STD Awareness: Sexual Transmission of Zika Virus

Zika

Zika virus. Image: Cynthia Goldsmith, CDC

I first heard of Zika virus in an epidemiology class, when another student made on offhand remark: “Did you know Zika virus can be transmitted sexually?” Ever vigilant for material for the STD Awareness column, I excitedly scribbled the name of the virus in my notes. But upon further investigation, I found that there were only a couple of documented cases of the sexual transmission of this virus that no one had heard of, and decided there was no reason to freak people out about yet another potential STD when rates of more common STDs, like chlamydia and gonorrhea, were on the upswing.

A year later, Zika virus was splashed across headlines on a daily basis, mostly for its newfound association with birth defects, but also in light of revelations that it could be transmitted by sex.


Access to condoms and reliable contraception is more vital than ever.


While Zika virus is usually transmitted by mosquito bites, the discovery that it can be sexually transmitted made it the only known virus that could be spread both sexually and by mosquitoes. It’s also the only known mosquito-borne virus that can cross the placenta to harm a fetus. Like several other viruses, including CMV and rubella, Zika is implicated in serious birth defects. But many health authorities worry that its potential as a sexually transmitted pathogen is dangerously underestimated. As of August 31, there have been 23 confirmed sexually transmitted cases of Zika virus in the United States — but sexual transmission will rise as the virus jumps into local mosquitoes, which will also make it difficult or impossible to tell if a sexually active Zika patient got the virus from sex or directly from a mosquito.

Earlier this year, sexually transmitted Zika virus in Texas made headlines, with many journalists incorrectly proclaiming it the first known case of sexual transmission. In fact, Zika’s sexual transmission was first documented in 2008, before “Zika” was a household name and the married couple who published their experience in a scientific paper thought they could share their STD status in relative obscurity. Despite referring to themselves as “Patient 1” and “Patient 3,” a science reporter quickly figured it out and (with their permission) revealed their identities in a 2011 article — still years before Zika-bearing mosquitoes would hit the Americas and trigger a microcephaly epidemic that propelled the virus to infamy. Continue reading

STD Awareness: What Does “Congenital Syphilis” Mean?

Treponema pallidum, the bacteria that causes syphilis

Treponema pallidum, the bacteria that causes syphilis

Congenital syphilis, for centuries a leading cause of infant mortality, is often thought of as an antique affliction, relegated to history books — but it is on the rise again. Between 2012 and 2014, there was a spike in congenital syphilis rates, which increased by 38 percent and are now the highest they’ve been in the United States since 2001. As of 2014, the last year for which we have data, more babies were born with syphilis than with HIV.

The word “congenital” simply means that the baby was born with syphilis after being infected in the womb. When an expecting mother has syphilis, the bacteria that cause the disease can cross the placenta to infect the fetus — and will do so 70 percent of the time. As many as 40 percent of babies infected with syphilis during pregnancy will be stillborn or will die soon after birth. It can also cause rashes, bone deformities, severe anemia, jaundice, blindness, and deafness. Congenital syphilis is especially tragic because it’s almost completely preventable, especially when expecting mothers have access to adequate prenatal care and antibiotics. Penicillin is 98 percent effective in preventing congenital syphilis when it is administered at the appropriate time and at the correct dosage.


More babies are being born with syphilis — but this trend can be reversed with wider access to prenatal care.


Incidence of congenital syphilis is growing across all regions of the country, but rates are highest in the South, followed by the West. Rates have also been increasing across ethnic groups, but, compared to white mothers, congenital syphilis rates are more than 10 times higher among African-American mothers and more than 3 times higher among Latina mothers, illustrating the need to increase access to prenatal care for all expecting mothers — and to ensure that this prenatal care is adequate.

Anyone receiving prenatal care should be screened for syphilis at their first visit, and some pregnant people — including those at increased risk or in areas where congenital syphilis rates are high — should be screened a second time at the beginning of the third trimester and again at delivery. Continue reading

STD Awareness: June Is National Congenital Cytomegalovirus Awareness Month

CMVPop quiz: Can you name the virus that most commonly infects developing fetuses when they are still in the womb?

Here’s a hint: June is National Congenital Cytomegalovirus Awareness Month.

In case that clue didn’t make it obvious enough, I’ll tell you the answer. The most common infection among developing fetuses is caused by a virus you might not have heard of: cytomegalovirus, or CMV. Around 30,000 children are born with this infection every year, and some of these babies will go on to develop serious problems because of it. National Congenital Cytomegalovirus Awareness Month is a time to learn about how CMV can affect pregnancy.


Cytomegalovirus can damage developing brain cells early in an embryo’s gestation.


This year, it might be of even greater interest, given the parallels that can be drawn between CMV and Zika virus, the emerging pathogen that has been dominating headlines lately. First of all, both CMV and Zika virus can be transmitted sexually, though they are not the first things you think of when the topic of STDs comes up, as they are overshadowed by more famous sexually transmitted viruses like herpes and human papillomavirus. While many of us are infected with CMV as children, we can also be infected as adults, often through sexual transmission — the virus can be found in cervical and vaginal secretions, saliva, and semen. The sexual transmission of Zika virus is not as well understood, but we know it can be found in semen, and there are documented cases of men passing the virus to sex partners through vaginal and anal intercourse. It might even be transmitted from a male to a partner by oral sex.

Second of all, both CMV and Zika virus are associated with birth defects. However, while the connection between CMV and birth defects has been known to us for decades, it was only in April that the Centers for Disease Control and Prevention concluded that Zika virus can cause fetal brain defects (though we’re still waiting for conclusive proof). Microcephaly is probably the most infamous of the birth defects associated with Zika virus, as well as CMV, but it’s not well defined. When you get down to it, though, microcephaly just refers to an abnormally small head, which itself might be indicative of a brain that has failed to develop fully. Continue reading

May Is National Teen Pregnancy Prevention Month

The following is a guest post by Planned Parenthood Arizona’s Director of Education Vicki Hadd-Wissler, M.A.

mother daughterAt Planned Parenthood Arizona, we hope families are talking about changing bodies, healthy relationships, love, and sex throughout the year, and with May’s National Teen Pregnancy Prevention Month, parents and the important adults in the lives of teens have a unique opportunity to talk with teens about pregnancy prevention. The month is aimed at helping teens to identify their plans for the future, and consider how those plans would be impacted by an unintended pregnancy.

Ongoing conversations between parents and teens build in protective factors. Studies have shown that teens who report having ongoing conversations with their parents about sex wait longer to begin having sex and are more likely to use condoms and other birth control methods when they eventually become sexually active. Even more surprising for many parents is that these studies also show that teens want to hear about what their parents have to say about sex and relationships.

Planned Parenthood Arizona can suggest some amazing resources to fit the needs of your family and to start dialogue with a teen you love. Continue reading

Hepatitis B Vaccine: The Importance of the Birth Dose

babiesDid you know that Saturday kicked off National Infant Immunization Week, which is part of a worldwide observance that shines the spotlight on the importance of vaccination? Most of us think of infant immunization as a tool to protect babies from childhood illnesses like chickenpox and whooping cough. But did you know that one infant immunization protects them from cancer later in life?

Globally, hepatitis B virus (HBV) is one of the top causes of cancer. Every year, it kills more than three-quarters of a million people worldwide. An HBV infection might be defeated by the immune system, but when it’s not, it can become a chronic infection. And chronic infections can lead to serious health outcomes, including cirrhosis and liver cancer. The younger you are, the less likely you’ll be able to fight off an HBV infection — 90 percent of infants infected with HBV will develop chronic infections, and 25 percent of them will go on to die prematurely after developing liver disease. Compare that to 2 to 6 percent of infected adults who will develop chronic infections.


Because infants are so vulnerable to developing chronic infections, vaccinating them against hepatitis B at birth makes sense.


Most people think of hepatitis as a bloodborne disease, and it is spread very efficiently when IV drug users share needles, during needle-stick accidents and other occupational injuries, or by using contaminated piercing needles, tattoo equipment, or acupuncture needles. Even sharing items like razors, toothbrushes, and nail clippers can do it, as the virus can survive outside of the human body for a week. HBV can also be spread by sexual contact, including vaginal and anal sex.

Lastly, babies and children can be at risk as the virus can be transmitted from mother to infant during birth, and during early childhood when risk of chronic infection is high. A significant number of people with chronic infections acquired them during early childhood, but we don’t know exactly how they got them, as their parents and other household contacts were negative for the virus or its antibodies. Since infants and children are at the highest risk for developing chronic infections, focusing on that population for prevention is very important.

Luckily, there’s a vaccine. Continue reading

World Prematurity Day: A Time to Reflect on the Importance of Prenatal Care

The following guest post comes to us via Edna Meza Aguirre, regional associate development director for Planned Parenthood Arizona. Edna is a native Tucsonan, bilingual and bicultural. She received her JD from the Sandra Day O’Connor College of Law and worked in the area of criminal defense for 12 years before changing careers. Edna is in her 16th year of volunteering at the University of Arizona Medical Center’s neonatal intensive care unit helping comfort newborn babies.

baby_feetThe neonatal intensive care unit (NICU) I volunteer in is among the best in the country. It is known nationwide for the cutting-edge research and techniques that not only save the life of a premature baby, but encourage that same infant to thrive.

The moment the delivery health care staff senses the as-yet unborn child is in stress, the amazing doctors, nurses, and respiratory therapists are on the scene in the delivery room. As in a well-coordinated symphony, the lifesaving process begins. Through the priceless intervention of these medical professionals, I have seen babies born blue return to a normal color. I have seen listless children born with no sign of life emerge back into this world through the medicine and touch of these professionals. I’ve seen sobbing parents struggling with this difficult reality as hospital staff explain the problem at hand with caring words and a gentle tone.


There isn’t a single parent who isn’t deeply emotionally affected by watching their vulnerable baby receive treatment.


Premature birth, also called preterm birth, occurs when a baby is born before the pregnancy has reached 37 weeks, and affects 1 out of every 10 babies born in the United States. Because the last few weeks of pregnancy are so crucial to a baby’s development, being born too early can lead to death or disabilities, such as breathing, vision, or hearing problems, as well as cerebral palsy and developmental delays. Treatment can sometimes depend on how premature the baby is. With a normal gestation period of 40 weeks, a premature baby might be born at 25 weeks, 30 weeks, etc. This time frame can be calculated easily enough with mothers who are receiving prenatal care.

There are, however, cases where the mother has received no prenatal care and doesn’t know how many weeks pregnant she is. Continue reading

National Breastfeeding Month: A Glimpse Into My Breastfeeding Journey

The following guest post comes to us via Cynthia.

breastfeedingBreastfeeding is the most natural, rewarding, challenging, frustrating, amazing, and empowering thing I have ever done. While I was in my second trimester of pregnancy, I was starting to make all kinds of decisions about how I wanted to care for my baby, including diapers, daycare, pediatrician, and breastfeeding. After doing the research and talking to other women about breastfeeding, I decided it was the best decision for me. There are amazing benefits.


I was referred to a lactation consultant. I called this woman my fairy milk mother.


In fact, there are so many great benefits the American Academy of Pediatrics (AAP) has a health initiative around breastfeeding and recommends that babies be breastfed through 6 months of age. A breastfed baby gets a nutritional superfood (to use a popular phrase) that is so dense with beneficial vitamins, minerals, and fats that the list of ingredients is long enough to fill several sheets of paper (women’s bodies are pretty spectacular).

Breast milk is powerful stuff, too. Studies show that breast milk will boost the immune system of the baby and benefit the mother’s health as well, in addition to reducing her chance of breast cancer. Additionally, breastfeeding reduces the rate of SIDS (sudden infant death syndrome) and future obesity for infants as they go into childhood and adulthood. Oh, and breastfeeding helps a mom shed her pregnancy pounds quicker — bonus!

Breastfeeding also provides the opportunity to bond with a baby in a close and personal way (the AAP makes note of this benefit too). My favorite times were when I could sit with my son on my lap and just relax. I didn’t do anything else but touch his soft baby skin, look at his toes and fingers, store in my memory the chubby cheeks, little nose, and rosebud lips, and lovingly stroked his back and legs. Thinking about it now, the sweet scent of my little one comes back to me. There is never another moment like when a child is an infant. Soon they will be crawling, walking, and then running. And that close time does wonders for a baby, providing reassurance, confidence, and a closeness that lasts beyond infancy. Continue reading