June 18, 2016
The days are getting shorter, the summer solstice is almost here so stock mosquito repellent to be ready for mosquito season. The CDC is reporting more cases of Zika among pregnant women in the US (including DC) (234 cases) than in the US Territories (189). So far three children with birth defects have been born to mothers testing positive for Zika and there are 3 cases of pregnancy losses related to Zika caused defects. It’s here. This is the first wave. Over one quarter of babies had birth defects and five percent of women had miscarriages in one study with relatively low numbers of women infected in the first trimester with Zika. So far, 756 cases of Zika are reported in the US; 755 were travel associated including 11 sexually transmitted cases. There is one report of laboratory acquisition. In news unrelated to pregnancy, three cases of Guillain-Barré syndrome related to Zika have been reported.
The CDC does not include cases in its registry until a pregnancy is ended successfully or unsuccessfully. We don’t know how many women and families are facing bad news and an incredibly difficult decision. The relatively high ratio of Zika cases reported in pregnant women 234 to all cases 756 (30%) reflects the more comprehensive testing of pregnant women and likely underreporting of Zika acquisitions by the general public. Zika symptoms can be quite mild, not require medical attention, and thus are not tested and reported.
Expect to see an increase in Zika cases this summer. The increase will depend on the success of public health measures to prevent transmission. The US Congress could help those measures if they could quickly reach a political agreement on funding. Already it is too late to have much effect on 2016 prevention efforts. Money that should have been allocated to lower cost preventative measures may be instead required to address more expensive measures to help those afflicted.