Epidemiologists say there’s little worry about the impact the Olympics will play in the spread of Zika virus. While that may be true–it is winter in Rio–the virus is not there for the Olympics. The growing number of locally acquired infections in Miami highlight how restricting our attention to big, flashy events like the Olympics does a disservice to curbing this epidemic.
The most significant clinical outcomes of Zika virus infection are birth defects in babies born to infected pregnant women. While a majority of the focus to restrain Zika virus involves travel restrictions for pregnant women or women planning to become pregnant, we need to remember that the virus doesn’t seek out pregnant women. We are all susceptible and we can all contribute to minimizing the spread of Zika virus and reducing its affect on the next generation of our world.
Zika virus is unique in that it can spread by mosquitoes, sex, and blood. Some pathogens, like HIV, use blood and sexual fluids for transmission and others, such as Dengue virus and malaria, use mosquito vectors and can rarely be transmitted by contaminated blood. But to my knowledge, Zika virus is the only human pathogen known to use this particular trifecta of modes of transmission. Because of this, it’s epidemiology is and will continue to be very complicated.
To prevent Zika virus infection, one has to minimize mosquito bites, practice safe sex, and limit exposure to contaminated blood. If you live in Central or South America, this is particularly challenging, especially if you are planning a family. The Centers for Disease Control and Prevention (CDC) have some excellent resources on preventing Zika exposure, including what to do if you’re traveling to a Zika endemic area.
But your responsibility to curb the spread of Zika virus does not end upon your arrival back home. Because only 1 in 5 Zika-infected people will have a flu-like illness, it is imperative that everyone continue mosquito avoidance and practice safe sex AFTER they travel. And by everyone, I’m not kidding. Preventative measures should be undertaken whether you are a man, woman, trans, gay, straight, young, old, trying to conceive or not.
Safe sex and not sharing needles may be obvious preventative measures, but mosquito avoidance at home is also important to prevent your local mosquito population from getting Zika virus from you and thereby infecting other individuals. Importantly, this should be a consideration whether you live in Texas or Canada because viruses change. They are keenly able to mutate and adapt. Mosquito avoidance even in areas where Aedes mosquitoes don’t live, minimizes the opportunities that Zika has to adapt to another type of mosquito.
It’s important to keep in mind that although mosquitoes occupy certain ecological niches, sexual activity knows no such boundaries. It is likely to be this mode of transmission we will look back upon if Zika becomes endemic in the northern hemisphere. Despite that we have learned so much and come so far in our understanding of sexually transmitted infections, it’s the sociological impact of promiscuous and high risk sexual activity that underlies how the future of this virus may unfold.
Consider this, travelers who bring Dengue home may pass the virus on to a small number of local mosquitoes. If the virus cannot survive in that type of mosquito or the mosquito doesn’t find another person to sting, the virus dies with it. In this way, locally-acquired infections are rare and multiple infections resulting in an outbreak are even rarer. If we add another mode of transmission–via sex, like a game of Plague, this virus has a better ability to spread, a longer time to stick around an area, and more opportunities to adapt.
In the map below, Dengue virus endemic areas are marked with large yellow circles. When travelers bring Dengue elsewhere, small outbreaks are possible (small yellow circles). Zika endemic areas are denoted with large red circles. When travelers bring Zika elsewhere because it may be spread by mosquitoes and sexual activity, small, medium, or large outbreaks may be possible.
The Zika virus epidemic will not end with the Olympics. Families in South and Central America face the true possibility of a generation rife with mental disabilities. And those elsewhere shouldn’t feel comfortable either. I’ve heard far too many people remark, “Zika doesn’t apply to me”, “I’ve had all the kids I’m going to have”, “I’m not having kids”, “I’m gay”, “I’m a guy”, “I’m old”, etc.
It should matter to you. It should matter to everyone. We’re in this together and we can help prevent it together.