Ask the Doctor: Zika Virus; Red Hair-Parkinson’s Link; Ankle Fusion

Q: Can you die from the Zika virus? I’m going to be visiting my daughter in Panama this summer, and I’m concerned, since Zika is a known risk in the region. I remember hearing about an elderly man in France who died due to the Zika virus.

A: It is mainly pregnant women who can suffer serious complications associated with Zika—as you are likely aware, unborn babies can be seriously affected by the virus. However, there is also some evidence that older adults may be susceptible to Zika because the immune system wanes with age, meaning you have less resistance when it comes to combating infections.

According to the Centers for Disease Control and Prevention (CDC), seniors who contract Zika may have a slightly greater risk for a neurological condition called Guillain-Barre syndrome. Guillain-Barre causes the immune system to attack the nervous system, resulting in gradual weakness in the arms and legs, with paralysis occurring in severe cases. Temporary hearing loss and vertigo have also been reported in older adults with Zika. The elderly man you heard about was in Martinique, a French island in the Caribbean Sea. However, deaths among adults infected with the virus are rare. Symptoms include a mild fever, rash, headache, joint pain, and red, sore eyes. In fact, the majority of adults who have the virus experience no symptoms.

Complications associated with the Zika virus are very rare, but since there is no vaccine for the virus, you should take steps to protect yourself from mosquitoes while you are in Panama. The mosquitoes that carry the Zika virus are most active during the two hours after sunrise and several hours before sunset, so stay indoors during these times if possible, use a good mosquito repellent, and wear long-sleeved clothing and pants at all times. These precautions should ensure that you can safely enjoy your vacation.

Q: I recently saw a news headline claiming that people with red hair are more likely to develop Parkinson’s disease. Is this true?

A: The headline you saw is probably based on a recent study suggesting that a gene for red hair is active in a particular brain area that is affected by Parkinson’s. However, the study was carried out in mice, not humans—and not all of the studies that have been carried out in humans have found a link between the gene and Parkinson’s disease.

Parkinson’s is a complex condition, and its causes are not clear. While studies such as this help increase our understanding of the disease, these data need further research before any firm conclusions can be drawn.

Q: I have suffered from ankle arthritis for years, and my doctor recently mentioned ankle fusion as a possible solution. What’s involved in this procedure?

A: Ankle fusion is the standard surgical procedure for the later stages of ankle and foot arthritis. During the procedure, the surgeon removes the cartilage between the tibia (shinbone) and talus (one of the ankle bones) and then fuses them together using stainless steel rods, screws, or plates. This eliminates motion, thereby stopping the bones from grinding against each other and relieving the pain.

You’ll need to wear a splint or cast for several weeks after the surgery, as well as use crutches for six to eight weeks in order to avoid placing your weight on the ankle while it fuses. During your recovery period, you’ll have physical therapy to help you maintain the strength in your foot and leg.

Most people who undergo ankle fusion have some loss of motion in the ankle afterward, but, typically, the relief from arthritis pain far outweighs any minor problems due to reduced mobility.

—Editor-in-Chief Maurizio Fava, MD

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