This year marks the tenth year of the HPV vaccination program in the U.S. A new study released on Monday compared two and three doses of the vaccine and a new policy is now being recommended. Watch full news story on NBCDFW.com.
Texas health officials confirmed Tuesday that an infant who passed away shortly after birth in Harris County had microcephaly linked to the Zika virus. Dr. Andrea Arguello, an OB/GYN affiliated with Las Colinas Medical Center, weighs in. Watch the full news story on NBCDFW.com.
You have likely heard a lot in the news in recent days about the Zika virus and the serious birth defects that are believed to be associated with it if a pregnant woman becomes infected. Cases have now been reported in 23 countries internationally, and the World Health Organization plans to convene a committee in the days to follow to determine whether this outbreak is to be considered an international public health emergency. Moreover, the Center for Disease Control and Prevention (CDC) published a warning this month advising pregnant women to avoid travel to certain areas in Central and Latin America with high reports of the Zika virus. And it may already be hitting closer to home, as a case of an infected woman in Texas has been revealed. With all the media craze, it’s understandable that many of my pregnant and even my non-pregnant patients have very pertinent questions regarding their travel plans, their risks, and what symptoms to look for. Here are some of the questions being asked.
What is the Zika virus, and what areas are being affected by it?
The Zika virus is transmitted by the Aedes species of mosquitos, which can also carry the Dengue, Chikungunya, and West Nile viruses. The first reports of the Zika virus were in Africa, and since then, the virus has spread across Asia and to the Americas. In March 2015, the first case of Zika virus infection was reported in Brazil, and the last few months have seen a rapid increase in the number of cases in Brazil and in other areas of South America, Mexico, and Puerto Rico. So far, the largest outbreak has been in Latin America.
Has it reached the U.S.?
There have been several diagnoses of the Zika virus in the U.S., however these individuals are believed to have contracted the virus during recent trips to Latin America. There is concern that if the virus does spread to the U.S., the states of Texas and Florida may be especially vulnerable given patterns of the mosquitos that carry it and the fact that these states tend to see a significant amount of commercial and business travel to and from Central and South America. However, at this time there have been no reports of anyone actually contracting the virus in the U.S., and there are no travel warnings against any region of the U.S.
What are the complications of a Zika virus infection?
In general, infection with this virus can cause mild symptoms such as fever, joint and muscle aches, rash, and red watery eyes, however only about 1 in 5 individuals with a Zika virus infection will actually develop any symptoms at all. An individual who has such symptoms and who happens to have traveled to Central and South America in the week prior to the onset of these symptoms should be evaluated for a possible infection.
In pregnancy, there may be more dangerous consequences as there is concern that the virus may be associated with microcephaly, a condition in which the infant’s head is significantly smaller than the heads of other infants of the same age and sex. Microcephaly can have several effects on a baby, ranging from developmental and intellectual delay to hearing or vision loss to seizures. It can also cause infant death. With the large increase in cases of Zika virus in Brazil and Latin America, the number of cases of infants born with microcephaly has seen a parallel increase (3500 cases in Brazil so far). Also, several infants who have died with suspicion of Zika virus infection have been tested and found to have Zika virus within the tissue or amniotic fluid. Although there is no definite proof that the Zika virus causes microcephaly, these cases are serious enough to prompt the CDC to make its recent statements and recommendations. And, according to the CDC, as the virus only remains in a person’s blood for up to one week, an infection out of pregnancy does not pose a risk of birth defects for future pregnancies.
Is there treatment for the Zika virus?
There are no medications available to fight the Zika virus and there is no vaccine to prevent someone from becoming infected with it. The CDC advises to treat symptoms by staying in bed, staying hydrated, and taking Acetaminophen as needed. It is also recommended that pregnant and non-pregnant patients suspected of having the Zika virus avoid Aspirin and other non-steroidal anti-inflammatory drugs, or NSAIDs. Most importantly, those with a possible infection should stay indoors and in isolation for at least one week after the onset of symptoms, to avoid getting bitten by another mosquito and then transmitting the virus to another person.
How can I protect myself from it?
First of all, heed all travel warnings, particularly if you are pregnant. This is especially important for the public to recognize given the upcoming 2016 Olympics that will be held in Brazil. If you are considering travel, make sure to look for the travel advisory on the CDC’s website for the updated list of areas to avoid or postpone.
Use insect repellant and cover up. Apply insect repellant frequently and wear long sleeve shirts and long pants to help protect yourself from mosquito bites. Use screens on your doors or windows if you must leave them open. Get rid of standing water around your home to prevent mosquito breeding.
And of course, if you are pregnant and have any questions or concerns regarding your recent travel or plans for any upcoming travel, see your doctor.
For more information, visit www.cdc.gov/zika.
Keeping your baby safe during pregnancy is likely the most important concern on your mind if you are pregnant, and it depends on many factors. Just like taking your prenatal vitamins and keeping your doctor’s appointments, one of the best things you can do for the health of your baby is to protect him or her from getting sick, and many women go through pregnancy without realizing that they can prevent certain diseases simply by keeping up with all recommended vaccinations.
What are vaccines?
Vaccines contain substances that prepare your body’s immune, or defense, system so that it can fight off certain infections when exposed to a particular virus or bacteria in the future. In this way, your body is trained to resist a disease, and you become immune to it. Vaccines can help prevent certain infections and serious complications during your pregnancy and in the first few months of your baby’s life.
Are vaccines safe in pregnancy?
Certain vaccines are safe in pregnancy and certain ones are not. In general, vaccines that contain inactivated or killed viruses are considered safe, while those that contain live viruses may be harmful to an unborn baby, and are therefore not given during pregnancy.
Which vaccines should I get during pregnancy?
Two vaccines are routinely recommended for all pregnant women and will be offered to you during your prenatal visits. They are the influenza vaccine and Tdap.
Influenza – You may think of having “the flu” as having a fever, runny nose, and muscle aches, however this infection can actually be especially dangerous in pregnant and post-partum women and can lead to serious complications including hospital stays and even ICU admissions. The influenza vaccine, or flu shot, can help prevent these serious complications. And by delivering protective antibodies to your baby through the placenta during pregnancy and through breastfeeding post-partum, the flu shot also helps protect your baby during his or her first few months of life, as babies cannot receive the flu shot before they are six months old and can also get very sick from an infection. The flu shot is recommended for all women who are pregnant or who might be pregnant during the flu season (typically October through March). It can be safely given at any week of pregnancy (even in the first trimester), and is in fact recommended as soon as it becomes available during a season and ideally before the outbreak of the flu in the community. While the inactivated influenza vaccine, which is given in an intramuscular injection, is safe in pregnancy, the nasal spray influenza vaccine is made from a live virus and is therefore avoided during pregnancy.
Tdap – The tetanus toxoid, reduced diptheria toxoid, and acellular pertussis, or Tdap vaccine is safe in pregnancy and is recommended to be given to all pregnant women between 27 and 36 weeks. It most importantly protects against Pertussis, or the “whooping cough,” a bacterial disease that can spread through air droplets by coughing or sneezing. This disease has the most severe consequences in infants less than three months of age, and in the 1900s before the vaccine was available, it was a major cause of sickness and death in babies and children. After the vaccine was developed, the number of cases significantly decreased, however in recent years we are again seeing a rise in the disease and it is important for everyone to get vaccinated. You likely received DTaP, another form of the vaccine that is given in five doses during childhood, however Tdap is a booster you need to get in every pregnancy (even if you just got it during your last pregnancy) in order to protect you from getting sick and allowing for transfer of protective antibodies through the placenta to protect your baby during the first few months of life when he or she is too young to get vaccinated. If TDap is missed during pregnancy, it should be given immediately postpartum so that your baby can receive the protective antibodies through your breast milk. The TDap booster is also recommended for all teenagers and adults who have not previously received it and especially for household members who will be having close contact with an infant.
Should I receive any other vaccines during pregnancy?
You may need a certain vaccine to be given during pregnancy if you are at risk for a particular infection due to travel, a certain job, or other risk factors. These may include Hepatitis A or B, meningococcus, Yellow fever, or others. Don’t forget to tell your doctor if you plan on international travel, especially to tropical areas of South America and sub-Saharan Africa, although travel to such places should be avoided during pregnancy if possible.
What if I’m not pregnant yet but planning for pregnancy?
It is important to be up to date on all your vaccines and boosters prior to pregnancy. This can help prevent certain serious complications when you do become pregnant. Besides routine vaccines that you should have received as a child or teen, it is also important to receive immunity against measles, mumps, and rubella (MMR) and varicella (chicken pox) if you are not already immune. The reason is that these vaccines cannot be given during pregnancy as they contain live virus, and getting one of these infections during pregnancy can have serious consequences such as miscarriage or birth defects. If you do receive one of these vaccines, it is recommended to wait at least one month (or 3 months with varicella) prior to conceiving. You should see your doctor for a “preconception counseling visit” during which your doctor will review your vaccine history (bring your immunization record if you have one) and possibly draw some blood tests to help identify what vaccines if any you should receive in order to prepare for a healthy pregnancy.
Influenza vaccination during pregnancy. Committee Opinion No. 608. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;124:648–51.
Update on immunization and pregnancy: tetanus, diphtheria, and tetanus vaccination. Committee Opinion No. 566. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013; 121:1411-4.