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Travelers must still be wary of Zika

Dear Dr. Roach: My son and his new wife went on a dream honeymoon that has since turned into a nightmare. They went to Costa Rica and of course were bitten by mosquitoes. Upon returning home, they were told about the Zika virus. One person told them to wait six months before trying to have a baby. They are in their mid-30s and want to have a baby. What do you know about this scary virus?

E.I.

Answer: Zika virus is transmitted by mosquitos and is present in many areas of the Americas, Caribbean and Pacific. There has been an ongoing outbreak over the past few years. One major concern about Zika is that it can cause neurological complications in babies born to women who were infected during pregnancy.

Couples who are planning pregnancy should avoid areas where Zika transmission occurs. For couples who have been exposed or who might have been infected, the most conservative recommendation I have read is six months.

Dear Dr. Roach: I am a postmenopausal woman with osteoporosis (my T-score is -3.2) in my spine. I used alendronate, but stopped because it caused bone pain. I haven’t been on any medication for a few months now, but I have started walking 40 minutes every day and I use weights. My doctor would like me to try Tymlos. I can’t find much information about it except that it hasn’t been out long and may cause osteosarcoma. Do you know what the chance of this might be? A similar drug, Forteo, is not covered by my insurance, even though it has been around longer.

M.L.

Answer: Abaloparatide (Tymlos) is an analog of parathyroid hormone. It works against osteoporosis by stimulating bone growth. Teriparatide (Forteo) indeed works the same way as Tymlos. During drug testing, teriparatide was found to increase the risk of a type of bone cancer, osteogenic sarcoma, in rats. Because of this, the Food and Drug Administration required a black-box warning, the agency’s highest degree of caution. However, a study on women who have taken Forteo showed no cases of osteogenic sarcoma.