Zika Virus: A Patient’s Perspective

IT COULD HAVE been a bad case of the flu, with symptoms that included a painful sore throat, unrelenting fever and night sweats. Reuters journalist Nick Brown was on assignment in Puerto Rico, and while his symptoms were troubling, they were hardly an immediate cause for alarm. A seasoned traveler, Brown remained unconcerned, even as the symptoms escalated to include joint pain, a genital rash and a persistent throbbing ache behind his eyes. As the symptoms came and went, increasing in severity over time, it was Brown’s mother who correctly guessed he’d contracted the Zika virus. Brown recounted his experience and eventual diagnosis in a September 2016 interview with Reuters. “Initially, I laughed off her ‘Internet diagnosis’ as the overwrought worries of a long-distance mom,” Brown recalled. “But I agreed to see my long-time physician during a visit home in late June, and after listening to my symptoms and learning I’d been working in San Juan, my physician arranged to have my blood sent for screening. Eight days later, we learned my mother was correct. I had contracted Zika.”¹

A Growing Global Concern

Zika has made headlines in recent years, and to date, hundreds of thousands of people are estimated to have been infected since it was first detected in Brazil in early 2014.

Zika is spread mostly by the bite of an infected Aedes species mosquito. But, an unusual attribute of Zika (and of special concern to Brown) is that it can also be transmitted through sexual intercourse, a highly uncommon concern with mosquito-borne viruses. While many people experience no notable symptoms, Zika poses a particular threat to pregnant women, since it can penetrate the womb and infect unborn children with a birth defect called microcephaly. In adults, it has been linked to Guillain-Barré syndrome (GBS), a rapid onset muscle weakness that causes temporary paralysis. Although research is ongoing, to date, Zika has no vaccine or treatment.

Puerto Rico, the island where Brown was infected, has been hit especially hard by the Zika virus. As of this writing, more than 38,000 infections have been reported in the region, including more than 3,000 among pregnant women and at least 12 cases of microcephaly.²

“As a journalist and a patient, I’ve had access to some of the brightest minds studying Zika. But the virus has confounded experts at the highest levels and launched a global race to understand its risks,”¹ said Brown.

A Look at Life After Zika

Brown’s case was puzzling to doctors, both for its rarity and because of the way his symptoms came and went during the three weeks following his initial infection. But, for Brown, there were more pressing personal concerns: the risk of sexually transmitting the virus to his wife, Julie, and the potential threat of developing GBS. “My wife and I are both in our early 30s, and have had to consider how dangerous my bout with Zika could be to our plans to have children someday,” he explained. “Our most intimate decisions were suddenly affected by the uncertainty surrounding Zika.”¹

With more questions than answers about his long-term prognosis, Brown agreed to join a Centers for Disease Control and Prevention (CDC) study gauging how long Zika can be spread through semen and urine. As one of 140 participants, he was required to provide monthly semen samples and detailed sexual activity updates via FedEx shipments and email. “I endured the embarrassment in exchange for a $50 Visa gift card for each sample, and, more importantly, for the chance to learn and to contribute to science,” he explained.

After waiting for months to get results, in December, Brown learned the study he participated in revealed he no longer tested positive for Zika. As of this interview, he says his health outlook is a good one. “Overall, my health is good and my life is totally normal, although I’ve developed a lot of minor skin-related symptoms that I never had before. I seem to be more prone to rashes and skin irritations. I was diagnosed with mild rosacea and find myself scratching a lot. I have no idea if these are related to Zika,” he said. “As for family planning, my wife and I are both content to take the CDC’s word that I am Zika-free, and we don’t plan to have kids for a couple of years. So, in that sense, all is well.”