Zika 101: A Health Update From Our Medical Director

Health Update: Dr. Mary Diana, Medical Director

Zika virus is transmitted through the bite of an infected mosquito (Aedes aegypti and Aedes albopictus). These species are common in Central and South America, but have now made their way north and have been found in Puerto Rico and Florida. New York State has one of the highest numbers of Zika cases in the U.S., although all of these are associated with travel.

While Zika is primarily a mosquito-borne infection, it can also be transmitted sexually through bodily fluids. The vast majority of sexually transmitted cases are from a male traveler to a female partner. There have recently been cases of female-to-male and male-to-male transmission. No one knows how long the virus stays alive in the blood/semen.

The CDC recommends that men who have had a symptomatic Zika infection use condoms for 6 months. If they have traveled to an area where Zika is common, but don’t develop any symptoms, they should use condoms for 6 weeks.

Symptoms of Zika infection are headache, fever, joint or muscle pain, conjunctivitis (pink eye), rash, and vomiting. Some people don’t have any symptoms. There is no treatment or vaccine for Zika virus. The infection is self-limited, and usually resolves by itself within a week. Routine testing/screening of the general population for Zika virus is not recommended. Recently, Zika virus infection has been associated with development of Guillain-Barré Syndrome, a rare neurologic condition involving weakness and sometimes, paralysis. Research is being done to better understand this link.

Zika is a very serious problem in pregnancy. It is passed from the mother’s blood through the placenta to the fetus. Fetuses who become infected during the late first trimester or early second trimester develop severe microcephaly (a condition in which the brain is markedly underdeveloped) as well as other serious irreversible neurologic birth defects. Zika infection later in pregnancy can lead to low birth weight and stillbirth.

Since there is no treatment for Zika virus infection, preventing infection is paramount. Women who are pregnant or trying to become pregnant should avoid travel to areas where Zika is endemic and should avoid having unprotected sex with men who have travelled to these areas. Women who live in endemic areas are advised to prevent mosquito bites by using insect repellants, window screens and mosquito netting, and by wearing long sleeves and pants. If a woman has had a Zika virus infection, she should wait at least 8 weeks before trying to become pregnant.

Policy Update: Katherine Bruno, VP Public Affairs 
Recently the Senate finally passed a bipartisan Continuing Resolution (CR) and Zika funding package and the House is expected to pass the bill before the end of the week, averting a government shutdown and funding the government through December 9, 2016.

We can’t believe it took Congress more than 220 days to approve funding to fight the Zika virus without excluding some of the providers most qualified to help. It shouldn’t have taken this long, but this is still welcome news for women in the Capital Region and around the country.

With the serious risks Zika poses for pregnant women, we are not surprised that medical experts have consistently said that family planning providers must play a central role in preventing the spread of this virus. What surprises us is that some in Congress managed to ignore that guidance for months, trying to jam through a bill that excluded family planning providers. Thankfully, this funding demonstrates importance of family planning providers in combatting Zika, and more broadly, in providing basic health care to women, men and young people.

Planned Parenthood is here to make sure that all women, men and young people the Capital Region and all over the nation have access to the information, health care and support necessary to decide to prevent unintended pregnancy, safely end a pregnancy, or carry a pregnancy to term and raise a child. We believe that all people should be empowered to make decisions for themselves and their families, including the decision of whether to have a child, no matter who they are or where they live.

The Real Truth about Mycoplasma Genitalium, the "New STI." A Word from our Medical Director.

By Mary Diana, M.D.
Note: this article has been minimally edited for public consumption.

I’m writing to let you know about a “new STI” which you might be reading about in the media.

Mycoplasma is a class of bacteria, of which there are six different species. Five of them inhabit the genitourinary tract. The species Mycoplasma pneumoniae infects the respiratory tract, causing what is commonly referred to as “walking pneumonia.” Mycoplasma hominis is another well-known species in Ob/Gyn, and is often related to pregnancy complications including miscarriage, pre-term labor, low-birth weight, neonatal infection, and stillbirth.

Mycoplasma genitalium is the species that is recently in the lay press and is being called the “new STI”. This species was first identified in the early 1980s and has been recognized as a common cause of male urethritis, representing 15-25% of nongonococcal urethritis in men. Symptoms include pain during urination and discharge from the penis. In women, it is less clear what role it plays, and has not been well-studied. It can be found in the vagina, cervix, and endometrium. Much like Chlamydia and Gonorrhea, there are usually no symptoms in women. There is some evidence that it may cause pelvic inflammatory disease (PID), although it appears that this only occurs in 5% of women who are infected. Studies looking at its relationship to infertility are conflicting. More research needs to be done.

There is good evidence that M. genitalium is transmitted sexually. As far as incidence of infections goes, it is more common than Gonorrhea but less common than Chlamydia, depending on the population studied.

Currently there are no FDA-approved tests for Mycoplasma genitalium. Cultures can take up to 6 months and there are only a few labs in the world that can do this. In research settings, M. genitalium is diagnosed using a method called NAAT (nucleic acid amplification test) which detects the genetic material of the bacteria (this is the same type of test we currently use for Chlamydia and Gonorrhea). It can be detected in urine as well as cervical, vaginal, and urethral swabs. Again, this test is not FDA-approved and is not commercially available. Even if it were available, screening the general population would not necessarily be recommended, and testing would be limited to patients who have symptoms of urethritis, cervicitis, or PID.  Unfortunately, treatment is not straightforward. 

Hopefully we will be able to test for this infection in the near future, but at this time, testing is not available. This is another great reason to encourage condom use!!

If you have further questions, please contact your local Planned Parenthood Health Center.

Thank you, Olympic Condom Guy.

As reported by Distractify and other news sites, officials will be handing out half a million condoms to athletes at the Olympics this summer, which averages out to over 40 condoms per athlete.  I get it-- all of these people are young, fit, full of stamina, and they're on a big trip away from home, so excitement levels are high. Things happen.  And while it may not be the first time officials have done this-- the first time was in 1988, when they handed out 8,500 condoms-- it is the first time condoms are being given directly to women. Hooray to Olympic officials for finally realizing that women can annihilate an 800 meter freestyle world record, and also initiate sex. Wow!

Zika has been classified as a new STI directly linked to birth defects, so the increase in condom distribution isn't a total shock. Regardless, the efforts should not be overlooked. In conjunction with Olympic officials, people also have this fellow to thank:

Thank you, Eric. Olympians, go forth and sex safely.

Buzzfeed: 21 Things You Should Know About Herpes

If herpes isn't on your radar, it should be.  After all, "the World Health Organization released a study that estimates that two thirds of people in the world (67%) have the HSV-1 strain of the herpes simplex virus — that’s approximately 3.7 billion people worldwide."  That is a mind-blowing statistic.  67% percent of all the people. Wow.

A genital herpes diagnosis can be devastating.  Here at our Albany health center, we once received a letter from a patient who admitted that she had considered suicide after a herpes diagnosis. However, after receiving compassionate education from UHPP staff about what it means to live with this disease, she realized that it doesn't need to alter her quality of life. Also, knowing that she was not alone helped erase part of that terrible taboo.

However, despite the fact that it is so prevalent, herpes does-- like most STIs-- remain taboo. Arming yourself and your loved ones with education should help dispel a lot of the myths and mistruths that surround this disease.  

Another thing the article mentions is that it is possible to have herpes and not know it, so if you're not sure, please visit your physician or make an appointment at your local Planned Parenthood center. Remember-- knowledge is power!  

Without further ado, here is the terrific list of facts that Buzzfeed put together for us.  Tell your friends!

Click the picture to find out!

Let's Talk About Sex!

This Wednesday, May 7 at 7pm, Upper Hudson Planned Parenthood is hosting a film screening of Let's Talk About Sex. I have had the pleasure of seeing this film, and it really is illuminating. Of course, I personally find the subject matter fascinating, having always had an interest in how sexuality is approached in different cultures, and my continued bafflement of how it is regarded in many aspects of American life.  Countless studies have shown that a more direct approach in our dealings with teenagers and sex means that they (duh) have a much better understanding of the subject matter and will be better prepared.  Sounds pretty simple, but so many people simply can't deal with the concept. This film examines the contrast between the rather puritanical approach utilized by many American families, and the more practical method utilized by Europeans.  Which culture has fewer teen pregnancies and instances of STIs? I guess you'll have to check it out.  After the film, which is about an hour long, there will be a panel of experts to engage the audience in a discussion.  Please visit the Facebook event page and/or Eventbrite to find out more and RSVP.

From the Times Union:

"Let's Talk About Sex (The Movie)" is about more than just sex. The film focuses on sex and sexuality in today's society and how those attitudes affect teenagers. Director James Houston talks to teens and families about the subjects, and examines how other nations deal with protecting adolescent sexual health. The movie won the Youth Award at Spain's Mostra de Ciencia e Cinema Festival and was an official selection of the Provincetown International Film Festival. Upper Hudson Planned Parenthood will sponsor a free screening of the film this week. A panel discussion will follow, featuring College of Saint Rose Visiting Professor Ellen Cole, University at Albany Sexuality Educator/Counselor Carol Stenger and Upper Hudson Planned Parenthood President Chelly Hegan. 7 p.m. Wednesday. Free (donations accepted). Spectrum 8 Theatres, 290 Delaware Ave., Albany. 449-8995.

(Note from me: the Times Union write-up did not mention the inclusion of Dyrleif Bjarnadottir on the panel, a member of the UHPP Board of Directors, mother, and European who has been living in the US for quite some time, and has some interesting observations to share about the subject.)

Check out the trailer!

What you may not know about STIs (and should scare you!)

April marks the launch of the GYT campaign, Planned Parenthood's effort to raise awareness of the importance of getting yourself tested. It is vitally important to have yourself checked out for a number of reasons; some of which will probably freak you out, but if that's what I have to do to get the job done, then so be it!

Four things you may not know about STIs (Sexually Transmitted Infections):

• 1 in 2 people will contract an STI before the age of 25.  Yes, that means you have a 50% chance of getting one.  If you do, just cross your fingers that it's one of the curable ones!  And this leads me to my next point...
• Many STIs are incurable.  That's right, you're stuck with them for life.  That doesn't mean they're fatal, but you will have to take medication for your condition forever.  These include herpes, genital warts, and HIV.  Unfortunately, many of these conditions are spread because...
• More than half of people currently carrying an STI don't know they have one!  I have been asked how it can be in this age of medical awareness that so many people still contract these diseases.  The truth is simple, if not disturbing: people don't get tested!  Many STIs don't have symptoms, so people remain under the impression that they're disease-free. Also, just because a disease doesn't cause any discomfort, that doesn't mean it's not dangerous; if left untreated, many STIs can lead to cancer or infertility! (Read my earlier post about the importance of the HPV vaccine.)
• There are so many ways to have yourself checked.  UHPP wants to make sure that nobody is turned away for service, so even if have no insurance, there are ways to get the health care you need.  The HPV vaccine is free, and payment for other services; such as office visits and exams, tests, consultations and treatment, can be done on an income-based sliding scale.  NYS also offers other programs, like the Family Planning Benefit program, which you may qualify for.  Visit the UHPP website for more information. This is important, people! 

 

Well I've said my piece.  I'm not sure what else I can do, short of posting horrifying pictures so you can see the nauseating truth of what some of these infections can do to your privates.  I will refrain for now, but I'll do it-- I swear!  Just remember that most STIs can be cleared up with simple antibiotics, and even those that can't are treatable-- but only if you GET YOURSELF TESTED!!!