The Latest on Zika
I’ve been talking a LOT on Zika – and the info at times seems like a moving target.  I caught up with the Environmental Working Group (EWG) to get their take on how to protect ourselves.  To learn what I learned, read below, and watch my latest Facebook Live session with Sharecare, where I answered more Qs. Want more info? Facebook Live sessions are every Tuesday at 2pm - and as long as I'm getting Zika questions, I'll be answering them! Check out Sharecare's Facebook page (or my own) to see them there!
Some new info:
  • What’s the risk to infants and children infected after birth? While those infected as infants (after the neonatal period) or young children would typically get the rash, joint pain, fever, and eye redness that is the acute Zika infection, the CDC doesn’t have any evidence that they’d develop any brain or nerve abnormalities.  In fact, children are at even lower risk of developing Guillain-Barre Syndrome.  That said, they say they’ll “continue to monitor”, and to date cannot comment on the long-term effects. (Yes, my reaction, like yours was “Yay…I guess?”.
  • Fewer geographic areas are at risk. Previous maps showed practically half the US at risk.  It turns out, those were maps of areas that could potentially support the Aedes mosquito.  A new map has been released that shows places the mosquito has actually been ID’ed in the past.  Now, many counties don’t actually report the Aedes mosquito, meaning that the new map likely underestimates the risk a little, but reality is far better than first portrayed.
  • Plus, I learned a few more repellant facts.  Those include learning that Permethrin (commonly used to for repellant-treated clothing) comes off on skin – especially if you spray the permethrin on yourself, and don’t buy the manufacturer kind.  I also learned that – while DEET has the most history and anecdotal evidence that it exposure doesn’t cause problems, they don’t actually have a case/controlled study of it (or any other repellant) in the first trimester.  I get that (I mean, what pregnant woman is going to sign up for THAT trial?!), but it gave me more pause.  That said, DEET has more safety evidence than other repellants of equal efficacy – and waaay more than most botanicals, for which the FDA doesn’t require any testing of efficacy OR safety, and which are often manufactured at such high concentrations (to be effective) that they’re highly allergenic.   
If you’re pregnant (My most conservative guidance to keep you safe, but minimize chemical exposure)
  • Minimize repellant need and exposure by wearing good cover-ups:
    • Wear long sleeves and pants as much as possible (I know, y’all I get it, this is Georgia.  And, I’m being conservative, as there are no Zika cases here from mosquitos; but I’m risk averse, and I wouldn’t want to be the first.).  Don’t wear permethrin treated clothing (especially don’t treat it yourself).
  • In those areas that need repellant, use the lowest % and amount possible:
    • Use the LOWEST % DEET or Picaridin possible. When you see % on the bottle, it doesn’t mean efficacy.  It means how long it lasts.  So, if you’re out for an hour or two, 10% DEET or 7-10% Picaridin are effective, with less chemical exposure.
    • Spray DEET or Picaridin on your shoes, and lightly over the loose long-sleeve T and pants (don’t saturate, as you don’t want it to seep through your clothing).
    • When you come inside, remove repellant-sprayed clothing (don’t wear that inside), and wash off any repellant-exposed areas.
  • According to the EWG, avoid using Oil of Lemon Eucalyptus while pregnant.
For children:
  • Minimize repellant need and exposure by wearing good cover-ups:
    • If they’ll let you, put on a UPF (sun-protection) long-sleeve shirt.  We use pink and green ones on my daughter, and (to date), have been able to do so without too much complaint.
    • If they’re out in the woods or a place with lots of mosquitos, aim for light long pants.
  • In those areas that need repellant, use the lowest % and amount possible:
    • When it comes to repellant, I like the EWG’s recommendations to follow the Canadian government’s recommendations). Those include waiting until 6 months to use DEET (10-20% - just like for pregnancy, use the lowest percent effective for how long you’ll be outside), or Picaridin 5-10%. Spray repellant onto shoes, and lightly onto clothing.  Don’t apply to hands, as kids put them in their mouth.   I hate applying to the face, but according to the EWG, you can apply sparingly (by hand) around the ears. 
    • Remove all repellant clothes and wash skin when coming inside!
  • Again, as in pregnant women, the CDC and EWG advise against using Oil of Lemon Eucalyptus in kids under 3.
  • (Of note - one thing that really bothers me? When schools tell you to "Apply sunscreen and bug repellant to your child, as we will not have time to apply it".  This makes me crazy! (1) Sunscreen will have worn off in 90 minutes (ok that's another blog post), but especially (2) I dont want my child wearing bug repellant all day - that totally defeats the purpose of trying to minimize her exposure! I dont have a good answer for this- aside from education of schools for the appropriate application of repellant.  It's definitely worth having a conversation with your child's school.
For everyone else: Of course, you don’t want Zika (nor any other mosquito-borne illness, for that matter), but you’re at a lower risk of the tragic consequences of getting it when you’re pregnant.  That means, you have a little more leeway.
  • The CDC and EWG say that the most effective are DEET (20-30%), Picaridin (20%) and IR 3535 (20%).  They grade Oil of Lemon eucalyptus as “less effective”, but an alternative if you want and happen to live someplace at lower risk for mosquito-borne illness.  
You’re better off using repellents wisely (and sparingly), rather than using botanicals.
I get the desire to go botanical – it’s better than putting chemicals on our body, right? Unfortunately, according to both the CDC and the EWG, that’s not the case.  Not only are botanicals less effective, to increase efficacy, many are in highly concentrated forms that can be extremely allergenic.  The EPA doesn’t require testing for efficacy OR safety – meaning that you’re relying on the companies claims.