Welcome everyone! The recent epidemic of the Zika virus and its association the severe birth defect, microcephaly, has many women who are pregnant or desiring pregnancy understandably worried.   The purpose of this blog is to provide information on Zika infection and how to protect yourself and your baby.

1.) Zika virus is a mosquito-borne flavivirus. The main mode of transmission of the Zika virus is between the Aedes Aegypti mosquito and humans.  Zika can also be passed through sex from a person who has the virus to his or her sex partners.  One of the most devastating aspects of Zika infection is that it can be spread from a pregnant woman to her fetus through the placenta or during labor and delivery.

2.) Zika is associated with the birth defect, microcephaly. Babies with microcephaly have smaller heads in which the brain may not have developed properly.  Microcephaly can lead to a host of unfortunate outcomes which include: seizures, developmental delay, problems with movement, intellectual disability, as well as hearing and vision problems.  Increased rates of miscarriage and stillbirth may occur in women exposed to Zika.  Not every woman who contracts Zika during pregnancy has a child with birth defects.

3.) It is estimated that up to 80% of Zika infections are asymptomatic. Zika incubation after an infectious mosquito bite is 3-12 days.  Zika is typically a mild disease in the general population.  However, the 20% of people with Zika who have clinical symptoms may experience mild fever, joint and muscle pain of the hands and feet, as well as red eyes.  The clinical symptoms of Zika typically resolve within 2-7 days.

Zika infection in adults can also be associated with Guillain-Barré syndrome (GBS). GBS is an uncommon condition in which a person’s own immune system damages nerves causing muscle weakness and sometimes paralysis.

4.) Zika exists in vaginal secretions and semen after the infection is cleared from the blood allowing it to be sexually transmitted.   Zika virus can remain in the semen longer than other body fluids.  The Zika virus has been shown to persist in the semen for greater than 6 months beyond initial infection.

The World Health Organization (WHO) advises waiting at least 6 months prior to attempting pregnancy if the male partner has experienced symptoms of Zika. If a woman is pregnant and her male partner could possibly have been infected, they should use a condom or abstain from sex for the entire duration of pregnancy.

5.) Diagnosis of Zika is based on a person’s recent travel history and symptoms. Zika RNA can be detected in the serum or blood.  Zika can be detected in the urine longer than it is present in the blood.  The Center for Disease Control (CDC) recommends that pregnant women with history of travel to an area where Zika is endemic undergo serologic testing for Zika and fetal ultrasound to screen for microcephaly.

6.) Prevention of Zika infection in adults includes:

  • Wearing long-sleeved shirts and long pants
  • Treating clothing and gear with permethrin (do not use directly on skin)
  • Using Environmental Protection Agency (EPA)-registered insect repellent (DEET, picaridin, IR535, or oil of lemon eucalyptus or paramenthan-diol)
  • Condoms use can reduce the chance of getting Zika from sex
  • If you are pregnant, do not travel to areas with Zika

I hope these important facts on Zika have been informative. Our understanding of the Zika virus is still evolving as research yields more details about the pathophysiology of this disease.  Therefore, remember to discuss any concerns you have regarding Zika with your doctor.

The most up to date Zika-related travel information can be obtained by visiting https://wwwnc.cdc.gov/travel/page/zika-information. Other resources are available through the Center for Disease Control and the World Health Organization websites by visiting: http://www.who.int/emergencies/zika-virus/en/ or https://www.cdc.gov/zika/.

Sincerely,
Monica Best, MD