As summer approaches, anxiety about Zika is growing in states like Florida and Texas. The virus hasn鈥檛 spread to mosquitoes along the Gulf Coast, and it , but experts are preparing nonetheless.
And because Zika can cause birth defects in newborns, many women 鈥 and their doctors 鈥 are nervous. In the waiting room at Houston IVF, patients are handed a map of Zika-affected countries and asked to fill out a questionnaire.
鈥淭he first thing I鈥檓 discussing now is Zika,鈥 said聽.
Public health officials said there have been 15 travel-related incidences of Zika in the Houston area. Nodler said at least a few couples have had to聽delay starting聽fertility treatment because the woman or her partner already may have been exposed to the virus while traveling south.
This map shows the predicted distribution of Aedis aegypti, the mosquito that can carry the Zika virus. The redder the area, likelier you are to find A. aegypti there. (Courtesy Kraemer et al., eLife)
鈥淓specially in Houston a lot of our patients and families are in the oil and gas industry,鈥 Nodler said. 鈥淭hese aren鈥檛 people who are traveling to Mexico and Puerto Rico for fun or vacation. These are people who have to work in some of these offshore drilling areas.鈥
Even for patients who haven鈥檛 traveled, Nodler is advising they slather on repellant, just in case the virus is already here, but we don鈥檛 know it yet.
鈥淣o one wants to see an affected child,鈥 he said.
Nodler says couples will need to manage Zika risk together. If his partner is already pregnant, a man should use condoms to avoid sexually transmitting the virus.
All over the city, parents and would-be parents have been absorbing the news about Zika.
鈥淭hey鈥檝e been saying Zika is coming to Houston, they don鈥檛 know when,鈥 said Annie Tursi. She鈥檚 35, owns four hair salons and her husband is a consultant. She said they were going to try for a third baby in 2016, but now they鈥檙e going to watch and wait.
鈥淚 think we鈥檙e really blessed to have two healthy boys, and if it does come this summer and it is a risk, then I probably just won鈥檛 even try for another one.鈥
Between their jobs and the toddler and the baby, there鈥檚 no way she can simply hunker inside all summer avoiding mosquitoes.
鈥淩ight now there鈥檚 just so many unknowns and I think by the time they have a vaccine and know more that we鈥檒l be done鈥 with having children, she said, chuckling. 鈥淲e鈥檒l be out of diapers and we鈥檒l be done.鈥
Because of concerns about Zika, Annie Tursi and her husband Brian are rethinking plans to try for a third child in 2016. Here with Oliver (2) and Arthur (6 months). (Courtesy Annie Tursi)
Another Houston mom, Tracy Smith, couldn鈥檛 make that choice. She was already pregnant with twins when she heard about Zika. At a recent check-up, she learned she still had to be cautious even though her first trimester was over.
鈥淪he said it鈥檚 something to be concerned about your whole pregnancy you need to be in long sleeves, and long pants, wearing DEET,鈥 said Smith, who was shocked to get that advice.
鈥淢y first thought was 鈥業鈥檓 pregnant, I鈥檓 not going to put DEET all over myself!鈥 But I guess that鈥檚 what we do this summer,鈥 she said.
She鈥檚 now wondering if she and her two other kids should move to her parent鈥檚 house for the summer, in a less buggy part of Houston.
鈥淭he probability is low,鈥 that she鈥檒l contract Zika, she said, 鈥淏ut the potential impact is so great and those are the kinds of threats that can be scary and disproportionately sort of taking up space in my brain.鈥
Health officials say because U.S. cities have a lot of closed spaces with air conditioning or screens, people are generally better shielded from mosquitoes than in some other countries.
Nonetheless, doctors in Houston have already opened a special clinic where women who have traveled to affected countries can get blood tests and counseling. A second clinic will open this summer.
, a professor at Baylor College of Medicine, said doctors are offering those clinic patients an ultrasound 15 weeks into pregnancy.
鈥淲e鈥檝e actually developed a protocol around looking for very special views of the fetal brain and the eyes to look at for any evidence of fetal malformation with the Zika.鈥
Dr. Kjersti Aagaard, an associate professor of obstetrics and gynecology at Baylor College of Medicine, is helping screen pregnant women in Houston who may have been exposed to Zika through travel or a partner who has traveled to affected areas. (Courtesy Baylor College of Medicine)
Aagaard reminds her patients that Zika is just one of many possible risks during pregnancy 鈥 and risks can be managed, whether that鈥檚 through prenatal vitamins, genetic screening, or bug spray.
Zika is tough to talk about, though, because the studies are just not there yet.
鈥淎s much as we wish we could give them a very set of clear facts around: this is your risk, this is the time in pregnancy you鈥檙e at highest risk, or this is the time prior to planning a pregnancy you鈥檙e at highest risk. We simply don鈥檛 have that information,鈥 she said. 鈥淲e don鈥檛 know.鈥
Despite the unknowns, doctors in Houston aren鈥檛 telling people not to get pregnant.
What they are telling them is that they need to add mosquito bites to the list of cares and calculations that surround any pregnancy.
This story is part of a reporting partnership with NPR, Houston Public Media and聽.