Getting Tested for Zika
I remember the moment I thought that I could have contracted Zika virus.
It was our fourth wedding anniversary, and my husband and I wanted to go somewhere dreamy and tropical with pristine beaches. We decided that we would spend May 19 and several days surrounding it in the Dominican Republic.
We were sitting in comfy patio chairs in an open-air stage at our resort watching a bad Michael Jackson impersonator while enjoying our cold beverages when I felt a familiar stinging and burning on my leg.
I thought it was strange because I had not seen any mosquitoes at all since I had gotten there. I could have sworn I heard someone mention the resort sprayed for mosquitoes.
I shrugged it off. “Maybe they’re just biting gnats, or maybe I nicked myself when I shaved my legs earlier.”
I had religiously worn bug spray the first two days there, and the second night I decided to forgo it. After all, I hated the smell and I hadn’t come across any of those biting critters since we landed.
I mentioned it to my husband. He said he had not been bitten, so I sat there, enduring about half a dozen or so more instances of that uncomfortable sensation.
When I couldn’t take any more, we walked back to the room. I saw several half-dollar-sized welts pop up on my legs. Per usual, they itched and they burned, but the possible implications were far worse.
About a week and a half after we returned, I met with Dr. Jeff Hall, who supervises the travel clinic for the Palmetto Health/USC Medical Group. The clinic provides primarily pre-travel consultations for people traveling abroad on how to avoid regional maladies, such as malaria and even Zika virus.
Hall said Zika is nothing new, though the link to birth defects is recent. The virus was discovered in the 1940s and is spread by mosquito bites or through semen. Other than avoiding mosquito bites, there’s no other form of prevention. No vaccine, no nothing.
He said the symptoms are fairly mild, including a fever, joint pain, rashes and conjunctivitis.
Uh oh. I had worn glasses that day instead of contacts due to unexplained redness and irritation in one of my eyes. I had also some moderate headaches the week after I came back with some mild fevers.
Hall said the major concern for those contracting Zika is when it causes microcephaly, meaning the head of a fetus is too small, often meaning the brain is also too small.
“What it looks like is that the Zika virus seems to attack developing brain tissue and stops brain growth at a very early time,” he said. “Those babies are born with very small heads and very small brains and seem to be significantly developmentally delayed.”
My husband and I don’t plan to have children for a couple more years, but I learned the concern isn’t just for people wanting to expand their families immediately. Everyone who is bitten in a Zika-ravaged area has the potential to bring it back home with them as an unintentional, unwanted souvenir.
Hall said the same breeds of mosquitoes that spread the virus also live in South Carolina. If someone with the virus came to the state and was bitten, it could spread to other people. “This could be something that could be very easy to transmit here,” he said. “... It seems like it’s not unlikely that we could have some Zika virus in the Southeast. It’s just not happening to date yet.”
Panic started to set in. How careless was I for not doing everything I could to protect not just myself but everyone around me?
When Hall heard my symptoms, he became concerned. He said I had two options: Receive approval for testing by DHEC or pay a private lab, Quest Diagnostics, $500.
The second option was out of the question.
“(DHEC is) keeping a fairly tight rein on this testing right now,” Hall said. “They’re focusing their efforts on testing people of what they consider to be the highest risk, which is going to be folks who have traveled in an area affected by Zika and have either had symptoms or if they’re pregnant.”
Dr. Teresa Foo, DHEC medical consultant, said anyone who has traveled to a Zika-affected area and is exhibiting one or more of the symptoms should see their health care provider for assessment. If the physician believes the symptoms could be connected to Zika exposures, he or she can contact DHEC to receive approval.
“If it’s determined a person does meet the criteria for testing, we work with the physician to get the sample to our lab where the testing is then done,” Foo said.
I explained my symptoms to a DHEC representative, received approval shortly after and gave a urine and blood sample.
Then the waiting game began. In the meantime, DHEC gave me specific instructions to avoid going outside when possible or wear insect repellent and long sleeves and pants.
DHEC reported South Carolina has six confirmed cases of Zika virus, one of which was sexually transmitted.
But Foo said anyone bitten by mosquitoes in Columbia does not have to worry about Zika, and testing is reserved for those who are at risk.
Megan Davis, DHEC director of the Division of acute disease epidemiology, said at this time there’s no risk to public health from those cases, five of which were because those people traveled to Zika-impacted countries. “We do expect the number of travel-associated infections to continue to go up as this summer goes on and people begin their travel plans,” Davis said.
DHEC met in February to form a Zika Task Force to prepare for potential outbreaks, which includes spraying for mosquitoes in areas where South Carolina residents with Zika virus live and frequent.
Hall said men exhibiting symptoms should also be tested for Zika virus, too, if they have been bitten in affected regions. He said one way Zika is different from other mosquito-borne illnesses is that it can be spread through sexual contact.
“The concern is for sexual transmission,” he said. “The virus does seem to persist in semen longer than it persists in the blood.”
Hall said the best strategy to avoid Zika is to avoid mosquito bites by using insect repellent, such as DEET, picaridin or permethrin. People who return from a Zika-affected area and may have been exposed are asked to use insect repellent when they return home for at least eight weeks to reduced the chance of it becoming a locally transmitted infection. Men who may have been exposed should avoid spreading it through semen for at least six months.
It took about a week to hear back from Hall, but I’m glad to report that a health crisis was averted. Well, at least one caused by me.
Hopefully my experience can serve as a reminder to others about the possible risks associated with traveling internationally, and how we can bring those problems home with us.
Many infected people will have no or only mild symptoms, which can last for several days to a week. Zika virus usually remains in the blood of an infected person for about a week, but it can be found longer in some people.
Countries and territories with active Zika virus transmission:
Argentina, Aruba, Barbados, Belize, Bolivia, Bonaire, Brazil, Colombia, Puerto Rico, Costa Rica, Cuba, Curacao, Dominica, Dominican Republic, Ecuador, El Salvador, French Guiana, Grenada, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Nicaragua, Panama, Paraguay, Peru, Saint Barthélemy, Saint Lucia, Saint Martin, Saint Vincent and the Grenadines, Saint Maarten, Suriname, Trinidad and Tobago, U.S. Virgin Islands, Venezuela,
American Samoa, Fiji, Kosrae, Federated States of Micronesia, Marshall Islands, New Caledonia, Papua New Guinea, Samoa, Tonga
How Zika virus spreads:
The mosquitoes that carry Zika are aggressive daytime biters, but they can also bite at night. A mosquito becomes infected when it bites a person already infected with Zika. That mosquito can then spread the virus by biting more people. Zika virus can also spread:
▪ During sex with a man infected with Zika.
▪ From a pregnant woman to her fetus during pregnancy or around the time of birth.
▪ Through blood transfusion (likely but not confirmed).
Source: CDC. To learn more about Zika virus, visit www.cdc.com/zika/
Steps for South Carolinians to get tested for Zika virus through DHEC:
1. If you have been to a Zika-affected area, meet with your physician, such as a family doctor or a OB/GYN if you are pregnant.
2. Explain any symptoms you have.
3. You doctor will contact DHEC with the information.
4. DHEC will decide who will receive testing.
5. If approved, your physician will collect urine and/or blood samples and send them to DHEC.
6. DHEC or your physician will contact you in about a week with your results.