What we know about the Zika virus is changing every day. This is a page of links to scholarly journals and media, updated between my work as an emergency physician and writer.

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Flikr photo by frankieleon, https://www.flickr.com/photos/23307937@N04/3779182508/

Zika is a mosquito-borne disease mostly spread by the Aedes aegypti mosquitoes. Also called the Asian Tiger mosquito because of those white markings on the legs.

Canada and Chile don’t have the Aedes aegypti mosquitoes that spread Zika. But what if the Aedes albopictus mosquitoes start spreading it widely too? (https://www.washingtonpost.com/world/the_americas/new-discovery-means-more-us-states-will-face-a-risk-from-zika/2016/04/29/497ffa98-0d59-11e6-bc53-db634ca94a2a_story.html;

Map from CDC: http://www.cdc.gov/zika/vector/range.html

So is Zika spread by mosquito in Canada? Not yet, but it could be in the future: http://www.cbc.ca/news/health/zika-mosquitoes-1.3426603

If you travel to an area with Zika, you must wear mosquito repellent for three weeks after you come home. Aedes aegypti are “sippers” who bite multiple people and can transmit infection. If you don’t take precautions, you are potentially spreading Zika.  http://www.mnn.com/health/fitness-well-being/blogs/zika-mosquitoes-aedes-aegypti-aedes-albopictus

Travel advisories: for Zika, from the CDC: http://wwwnc.cdc.gov/travel/page/zika-information

http://www.cdc.gov/zika/geo/united-states.html (State by state breakdown)

Canada’s general travel advisories: https://travel.gc.ca/travelling/health-safety/travel-health-notices

CDC outline for the Dominican Republic, but has good tips on mosquito repellant that is safe in pregnancy and how to stay safe when you come home: http://wwwnc.cdc.gov/travel/notices/alert/zika-virus-dominican-republic

You already know that Zika can be sexually transmitted: http://www.cdc.gov/zika/transmission/sexual-transmission.html.

Hang on, there’s a case in Utah where it seems like a high viral load means it can also be transmitted non-sexually (http://www.aafp.org/news/health-of-the-public/20160720zikaupdate.html).

Can Zika be spread through tears, saliva, urine, or something else? We trying to figure that out. it’s spreading faster than it should for a purely mosquito-transmitted virus. Viral RNA has been found in mouse tears: http://sciencebulletin.org/archives/4952.html

Zika can also be transmitted between mother and fetus, through blood transfusions, and in the laboratory: http://www.cdc.gov/zika/transmission/

If you’re pregnant, your fetus may have neurological damage no matter what trimester you got infected. The skull may be normal-sized at birth, but you’d better monitor developmental milestones to make sure the baby’s brain is okay. Preliminary article: http://www.nejm.org/doi/full/10.1056/NEJMoa1602412

Follow-up article: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30902-3/abstract

Summary: http://www.theatlantic.com/health/archive/2016/06/zika-after-30-weeks/489284/

What if we’re trying to get pregnant or already pregnant? First of all, don’t travel to endemic areas. Here are more recommendations from the CDC: http://www.cdc.gov/zika/hc-providers/pregnant-woman.html

So how long should we wait before we try try to conceive? Some recommend six months. Longer is, of course, better. If the man is travelling to an endemic area, it’s safe for him to provide semen before he travels and have the woman do intrauterine insemination. http://www.cdc.gov/media/releases/2016/s0325-zika-virus-recommendations.html

 http://www.cbc.ca/news/health/zika-virus-1.3608713

If you’re in a place where it’s endemic, like El Salvador, they’re recommending two years (!): http://www.aljazeera.com/news/2016/01/zika-virus-women-told-delay-pregnancies-years-160122040824263.html 

Zika also causes joint problems (arthrogryposis) http://www.ncbi.nlm.nih.gov/pubmed/27509902

Zika attacks adult brains too. It’s linked to Guillain-Barré, which can cause ascending paralysis: http://www.cdc.gov/zika/healtheffects/gbs-qa.html

Maybe Zika can affect adults’ memories or cause depression even if it doesn’t paralyze you or hurt your baby: case study only (http://wwwnc.cdc.gov/eid/article/22/12/16-1280_article. A case study means that it happened to only one person. That’s not high quality research. However, it can point out something that needs further research.

How many cases are in Canada? And other Canadian resources: http://healthycanadians.gc.ca/diseases-conditions-maladies-affections/disease-maladie/zika-virus/index-eng.php

Spraying for Zika is killing bees. http://www.iflscience.com/plants-and-animals/millions-of-honey-bees-killed-accidentally-by-zika-mosquito-spray/ As an environmentalist, I’m so sad about this. Even if you don’t care about the earth, bees account for 30 percent of pollination, and their populations were already devastated by colony collapse disorder. How would you survive a 30 percent drop in food supply?

Zika articles, free until September 30th: https://www.google.com/url?hl=en&q=http://oxfordjournals-marketing.oup.com/c/1khuQzKUINIsgdH5t9lJYzci&source=gmail&ust=1474062105972000&usg=AFQjCNELHIH21Z1FYr1tA4Q9tcbJDAOBoA

If you would like to add a link or information that is based on science, please let me know.

Thanks,

Melissa Yuan-Innes, M.D.