Zika!

FOR 68 YEARS FOLLOWING ITS DISCOVERY, THE Z IKA VIR US WAS AS OBSCURE AS THE SMALL 62-ACRE FOREST IN UGANDA THAT IS ITS NAMESAKE. UNFORTUNATELY, THAT’S NO LONGER THE CASE.

BY JIM GIBSON

Once confined almost primarily to equatorial regions of Africa and Asia, it has, within the past decade, spread to Central and South America via the Pacific Islands. An outbreak in Brazil in May 2015 garnered the virus its first real international attention, and as of the beginnings of April, the Centers for Disease Control and Prevention (CDC) reports there have been 346 travel-associated cases reported in the United States, with 78 of those cases reported in Florida. There have currently been no locally acquired, mosquito-borne cases reported in the United States. The number of locally acquired infections is much higher in U.S. territories such as Puerto Rico, the U.S. Virgin Islands and American Samoa.

Studies published by the CDC state that following the outbreak in Northeast Brazil last year, researchers noted a sharp increase in cases of children born with microcephaly (abnormally small skulls and under-developed brains). When RNA evidence of the Zika virus was found in the amniotic fluid of two women carrying fetuses suffering from microcephaly and an infant with microcephaly who died shortly after being born, researchers began to strongly suspect a possible link between mothers being infected with the virus and their children being born with microcephaly.

“Although this relationship hasn’t been definitively proven, it is greatly suspected that if a pregnant woman is infected with the Zika virus, there is a possibility it could increase the chances of her child being born with microcephaly,” says Cindy Prins, Ph.D., MPH, CIC, CPH, a clinical assistant professor and epidemiologist at the University of Florida. “Researchers have also seen an increase in the incidence of Guillain-Barre Syndrome in several of the countries with Zika outbreaks, and they are actively investigating an association there also.”

Transmission of the virus comes most often through the bite of the Aedes aegypti mosquito, which is abundant here in Central Florida. According to the CDC’s April 6 Zika update, there have been seven reported cases of sexual transmission of the disease in the United States, and Prins says the virus has been found in the semen, blood and saliva of infected men. The CDC suggests the use of condoms when having any form of sexual contact with someone who might have been infected or exposed to the virus.

In March, the CDC issued detailed guidelines for couples who are trying to have a baby. If a woman has been diagnosed with or has symptoms of the Zika virus, she should wait at least eight weeks after her symptoms first appear before trying to get pregnant. If the couple is trying to have a baby and the man has been diagnosed with Zika or has symptoms, he should wait at least six months from the first symptoms before having unprotected sex. For couples without symptoms of Zika but who have had possible exposure due to travel, the CDC recommends waiting at least eight weeks after that potential exposure before trying to conceive. It is believed, based on the available evidence, that a Zika virus infection in a woman who is not pregnant does not pose a risk for birth defects in future pregnancies after the virus has cleared from her blood, and, once a person has been infected with Zika, she is likely to be protected from a future Zika infection.

Prins says that in the vast majority of persons infected with the Zika virus, the disease is mild and runs its course within a week or so, and as of this date, no deaths have been directly attributed to Zika infection.

“The overwhelming majority of people will only have one or more of the following symptoms: fever, a generalized rash, conjunctivitis, joint and muscle pain and possibly headache,” she says. “Virtually all will recover quickly.”

So far, 78 cases of Zika have been diagnosed in out-of-country travelers in Florida. However, Prins says it is “highly likely” we will see local transmissions occur here in much the same way chikungunya and dengue fever have spread. Once an infected person is bitten by a mosquito, the mosquito population becomes infected and begins to locally spread the disease among humans.

Prins says that to control the spread of the Zika virus we must do two things: control the mosquito population and protect ourselves from mosquito bites.

“What makes the Aedes aegypti mosquito unique is that its eggs can survive for at least two months without contact with water,” Prins says. “The female mosquito lays them right at the waterline in indoor or outdoor water-filled containers, and if the water dries up, the egg can remain stuck there until it rains and the water covers them. They then hatch into larvae. This is why it is important not only to empty any container that might hold rainwater but to also thoroughly scrub the container to destroy any eggs that might be left.”

So far there is no cure for or vaccine against a Zika infection.

“We are still several years away from the point of distribution of a vaccine for Zika,” says Prins. “Once the proposed vaccine reaches clinical trials, it still takes two or three years to determine efficacy and both short- and long-term safety. It does help that we have a vaccine for yellow fever, which is quite similar to Zika, but it will still be a while before we have the finished product. In the meantime, the best defense against a Zika infection is to avoid mosquito bites.”

We are still several years away from the point of distribution of a vaccine for Zika. In the meantime, the best defense against a Zika infection is to avoid mosquito bites.

CINDY PRINS

Meanwhile, the CDC has warned pregnant women at any stage of pregnancy or women trying to become pregnant not to travel to any country where transmission is ongoing.

Protect yourself

• WEAR LONG CLOTHING THAT COVERS EXPOSED SKIN.

• BE AWARE THAT A. AEGYPTI MOSQUITOES BITE PRIMARILY AT DAWN AND DUSK BUT CAN BITE ANY TIME OF DAY.

• USE AN PROTECTIONENVIRONMENTAL (EPA)-REGISTEREDAGENCY INSECT REPELLENT WHEN GOING OUTDOORS.

• PATCH WINDOW SCREENS, CLOSE WINDOWSUNSCREENED AND KEEP DOORS CLOSED DURING EVENING HOURS.

Control the mosquito population

• DISPOSE OF ANY CONTAINERS THAT MIGHT COLLECT RAINWATER.

• EMPTY AND SCRUB ANY WATER-FILLED CONTAINERS.

• PUT A TIGHT LID ON WATER STORAGE CONTAINERS.

• EMPTY AND CLEAN BIRD BATHS AND ORNAMENTAL FOUNTAINS WEEKLY.

• DRAIN STANDING WATER INSIDE OR OUTSIDE YOUR HOME.

We revel in barbecues, picnics, sports and maybe long hikes in the woods. But we are not alone. Nature also re-awakens in the spring, which means bugs that bite and sting and plants that give us nasty rashes. So, if you’re planning on spending any time outdoors this spring and summer, here’s a rundown of how to happily co-exist with some of Nature’s less social bugs and plants.

Mosquitoes

They may be tiny, but mosquitoes make big headlines around the world. According to the World Health Organization, mosquito-borne diseases cause more than 1 million deaths globally each year. Of course, the latest mosquito-borne disease in the news is the Zika virus. At this writing and according to the Centers for Disease Control and Prevention, no locally transmitted, mosquito-borne Zika cases have been reported in the United States. All reported cases have occurred in travelers returning from countries with active Zika virus transmission and through sexual transmission. But, the CDC notes that these imported cases could result in the local spread of Zika in some areas of the United States. The mosquitoes that can carry the Zika virus are the Aedes aegypti and the Aedes albopictus, which can also transmit chikungunya and dengue fever. The mosquito that transmits the West Nile virus is the Culex pipiens species. All three mosquito species are found in the United States.

PREVENTION: Use an Environmental Protection Agency (EPA)-registered insect repellent that includes either DEET, picaridin, oil of lemon eucalyptus (OLE), or para-menthane-diol (PMD). Wear long sleeves and long pants when outdoors, especially at dawn and dusk. Remove any possible mosquito habitats, such as standing water from your yard and around your house.

Ticks

BITE ID: Raised red bumps that itch. According to the CDC, one in five people infected with the Zika virus will exhibit symptoms such as fever, headache, rash, joint pain and conjunctivitis (red eyes) that last several days to a week. The Zika virus has also been linked to birth defects.

TREATMENT: Take an antihistamine to relieve the itching. If you think you might have been exposed to the Zika virus, call your doctor.

Ticks like to attach themselves to humans just as much as our pets. According to the CDC, tick-borne diseases such as Lyme disease and Rocky Mountain spotted fever are on the rise. And ticks can cause serious allergic reactions and pain. When you’re out walking in the woods or through long grass, ticks like to hitch a ride on your legs. And once a tick latches on, it often moves to warm, moist spots like the armpit or groin.

PREVENTION: Use repellents with DEET on your skin and clothes; wear long pants, long-sleeved shirts and socks. After being outside, check yourself carefully for ticks.

BITE ID: Typically, a tick bite causes small red welts. If a tick carrying Lyme disease bites you, the first sign is typically a circular rash around the bite.

TREATMENT: If you find a tick on your body, use tweezers to remove it by pulling the tick straight off the skin. Thoroughly clean area with soap and warm water, and apply an antibiotic ointment. If you have a bull’s eye rash from a tick bite, seek medical attention immediately.

Bees & Wasps

Although bees and wasps have their roles in nature as pollinators and insect predators, respectively, our encounters with them can leave us with a nasty sting. For those with bee sting allergies, a severe anaphylactic response can occur. If you fall in the latter category, always carry an EpiPen.

PREVENTION: Don’t aggravate bees or wasps. If you have wasp nests outside your house, use an EPA-registered pesticide to remove them or call a professional pesticide company.

STING ID: Redness, swelling and pain around the sting site

TREATMENT: Remove the stinger with a tweezer, use soap and warm water to clean the area, apply ice and take an over-the-counter antihistamine if necessary.

Puss Caterpillar

Don’t mistake this little creature for a cuddly miniature Star Trek tribble. Measuring about 1-inch long with long hairs that camouflage venomous tiny spines, the puss caterpillar is the most toxic caterpillar in the United States. They can be golden brown and light or dark gray. It feeds in oak, elm and sycamore trees as well as holly bushes and is known to fall out of trees onto people. When a puss caterpillar comes in contact with your skin, it releases those venomous spines into your skin. This can cause nausea, vomiting, fever, muscle cramps and even symptoms of shock.

PREVENTION: If you see a puss caterpillar, don’t touch it.

STING ID: Itchy red rash with immediate intense burning pain.

Fire Ants

TREATMENT: Use tape to remove spines from site and call a doctor. You can also apply an ice pack and take an OTC pain reliever and antihistamine.

Like with bees and wasps, you don’t want to start a battle with fire ants by disturbing their mounds. When provoked, these little creatures are very aggressive and will bite multiple times. Fire ants don’t transmit any diseases, but they can cause burning, itching painful lesions. And some people, especially young children, can have a severe toxic or allergic reaction that could require medical attention.

PREVENTION: Spray your yard with an EPA-registered pesticide or hire a professional pesticide company.

TREATMENT: Keep area clean with warm soapy water, and do not break the blisters. You can use over-

The Don’t Touch Plants

The three most common poisonous plants in the United States are poison ivy, poison oak and poison sumac. All three cause a rash produced by urushiol, a clear liquid compound released by the plant when touched. According to the CDC, 80 to 90 percent of the human population is allergic to urushiol. Individuals have different tolerances, and the amount of contact time necessary for an allergic reaction can also vary per individuals.

Poison ivy

The most common poisonous plant found throughout the United States, poison ivy has a woody stem (no thorns) with clusters of three leaves consisting of two opposing leaflets and one larger terminal leaf. Each group of three leaflets grows on its own stem, which connects to the main vine. Yellow-green flowers, which appear from May through July, are in clusters near round, waxy white berries.

Poison oak

A low-growing, up to 3-feet-tall shrub with compound leaves containing three leaflets, poison oak has two types. The Pacific Poison Oak is found on the western U.S. coast, while the Atlantic Poison Oak is found predominately in the southeastern states. Both types have leaflets that are lobed with rounded edges, giving the plant the appearance of a white oak tree leaf. Leaves are brighter on the top side while slightly hairy underneath. Yellow-green flowers, which blossom May through June, are found in clusters near the hard waxy berries that turn white in the fall. Poison oak tends to climb on the trunk of oak trees.

Black Widow Spider

According to the CDC, the venomous black widow spider is found throughout the United States and is easily identified by its distinctive orange, red or yellow hourglass shape on its body. And only the female bites humans. Their favorite hiding places include tree stumps and wood piles. According to the National Institutes of Health, a black widow bite can cause a spike in blood pressure, seizures, muscle cramps, nausea and vomiting.

PREVENTION: Use caution when stirring up wood piles.

BITE ID: Two fang marks indicate a black widow spider bite.

TREATMENT: If you’ve been bitten by a black widow spider, seek immediate medical attention.

Brown Recluse Spider

Also called violin spiders for their dark violin-shaped markings, brown recluse spiders also have six eyes instead of the eight that spiders typically have. According to the CDC, brown recluse spiders prefer sheltered areas such as underneath logs and structures. But they can also be found in piles of leaves or rocks. In rare cases, their venom can be deadly.

PREVENTION: Use caution when disturbing their known habitats.

BITE ID: Bite may feel like a mild sting or can be painless. The bite area reddens, turns white and develops a painful red “bull’s eye” blister. Symptoms such as severe pain, itching, nausea, vomiting, fever and muscle pain can develop four hours after the bite.

TREATMENT: Seek immediate medical treatment.

Poison sumac

A short tree that grows up to 25 feet, poison sumac is found in the eastern United States, particularly around swamps and marshes. The compound leaves contain usually between seven and 13 leaflets, which are 2 to 4 inches long with a smooth edge and pointed tip. The flower and fruit from the poison sumac are very similar to those of the poison ivy and poison oak.

SYMPTOMS: Red rash and inflammation, spreading blisters and scabs four to 24 hours after contact with plant. Worst symptoms are usually seen four to seven days after contact and may last one to three weeks. You cannot spread the rash by scratching it. But if you get the urushiol on your fingers, you can spread it that way and can cause temporary blindness if urushiol gets into your eyes. If you suspect you’ve come in contact with a poisonous plant, wash your hands immediately.

TREATMENT: Wash affected area thoroughly with soap and warm water as soon as possible, especially within 30 minutes after contact. Also wash your clothes and shoes. Apply cool compresses, calamine lotion or hydrocortisone cream. Take an over-thecounter antihistamine to relieve itching. In a severe case, your health care provider may prescribe a corticosteroid like prednisone.

Stinging Nettle

This plant, found in woods, fields and even yards, has thin stems with triangular or heartshaped, scalloped leaves. It gets its name from the hypodermic-needle-like stinging hairs filled with irritant compounds on the stem and leaves. When the tip of the stinging hairs is broken, the irritants are injected into the skin.

SYMPTOMS: The immediate reaction is reddening of the skin and intense itching. More sensitive individuals may experience swelling and burning. The rash looks similar to hives with raised areas of whitish blisters.

TREATMENT: Wash affected area gently with soap and water. Apply cool compresses, aloe vera gel or a baking soda paste to affected area. Take over-thecounter antihistamine.