly, often results in mental retardation.Felipe Dana / AP

“We are in the process of developing a travel warning not only for pregnant women but for everybody."

And microcephaly — an abnormally small head and brain — can kill babies, cause miscarriages or cause severe and untreatable handicaps.

Until recently Zika wasn’t on the radar screens because it caused very mild illness.

“Zika does cause a dengue-like illness,” Petersen said.

“It causes fever, headache, skin rash, red eyes ,muscle ache, that sort of thing. Those illnesses are pretty mild.” And they look like the symptoms of many other viral infections, including dengue, which is far more dangerous and deadly.

It was also suspected of causing Guillain-Barre syndrome, a sometime dangerous reaction to viral infections.

But not birth defects. Rubella, yes. Rubella, also known as German measles, can cause microcephaly, learning disabilities, heart disease and other defects. And the most dangerous time is during the first trimester, when women might not realize they are pregnant. It’s one reason why doctors stress rubella vaccination and why pregnant women are tested to make sure they’re immune.

So another virus that could do this gets the attention of doctors.

Severe brain damage possible

Other viruses related to Zika, dengue for instance, are not known to cross the placenta and affect a fetus. Petersen says there is now some evidence that Zika is doing this.

CDC tested tissue taken from two babies who died of microcephaly in Brazil. “We found virus in the heads of those children,” Petersen said. “That’s pretty good evidence at, at least in those children with microcephaly, there was Zika virus in their brains.”

Other researchers found evidence of the virus in the placentas of two babies that were miscarried. And Brazilian researchers have found evidence of the virus in amniotic fluid – which supports and surrounds a fetus.

Their reports suggest severe brain damage. Some of the babies had brain calcifications – which suggests the brain tissue had been killed by something.

Brazil’s reported an explosion of microcephaly, from a few hundred cases a year to close to 4,000 over the past year.

But it’s not easy to test for Zika. A quick blood test can get Zika mixed up with dengue, which is a longtime resident of the region and all tropical areas. A test called PCR is needed to detect Zika, and it takes longer and is more expensive that a quick test.

So it’s hard to know just how many people are infected or have been infected. "We need to investigate more," Petersen said.

When another virus called Chikungunya started spreading across the Caribbean and Central America in 2013, the CDC issued a travel warning that simply cautioned people traveling to affected areas to take precautions against mosquito bites – staying inside, wearing long sleeves and using insecticide. So far, that’s what the Pan American Health Organization (PAHO), an arm of the World Health Organization, has done.

"Zika is still a pandemic in progress."

CDC are now deciding what they should tell people about Zika, how wide an area to include in any warning and whether it should go beyond the standard cautions about mosquito-borne diseases.

Zika's been reported across the warm parts of Latin America, from Brazil to Mexico and even in Puerto Rico. Travelers have occasionally carried it to the U.S. and some experts believe it's only a matter of time before it settles into warm regions such as south Texas, Florida and Louisiana.

Hawaii just battled an outbreak of dengue carried by travelers. It's becoming clear that viruses carried by mosquitoes are a growing threat, says Dr. Anthony Fauci, head of the U.S. National Institute for Allergy and Infectious Diseases. "To respond, we urgently need research on these viruses," he wrote in Thursday's issue of the New England Journal of Medicine. And researchers need to develop broadly effective antiviral drugs that can treat more than one virus.

"Zika is still a pandemic in progress," Fauci said. "We clearly need to up our game with broad and integrated research."