Q. Can I get Zika from anal sex, oral sex, or any other form of sex?
A. Definitely from anal sex. Transmission by oral sex is suspected but not proven. The virus has been found at high levels in semen, blood, and urine, and at low levels in saliva. Transmission by kissing has not been documented and is thought to be unlikely. Contact between infectious fluids and mucus membranes like the insides of vaginas, rectums, and mouths, or with the eyes or nose, is not considered safe. Contact with hands, breasts, or any part of the body covered by intact skin probably is.
Q. I’m a gay man. Can I get Zika from anal sex from my boyfriend?
A. Absolutely, yes. It has happened.
Q. If I’m pregnant, and have had Zika, how soon will I be able to tell whether my baby has been hurt?
A. If you had a positive Zika test, your doctor should schedule ultrasounds and MRIs as often as every three weeks. They may suggest amniocentesis, to look for virus in the fluid around the baby. No one knows how long from the date of infection it takes for damage to show up on an ultrasound, but changes indicating brain damage have been detected as early as week 19 of pregnancy, in the second trimester.
Q. If I have had Zika, what are the chances that my baby has been hurt?
A. No one knows. The majority of babies whose mothers had Zika appear normal at birth. Very early studies suggested the chances of brain damage are somewhere between 1 percent and 29 percent, which is a very wide margin. A CDC-sponsored study published May 25 found the risk of microcephaly to be as high as 13 percent. It did not make estimates for other types of fetal brain damage. Bigger studies that should answer the question more accurately are now underway.
Q. If I have Zika, can I safely breastfeed my child?
A. Although the virus has been found in breast milk, breastfeeding has has never been proven to transmit it, so the WHO and CDC recommend that women with Zika continue to breastfeed. They believe the benefits greatly outweigh the risks.
Q. Is there a Zika vaccine? Will there be?
A. No, not yet. Nearly 20 laboratories are working on them, but lengthy testing is mandatory. The most optimistic scenarios hope for one by late 2018. Sometime before 2021 is considered more realistic. Some pessimists fear the risk of triggering Guillain-Barré paralysis will make a vaccine impossible.
Notes
Note: Page numbers listed correspond to the print edition of this book. You can use your device's search function to locate particular terms in the text.
CHAPTER 1
15“Zika doesn’t worry us”: Donald G. McNeil Jr., Simon Romero, and Sabrina Tavernise, “How a Medical Mystery in Brazil Led Doctors to Zika,” New York Times, Feb. 6, 2016, http://www.nytimes.com/2016/02/07/health/zika-virus-brazil-how-it-spread-explained.html.
CHAPTER 2
18“Ziika”—the spelling was shortened: Josh Kron, “In a Remote Ugandan Lab, Encounters with the Zika Virus and Mosquitoes Decades Ago,” New York Times, April 5, 2016, http://www.nytimes.com/2016/04/06/world/africa/uganda-zika-forest-mosquitoes.html.
19On April 19, 1947: Jon Cohen, “Zika’s Long Strange Trip into the Limelight,” Science, Feb. 8, 2016, http://www.sciencemag.org/news/2016/02/zika-s-long-strange-trip-limelight.
20a “filterable, transmissible agent”: G. W. A. Dick, S. F. Kitchen, and A. J. Haddow, “Zika Virus (I). Isolations and Serological Specificity” Transactions of the Royal Society of Tropical Medicine and Hygiene, Sept. 1952, p. 509, http://trstmh.oxfordjournals.org/content/46/5/509.full.pdf+html.
25“an African female aged 10”: F. N. Macnamara, “Zika Virus: A Report on Three Cases of Human Infection during an Epidemic of Jaundice in Nigeria,” Transactions of the Royal Society of Tropical Medicine and Hygiene, March 1954, p. 139, http://trstmh.oxfordjournals.org/content/48/2/139.full.pdf+html?sid=864a5093-2f7f-4f0b-ba6d-30030da79028.
27After marking the spot: W. G. C. Bearcroft, “Zika Virus Infection Experimentally Induced in a Human Volunteer,” Transactions of the Royal Society of Tropical Medicine and Hygiene, Sept. 1956, p. 442, http://trstmh.oxfordjournals.org/content/50/5/442.full.pdf+html?sid=ad409066-59d5-4ef4-a3a7-29dd4a149ae1.
28In 1964, another researcher: D. I. H. Simpson, “Zika Virus Infection in Man,” Transactions of the Royal Society of Tropical Medicine and Hygiene, July 1964, p. 335, http://linkinghub.elsevier.com/retrieve/pii/0035920364902007?showall=true.
32In March 2016, researchers: Shannan L. Rossi et al., “Characterization of a Novel Murine Model to Study Zika Virus,” American Journal of Tropical Medicine and Hygiene, March 28, 2016, doi:10.4269/ajtmh.16-0111.
CHAPTER 3
37The first time Zika was noticed: Mark R. Duffy et al., “Zika Virus Outbreak on Yap Island, Federated States of Micronesia,” New England Journal of Medicine, June 11, 2009, doi:10.1056/NEJMoa0805715.
38Dengue kept looking: Austin Ramzy, “Experts Study Zika’s Path from First Outbreak in Pacific,” New York Times, Feb. 10, 2016, http://www.nytimes.com/2016/02/11/world/asia/zika-virus-yap-island.html.
39“We worked through hot”: Tai-Ho Chen et al., “Zika Virus Outbreak—Yap, Micronesia, June 2007,” EIS e-Bulletin, March 2008.
40“Our health care system”: Reuters Health E-Line, “Little Known Virus Causes Outbreak in Pacific Isles,” Reuters, July 10, 2007, http://www.reuters.com/article/us-virus-mosquito-zika-idUSHKG4179220070710.
41On October 7, 2013: Henri-Pierre Mallet et al., “Epidémie de virus Zika en Polynésie française” (PowerPoint presentation at interregional conference on public health surveillance, Fort de France, Martinique, Nov. 5–7, 2015).
41“Tahiti is a small island”: Jason Beaubien, “Zika in French Polynesia: It Struck Hard in 2013, Then Disappeared,” NPR News, Feb. 9, 2016, http://www.npr.org/sections/goatsandsoda/2016/02/09/466152313/zika-in-french-polynesia-it-struck-hard-in-2013-then-disappeared.
41The first household: Van-Mai Cao-Lormeau et al., “Zika Virus, French Polynesia, South Pacific, 2013” (letter), Emerging Infectious Diseases, June 1, 2014, doi:10.3201/eid2006.140138.
42The first was a woman: E. Oehler et al., “Zika Virus Infection Complicated by Guillain-Barré Syndrome—Case Report, French Polynesia, December 2013,” Eurosurveillance, March 6, 2014, doi:http://dx.doi.org/10.2807/1560-7917.ES2014.19.9.20720.
43“Up till then, everyone”: Damien Mascret, “Interview with Dr. Sandrine Mons,” Le Figaro, Feb. 18, 2016, http://sante.lefigaro.fr/actualite/2016/02/18/24642-tahiti-zika-etait-considere-comme-benin.
44Four cases of “immune”: “Surveillance de la dengue et du zika en Polynésie française,” Centre d’Hygiène et du Salubrité Publique, Feb. 7, 2014, http://www.hygiene-publique.gov.pf/IMG/pdf/bulletin_dengue_07-02-14.pdf.
44The worst-off was Larry Ly: Karen Weintraub, “Scientists Link Zika Firmly to Paralysis, as Patients in Tahiti Know Too Well,” STAT News, Feb. 29, 2016, https://www.statnews.com/2016/02/29/zika-guillain-barre-tahiti/.
44As fear of the disease: “Epidémie de Zika: La ministre de la santé au chevet des malades,” Tahiti Infos, Feb. 22, 2014, http://www.tahiti-infos.com/forum/Epidemie-de-Zika-La-ministre-de-la-sante-au-chevet-des-malades_m195232.html.
45Finally, the French high commissioner: “Les maires résistants aux pulvérizations d’insecticide rappelés à l’ordre,” Tahiti Infos, Feb. 19, 2014, http://www.tahiti-infos.com/L-epidemie-de-zika-recule-mais-la-situation-sanitaire-reste-tendue_a95004.html.
45By April 2014, when: Henri-Pierre Mallet, “Emergence du virus Zika en Polynésie française” (PowerPoint presentation at national infectious disease conference, Bordeaux, France, June 11–13, 2014).
46The Guillain-Barré “attack”: Van-Mai Cao-Lormeau et al., “Guillain-Barré Syndrome Outbreak Associated with Zika Virus Infection in French Polynesia: A Case-Control Study,” Lancet, Feb. 29, 2016, http://dx.doi.org/10.1016/S0140-6736(16)00562-6.
46In an interview: Gwendoline Dos Sant
os and Frédéric Lewino, “Scandal: Health Authorities Ignore a Leading Zika Specialist,” Le Point, Feb. 3, 2016, http://www.lepoint.fr/sante/zika-la-propagation-de-l-epidemie-etait-previsible-depuis-2014-03-02-2016-2014974_40.php.
46In 2015, when France’s High Council: Dos Santos and Lewino, “Scandal.”
47From Tahiti, the virus: “L’épidémie de zika en phase terminale en Polynésie française,” Tahiti Infos, April 9, 2014, http://www.tahiti-infos.com/L-epidemie-de-zika-en-phase-terminale-en-Polynesie-francaise_a98643.html.
48Dr. Musso then: Didier Musso, “Zika Virus Transmission from French Polynesia to Brazil,” Emerging Infectious Diseases, Oct. 2015, http://dx.doi.org/10.3201/eid2110.151125.
48But in March 2016: Nuno Rodrigues Faria et al., “Zika Virus in the Americas: Early Epidemiological and Genetic Findings,” Science, March 24, 2016, http://science.sciencemag.org/content/early/2016/03/23/science.aaf5036.
48In April, researchers: John Lednicky et al., “Zika Virus Outbreak in Haiti in 2014: Molecular and Clinical Data,” PLOS Neglected Tropical Diseases, April 25, 2016, http://dx.doi.org/10.1371/journal.pntd.0004687.
49This was not the first: “L’origine de l’épidémie de zika en Polynésie restera un mystère,” Tahiti Infos, Dec. 9, 2013, http://www.tahiti-infos.com/Dengue-Zika-la-chasse-aux-moustiques-doit-etre-totale_a89989.html.
CHAPTER 4
52Hospital hallways: Donald G. McNeil Jr., Simon Romero, and Sabrina Tavernise, “How a Medical Mystery in Brazil Led Doctors to Zika,” New York Times, Feb. 6, 2016, http://www.nytimes.com/2016/02/07/health/zika-virus-brazil-how-it-spread-explained.html.
53As well they might: J. P. Messina et al., “Mapping Global Environmental Suitability for Zika Virus,” eLife Sciences, Jan. 18, 2016, http://simonhay.well.ox.ac.uk/uploads/publications/309/Messina_MappingGlobalEnvSuitZikaVirus_2016_provis_SI.pdf.
54After that, the greatest: Van-Mai Cao-Lormeau et al., “Guillain-Barré Syndrome Outbreak Associated with Zika Virus Infection in French Polynesia: A Case-control Study,” Lancet, Feb. 29, 2016, http://dx.doi.org/10.1016/S0140-6736(16)00562-6.
CHAPTER 5
59He forwarded me: S. C. Weaver and W. K. Reisen, “Present and Future Arboviral Threats,” Antiviral Research, Oct. 24, 2009, doi:10.1016/j.antiviral.2009.10.008.
61On Google News: Shasta Darlington, “Brazil Warns against Pregnancy Due to Spreading Virus,” CNN News, Dec. 24, 2015, http://www.cnn.com/2015/12/23/health/brazil-zika-pregnancy-warning/.
62A few years earlier: Donald G. McNeil Jr., “Fast New Test Could Find Leprosy before Damage Is Lasting,” New York Times, Feb. 19, 2013, http://www.nytimes.com/2013/02/20/health/fast-new-test-could-help-nip-leprosy-in-the-bud.html.
63I wrote a brief: Donald G. McNeil Jr., “Zika Virus, a Mosquito-Borne Infection, May Threaten Brazil’s Newborns,” New York Times, Dec. 28, 2015, http://www.nytimes.com/2015/12/29/health/zika-virus-brazil-mosquito-brain-damage.html.
66Simon’s story arrived: Simon Romero, “Alarm Spreads in Brazil over a Virus and a Surge in Malformed Infants,” New York Times, Dec. 30, 2015, http://www.nytimes.com/2015/12/31/world/americas/alarm-spreads-in-brazil-over-a-virus-and-a-surge-in-malformed-infants.html.
67On January 4, 2016: Donald G. McNeil Jr., “U.S. Becomes More Vulnerable to Tropical Diseases Like Zika,” New York Times, Jan. 4, 2016, http://www.nytimes.com/2016/01/05/health/us-becomes-more-vulnerable-to-tropical-diseases-like-zika.html.
67Then, on January 4, Puerto Rico: Lisa Schnirring, “Puerto Rico Reports First Locally Acquired Zika Virus Case,” CIDRAP News, Jan. 4, 2016, http://www.cidrap.umn.edu/news-perspective/2016/01/puerto-rico-reports-first-locally-acquired-zika-virus-case.
68Actually, I learned: “First Case of Zika Virus Reported in Puerto Rico,” Centers for Disease Control and Prevention, Dec. 31, 2015, http://www.cdc.gov/media/releases/2015/s1231-zika.html.
68until an Associated Press: “Puerto Rico Reports Its First Mosquito-Borne Zika Case,” Associated Press, Jan. 4, 2016, http://wgntv.com/2016/01/04/puerto-rico-reports-its-first-mosquito-borne-zika-case/.
72On January 13, I got: Lavinia Schuler-Faccini et al., “Possible Association between Zika Virus Infection and Microcephaly—Brazil, 2015,” Morbidity and Mortality Weekly Report, Jan. 22, 2016, http://dx.doi.org/10.15585/mmwr.mm6503e2.
72This was a second: “Zika Virus Epidemic in the Americas: Potential Association with Microcephaly and Guillain-Barré Syndrome,” European Centre for Disease Prevention and Control, Dec. 10, 2015, p. 7, http://ecdc.europa.eu/en/publications/Publications/zika-virus-americas-association-with-microcephaly-rapid-risk-assessment.pdf.
75The agency issued: Donald G. McNeil Jr., “To Protect against Zika Virus, Pregnant Women Are Warned about Latin American Trips,” New York Times, Jan. 15, 2016, http://www.nytimes.com/2016/01/16/health/zika-virus-cdc-pregnant-women-travel-warning.html.
76That must really have upset: Simon Romero, “Zika Warning Spotlights Latin America’s Fight against Mosquito-Borne Diseases,” New York Times, Jan. 17, 2016, http://www.nytimes.com/2016/01/18/world/americas/brazil-zika-warning-rio-games.html.
76The first American baby: Donald G. McNeil Jr., “Hawaii Baby with Brain Damage Is First U.S. Case Tied to Zika Virus,” New York Times, Jan. 16, 2016, http://www.nytimes.com/2016/01/17/health/hawaii-reports-baby-born-with-brain-damage-linked-to-zika-virus.html.
CHAPTER 6
77People all over: Andrew Jacobs, “Brazilians Shrug Off Zika Fears to Revel in Carnival Fun,” New York Times, Feb. 10, 2016, http://www.nytimes.com/2016/02/11/world/americas/brazil-zika-virus-carnival.html.
77Up to then, the WHO: Editorial, “Zika Virus Requires an Urgent Response,” New York Times, Jan. 28, 2016, http://www.nytimes.com/2016/01/28/opinion/zika-virus-requires-an-urgent-response.html.
78two weeks later: Sabrina Tavernise and Donald G. McNeil Jr., “Zika Virus a Global Health Emergency, W.H.O. Says,” New York Times, Feb. 1, 2016, http://www.nytimes.com/2016/02/02/health/zika-virus-world-health-organization.html.
81In fact, within a week: “Statement on Data Sharing in Public Health Emergencies,” PLOS in the News, Feb. 10, 2016, http://blogs.plos.org/plos/2016/02/statement-on-data-sharing-in-public-health-emergencies/.
83My colleague Catherine: Catherine Saint Louis, “Microcephaly, Spotlighted by Zika Virus, Has Long Afflicted and Mystified,” New York Times, Jan. 31, 2016, http://www.nytimes.com/2016/02/01/health/microcephaly-spotlighted-by-zika-virus-has-long-afflicted-and-mystified.html.
83The BBC did: Graham Satchell, “‘He Is Enjoying Life’: Living with Microcephaly in the UK,” BBC News, Feb. 5, 2016, http://www.bbc.com/news/health-35500306.
83French Polynesian scientists: Dr. Simon Cauchemez et al., “Association between Zika Virus and Microcephaly in French Polynesia, 2013–15: A Retrospective Study,” Lancet, March 15, 2016, http://dx.doi.org/10.1016/S0140-6736(16)00651-6.
84Sabrina Tavernise interviewed: Donald G. McNeil Jr., Simon Romero, and Sabrina Tavernise, “How a Medical Mystery in Brazil Led Doctors to Zika,” New York Times, Feb. 6, 2016, http://www.nytimes.com/2016/02/07/health/zika-virus-brazil-how-it-spread-explained.html.
84a story about mosquito control: Sabrina Tavernise, “Prepare for Guerrilla Warfare with Zika-Carrying Mosquitoes, Experts Warn,” New York Times, Feb. 12, 2016, http://www.nytimes.com/2016/02/13/health/prepare-for-guerrilla-warfare-with-zika-carrying-mosquitoes-experts-warn.html.
84Simon did one: Simon Romero and Donald G. McNeil Jr., “Zika Virus May Be Linked to Surge in Rare Syndrome in Brazil,” New York Times, Jan. 22, 2016, http://www.nytimes.com/2016/01/22/world/americas/zika-virus-may-be-linked-to-surge-in-rare-syndrome-in-brazil.html.
84The first American to die: Donald G. McNeil Jr. and Daniel Victor, “First U.S. Death Tied to Zika Is Reported in Puerto Rico,” New York Times, April 29, 2016, http://www.nytimes.com/2016/04/30/health/zika-virus-
first-death-in-us-puerto-rico.html.
86And there was no way: Joari De Miranda et al., “Induction of Toll-Like Receptor 3-Mediated Immunity during Gestation Inhibits Cortical Neurogenesis and Causes Behavioral Disturbances,” mBio, Oct. 5, 2010, doi:10.1128/mBio.00176-10.
87In 1988, Finnish: Sarnoff A. Mednick et al., “Adult Schizophrenia Following Prenatal Exposure to an Influenza Epidemic,” Archives of General Psychiatry 45, no. 2 (1988): 189, doi:10.1001/archpsyc.1988.01800260109013.
87And a pioneer: E. Fuller Torrey, interview with the author, Feb. 2016.
88Whether psychiatric problems: Donald G. McNeil Jr., “Zika May Increase Risk of Mental Illness, Researchers Say,” New York Times, Feb. 18, 2016, http://www.nytimes.com/2016/02/23/health/zika-may-increase-risk-of-mental-illness-researchers-say.html.
88Eventually, scientists from: Cauchemez et al., “Association.”
CHAPTER 7
94The only obvious: Brian D. Foy et al., “Probable Non-Vector-Borne Transmission of Zika Virus, Colorado, USA,” Emerging Infectious Diseases, May 17, 2011, p. 880, doi:10.3201/eid1705.101939.
94The paper described: Martin Enserink, “Sex after a Field Trip Yields Scientific First,” Science, April 6, 2011, http://www.sciencemag.org/news/2011/04/sex-after-field-trip-yields-scientific-first.
95It was in a relatively minor: Didier Musso et al., “Potential Sexual Transmission of Zika Virus,” Emerging Infectious Diseases, Feb. 2015, p. 359, doi:10.3201/eid2102.141363.
95On January 25, 2016: Donald G. McNeil Jr., “Zika Virus: Two Cases Suggest It Could Be Spread through Sex,” New York Times, Jan. 25, 2016, http://www.nytimes.com/2016/01/26/health/two-cases-suggest-zika-virus-could-be-spread-through-sex.html.
98In retrospect, part of: D. Trew Deckard et al., “Male-to-Male Sexual Transmission of Zika Virus—Texas, January 2016,” Morbidity and Mortality Weekly Report, April 15, 2016, http://www.cdc.gov/mmwr/volumes/65/wr/mm6514a3.htm.
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