South Florida Zika scare means new worries for pregnant women
Giving birth is stressful enough. Having a baby in South Florida, the nation’s Zika ground zero, at a time when so much remains unknown about the virus and the news changes daily?
“I have to admit, I have had my freak out moments. I have called my husband crying,” said Annemarie Johnston, 28, a Tamarac resident who is 10 weeks pregnant with her first child. “I feel like I am a bad mom sometimes. What am I getting my child into?”
Moms-to-be and their partners have a lot more options to weigh these days than what to name the baby or what color to paint the nursery.
Should they get tested for Zika, a mosquito-borne virus that can cause fetal abnormalities? Move out of state until delivery? Wear repellent with DEET, when women have been told for decades to avoid the insecticide during pregnancy? Stop having sex, as Zika can be sexually transmitted — and 80 percent of those infected don’t know they are a carrier because they have no symptoms?
“Of all times, there is a health issue affecting unborn children and it’s right in my backyard,” said Marielle Kunhardt, 32, a communications executive who lives in Fort Lauderdale and is due in November.
As of Friday, 75 pregnant women in Florida have tested positive for the virus. State health officials will not say where they live. There are 529 pregnant women among the more than 2,500 confirmed Zika cases nationwide.
This month, officials with the federal Centers for Disease Control and Prevention have issued advisories recommending pregnant women and their partners not travel to two areas with the only confirmed active Zika transmission in the country: a 1-square mile area north of downtown Miami that includes the trendy Wynwood neighborhood; and a slightly larger area in south Miami Beach.
On Aug. 19, the CDC raised the stakes by suggesting expectant couples “consider” not traveling anywhere in Miami-Dade County.
That news is particularly alarming to Johnston, a teacher at a private school just outside Wynwood. She thought about taking a leave of absence but gained confidence when her boss was extra supportive.
The school arranged Johnston’s schedule and gave her a new parking spot so that she will spend as little time outside as possible. Her supervisor also bought Johnston indoor bug zappers and fumigated her classroom.
“I have to stay protected to keep myself safe,” Johnston said. “I cover myself with DEET every single day.”
The CDC is continually updating its pregnancy guidelines as scientists learn more and advise pregnant women to consult their doctors about Zika. Yet often, physicians can only say: We’re not sure.
“There are a lot of unknowns. I give them the facts that we know and let them decide,” said Dr. Rachel Bernstein, a obstetrician-gynecologist at Holy Cross Hospital in Fort Lauderdale who is Kunhardt’s doctor. She said she receives Zika updates from the CDC and her medical specialty association almost daily.
Things haven’t gotten any easier since state health officials announced the first locally transmitted cases of the virus, which can cause fetal birth defects if the mother is infected, on July 29.
Hoping to ease fears, Gov. Rick Scott on Aug. 3 authorized free Zika screenings at county health departments for all Florida pregnant women. Previously, expectant mothers struggled to get tests authorized unless they were showing symptoms — which few people with Zika do — or they or their partners had traveled to countries with Zika outbreaks.
The Florida Department of Health has screened 1,118 pregnant women at no cost since free testing was started, said spokeswoman Mara Gambineri. Either a viral test, which would determine if the virus is active in the bloodstream, or an antibody test, which can tell if someone ever has been exposed to Zika, are used depending on what’s appropriate for the patient, Gambineri said.
Wait time for results is about two weeks, she said. “The county health departments are keeping up with the demand and we are in constant communication with them should we need to provide additional personnel,” Gambineri said.
Both Kunhardt and Johnston opted to be tested. Kunhardt, who went in about a week ago, is still waiting for results. Johnston, whose doctor had encouraged her to be tested because she works so close to Wynwood, got a call from the health department Thursday: her test was negative.
Johnston, who still has seven months until delivery, was worried she couldn’t be tested again. Gambineri, however, said there is no limit on the number of tests a person can receive.
The spectre of Zika-induced microcephaly — where babies are born with abnormally small heads and often have severe brain damage or developmental problems — drives many women to be tested. The CDC also recommends additional ultrasounds, which can detect the disorder in the womb, for women with Zika symptoms or risky travel history.
News photos of severely deformed, sobbing microcephalic infants in Brazil, where there have been thousands of cases possibly tied to Zika, are etched in the minds of pregnant women worldwide. Kunhardt remembers seeing such pictures in February, shortly before discovering she was pregnant.
“At that point, I figured it was isolated in the forests of Brazil and in poor countries,” she said. A month later, a pregnant friend out of state told Kunhardt she didn’t want to come visit during mosquito season because of Zika.
Researchers have estimated an infected pregnant woman has a 1 to 13 percent chance of giving birth to a microcephalic child. And evidence is emerging that the virus also may cause other initially hidden prenatal central nervous deformities, such as vision problems.
Although Kunhardt is comforted that fetal problems due to Zika usually occur in the first and early second trimesters, she wonders if she’ll always worry as her child grows older.
“Even if my baby comes out normal, what about 10 years down the road? What concerns me is the virus is so new, there are no studies out there about the long-term affects,” Kunhardt said.
Three babies in the U.S. have been born with microcephaly due to Zika, according to federal statistics. On was an infected pregnant woman who came to Broward County from Haiti in May, and gave birth a month later to the first microcephalic Zika baby in Florida.
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