microcephaly zika birth defect

This image from the U.S. CDC depicts microcephaly, a serious birth defect linked to Zika. The virus, which often has no symptoms, can be transmitted by mosquitoes and by sex.

In November, local health leaders said 12 pregnant women in Lancaster County had contracted Zika, but so far none of their babies had the serious birth defects the virus can cause.

Since then, details have been hard to come by, even as researchers continued to make progress in understanding the virus that first made headlines across the world early last year.

Here’s what we currently know about Zika in Lancaster County and its likely impact.

How many pregnant women in Lancaster County have gotten Zika?

That’s unclear, because the Pennsylvania Department of Health and the U.S. Centers for Disease Control and Prevention do not release state- or county-level data on Zika-affected pregnancies or their outcomes, and most health care organizations in Lancaster County declined to give LNP details on any Zika cases they may have seen.

However, in November a report given at Lancaster Chamber’s State of the County event said 12 pregnant women here had tested positive for the Zika virus.

Hilda Shirk, president and CEO of SouthEast Lancaster Health Services, said then that they weren’t all patients of SouthEast.

This month Brittany Hernandez, the organization’s Zika coordinator, said in a written statement, “I am just tracking our patients. As of right now, we have had 10 confirmed positive Zika pregnant mothers since 10/2016.”

And Mary Ann Eckard, spokeswoman for Lancaster General Health, said its Women & Babies Hospital has seen 29 mothers who had been infected or exposed to Zika.

Have any infants in Lancaster County been born with Zika-related birth defects?

Again, it’s unclear.

In November, Shirk said no birth defects had been found in the infants born by that point.

This month, Hernandez said two babies have tested positive for Zika infection, but no birth defects have been discovered that can be attributed to Zika.

And Eckard said there were no birth abnormalities among the mothers and babies it saw.

Does no Zika-related birth defects at birth equal an all-clear?

No.

Dr. Anne Schuchat, acting director of CDC, said last week that the effects of Zika infection during pregnancy are not always obvious at birth.

“Some babies whose mother were infected during pregnancy may be born with the head size in the normal range but might have underlying brain abnormalities, experience slowed head growth and develop microcephaly after birth,” she said. “That’s why identification of and follow-up care with babies with possible Zika virus infection is so crucial.”

What numbers do we have?

Since officials started counting last year, there have been 148 confirmed cases and 74 suspected cases of Zika in Pennsylvania, all believed to have been contracted outside the state or spread through sexual contact.

None are believed to have been spread by mosquitoes here — although a type of mosquito found in Lancaster County could spread the virus if it bites an infected person and then someone else.

In the 50 U.S. states and the District of Columbia, there have been 5,283 cases, of which 1,883 have been in pregnant women, who have had 72 infants and eight pregnancy losses with Zika-linked birth defects.

And in the U.S. territories there have been 36,587 cases, of which 3,916 have been pregnant women, who have had more than 120 infants or pregnancy losses with Zika-linked birth defects. These numbers include Puerto Rico, which has strong ties to the Lancaster area.

Some 17,000 people in Lancaster have direct ties to the island territory, with friends and family often traveling between the locations.

What birth defects are associated with Zika?

A primary one is microcephaly, which is characterized by abnormally small heads and brains. It can cause many problems that might require life-long specialized care.

Schuchat described the effects of Zika-related birth defects as follows.

“Some babies have seizures, while others have little to no control over their limbs and cannot freely reach out to touch the things around them due to constricted joints,” she said. “Some babies are not reaching their typical milestones, like sitting up. Some babies have significant feeding difficulties and they have trouble swallowing or even breathing while feeding. Some babies cry constantly and are often inconsolable no matter what their caregiver does to soothe them.”

How likely are birth defects if a pregnant woman gets Zika?

So far, the CDC says, about 5 percent of babies born in the U.S. and territories to mothers who had confirmed or suspected cases of Zika have developed related birth defects.

The agency said it appears that the chance of birth defects is slightly higher when mothers get the virus early in the pregnancy.

The virus has mild symptoms — fever, rash, joint pain, and red eyes — and many people who contract it report no symptoms. The agency said it does not seem to make much difference whether the mothers had symptoms of Zika or not.

Are there any Zika health risks to adults?

Researchers are investigating whether Zika increases risk of Guillain-Barre, a rare syndrome that is not fully understood and can cause paralysis. It appears they are strongly associated, according to the CDC, but that the number of cases in question is small.

Which mosquitoes can spread Zika?

Two related types of mosquitoes can carry Zika. Both are aggressive biters active during the day that generally stay within a 50-yard radius of the small amounts of stagnant water where they hatch.

The species that presents the greatest threat, Aedes aegypti, has not been found in Pennsylvania since 2002, the state Department of Environmental Protection says.

The Aedes albopictus, sometimes called the Asian tiger mosquito, is present here but not common.

Fourteen locations in Lancaster County monitored last year caught 3,962 Aedes albopictus mosquitoes, of which 2,336 were tested for Zika and all came back negative, according to the DEP.

What areas have Zika?

The CDC has a travel alert for places where mosquitoes could spread the virus to people.

It includes Mexico, Puerto Rico, the Dominican Republic, nearly all of central and south America, about half of the African continent, India, much of Africa and many island countries of southeast Asia.

It also mentions two specific areas in the United States — Brownsville, Texas, and Miami-Dade County, Florida — where mosquitoes have spread the virus to people.

The CDC says pregnant women should consider postponing nonessential travel to areas with Zika, and all travelers should take extra precautions against mosquito bites both during the trip and three weeks after returning, to avoid spreading the virus.

Travelers should also avoid unprotected sex with a woman who is or may become pregnant for at least six months after being in a Zika-infected region, the agency says.

Puerto Rico last week declared that its Zika epidemic is over, but CDC officials said they believe mosquitoes there are still carrying the virus and it continues to advise pregnant women not to travel there.

“We think this may be an ongoing risk,” Schuchat said, noting that efforts to develop a vaccine against Zika continue.

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