You have probably been hearing a lot about the Zika virus and pregnancy in the news since the beginning of 2016. The information can be very frightening if you are pregnant or considering pregnancy. The best thing you can do as an expecting mother or potentially expecting mother is to stay informed so that you can keep your risk as low as possible.
Zika virus is mostly spread by the bite of an infected Aedes aegypti mosquito. These mosquitoes are found throughout much of the Americas, including parts of the United States. These mosquitoes can also spread dengue, yellow fever and chikungunya viruses. You cannot get Zika virus from simply standing near an infected person. However, Zika virus can also be transmitted sexually from an infected man to his sexual partner.
Symptoms of Zika virus infection include fever, rash, joint pains, headaches and red eyes. Only 1 in 5 people who become infected with the Zika virus will have any of these symptoms, and most people will have mild symptoms. If you have travelled to a Zika-infected area, symptoms might not show up until you return home. There is no antiviral treatment available for Zika virus infection. Rest, oral fluids and acetaminophen (Tylenol) are recommended.
At the present time, most cases of Zika virus infection in the United States are limited to people who have recently traveled to countries that have reported Zika transmission. The World Health Organization (WHO) expects the Zika virus to spread to the United States because the Aedes mosquitoes are found here. But at the moment, prevention efforts are focused on raising awareness about the risk of both travel-related and sexually transmitted Zika virus infections.
Zika virus was first found in Africa in 1947 and it was considered rare until there was an outbreak in Micronesia in 2007. It was in May 2015 when Zika virus began to spread rapidly in Brazil and the rest of South America. Between October 2015 and January 2016, an increase in the number of babies born with microcephaly was reported in Brazil at the same time as an increase in the number of Zika virus infections. Microcephaly is a condition where babies are born with small heads and sometimes small brains. This condition can be associated with severe developmental issues and rarely death.
Zika virus can be transmitted to the fetus in all trimesters of pregnancy. In addition to microcephaly, complications that can occur from Zika virus infection include other brain abnormalities, stillbirth, poor fetal growth and eye abnormalities. It is still unclear what the chance is that a fetus will be infected if a woman becomes infected while she is pregnant. One study suggests there may be a 1 percent risk if infection occurs in the first trimester and another showed complications in up to 29 percent of women when infection occurred at any time during the pregnancy. The full range of problems that can occur during pregnancy are not yet fully understood.
Because of the serious nature of Zika virus on the unborn baby, the Center for Disease Control (CDC) has issued strict travel guidelines. Pregnant women should not travel to countries with Zika transmission, and if they must travel, they should be extremely careful to avoid mosquito bites. The CDC keeps a list of affected countries and territories where cases of active transmission have been reported. If you are traveling to an area with an elevation above 6,500 feet, studies have shown that there is minimal risk of Zika virus infection from a mosquito in these areas. Women considering pregnancy should discuss with their obstetric providers the advisability of travel.
When traveling to areas where Zika has been reported, women should take all precautions to avoid mosquito bites including the use of EPA-approved bug spray with DEET, covering exposed skin, staying in air-conditioned or screened-in areas, and treating clothing with permethrin. All of these protective measures should be followed both day and night and can be safely used during pregnancy.
Any pregnant woman with a history of travel to an area with ongoing Zika virus transmission should be tested for Zika virus infection. Women with symptoms of Zika virus infection such as fever, rash, joint pains and red eyes during or within two weeks of travel should have their blood and urine sent for Zika virus infection using two tests: 1) the first is called Trioplex rRT-PCR which can detect Zika virus in your blood and urine and 2) the second is called Zika MAC-ELISA which can detect proteins called antibodies made to fight a Zika virus infection.
For women without symptoms of Zika virus infection during or within two weeks of travel to an area with ongoing Zika virus transmission, the Zika MAC-ELISA test should be done to look for antibodies. These tests can sometimes be inconclusive since the Zika virus is closely related to other viruses such as dengue and chikungunya and additional testing may be needed by the CDC. If your test is positive for Zika virus, you will be offered an amniocentesis to test the amniotic fluid for Zika virus as well as regular ultrasounds to look at the fetal brain and monitor the growth of the head to look for signs of microcephaly or calcifications in the brain.
Because sexual transmission of Zika virus has been reported, pregnant women whose male partners have traveled to countries in which Zika virus transmission is reported or those who have Zika virus infection should consider using condoms or abstaining from sexual intercourse for the remainder of pregnancy.
For those couples who are considering pregnancy, if the man had confirmed Zika virus infection or clinical illness consistent with Zika virus disease, then the couple should consider using condoms or abstaining from sex for at least six months after onset of illness prior to attempting pregnancy. If the woman had confirmed Zika virus infection, then they should wait at least eight weeks from the onset of symptoms before attempting pregnancy. If either the man or the woman traveled to an area with active Zika virus transmission but did not develop symptoms of Zika virus disease, then the couple should consider using condoms or abstaining from sex for at least eight weeks after departure from the area.
Although the presence of Zika virus in breast milk has been reported, it is in very small amounts and unlikely to be harmful for the neonate. Infection through oral intake is not known and any effects of neonatal infection, as with adults, are likely to be mild and of short-term consequence. The benefits of breastfeeding likely outweigh the potential neonatal risks. Therefore, the recommendation is that women should feel safe to continue to breastfeed.
Although Zika virus infection in pregnancy can be very scary and may lead to severe complications for the baby, there are ways to educate yourself and reduce your risk of infection. Pregnant women should consult their health care provider and seek testing for Zika virus between two and 12 weeks after returning from a Zika affected area. You should always check the CDC for travel guidance. All travelers should consult their health care provider if they develop illness within 14 days of returning from Zika affected areas. You should prevent mosquito bites by using an EPA-registered insect repellant that is safe to use during pregnancy. If your male partner has been to an area with Zika during your pregnancy, you should use latex condoms the right way every time or choose not to have any type of sex. These tips will help you have a safe and healthy pregnancy.
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Posted In Health Information, Pregnancy, Women's
