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Monday, April 4, 2016

Zika Virus in Nicaragua

Welcome spring!  Or I would if it weren’t so dry, hot and dusty right now in Nicaragua.  The only two things I am for which I am grateful in the hot, barren, brown, lifeless time of year in Nicaragua…I did mention hot, didn’t I?...are 1) clothes on the line dry very quickly and 2) the mosquito population is down…they at least know that the only thing worth doing these days (besides laundry…no, wait they wear no clothes!) is to lay eggs and die.
 


I only wish their eggs were not so hearty…eggs from mosquitoes can lie dormant for one year just waiting for that little bit of standing water to hatch bringing forth those pesky, pesky…and now, disease ridden pests.
 

AND we have just one more virus with which to deal, here in the tropics when the rains do come and flowers burst open and dust gets driven back into the soil.
 

There has been lots of hoop-la in the States over the Zika virus passed to one person and another by the Aedes Aegypti mosquito, the same mosquito, by the way, that carries the five strains of dengue (which can have a hemorrhagic component) and chikungunya…remember that one from our blog last year?

There is much we do not know about the Zika virus, but we do know these things:
•    Symptoms when infected can include fever, mild rash, headache, malaise, joint pain, conjunctivitis (much like dengue and chikungunya), although…
•    frequently people may not know they even have it because of the mild symptoms.
•    Some studies have shown that the Zika virus is not only passed by the mosquitoes but also by semen…that’s a new one!  One man was tested to have had the active virus up to 10 weeks in his semen.  Why is all this a concern?  Because…
•    In Brazil, recently the local health authorities have observed that there has been an increase in babies born with microcephaly in the northeast part, as well as…
•    An increase in Guillain-Barré syndrome that has coincided with those infected with the Zika virus.
 

Microcephaly is a condition when the baby’s brain does not develop and can result in death in the early years.  Guillain-Barré syndrome is temporary, partial to more severe paralysis

What does this mean, besides that there is still a whole lot we do not know?


Guillain-Barré syndrome requires hospitalization in case the respiratory system shuts down.  Outside breathing machines are required to keep the patient breathing.
 

Microcephaly is a condition no parent wants for their children, but for poor countries that do not have the resources to care for special needs children, a large population of microcephalic children would be a public health nightmare as well as an extreme burden for families, most of whom would have difficulties caring for their little ones.
 

Patients with Guillain-Barré in El Salvador
As of publishing, the Ministry of Health in Nicaragua has reported 131 cases of Zika, of which 12 are pregnant women. 

There is no Zika virus vaccine now.  Experts think that once exposed, one becomes immune to the virus…so the best hope right now is to prevent getting bitten (almost impossible without air conditioning and bug spray), use condoms if pregnant (difficult in a machista culture),  and to postpone pregnancy, which is the strategy we are offering in Nicaragua: 

Postpone pregnancy until more information is out and/or until the woman is immune because she has been exposed or vaccinated. -- Becca