This is a difficult one as the studies completed in the area are few and far between however there is current guidance from ‘bumps’ – best use of medicines in pregnancy from the UK teratology information service which is recommended by the HSE’s Health Protection Surveillance Centre.
During pregnancy or whilst trying to conceive women should follow the same recommendations as all other travellers. If travelling to an area at risk of the Zika virus, Malaria, west nile virus, or Lyme disease it is worth postponing your trip if at all possible. If this is not possible then every measure possible should be taken to reduce the chance of being bitten as discussed below. I will also discuss the problems with contracting Zika during pregnancy and how it can put you and your baby at risk.
How to avoid insect bites:
- Use mosquito nets.
- Cover up using light clothing – even go as far as tucking your trousers into your socks – attractive I know!
- Use insect repellent – I recommend different ones below for pregnancy, trying to conceive or if you are not pregnant. It also depends on where you are travelling to. Apply insect repellent when appropriate to exposed skin, clothes and bed nets.
- Use other non-chemical methods such as repellent arm bands such as these –http://www.milltownpharmacy.ie/p/mos_repel_anti_mosquito_bracelet – in addition to the use of DEET in high risk areas. These may be sufficient if you are travelling to areas where these diseases are not present.
- Use air conditioning to keep mosquitos outside.
- Keep your baby safe using one of these http://www.milltownpharmacy.ie/p/clippasafe_universal_insect_net
Adopt these measures all day long but especially during mid-morning and late afternoon to dusk as this is when mosquitos are at their busiest! Always discuss your travel plans with your ante-natal team – especially when travelling to at risk areas.
So how do you weigh up the risks?
Here is some information to help you make the safest decision for you and your baby. The Zika virus often only causes mild illness in infected women who have received a bite but it is thought to cause potentially severe brain abnormalities in the unborn babies of these women if they are infected during pregnancy. This abnormality is known as microencephaly and it means that a baby is born with an unusually small head. There is also a possible connection with the Zika virus and Guillain Barre syndrome which is a neurological illness.
The mild illness that the Zika viral infection causes in bitten people usually only lasts from two to seven days and occurs most often between three and twelve days after receiving a bite. Common symptoms include mild fever, muscle pain, headache, itchy rash and conjunctivitis. At the time of writing this article outbreaks were occurring in countries like south and central Amera, the Caribbean and the Pacific Islands. An update of the countries affected can be found here http://ecdc.europa.eu/en/healthtopics/zika_virus_infection/zika-outbreak/Pages/Zika-countries-with-transmission.aspx
The Zika Virus can be spread through several means including receiving a bite from a mosquito, by having unprotected sex with an infected partner or by a blood transfusion. It can be passed from mother to baby during pregnancy or childbirth. It is not spread through coughs or social contact so it is possible to care for someone with the Zika Virus without being at risk. Here is a useful chart which explains the recommendations for the prevention of the spread of the Zika Virus through sexual contact.
If you feel unwell within two weeks of your return from a high risk area and you are pregnant or trying to become pregnant then you should contact your doctor to let them know about your travels and to see if you need a blood test. Your doctor may also recommend a blood test if you were pregnant since Autumn 2015 and in a high risk area or became pregnant within two weeks of your return. Basically it is unlikely you have Zika if you have no symptoms within two weeks of your arrival home.
The first three months of pregnancy seem to be associated with the highest risk of birth abnormalities associated with the Zika Virus. If trying to conceive you should wait for 4 weeks after your return from the Zika area if you did not contract the illness and 8 weeks after your return if you did. Men should wait for 8 weeks if they were in a Zika area even if they did not have the illness and six months if they did have the illness. Condoms should be used during these periods.
Repellent Tips and Choices
- If travelling to a risk area for Malaria or Zika you need to use a product with approx. 50% DEET in it. Higher DEET levels may not be safe during pregnancy but lower levels may not be effective and the risk of contracting the disease outweighs the risk of using the repellent. Examples of these include Jungle Formula Maximum and Maximum Plus. Available here :http://www.milltownpharmacy.ie/p/jungle_formula_maxium_insect_repellent
- If you are not pregnant or trying to conceive you should use a high level DEET if travelling to a high risk area such as this TMB 100% DEET Insect Repellent
- If you are pregnant but not travelling to a high risk area you could try a product containing a safe active ingredient IR3535 such as Jungle Formula for Sensitive Skin.
- Put repellent on after your sun cream has dried in – not the other way around.
- Fear not – the potential risks from the use of insect repellents during pregnancy are deemed to be much less than the risks of contracting the infections.
- Use repellent as per manufacturers advice but in general you can apply it to clothes but it may cause damage. Also apply it to exposed skin and mosquito netting for best results.
- Check your product to see how often you need to reapply it as it varies between five and ten hours.
I hope you have found this article helpful and if you have any questions at all please don’t hesitate to contact me by sending a private message to the WonderBaba facebook page (www.facebook.com/wonderbabacare) or by calling me (Sheena) at Milltown totalhealth Pharmacy in Dublin 6 on 012600262. I’m always happy to help!