Zika virus infection prompts CDC pregnancy warnings

I have had several patients share their concern with me regarding Zika virus infection (Zika) and pregnancy. According to the Centers for Disease Control and Prevention (CDC), Zika virus is spread through mosquito bites. The most common symptoms of Zika virus are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon.

There is currently an epidemic of Zika cases in Brazil and there have been more than 3,000 babies born with birth defects (microcephaly or small head) and poor pregnancy outcomes. Cases have also been reported in Central America, Mexico and other Caribbean countries.

As of February 3, 2016, there have been 35 travel associated Zika virus disease cases in the U.S. There have been no cases so far that were locally acquired via mosquito bites.

The following information, sourced from the CDC, has been useful in answering our patients' questions on Zika. In addition, the American Society for Reproductive Medicine has issued an advisory bulletin on Zika.

Is there a vaccine to prevent or medicine to treat Zika?

No. There is no vaccine to prevent infection or medicine to treat Zika.

I am pregnant. Should I travel to a country where cases of Zika have been reported?

Until more is known, CDC recommends special precautions for pregnant women and women trying to become pregnant:

• Pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who do travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow steps to avoid mosquito bites during the trip.
• Women trying to become pregnant or who are thinking about becoming pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip.

Because specific areas where Zika virus transmission is ongoing are difficult to determine and likely to change over time, CDC will update this travel notice as information becomes available. Check CDC’s Zika Travel Information website frequently for the most up-to-date recommendations.

I am pregnant. How will Zika virus affect me or my unborn baby?

CDC has issued a travel notice (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing.

This notice follows reports in Brazil of microcephaly and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant. However, additional studies are needed to further characterize this relationship. More studies are planned to learn more about the risks of Zika virus infection during pregnancy.

Until more is known, CDC recommends special precautions for pregnant women and women trying to become pregnant:

• Pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who do travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow steps to avoid mosquito bites during the trip.
• Women trying to become pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip.

Because specific areas where Zika virus transmission is ongoing are difficult to determine and likely to change over time, CDC will update this travel notice as information becomes available. Check CDC's Zika Travel Information website frequently for the most up-to-date recommendations.

Is it safe to use an insect repellent if I am pregnant or nursing?

Yes. Using an insect repellent is safe and effective. Pregnant women and women who are breastfeeding can and should choose an EPA-registered insect repellents and use it according to the product label.

If a woman who is not pregnant is bitten by a mosquito and infected with Zika virus, will her future pregnancies be at risk?

We do not know the risk to the infant if a woman is infected with Zika virus while she is pregnant. Zika virus usually remains in the blood of an infected person for only a few days to a week. The virus will not cause infections in an infant that is conceived after the virus is cleared from the blood. There is currently no evidence that Zika virus infection poses a risk of birth defects in future pregnancies. A women contemplating pregnancy, who has recently recovered from Zika virus infection, should consult her healthcare provider after recovering.

Should a pregnant woman who traveled to an area with Zika virus be tested for the virus?

See your healthcare provider if you are pregnant and develop a fever, rash, joint pain, or red eyes within 2 weeks after traveling to a country where Zika virus cases have been reported. Be sure to tell your health care provider where you traveled.

Can a previous Zika virus infection cause someone who later becomes pregnant to have an infant with microcephaly?

We do not know the risk to the baby if a woman is infected with Zika virus while she is pregnant. However, Zika virus infection does not pose a risk of birth defects for future pregnancies. Zika virus usually remains in the blood of an infected person for about a week. The virus will not cause infections in a baby that is conceived after the virus is cleared from the blood.

Is it safe to get pregnant after traveling to a country with Zika virus?

If infected, Zika virus usually remains in the blood of an infected person for about a week. The virus will not cause infections in a baby that is conceived after the virus is cleared from the blood.

If a woman has traveled to an area with Zika virus transmission, should she wait to get pregnant?

We do not know the risk to an infant if a woman is infected with Zika virus while she is pregnant. Zika virus usually remains in the blood of an infected person for only a few days to a week. The virus will not cause infections in an infant that is conceived after the virus is cleared from the blood. There is currently no evidence that Zika virus infection poses a risk of birth defects in future pregnancies. A women contemplating pregnancy, who has recently travelled to an area with local Zika transmission, should consult her healthcare provider after returning.

If a mother infected with Zika near the time of delivery passes the virus to her newborn at birth, can the baby develop microcephaly?

We do not know if a newborn who gets Zika at birth will develop microcephaly after birth, which is also called acquired microcephaly. Babies can get microcephaly if their head growth slows or fails to develop after birth. There have been no reports of Zika infection around the time of birth. There have also been no reports of babies with acquired microcephaly. All reports so far have been congenital microcephaly, meaning the microcephaly occurred before birth.

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