How Scared Should I Be of Zika?

Should I give a shit about a virus that causes a mild fever, even if I'm not planning to get pregnant? (Answer: yes)
August 11, 2016, 12:35am
Photo via CDC/Wikimedia Commons

In the column "How Scared Should I Be?" VICE staff writer and generalized anxiety disorder sufferer Mike Pearl seeks to quantify the scariness of the world he lives in. We hope it helps you to more wisely allocate that most precious of natural resources: your fear.

If you're a consumer of fear-mongering news stories like I am, the 2016 Olympic Games in Brazil seem to have a cloud hanging over them—a cloud made of mosquitoes carrying the Zika virus.

Scarier still, that cloud isn't neatly contained in Brazil either; it's already spread throughout Latin America and is working its way north, gaining a foothold in Florida. So while there aren't any reports of mosquito-born Zika in Los Angeles where I live, I'm already on high alert, and I'm starting to get concerned about the red patch of skin on my shoulder.

But even if my red patch is Zika, I'm far from doomed. Yes, Zika can cause microcephaly in infants born to Zika-infected mothers, but Zika fever is usually pretty mild, causing either no symptoms at all, or a rough couple of days coping with a rash, a fever, some pinkeye, and maybe the odd body ache. With all the other things in the world to be concerned about, does it make sense to keep Zika in my thoughts at all?

Yes, according to Professor David Heymann, head of the Centre on Global Health Security at the British policy research organization Chatham House. "It makes sense to worry about it if you're going to an area where there's Zika transmission," Heymann told me. And he means me, not just pregnant women.

By way of an explanation, Heymann gave me an epidemiology history lesson about a comparably benign virus—German measles:

"If you think back to before there was a vaccine for German measles, it was pretty much the same situation: a viral infection led to—in many instances—[birth defects like] neurological damage, or damage to eyes or damage to hearing," he told me. German measles spreads like the common cold, rather than mostly via mosquitoes and sex, like Zika.

During the German measles outbreak of the 1960s, that virus's shocking effects on fetal development mobilized an enormous, multi-decade effort to contain the disease, which finally concluded last year with the eradication of the virus in North and South America.

The CDC estimates that from 1962–1965 20,000 infants were born with the devastating effects of German measles, but from 2005–2011, there were only four. So it appears that organizing around the need to control a virus not because it can kill you but because it causes birth defects is something that has helped dramatically in the past.

Read our related story: Zika is about to hit states with the most restrictive abortion laws in the US.

But the comparison between Zika and German measles isn't perfect, particularly since German measles causes birth defects "at a rate of 85 to 90 percent," according to Heymann. So if a pregnant woman got German measles, it was fairly certain that she would have a child with devastating congenital effects. "Zika is on a much less great scale. It's thought to be about less than 2 percent or less than 1 percent risk at this point from the evidence that's available," Heymann explained. Other estimates have placed the rate of effects from Zika as high as 13 percent in pregnant women confirmed to have the virus.

"If men come back after they've been in a Zika area, they must be careful for quite a while in their sexual relationships." —David Heymann

Microcephaly, in which a baby is born with a small head and brain, is the most obvious, and arguably the most awful symptom of congenital Zika syndrome, or CZS. It should be noted, however, that there are varying prognoses for living life with microcephaly. Some microcephalic people thrive. Others live to a ripe old age with cognitive impairment. Tragically, some never have a chance at life, as was the case with a baby born with CZS who died on Tuesday—the first such death in Texas.

So CZS is the scary part, and science is scrambling to figure out everything it entails—which we already know is more than just microcephaly. In June, the World Health Organization issued a warning, saying it can cause defects in the heart, digestive tracts, and genitals of babies. More recently, we learned that it can cause curving joints.

Worrying about Zika stands to benefit public health if it drives people to take the steps that can help prevent CZS. In areas where Zika is hitching rides on mosquitoes, like Florida or a sports stadium in Brazil, people need to avoid day-biting mosquitoes like the literal plague, Heymann told me. "That means repellants during the day, long sleeves, long pants, tucking your pant legs, making sure they don't bite through your socks, [and] a whole series of actions that must be taken," he said.

In a perfect world, it's not just pregnant women who would take these modest, anti-mosquito precautions, particularly wearing mosquito repellant made with the chemical DEET, which mosquitoes absolutely abhor. Studies have repeatedly found that DEET kicks ass at getting bugs to not bite you, and it's safe for pregnant women. So use it.

Meanwhile, in the absence of symptoms, Zika can spread through sex. "If men come back after they've been in a Zika area, they must be careful for quite a while in their sexual relationships," Heymann told me. You know damn well there are good preventative measures out there for STDs, and they're called condoms. Good science isn't available yet to show that condoms are effective—although some questionable science says they are. But condoms are a no-brainer anyway since they also prevent pregnancy.

Maps by the Centers for Disease Control and Prevention

But part of what makes Zika transmission so unsettling is that it can flow through us so stealthily. The virus leapfrogs from mosquitoes to people, to more mosquitoes, to more people, and most of the organisms in that chain will never notice. "If you've been bitten," Heymann said, "the consequences may not even be known."

If you're in territory where the two potential Zika-spreading mosquito species, Aedes egypti and Aedes albopictus, live—meaning most of the continental US—is it so much to ask that you avoid mosquito bites?

No, you probably shouldn't be scared at all of Zika. But given the nightmarish consequences that could stem from a large outbreak, it makes sense to at least step up your giving-a-shit game.

Final Verdict: How Scared Should I Be of Zika?

2/5: Taking Normal Precautions

Follow Mike Pearl on Twitter.