Wednesday, November 22, 2017
Health

For pregnant women in Tampa Bay, a lack of answers heightens worries about Zika

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TAMPA — Rosa Mayerly Velasquez was overjoyed to learn in January that she was pregnant.

But her excitement quickly turned into anxiety.

Weeks earlier, Velasquez, 33, and her husband had visited family in Colombia, a country that has seen an alarming spike in Zika infections and birth defects linked to the mosquito-borne virus.

She didn't experience the fever, headaches or rashes that typically signal an infection, she said. But then again, most people who have the virus don't realize it.

So while her physicians in Tampa have been paying close attention to her baby's development, Velasquez lives with a nagging list of questions that doctors can't yet answer.

"Until I have my baby in my hands," she said, "I'm not going to be 100 percent sure everything is fine."

Her concerns aren't unique. Pregnant women across the Tampa Bay region are anxious about Zika. Some, like Velasquez, have recently traveled to countries like Colombia and Brazil, where the virus is spreading. Others fear the hot, wet summer months will bring Zika to Florida.

Patients at Premier ObGyn in Tampa pepper Dr. Luciano Martinez Jr. with questions, he said. How long can Zika live inside the body? Can it go dormant? What percentage of women who contract the virus while pregnant will have complications?

The veteran obstetrician doesn't have many answers. "A lot is still unknown," he said. He can urge those who have traveled abroad to get a blood test at the county health department. But the only way to tell if a fetus has been affected is an ultrasound, which can show a misshapen head.

"Once you discover it there," Martinez said, "it's too late."

• • •

Zika gained international notoriety earlier this year, when the virus exploded across Central and South America and the Caribbean. As it spread, officials in Brazil noticed a surge in the number of babies born with abnormally small heads, a condition known as microcephaly, and theorized the two were linked.

The Centers for Disease Control and Prevention in Atlanta has since concluded that Zika can cause microcephaly — a troubling discovery, since the condition is often accompanied by intellectual disabilities and seizures, and cannot be cured.

To date, Zika outbreaks have occurred mostly in Latin America and the Caribbean. All 544 cases reported in the United States, including 122 in Florida, involve people who had recently traveled to a country where Zika has been spread through mosquitoes.

But public health officials fear the southeastern United States may be the next battleground. The type of mosquito that carries Zika in other countries can also be found in Florida and is ubiquitous in the summer. What's more, the CDC has determined Zika can be passed from a man to his sex partners.

"Everyone is terrified that it is coming (to Florida), and I think it might come in the future," said Dr. Jill Hechtman, who practices at Tampa Obstetrics.

Because the virus has not been spread by mosquitoes in the United States, top public health officials have said women here don't need to consider delaying pregnancy on account of Zika.

Earlier this year, Hechtman was telling her patients not to worry at all. But the latest developments have prompted her to think differently.

"My tune is changing a little," she said.

She now says this: "Don't stress out about it, but take the proper precautions. Look out for standing water (where mosquitoes breed). Cover yourself if you can. Wear repellent."

She also urges patients to heed the CDC's advice and avoid travel to Zika-infected countries.

Many pregnant women are already taking those steps.

Atisha Suarez, a 28-year-old housekeeper from Tampa, is trying to stay inside as much as possible, she said. If she notices pots filling up with water in her yard, she dumps them out.

Lauren Feaster has been especially diligent about having her St. Petersburg home sprayed for mosquitoes. The 30-year-old Realtor also put off plans to travel with her family to the Caribbean during spring break.

Vilma Silva Butym, 37, isn't pregnant — but if she and her husband conceive this month, they will cancel an upcoming trip to Brazil for her cousin's wedding. Family members who live in Rio de Janeiro have told her the city is "a war zone for Zika," she said.

If they do travel to Brazil, they know they will have to delay starting a family for at least few months after the trip. Silva Butym isn't quite sure how long they will have to wait.

"It is hard to find reliable, scientific information," she said. "I'm a librarian, and I'm having trouble finding out how long the virus stays alive inside your body."

Some people are less willing to change their plans.

"What I'm finding in my practice is patients still want to go on their vacations," said Hechtman, the Tampa obstetrician. "We keep hearing about these new cases and they are all travel-related. . . . As a physician, I'm curious as to why people are considering traveling at the moment and not listening to the warnings."

• • •

A pregnant women who has already been exposed to the virus is in a different position. Scientists don't know how likely she is to develop an infection, or when in pregnancy she is most likely to pass the infection to her developing baby.

If she does test positive, doctors don't know the possibility of her fetus contracting the virus or having birth defects, said Dr. Mary Ashley Cain, an assistant professor of maternal fetal medicine at the University of South Florida Morsani College of Medicine.

"It is not likely that 100 percent of babies have adverse outcomes," said Cain, who is also expecting. "But we don't know if it is 10 percent or 20 percent or more."

So far, nine pregnant women in Florida who recently traveled to Zika-affected countries have been diagnosed with Zika virus infection. One case was confirmed Thursday.

For many women in the Tampa Bay region, travel to and from Latin America and the Caribbean is a part of life. Some have family in Zika-affected countries, or travel there for work. Others have husbands who make frequent trips and could pass on an infection.

Martinez, the doctor at Premier ObGyn, says many of his patients have recently come from Cuba, Colombia and Venezuela. Some want to know if their developing babies are at risk.

"It's hard," he said. "And there's no treatment."

Velasquez and her husband, Franciso Acevedo, continue to watch and wait. They are already acquainted with the virus; Acevedo's father in Colombia recently had an infection. He was sick for several weeks.

On a recent afternoon, Velasquez and Acevedo went to the doctor for an ultrasound. The grainy image brought welcome news: Their baby was developing normally.

Before the visit was over, a nurse handed Velasquez a tiny black-and-white photograph. The soon-to-be-mom held the photo close to her for a moment before holding it up for her husband to see.

"That's our baby," she said, grinning.

Tampa Bay Times researcher Caryn Baird contributed to this report. Contact Kathleen McGrory at [email protected] or (727) 893-8330. Follow @kmcgrory.

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