One of the more frequent reasons that pregnant women consult us is that they are planning a trip to Mexico and want to know the potential medical risks. Reasons for the trip vary from destination weddings at all-inclusive resorts to emergency trips home because of an illness or death of a family member.
The first concern in many minds is the risk of exposure to Zika virus. This virus was first identified several decades ago and known to be spread by mosquitoes. It was not until a major outbreak in Brazil in 2015, however, that it was found to be associated with microcephaly and other birth defects.
With heightened surveillance, it has been discovered that the virus has been present in many countries for a long time, often with no noticeable increase in cases of microcephaly or other birth defects. The evidence is that the vast majority of people who become infected with the virus have no symptoms. Those who do get sick from the illness usually have symptoms similar to the flu or a bad cold, so Zika would not be suspected. Unfortunately, therefore, it is impossible to predict a pregnant woman’s risk of contracting the disease or of her baby having a birth defect.
Since both the Zika virus and the mosquitoes that spread it are found in Mexico, the safest advice to a pregnant woman is simply not to travel there until after pregnancy. Unfortunately, the travel is sometimes unavoidable. In that case, we advise our patients to use mosquito avoidance measures such as insect repellents and wearing long sleeves and long pants
A much more likely problem that a traveler is apt to encounter is traveler’s diarrhea. This is due to a change in diet as well as bacteria or parasites. The CDC has been reporting this problem even from high-end resorts. Pregnant women are more apt to get traveler’s diarrhea and to have a more severe case if they do get it.
The most effective preventive measures are to avoid the food and beverages where these organisms are present. This means eating only food that has been thoroughly cooked and is served hot. Salad bars are often made to look fresh by sprinkling them with water that may have come from the tap in the garden. And fruit sold by vendors may have been washed with unclean water and cut up with unclean knives. Water and drinks should come bottled and served with ice made with boiled water.
If a pregnant traveler does get diarrhea, the best treatment is vigorous oral hydration. That means drinking enough fluids that she has to urinate every two hours and her urine is pale in color. Imodium or Lomotil may be taken if necessary, but Pepto-Bismol is best avoided. Antibiotics should be reserved for cases severe enough to require medical attention.
Sunburn and heatstroke tend to be more severe in pregnancy so sunscreen, shade and a good fluid intake are important. At seaside resorts swimming and snorkeling are fine, but pregnant women should avoid scuba diving. There is no way of knowing a safe depth to dive without running the risk of decompression illness (the bends) in a developing infant.
Finally, while sunning on the beach, she should not lie on the bare sand. In tropical environments there are parasites that live in the sand and can penetrate intact skin. They then cause a very itchy rash that look like a worm crawling under the skin!
- It is best not to travel to Mexico while pregnant unless necessary.
- Always stay well hydrated with safe beverages
- Have fun but protect yourself from the dangers of sun and sand.
Safe travels…until next time!
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