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Health Dept. Head Questions Why Pregnant Women Are Traveling to Zika Areas

By Nicole Levy | August 19, 2016 2:36pm | Updated on August 21, 2016 12:55pm
 New York City is the site of one quarter of Zika cases in the U.S., NYC Health Department Commissioner Dr. Mary Bassett said.
New York City is the site of one quarter of Zika cases in the U.S., NYC Health Department Commissioner Dr. Mary Bassett said.
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TRIBECA — Health Department commissioner Dr. Mary Bassett questioned why pregnant women are still traveling to Zika-affected areas during a talk about the virus Friday morning.

"We tell people they should not engage in any non-essential travel, but for me — and this may represent a value judgment — it's really hard to understand what essential travel is for a pregnant women who may be placing her unborn baby at risk for birth defects," Bassett said at the New York Law School event.

The virus, which can be transmitted by mosquitoes or sexual intercourse, has been shown to cause such birth defects such as microcephaly, a condition characterized by unusually small heads and incomplete brain development.

Many pregnant New Yorkers who have been tested for Zika didn't know they were carrying a child when they traveled to an area with local transmission of the virus, Bassett said.

The city advises women who are pregnant and "trying to become pregnant" to avoid traveling to such areas. Miami Beach is the latest place to report cases of local transmission through mosquitoes, the second in the continental U.S after another neighborhood in Florida.

"If you're sexually active and fertile and not using effective contraception, you're trying to get pregnant, even if you're not thinking about it like that," the commissioner said amid light laughter from her audience.

While Bassett's department is committed to its campaign limiting Zika cases linked to travel, it has reconsidered the way it addresses the issue of sexual transmission.

"In a focus group, it came out that inadvertently we were shifting responsibility to the pregnant woman, when in fact it needed to be shared," Bassett said.

A woman instructed to tell her partner to use condoms after returning from travel abroad "understandably may feel that she's being asked to imply that her partner has been unfaithful to her," she continued. "We don't want that woman to have that responsibility.

"So we shifted our messaging to directly call upon male partners to limit their risk of transmitting Zika to their pregnant partners."

The key message now: "Protect your baby."

Only 15 percent of pregnant women exposed to Zika in New York have been attributed to unprotected sex, Bassett said. The city has reported a total of five cases of sexually-transmitted Zika.

Health officials have so far tested 6,500 individuals for the virus and continue to test at a rate of 100 people a day, the commissioner said. 

In addition to spreading information about Zika and testing for the virus in humans and mosquitos, the city is working to limit the mosquito population.

"We're just trying to kill aedes mosquitos," Bassett said, referring to the northern-dwelling cousin of the mosquito known to carry Zika. "We don't have any evidence that they have Zika in them. And we're reasonably optimistic that we won't find that evidence." 

Despite expressing confidence in New York's three-pronged response to Zika, Bassett said she still worries.

"I know also that we're learning a lot about Zika, and much is unclear, particularly the long-term effects on babies born to women with ZIka infection," she said.

Asked about a study out Thursday, which suggests the virus could endanger adult brain cells, potentially causing long-term damage and behavioral changes, Bassett emphasized her focus on infant health. 

"I'm frankly concerned that there may be more long-term effects for babies born to Zika-infected women than what we see at birth, but time will tell," she said. 

"The key really for most of us is to remember that Zika infection seems to be a mild infection in the majority of people who get it," the commissioner said.

Most adults with Zika have no symptoms, but those that develop them often have fevers, rashes, joint pain and conjunctivitis. Zika has also been linked to Guillain-Barré syndrome, a rare auto-immune disorder that can cause paralysis. 

"I think we know the big picture already," Bassett said. "There may be added rarer outcomes, but we know the big picture and that's bad enough."