Zika virus appears to be especially dangerous for pregnant women and their babies – and now experts say it’s likely to hit the U.S. What you need to know to protect yourself.
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News of the Zika virus is frightening. Indeed, there are many uncertainties about the Zika virus during pregnancy, and the information is changing rapidly. But one of the most important things that you need to know as an expecting mom is if you live in the continental U.S., your odds of contracting the Zika virus right now are extremeley low. Here's what is known now about Zika, and what you can do to protect yourself and your baby.
WHAT IS ZIKA VIRUS?
The Zika virus is a usually mild disease that's transmitted through the bite of an infected mosquito. Most people fully recover from Zika virus without severe complications, and severe illness or deaths from Zika virus are extremely rare, says the CDC. But Zika virus can be dangerous for pregnant women and their babies. Experts are also investigating Zika's link to Guillain-Barrésyndrome, a rare immune disease that most people recover from but can occasionally cause paralysis.
WHY THE SPECIAL WARNING FOR PREGNANT WOMEN?
When a mom-to-be becomes infected with Zika virus, the virus can also infect the fetus. In countries affected by Zika outbreaks, there has also been an increase in cases of microcephaly. That link is why health experts believe Zika infection during pregnancy may lead to this rare birth defect. Microcephaly is a neurological condition that causes babies to be born with small heads and severe developmental issues, and in rare instances it can result in death. The highest risk to the fetus is believed to be when the mother is infected during the first trimester.
The CDC cautions that more research is needed to better understand the link between the Zika virus and microcephaly. The exact outcomes that might be associated with infection during pregnancy and the factors that may increase risk to a fetus are not yet fully understood.
WHAT ARE THE WARNING SIGNS AND SYMPTOMS?
Common symptoms of Zika virus include fever, rash, headaches, red eyes, muscle and joint pain and pain behind the eyes. Only one in five people infected with the virus end up exhibiting symptoms. And the symptoms, which are mild to begin with, often don’t show up right away. In other words, if you traveled to an area with Zika virus, you might not become sick until after you return home.
IS ZIKA CONTAGIOUS?
No, the Zika virus is not contagious from person to person. Because it's not airborne or transmitted via physical contact, there's no risk of becoming infected with the virus from simply standing near an infected person. There has been one confirmed case of Zika spread through sexual transmission.
However because few people have immune defenses against the virus, it is spreading rapidly as more mosquitoes that carry the virus continue to bite people.
There are two reasons for the virus’ rapid spread. First, most people in South, Central and North America have not previously been exposed to Zika and therefore lack immunity. Any new virus can spread quickly in a population with no immunity. Second, Aedes mosquitoes — the main source for Zika transmission — are present in all the region's countries except Canada and Chile. The more infected people there are (because of low immunity), the more likely it is that a mosquito that is able to carry the infection (the Aedes variety) will bite one of those infected people and then bite someone else, spreading the virus.
WHERE HAS ZIKA BEEN FOUND?
Zika virus was first identified in Africa and Asia in 1947. There were very few documented cases of it, and it was considered a rare disease until 2007, when there was an outbreak in Micronesia. Then, in May 2015, the virus began to spread rapidly in Brazil and throughout the rest of South America; the World Health Organization now says as many as 4 million people could be infected in the next year in the Americas.
At the same time, cases of microcephaly in Brazil increased: Between October 2015 and January 2016 alone, more than 4,180 cases of microcephaly were reported, according to Brazilian health authorities. In previous years, a total of only about 150 cases of microcephaly were reported in Brazil every year. Of the 1,113 cases that have been cross-checked to-date with Zika in Brazil, 404 have been confirmed linked to the virus. This possible link led the Brazilian Ministry of Health in November 2015 to warn women living in Brazil against getting pregnant.
As of February 3, 2016, the CDC has issued Zika-related travel warnings after finding cases of infection in the following countries:
American Samoa
Barbados
Bolivia
Brazil
Cape Verde
Colombia
Commonwealth of Puerto Rico, US territory
Costa Rica
Curacao
Dominican Republic
Ecuador
El Salvador
French Guiana
Guadeloupe
Guatemala
Guyana
Haiti
Honduras
Jamaica
Martinique
Mexico
Nicaragua
Panama
Paraguay
Saint Martin
Samoa
Suriname
Tonga
U.S. Virgin Islands
Venezuela
Because of the prevalence of the mosquito-borne virus in these countries, the CDC advises that American women who are expecting (as well as those hoping to become pregnant) not travel to those countries.
HAS ZIKA BEEN FOUND IN THE U.S.?
While cases of Zika have been reported in the United States, as of January 2016 these are limited to people who recently traveled to countries with Zika transmission. But experts worry that if an infected person (let’s say someone who has traveled to that infectious region and then comes back to the U.S.) is bitten by another mosquito here, that mosquito — which is now carrying the virus — can infect someone else.
However experts at the World Health Organization (WHO) anticipate that the Zika virus will spread to all but two countries in South, Central and North America, Canada and Chile. That’s because the Aedes mosquitoes, which transmit the virus through their bites, are found in all countries in the Americas, including the United States, except Canada and Chile.
Still, Zika is unlikely to spread far outside tropical zones, say experts, even within the United States. And these southern U.S. regions will probably not see an outbreak until later in the spring and summer, when mosquitoes are more active. Even if that does happen, experts believe the spread of the virus will likely be more contained than it has been in South and Central America, because most people have window screens and air conditioning — two important ways to help prevent the risk of being bitten by mosquitoes.
WHAT ARE THE CDC-ISSUED TRAVEL GUIDELINES FOR PREGNANT WOMEN?
Because of the serious nature of the virus’s potential to impact an unborn baby, the CDC recommends using an "abundance of caution." According to the CDC, expectant moms in any trimester or women hoping to become pregnant should consider postponing travel to the areas where Zika virus transmission is ongoing (see the list above).
Pregnant women and those trying to become pregnant who do travel to one of these areas should talk to their prenatal practitioner before going on their trip. Most importantly, these women should strictly follow steps to prevent mosquito bites during the trip (see below).
WHAT IF I’VE BEEN TO OR LIVE IN A PLACE WHERE THERE’S AN OUTBREAK?
The CDC recommends all pregnant women who've lived in or traveled to a country with Zika see their doctors. The CDC hasissued additional guidelines in consultation with the American Congress of Obstetricians and Gynecologists and the Society of Maternal-Fetal Medicine recommending that pregnant women who have already traveled to affected areas be screened for the virus.
Concerned because you traveled to one of these places and have since conceived? The CDC says the virus usually remains in the blood of an infected person for only a few days to a week, so it’s a potential worry for only that short period of time. Zika virus will not cause infections in a baby that is conceived after the virus is cleared from the blood, happily, so an infection now doesn’t pose a risk of birth defects for future pregnancies.
WHAT TESTS & TREATMENTS ARE THERE IF I THINK I’VE BEEN EXPOSED TO ZIKA?
If you are expecting and have traveled or live in an affected country, see your doctor whether or not you’ve experienced any common symptoms of the virus (see above).
If you've had two or more Zika-like symptoms:
You will receive a blood test. (Note that your doctor might also test for dengue fever and chikungunya virus because they have similar symptoms to Zika and are found in the same regions.)
If you test positive for Zika (or the test is inconclusive): You will receive an ultrasound to see if there are any signs of microcephaly or unusual calcium deposits within the skull, called intracranial calcification. You can also have anamniocentesis to detect if baby has Zika virus.
If the Zika test is negative: You will receive an ultrasound to look for signs of microcephaly or intracranial calcifications. If either shows up, experts recommend an amniocentesis to test baby for Zika virus. If neither is present, then you don't need any more testing.
If you don't have Zika-like symptoms:
You will not receive a blood test for Zika virus. Only the CDC facility in Atlanta and a handful of state hospitals are equipped to handle the test, CNN reports. Plus the test can yield false positives or inconclusive results.
You will, however, receive an ultrasound to look for signs of microcephaly or intracranial calcifications.
If there are signs of either: Your blood will be tested for Zika and you should consider an amniocentesis to test baby for Zika.
If no signs are apparent: Your doctor should give you regular follow-up ultrasounds every three to four weeks for the rest of your pregnancy to continue checking for both conditions. If signs of either develops, you will receive a blood test and potentially an amniocentesis.
For more info on testing, see the CDC flow chart.
IS THERE A VACCINE FOR ZIKA VIRUS?
There is no vaccine against the Zika virus, and there is no treatment for Zika virus. The CDC does not recommend antiviral medications for those infected with the illness, mostly because the symptoms are usually mild. But because it can be so dangerous for a developing fetus, efforts to make a vaccine against Zika virus have begun. Still, because creating and testing a vaccine normally takes years and costs hundreds of millions of dollars, experts don’t expect a vaccine in the immediate future.
The good news is that experts suspect that Zika infection may trigger lifelong immunity to the virus, which means that people who have been infected could not be reinfected.
HOW CAN I PREVENT ZIKA VIRUS & MOSQUITO BITES DURING PREGNANCY?
Because there is no vaccine against Zika virus, and no medications to take to protect the fetus if you are bitten by a mosquito carrying the Zika virus, the best approach is prevention. A babymoon to Puerto Rico might not be worth the risk right now, and the same goes for a visit to family in Mexico that could be put off.
But if your plans are unbreakable or you currently live in one of the affected areas, you’ll need to take extra steps to avoid mosquito bites during pregnancy. That includes wearing long sleeves, pants and socks (permethrin-treated if possible); staying inside during peak mosquito hours; using air conditioning inside; and applying mosquito repellent (which is not only safe to use during pregnancy, it's recommended). Use according to the label's directions on all exposed skin.
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