After contracting Zika, new parents cope with a...
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Jan 26, 2016  |  Vote 0    0

After contracting Zika, new parents cope with a haunting diagnosis

When Larissa Fructuoso developed a bizarre rash while pregnant, she and her husband thought nothing of it. But that was before doctors realized Zika may be linked to an explosion of birth defects in Brazil — and before their daughter was born

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Last spring, just weeks after moving home to Brazil, Larissa Fructuoso developed a bizarre rash, like “red needle points on the skin.”

She and her husband Thiago worried — they were three months pregnant — but the strange malady quickly passed and the rash was forgotten.

It was only months later that they realized a mosquito’s bite may have changed their baby’s life forever.

“(We got) a microcephaly diagnosis,” said Thiago, a 31-year-old petroleum engineer. “The first reaction of the doctor was to ask us: did we get Zika virus?”

Both microcephaly and Zika are new words for the couple, but they will be haunted by them for the rest of their lives.

Zika is a virus spread primarily by the Aedes aegypti mosquito and first identified in Uganda in 1947. Since emerging in Brazil last spring, the virus has exploded across the Americas, spreading to at least 22 other countries and territories.

Zika’s symptoms tend to be mild, including fever and rash, and it’s estimated that only one in four people show signs of infection. There is no vaccine or specific treatment.

Microcephaly is a condition where babies are born with small heads and incompletely formed brains. It had never been linked to Zika virus until Brazilian doctors started noticing a dramatic rise in babies with brain malformations — nearly 4,000 reported microcephaly cases since late October, up from 147 in 2014.

More research is needed before Zika can be proven as a cause of microcephaly, but on Monday the World Health Organization said the circumstantial evidence is “extremely worrisome.”

When Larissa became sick, the couple’s first fear was dengue, a potentially fatal disease also spread by the aegypti. The Zika diagnosis, while surprising, was actually a relief and Larissa recovered after just three days.

“My friends living here, when I told them my wife had Zika, they said ‘That’s OK. Everybody got Zika here in the last month,’” Thiago said. “It’s not a big deal.”

Months later, when the microcephaly diagnosis was made, Larissa cried for days. The couple had no idea what it would mean for their baby.

Some babies with microcephaly grow up to have normal intelligence and development, despite their small heads. Others suffer serious developmental delays, dwarfism or seizures. Dr. Gustavo Malinger, an expert on fetal brain imaging who recently co-authored a report on microcephaly cases in Brazil, said the babies he saw faced severe mental handicaps with “no chances of intellect.”

As the Fructuosos’ due date approached, doctors prepared them for the worst. The baby could have a normal delivery; the newborn could also go into convulsions.

On Nov. 4, 2015, Isabela Fructuoso was born by C-section with no major problems. Her head circumference was 31 centimetres — just shy of the 32-centimetre threshold set by Brazil’s health ministry in their definition of microcephaly (this number was actually revised down from 33 centimetres in December).

“My wife cried again,” Thiago said, recalling his daughter’s birth. It was not just the ultrasound, “it was real now and it was here.”

Some doctors say Isabela’s brain shows signs of malformation and will never reach the final stages of development. Others caution it’s too early to make predictions. All they have for now are unanswered questions: will their daughter ever walk? Will she ever talk?

Thiago sometimes blames himself for what happened. He requested a work transfer to Brazil from Ecuador, which only recently confirmed its first locally acquired Zika cases. He even pushed for a March moving date after his company asked him to stay a few months longer, meaning he landed in Brazil just as Zika first began to spread. “Maybe if I was still living in Ecuador, my daughter would be normal,” he said.

But he also points a finger at the Brazilian government for failing to control the aegypti, which is responsible for spreading not just Zika and dengue but also another painful disease called chikungunya. “They can’t handle or exterminate the mosquito,” he said.

Thiago knows his family is relatively lucky, though. He has seen worse cases; a friend’s baby, also born with microcephaly, requires a feeding tube and appears to be “looking at nothing.”

Isabela, despite having a smaller head, is developing normally for a three-month-old. She is crying, laughing and smiling — all good signs.

“My first thought (upon hearing the diagnosis) was that I am just one of the millions of families that have a special child,” Thiago said. “I didn’t ask, ‘Oh God, why me?’ I asked ‘Why not me?’ I have a good situation to handle it … my daughter has luck to be in my hands.”

Scientists scramble for answers amid rising panic

With the virus now suspected of causing dramatic birth defects, Zika is becoming the biggest global health story of 2016. Here are the latest developments.

No country spared — except Canada

On Monday, the Pan American Health Organization warned that the virus will likely reach every country in the Americas where the Aedes aegypti mosquito thrives — everywhere but Canada and continental Chile (the aegypti has been detected on Chile’s Easter Island, where Zika was detected in 2014).

PAHO emphasized that the most effective way of preventing the virus is killing the mosquito and preventing bites. The health organization is also supporting investigations into Guillain–Barré syndrome, an autoimmune disorder that has recently surged in some Zika-affected countries, like Brazil and El Salvador. Cases of Guillain–Barré, which can cause temporary paralysis, were also observed after a 2013 Zika outbreak in French Polynesia.

‘Losing the battle’

In media interviews, Brazil’s health minister has admitted that in the fight against the aegypti, the insect has the upper hand. “The mosquito has been here in Brazil for three decades, and we are badly losing the battle,” Marcelo Castro told Folha de S. Paulo newspaper.

Castro has now pledged to mobilize some 220,000 troops, who will go door-to-door to help eradicate the mosquito. The government will also distribute mosquito repellent to approximately 400,000 pregnant women; repellent has reportedly sold out of many Brazilian pharmacies, as prices have tripled or even quadrupled.

The Zika sex factor

In a New York Times article, some experts say health officials should be warning people about the potential for Zika virus to be transmitted through sex. At least two medical studies suggest there is a “theoretical risk.” One involves a 44-year-old Tahitian man from the 2013 outbreak in French Polynesia, who had high Zika levels in his semen even after the virus had been cleared from his bloodstream. Another involves a Colorado biologist who developed Zika symptoms shortly after returning home from Senegal. A few days later, his wife developed similar symptoms and subsequent investigations concluded she was likely infected via sexual transmission.

The U.S. Centers for Disease Control and Prevention, however, cautioned that evidence is still insufficient to warrant a warning and mosquitoes remain the single most important source of Zika’s spread.

El Salvador to women: don’t get pregnant

A growing number of governments in Zika-affected countries are now urging women to delay their pregnancies, for fear of a potential increase in microcephaly cases. But El Salvador’s approach has been the most extreme, with recommendations that women avoid getting pregnant until 2018 — an unprecedented move some criticize as both heavy-handed and unrealistic.

Brazil, Colombia and Jamaica have also advised women to delay pregnancies, but only for a few months or until the virus is better understood. Such recommendations are now raising concerns over how birth rates might be impacted in the region. The outbreak is also igniting conversations about contraception use and abortions — both thorny subject issues in the many Zika-affected countries where Catholicism is dominant.

The race for a vaccine

On Tuesday, the head of the U.S. National Institutes of Health told the Associated Press that work was already underway to develop a Zika vaccine. But he cautioned that a vaccine, if possible, will still be years away. “This is not going to be overnight,” Dr. Anthony Fauci said in an interview. Brazilian President Dilma Rousseff has also said her government is working with foreign laboratories to try and develop a Zika vaccine.

Toronto Star

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