How to avoid being bitten by mosquitoes?

At 20160527 night, I think I was first bitten by a mosquito in Singapore, a global hub [1]. Honestly, I felt worried and can only now pray that Little Princess will be fine and we need to prevent future bites by Aedes mosquitoes, active during daylight hours to dusk!

My heart goes to every pregnant women during this ZIka outbreak period [2]. The Zika virus has been linked to fetal death (even after the gestational week 30 due to placental insufficiency) and the birth defect microcephaly, a neurological condition where babies are born with small heads and sometimes small brains. Only ~ 10% of children with microcephaly have normal intelligence. A study published in the New England Journal of Medicine (DOI: 10.1056/NEJMp1605367) found the estimated risk for microcephaly with Zika infections in the first trimester of pregnancy to be 1%-13%, but another study reported that all trimesters have the risk for adverse outcomes (DOI: 10.1056/NEJMoa1602412). Another study reported potential peak risk during gestational weeks 14 to 17.

The anomaly ultrasound performed during gestational week 20 is not reliable enough to detect microcephaly, one needs to wait until gestational week 30, but what is the use of this information? We need to prevent it before it happens!

The symptoms of Zika infection include headaches, fever, red eyes, rash, muscle and joint pain. However, only 1 in 4-5 infected people show symptoms.

According to CDC, Zika virus usually remains in the blood of an infected person for only a few days to a week. No vaccine against Zika virus as of 20160527!

Fetuses suffer from microcephaly have unusual calcium deposits in the skull.

Another bad news is that pregnant women attract mosquitoes twice more than normal people do possibly because of the frequent breaths and release of carbon dioxide that mosquitoes are fond of.

Some pregnant women infected have decided to terminate the pregnancy, some delivered healthy babies, but some and their babies were not lucky.

I felt crying now, but I must be strong and think positively. To quote Ganeshwaran H. Mochida, a pediatric neurologist and researcher at Boston Children’s Hospital, “A child’s brain is still very plastic. Even if certain parts are damaged or underdeveloped, sometimes with enough intervention early on we are surprised how much they are capable of.

Honestly, there are too many clutters at parents-in-law’s home, and I can only declutter for myself and our family, but not others. We have no rights to decide what to donate or discard for others’ stuff. Father-in-law was nice, trying to catch the mosquito but it has made a damage, hopefully this mosquito is not a harmful one.

Pregnant mothers must

  1. wear long sleeves, pants and socks (permethrin-treated if possible) [3]
  2. stay inside during peak mosquito hours (between sunrise and sunset)
  3. use window screens and air conditioning
  4. apply mosquito repellent with 10% DEET or picaridin daily
  5. take extra care to protect ankles and the back of neck [4]
  6. sleep under a bed net
  7. avoid clothes and furniture of dark color (father-in-law mentioned that the dark table is potentially the reason I was bitten)
  8. empty and scrub, turn over, cover, or throw out items that hold water, such as tires, buckets, planters, toys, pools, birdbaths, flowerpots, or trash containers

[1] I imagine how I will feel less worried if we are living in a four-season country with little or no mosquitoes (e.g. Canada, Chile, UK) or an area with an elevation above 6,500 feet. However, in the latter, medical access will be more limited. Even, USA is not safe especially in Summer 2016.

[2] I am grateful that my 2nd nephew was safely and healthily born in Spring 2016.

[3] Honestly, this action is pretty challenging as I have been sweating due to the humid tropical weather.

[4] I was bitten at my right ankle, see a photo 20160527*jpg.

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