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W.H.O. Advises Pregnant Women to Avoid Areas Where Zika Is Spreading W.H.O. Advises Pregnant Women to Avoid Areas Where Zika Is Spreading
(about 2 hours later)
The World Health Organization on Tuesday advised pregnant women to avoid travel to areas where the Zika virus is spreading. The World Health Organization advised pregnant women on Tuesday to avoid travel to areas where the Zika virus is spreading.
Experts on W.H.O.’s Zika emergency committee also recommended that pregnant women and their partners who may have been infected rely on abstinence or protected sex to prevent sexual transmission of the virus. Experts on the organization’s Zika emergency committee also recommended that pregnant women and their partners who have been in areas with Zika rely on abstinence or protected sex to prevent sexual transmission of the virus.
Sexual transmission is “more common than previously assumed,” said Dr. Margaret Chan, director general of the organization. Sexual transmission is “more common than previously assumed,” said Dr. Margaret Chan, the agency’s director general.
The committee experts emphasized that they were not recommending that pregnant women avoid whole countries, but that they avoid only “areas” where mosquitoes are transmitting the virus. Local transmission of the virus has now been reported in 31 countries or territories in Latin American and the Caribbean. The agency emphasized that it was not recommending that women avoid whole countries, but only “areas” where mosquitoes were transmitting the virus.
“The onus is on countries to report where they are having outbreaks,” said Dr. David L. Heymann, the emergency committee’s chairman. “Then it’s up to the pregnant women to decide whether they want to travel there.” “The onus is on countries to report where they are having outbreaks,” said Dr. David L. Heymann, the chairman of the emergency committee, who is a professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine. “Then it’s up to the pregnant women to decide whether they want to travel there.”
The agency stopped short of advising women who live in those areas to delay pregnancy. The virus has been linked to tiny heads and brain damage in infants born to infected women, as well as a paralysis in some adults. W.H.O. last month declared an international public health emergency because of the suspected connection between the virus and microcephaly. The committee also called for more research on the virus and better surveillance to track its spread.
But Dr. Chan said women who chose to avoid becoming pregnant for fear of having children with birth defects should be given access to voluntary contraception. The panel suggested that countries intensively control mosquitoes near airports and consider spraying insecticide inside planes before takeoff, a common anti-malaria measure.
“All of this news is alarming,” Dr. Chan said. The committee stopped short of advising women to delay pregnancy if they live in areas in which the virus is circulating, but Dr. Chan said women who chose to do so should be given access to contraception.
Both travel advisories and birth control advice are sensitive topics for the W.H.O. because it is a United Nations organization. Its member states often object to medical advice that country officials feel interferes with tourism, business or domestic policies. Asked why the committee had not advised women to delay pregnancies, Dr. Heymann said he considered that a “national recommendation” rather than one under the W.H.O.’s mandate, which is to prevent the international spread of diseases.
Previously, the W.H.O. had advised women only to “consider delaying travel” and to discuss travel plans with their doctors. The virus has been linked to microcephaly — tiny heads and brain damage — in infants born to infected women.
Some experts argue that persuading women to postpone pregnancy is the best way to prevent a wave of such birth defects, because mosquito control is usually ineffective, a vaccine is months off and previous Zika outbreaks rapidly peaked and fell.
Travel advisories and birth control are sensitive topics for the W.H.O. because it is a United Nations organization, and its member states sometimes object to medical advice they feel interferes with tourism, business or domestic policies.
This is the first time the W.H.O. has advised that pregnant women avoid travel. Previously, the W.H.O. had advised women only to “consider delaying travel.”
The Centers for Disease Control and Prevention issued similar warnings weeks ago. On Jan. 15, the C.D.C. advised pregnant American women to consider avoiding travel to any countries or territories where the Zika virus was being transmitted.
That advice upset officials in countries with low-risk areas. For example, although Mexico is on the list, Mexico City is at a high altitude and mosquito-borne diseases are not a threat.
On Feb. 4, the C.D.C. advised pregnant women to avoid unprotected sex with men who had been in areas where the Zika virus was spreading.
The United States, Italy and France have all reported cases of suspected sexual transmission.
Now, Dr. Chan said, the infection has also been linked to fetal death, slow fetal growth and injury to nerves in the developing brain, as well as to a temporary paralysis in children and adults called Guillain-Barré syndrome.
“We can conclude that the virus is neurotropic,” she said, meaning it targets nerve and brain cells.
Nine countries have reported either increases in cases of Guillain-Barré syndrome during Zika outbreaks or cases in which the virus was found in Guillain-Barré victims. The syndrome is caused by an autoimmune attack on the nervous system, often following a viral or bacterial infection.
Cases of microcephaly following outbreaks of Zika virus have been reported only in Brazil and French Polynesia.
But “it’s a timeline because pregnancy is nine months long,” Dr. Heymann said. “What we see in Brazil now is what we could see in Colombia and other countries in the next few months, and it’s very alarming.”
The W.H.O. declared a public health emergency on Feb. 1 and asked donors to give $56 million toward the response. Dr. Chan said the agency had received only $3 million. “We encourage countries to support this very important work,” she said.
Since the emergency declaration, Dr. Heymann said, the W.H.O. has reacted rapidly, issuing 10 sets of guidelines to countries on how to handle Zika virus outbreaks.
He said evidence continued to mount that the virus, and nothing else, was to blame for increases in birth defects and Guillain-Barré in affected countries.
The advisory committee said particular attention needed to be given to several research areas: studies comparing infected and uninfected pregnant women; genetic sequencing of viral strains; how often the infection causes symptoms; and whether asymptomatic infections are dangerous.