Zika Virus

Zika Virus

You have likely heard a lot of information recently about the zika virus and its effects on unborn babies.  We want to make sure you have the most up to date information, and help you distinguish between fact and fiction.  Here are the main facts that you need to know.  Please feel free to ask us questions at your appointments, and visit www.cdc.gov/zika for more information.   

The Virus

Zika virus is a mosquito-borne virus first identified in Uganda in 1947.  It is transmitted by 2 species of mosquitoes, Aedes aegypti, and Aedes albopictus.  Both species are found in the US, A. aegypti in limited areas of the South, and A. albopictus iacross the Southeastern US and the Midwest, including Illinois and Wisconsin.  These mosquitoes are daytime biters. 

About one in five people infected with Zika virus become ill.  Illness occurs anywhere from 2 days to 2 weeks after exposure to the virus.  The most common symptoms are fever, rash, joint pain and red eyes.  Symptoms are usually mild and last up to 1 week.  The most common mode of transmission is from the bite of an infected mosquito, although it may be transmitted sexually.  The amount of time the virus remains in the semen is unknown.

Zika virus testing can be performed and is processed through the CDC.  Testing should be done in all pregnant women who have traveled during pregnancy, or immediately prior to pregnancy, to an area with ongoing Zika virus transmission.  In addition, serial ultrasounds (US) should be performed in pregnancy to monitor for fetal abnormalities.  If maternal testing is positive, amniocentesis can be done to test for Zika in the amniotic fluid.

Zika and Pregnancy

Data on zika in pregnancy are limited.  Symptoms are similar in pregnancy as in non-pregnant individuals, and there is no evidence that pregnant women are more susceptible to infection.  Transmission to the fetus can occur throughout pregnancy, however the rate of maternal-fetal transmission, and the risk that an infected fetus will develop abnormalities are unknown.  Findings in the fetus can include microcephaly (small head as a result of poor brain development), and other brain abnormalities, eye defects and joint contractures.

Microcephaly is a condition in which the fetus’s head is smaller than expected for gestational age.  It can be detected by measurements of the head circumference as early as 18-20 weeks.  It can be difficult to predict long term consequences based on head size alone.  Children born with severe microcephaly can have seizures, vision or hearing problems and developmental disabilities.

Prevention

There is no specific treatment for Zika virus other than rest, fluids and anti-fever medications.  Because there is no treatment for Zika virus, prevention is paramount.  All women who are pregnant or planning to become pregnant should avoid travel to areas of ongoing Zika virus transmission (see list below, and for updated info see wwwnc.cdc.gov/travel/notices).  Pregnant women who travel to areas of Zika transmission should wear long sleeves and pants, use insect repellants and wear permethrin-treated clothes, especially during the day.  Insect repellants containing DEET, picaridin and IR3535 are all considered safe for pregnant and breastfeeding women.  Due to the risk of sexual transmission, pregnant women whose male partners have traveled to areas of Zika transmission should abstain or use condoms for the duration of the pregnancy.  If you are planning a pregnancy after travel to Zika transmission areas, wait 2 weeks before attempting to conceive.  If your partner also travelled, you must abstain or use condoms for at least 2 months before attempting to conceive. 

There have been cases of Zika virus in the US, but they were all acquired abroad.  As of yet, there have been no cases of Zika infection within the US.

Areas with active Zika Transmission (see http://wwwnc.cdc.gov/travel/notices for updated list)

• Caribbean:
  • Aruba, Barbados, Bonaire, Cuba, Curacao, Dominican Republic, Grenada, Guadeloupe, Haiti, Jamaica, Martinique, Puerto Rico, St Barthelemy, St Lucia, St Martin, St Vincent and the Grenadines, Trinidad and Tobago, US Virgin Islands
• Central America:
  • Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama
• Pacific Islands:
  • American Samoa, Fiji, Marshall Islands, Micronesia, New Caledonia, Papua New Guinea, Samoa, Tonga
• South America:
  • Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Paragua, Peru, Suriname, Venezuala