By Ashley Hayes
WebMD Health News
Reviewed by Arefa Cassoobhoy, MD, MPH
Latest Infectious Disease News
July 13, 2016 -- The Zika virus hasn't been found in mosquitoes in the mainland U.S. -- yet.
But predictions it will, possibly soon, are driving new concerns about mosquitoes and mosquito-borne illness, a new WebMD survey finds.
The survey of 2,700 people found that they are more concerned about mosquitoes this year than the past few years and are planning to take additional steps to prevent mosquito bites.
Of the potential illnesses associated with mosquitoes, the Zika virus worries survey respondents most, followed by West Nile. Those most concerned had a family member who was pregnant or planning to become pregnant.
An estimated 80% of people infected with Zika don't show symptoms. The others may experience a fever, joint pain, and red eyes or conjunctivitis. But Zika can wreak havoc on the unborn, causing devastating birth defects including microcephaly, in which babies have unusually small heads and brain damage.
Four babies in the U.S. have been born with Zika-related birth defects, according to the CDC. In all cases, the infections happened outside the U.S.
When asked about their levels of concern regarding mosquito-borne diseases including Zika:
- 45% of survey respondents said they're very concerned about Zika spreading in the U.S.
- 42% said they're more concerned about illness from mosquitoes this year than in past years.
- 32% said they're very concerned about mosquito-borne diseases
Among the people who know someone who is pregnant or planning a pregnancy, those levels of concern were higher:
- 51% of survey respondents said they're very concerned about Zika spreading in the U.S.
- 49% said they're more concerned about illness from mosquitoes this year than in past years.
- 39% said they're very concerned about mosquito-borne diseases.
"The concern for others stood out" in the survey results, says Dana Meaney-Delman, MD, an obstetrician-gynecologist on the CDC Zika Virus Response's Pregnancy and Birth Defects Task Force. "To me, this implies a responsibility to protect pregnant women, and direct family members seem to be feeling that the most."
While the only cases of Zika in the mainland U.S. have been associated with travel to areas where the virus is spreading, health officials have said it's only a matter of time until U.S. mosquitoes begin transmitting it locally. They spread Zika by biting an infected person and carrying the virus to others. Puerto Rico has been especially hard hit by the virus, with more than 2,400 locally transmitted cases as of July 6.
Among those who reported concern over mosquito-borne illnesses, more people (57%) said they were concerned about someone vulnerable in their family -- the elderly, children, or a pregnant woman -- becoming sick than they were for themselves (48%).
Bruce Cole, who lives outside of Charlotte, NC, says his main concern is for his two young children.
"We try not to have our boys out when it's feeding time (for mosquitoes), late in the afternoon," he says. They also have them wear clip-on mosquito repellents, although they usually put them on the boys' belt loops or socks because they don't want too much chemical exposure. And while they aren't huge fans of spray-on repellents, they've used them too, Cole says.
Mosquitoes tend to be "drawn" to his youngest child, as well as his wife, so they tend to use more protection, he says.
Meaney-Delman says her patients are concerned about Zika whether or not they are pregnant.
"Pregnant women are worried about the safety of their baby," she says. "They want to know when during pregnancy Zika is riskiest as well as other topics, like how safe insect repellent is. Women who are not pregnant are concerned about future pregnancies."
Asked which diseases they are concerned about:
Concern over Zika was higher among the people who know someone who is pregnant or planning a pregnancy: 74%.
Cole says while he and his wife aren't planning to have more children, two of his co-workers were pregnant -- one gave birth in March -- and "it was concerning for both of them."
Zika fears have prompted some athletes to pull out of the Olympics, to be held in August in Brazil, another country hit hard by Zika. More than 1,500 babies in Brazil have been born with microcephaly, according to the WHO.
"Microcephaly can be devastating for a child," says Hansa Bhargava, MD, WebMD Medical Editor. Babies born with it will face a lifetime of health challenges. "It is a life-changing defect and a real concern for pregnant mothers," she says.
Zika is a concern for men, as well. Some cases have been transmitted through semen during unprotected sex, and the CDC has recommended men diagnosed with Zika consider using condoms or not having sex for at least 6 months. The agency has reported 14 sexually transmitted cases in the U.S. that have happened after a person traveled to an area where Zika is spreading, then gave a sexual partner the virus after returning.
Those worries may have an impact on travel to areas with Zika. Eighty-five percent of survey respondents say they will not travel to areas known to be affected by the Zika virus. But the majority of those who already had travel plans -- 77% -- say they will keep them.
Karen Moseley, of Corpus Christi, TX, says she is concerned about the number of cruise ships leaving from and returning to Galveston and Houston after visits to the Caribbean or Central America.
Before she heard about Zika, she went on a cruise to Honduras and Belize, and even went zip-lining through the jungle. "I never would have done that had I heard about (Zika) before," she says.
The advice Meaney-Delman gives her patients follows the guidance from the CDC. Pregnant women should not travel to areas where Zika is spreading, she says. If they must, they should protect themselves from mosquito bites during the trip and see their doctor when they return. Pregnant women whose partners have traveled to Zika-affected areas should use condoms or abstain from sex for the duration of the pregnancy.
"Even in the U.S. where there is no local transmission, women should take steps to prevent mosquito bites to protect themselves from all kinds of mosquito-borne illnesses," she says.
While Zika poses the biggest risk to pregnant women and their babies, it's also been linked to other health conditions such as Guillain-Barre syndrome. That disorder can cause partial or complete paralysis, usually starting in the legs, most often temporary. Researchers are also looking into a possible link between Zika and an acute disseminated encephalomyelitis (ADEM), which is similar to multiple sclerosis.
Meaney-Delman says some of her patients who are not pregnant have asked her if they should try to get Zika purposely now to help protect them from future infections.
Her answer is "no," since Zika is linked to other serious illnesses. "Also, you never know how an individual's immune system will respond to infection with a particular virus," she says.
Around their homes, 89% of survey respondents say they're taking more action this year to protect themselves from mosquito-borne diseases.
Those steps include:
- Avoiding areas heavily populated with mosquitoes (59%)
- Removing standing water in their home or yard (58%)
- Wearing mosquito repellent more consistently (54%)
- Wearing protective clothing such as long pants or sleeves (44%)
The majority of respondents (62%) say they've used a mosquito repellent in the past three years, and most of those (77%) were DEET-based, such as Cutter, OFF!, or Skintastic. The CDC recommends using DEET-based repellents or those with picaridin (Cutter Advanced, Skin So Soft Bug Guard Plus), oil of lemon eucalyptus (Repel), or IR 3535 (Skin So Soft Bug Guard Plus Expedition, SkinSmart).
Natural or organic repellents were the next popular choice among survey respondents, at 22% overall. Except for oil of lemon eucalyptus, which is also known as the chemical PMD (para-menthane-3,8-diol) and is a chemical copy of an oil made by the lemon eucalyptus tree, the CDC doesn't recommend natural or organic repellents.
And what about mosquito control efforts in the community? Pesticide spraying remains fraught with controversy, despite the EPA and the CDC saying no unreasonable risk comes from spraying.
More than three-fourths of respondents (76%) say they support spraying of areas to kill mosquitoes. Among those who know someone who is pregnant or planning to be, even more support spraying, at 78%. The highest levels of support were seen in the Southeast or South-central regions -- the areas experts predict are at highest risk of Zika transmission.
"Our survey shows that people are aware of Zika and willing to take action," Bhargava says. "That's currently the best way they can fight this mosquito-borne disease and protect themselves and the unborn children it can affect."
The WebMD Mosquito Survey was completed by 2,714 WebMD site visitors on both desktop (49%) and mobile (51%) platforms. All respondents were randomly recruited on WebMD.com from May 17 through June 8, 2016. The margin of error of is +/-1.9% at a 95% confidence level.
SOURCES: WebMD Mosquito Consumer Survey, May 17 to June 8, 2016. Karen Moseley, Corpus Christi, TX. Bruce Cole, Charlotte, NC. Dana Meaney-Delman, MD, team lead, clinical team, Pregnancy and Birth Defects Task Force, CDC Zika Virus Response. CDC.
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