Ask Dr. Dana: CDC OBGYN Answers Questions About the Oropouche Outbreak

Background

This year's Oropouche virus outbreak in South America and most recently in Cuba has raised concerns about viral infections during pregnancy. Like Zika virus, which spread across the Western Hemisphere in 2015, Oropouche virus disease (Oropouche) during pregnancy has been associated with birth defects and stillbirths.

Oropouche spreads through insect bites -- biting midges and some types of mosquitoes have been shown to spread Oropouche.

CDC is working closely with medical and public health partners to learn more about the potential effects of having Oropouche during pregnancy. CDC's Dr. Dana Meaney-Delman is an OBGYN who leads the agency's efforts to monitor emerging health threats to mothers and infants, and here she provides answers to some of the common questions.

Ask Dr. Dana

How concerned should pregnant people be about Oropouche?

At this time, we do not have any reported cases of transmission of this virus from biting midges or mosquitoes in the United States. For my patients here in the United States who have not traveled or who don't plan to travel to a location with an Oropouche outbreak, with the information we have now, Oropouche is not likely to be a concern.

For pregnant people who may be considering travel during pregnancy, they should weigh the risks and benefits of traveling to places that have an Oropouche outbreak. For those places, I would recommend to my patient that they reconsider non-essential travel to these areas. Right now, we know that this includes Cuba, and we are closely monitoring other locations in the Caribbean.

But our understanding of Oropouche is evolving as we learn more. When we do, we'll update our partners, including public health officials and health care providers, and most importantly the American public.

What discussion would you have with a patient who is worried about Oropouche and other viruses spread by biting insects?

I would encourage pregnant people to communicate any travel plans with their prenatal providers. In our global society, understanding infectious disease risks related to travel is extremely important, not only for Oropouche but for other infections. I'd want to emphasize that if they do plan to travel during their pregnancy, it's important to know the types of infectious diseases in these areas and the options for preventing insect bites to reduce their risks. For people who travel, I highly recommend that they routinely use EPA-registered insect repellent. CDC has an insect repellent chat bot to help people find the right repellent to use.

What makes Oropouche concerning?

In Brazil, Oropouche has been associated with congenital infection. This is when the mother is sick with the virus, and the virus can affect the fetus. Brazil has reported stillbirths with detection of the Oropouche virus in the placenta and the fetus. Additionally, there have been reports -- again from Brazil -- of a possible association with birth defects, including microcephaly.

You helped lead the task force on pregnancy and birth defects during the Zika response. How are the lessons of that response being applied today?

The most important thing we learned was the need to monitor the maternal, pregnancy and infant outcomes associated with new or unknown threats to mom and baby. This information helped pregnant people and health care providers understand the specific risks and provided information to inform pregnant travelers. And data collected through the Surveillance of Emerging Threats to Mothers and Babies network provided information to pediatricians and parents about the types of abnormalities to look for in children whose mothers had infections during pregnancy. When there's an outbreak, epidemiologists and viral disease experts work hand-in-hand with maternal, child and birth defect experts to provide timely information about the effects of these viruses. The information we collect helps pregnant people and their health care providers provide the best care they can in the face of a new threat.

If you're pregnant, planning to travel, and seeing some of these reports, it's bound to make you a little nervous. What would you tell one of your patients in that position?

I'd want them to consider if the travel is essential and to think carefully about where they choose to travel. If they can't avoid travel to a location with a known Oropouche outbreak, for example for family or work obligations, it's really important to regularly apply, per the product label, EPA-registered insect repellents, which are safe during pregnancy. They should take other precautions to prevent biting midge and mosquito bites, like wearing long pants and shirts or staying inside when possible. These measures will help protect against Oropouche as well as other infections you can get from biting insects, like dengue, West Nile, and Zika.