It’s summer, which means it’s mosquito season. And as of last year, that also means it’s Zika season.
If you’re feeling a little like, “Didn’t we just go through all this?” you’re not the only one.
“It’s almost like Zoolander land. You feel like you’re taking crazy pills sometimes. [You ask yourself] did I not just talk about this?” says Dr. Chris Curry, an assistant professor of obstetrics and gynecology at the UM Miller School of Medicine. She’s also the obstetrics point person for the Zika response team.
“I think our biggest concern with this summer coming is a little bit of Zika fatigue – [people asking] ‘You’re telling me I have to do it again this year?’”
Miami-Dade learned a ton about Zika last summer, especially about how to limit transmission. Locals were good about getting tested, and medical facilities have figured out a workflow for processing them quickly.
This year, we also know a little bit about more how it affects babies – many of those born to Zika-infected mothers are now a couple months old and doctors can begin assessing whether it’s affected their development.
We chatted with Dr. Curry about what she’s seen one year into Miami-Dade’s Zika exposure and what we all should know heading into another mosquito season.
Sorry not sorry: it’s going to be another summer of Zika talk.
That’s because the women who had to be most concerned about Zika last year are obviously not the same ones who should be most worried this year.
“A lot of education happened last summer, except none of those women are still pregnant. It’s a whole new group of pregnant women” this summer, she says. “They may not have been listening with the same ear as they are this year… Pregnancy is not a permanent condition.”
Curry knows that feels really repetitive to a news cycle and to the broader public, but that’s how pregnancy-related conditions work.
We finally know a bit about risk
About 100 mothers infected with Zika came through their department in the last year. About 10 percent of pregnant women infected in the first trimester give birth to a baby with an abnormality. If they’re infected in the second or third trimester, that goes down to about five percent.
But the ability to predict how that’s going to affect the baby is still pretty limited.
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The department has had babies born with microcephaly, which is at the most severe end of the spectrum. But Curry said there have been more born with calcified parts of their brains, brains of abnormal shapes and sizes, brains with too much water or not enough brain matter, and folds and connections that are abnormal. All of these have implications for thinking and comprehension later in life. Some babies have seizures.
“Within congenital Zika syndrome, there’s a really large spectrum of what can be wrong with these babies. The focus on microcephaly takes away from the much broader set of diseases,” she says.
Some also have vision problems because the retina seems to be very sensitive to Zika.
Babies born to Zika-infected mothers are only now reaching an age where doctors can tell if the babies are developing properly.
Insecticides shouldn’t worry you as much as Zika.
There was as much of an outcry over the use of naled as there was as Zika last summer.
Curry says there’s no such thing as certainty when it comes to the safety of insecticides. But when compared to the consequences of not acting, she’ll go with the chemicals. So will almost all of us.
“[Much of] Florida is uninhabitable without mosquito control. We take for granted that our leadership, for decades, has one of the most [robust] mosquito control programs in the country,” she says. “By living here we’ve understood and acquiesced to mosquito control at this baseline”
“[Naled is only] part of our way out of this, but a really, really important way out of this.”
Low-income women are more at risk
Tests for Zika come back positive for low-income women and recent immigrants much more frequently. Curry and the doctors never know a patient’s income level explicitly, but they know what kind of insurance they have – or don’t have.
That’s because they may work outdoors or in a building without air conditioning, live in a home without window screens, or take the bus to get around. All of that increases mosquito exposure.
Communicating to these communities has proven to be a major challenge here in Miami – one that we haven’t totally figured out yet and one that Curry plans to make a priority this summer – although she hopes it will become unnecessary soon.
“Like any doctor who does an infectious disease, my goal is to be unemployed… because Zika is not in Miami anymore,” she says.
If you were infected with Zika while pregnant, UM now has a longitudinal study going that will provide years of neural and developmental testing for babies, including MRIs, to identify any issues. If you gave birth after being infected with Zika and you would like to participate, contact Dr. Curry at [email protected].
Mario Ariza contributed reporting.