West Virginia public health officials have confirmed the state's first case of Zika virus in a pregnant woman, bringing the total number of West Virginians who have contracted the mosquito-borne illness up to eight.
According to the West Virginia Bureau for Public Health, the woman traveled to a country where the virus is commonly found for a mission trip.
"She was ill, showed symptoms, was treated, and is recovering," said Dr. Rahul Gupta, state health officer and commissioner for the Bureau. "At this point, we've been able to send the samples and get the results, and we're monitoring the pregnancy very closely. It's important to raise awareness in these situations and reemphasize that the (Centers for Disease Control and Prevention) has stated that if you are pregnant, you should not travel to areas impacted by Zika."
Gupta declined to release any more information about the woman, including whether she was aware of her pregnancy while traveling. The CDC recommends that pregnant women not travel to countries where the virus is carried by mosquitoes, and that women of child-bearing age use birth control for eight weeks after traveling to a Zika-endemic country, or for six months if they become symptomatic.
"At this time, there are a lot of things we don't know about the virus, especially with regard to pregnancy," he said. "We don't know how many of the women who acquire Zika during their pregnancy will have adverse outcomes in terms of their babies being impacted ... we also don't know the rate of transmission from mother to child. We also don't yet know the extent of different birth defects - we know there are linkages to microcephaly and other significant fetal brain defects, as well as blindness, but as for the rate of those, we don't know."
The pregnancy will now be monitored by the Bureau for Public Health's Office of Maternal, Child and Family Health through the U.S. Zika Pregnancy registry due to the increased risk of microcephaly and other potential birth defects, according to Gupta. Microcephaly is a neurodevelopmental disorder that occurs during fetal development and causes abnormally small heads and impaired brain development in affected children.
The state has tested 36 West Virginians for Zika so far this year, with eight confirmed cases of the virus among people who have traveled abroad. There are three patients whose test results have not been returned yet - all three pregnant women, according to Gupta.
"The point that's most important here is that if you're pregnant, you're not recommended to travel (to Zika-endemic countries)," Gupta said. "For the overwhelming majority of women who are of childbearing age and who are traveling for tourism or missionary work or other activities, that's when they're most at risk; when you aren't planning for it or you're not aware of being pregnant and are traveling. At that point, you should consider taking every precaution."
Dr. David Patton, a Charleston OB-GYN, said that although a person's chances of contracting Zika abroad are still relatively low, he tries to advise patients who plan on traveling to Zika-endemic countries to take appropriate precautions, and for pregnant patients to reconsider traveling at all.
"Any time someone travels, we discuss their travel plans. We've had a couple of people who were going to go to Central or South America on vacation, and we talked about the importance of maintaining good birth control during that time period," Patton said. "I had one patient who was supposed to go to a wedding in Columbia, and we actually talked her out of it. She's currently pregnant, and that's one of the countries on the watchlist. After a long discussion, she decided it was better not to go, even though it's a long shot."
Patton added that pregnant women who insist on traveling are safe to use insect repellents that contain DEET, and should take precautions to avoid mosquito bites.
"If you're pregnant, especially if you're in the early stages, I would recommend holding off on travel," he said. "If you're of childbearing age and planning to travel - say you plan on going to the Olympics in Brazil this summer - then you should maintain good birth control practices there and for a while after you return to the U.S."
Although there have been no reports of local mosquito transmission of the disease in the U.S., there have been several cases in which the virus has been transmitted by sexual contact. Gupta said men who travel to countries where Zika is prevalent should use condoms or another form of birth control for at least six months.
Another case reported this week in Utah of a caregiver who potentially contracted the virus from an elderly dying relative has highlighted some lingering unknowns about the virus' transmission, and Gupta said the state's Zika Task Force is working to ensure that its monitoring practices and recommendations are kept up-to-date. The state can now perform its own Zika testing, Gupta said, which will hopefully expedite future tests on patients.
The Bureau has launched a new website, www.zikawv.org, that tracks cases of the virus in West Virginia and provides travel recommendations and other updated information on the disease.
Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.