Zika Virus and Pregnancy
Zika virus can cause severe birth defects in babies whose mothers are infected during pregnancy, and it is now carried by mosquitos in the continental United States. While this means pregnant women and women trying to conceive should take a few extra precautions, there are definitely ways to lower your risk of infection.
Here’s what you need to know about Zika virus and pregnancy, along with tips to keep your risk of infection as low as possible.
What is Zika virus?
The Zika virus is a usually mild disease that’s primarily transmitted through the bite of either an infected Aedes Aegypti or Aedes albopictus mosquito (though it can be transmitted sexually as well).
Most people fully recover from Zika virus without severe complications, and severe illness or deaths from Zika virus are extremely rare, says the Centers for Disease Control and Prevention (CDC). Many people don’t even show any symptoms. But Zika virus can be dangerous to pregnant women’s babies.
Why is Zika dangerous for pregnant women?
The CDC has noted that a Zika infection during any trimester may cause birth defects. The group determined that the risk of birth defects appears to be highest during the first trimester and decrease from there.
This does not, however, mean that if you are infected with Zika during pregnancy, your baby will definitely experience health problems. It simply means that babies whose mothers are infected with Zika during pregnancy have an increased risk of birth defects.
A few of the conditions linked to Zika infection during pregnancy include:
In April 2016, CDC experts confirmed that Zika can cause microcephaly, a neurological condition in which a baby is born with an underdeveloped brain and a smaller-than-average head, as well as other severe neurological defects in babies, including eye problems, hearing loss and impaired growth.
Research has also shown that children whose mothers are infected during pregnancy can develop neurological problems even after they’re born. Another report by CDC officials warns that Zika may also trigger clinical seizures and epilepsy in babies.
Congenital Zika syndrome
In February 2018, the CDC defined a distinct pattern of birth defects caused by the virus called congenital Zika syndrome. Unique to babies infected with Zika before birth, congenital Zika syndrome is described by the following five features:
- Severe microcephaly in which the skull has partially collapsed
- Decreased brain tissue with a specific pattern of brain damage
- Damage to the back of the eye
- Congenital contractures, such as clubfoot or arthrogryposis
- Hypertonia restricting body movement soon after birth.
Guillain-Barré syndrome (GBS)
Experts are also investigating Zika’s link to Guillain-Barré syndrome (GBS), a rare disorder where the immune system attacks the nervous system.
Currently, the CDC says there may be an association with Zika and GBS but stresses that only a small number of people who are infected with Zika go on to develop GBS.
How can I prevent Zika virus and mosquito bites during pregnancy?
Although there are a number of vaccines in clinical trials, as of now, there’s no way to treat Zika.
Your best defense is to protect yourself from mosquito bites. Even if you live in an area that does not have active Zika, follow these precautions:
- Apply mosquito repellent every day whenever you do outside. It’s a common myth about Zika that DEET- and picaridin-based mosquito repellents are not safe to use during pregnancy, but they’re actually more than safe — they’re FDA-approved, EPA-registered, and recommended by experts for moms-to-be.
- Wear long sleeves, pants and socks that are permethrin-treated. You can buy them with permethrin or treat them yourself.
- Stay inside during peak mosquito hours, between sunrise and sunset, as much as possible. Aedes mosquitoes are still present at night (though they’re less active) so still wear mosquito repellent if you go out after dark.
- Sleep in screened-in rooms. Or in rooms with closed windows and air-conditioning.
- Avoid traveling to Zika-active areas, if possible. The Centers for Disease Control has the latest information on areas that may be affected. If you live an area with active Zika, talk to your doctor about how best to protect yourself.
What are the warning signs and symptoms?
Common symptoms of Zika virus are similar to flu symptoms, including:
- Red eyes
- Muscle and joint pain
- Pain behind the eyes
Only one in five people infected with the virus end up exhibiting symptoms, and if they do, they usually last between two and seven days. And the symptoms, which are mild to begin with, often don’t show up right away.
In other words, if you traveled to or live in a Zika-infected area, you might not become sick until after you return home or some time has passed after you were bitten by a virus-carrying mosquito.
How is Zika transmitted?
Zika is transmitted primarily through mosquito bites, specifically the Aedes albopictus mosquitoes. Zika can also be contracted through sex by both men and women, and it’s likely it can be transmitted through blood transfusions. However, the CDC has not confirmed that. Zika virus can also pass from a mother to her baby if she is infected during pregnancy.
Should I get tested for Zika?
The CDC doesn’t recommend that everyone get tested. If you are:
- exhibit Zika symptoms
- and have recently been exposed to the virus (for example, you vacationed in an area with a Zika outbreak, or you’ve unprotected sex with someone who did)
YES: The CDC recommends you get tested as soon as possible. Your doctor can confirm a diagnosis with a blood or urine test.
If you are:
- not experiencing any Zika symptoms
- and you do have regular, ongoing exposure to the virus (for example, you travel to a Zika-impacted area once a month for work)
YES: The CDC recommends you get tested at least three times throughout your pregnancy.
If you are:
- have potentially been exposed to Zika but do not have regular, on-going exposure (for example, you vacationed recently in an area with Zika, but you don’t routinely visit that area for work or family)
- and do not show any Zika symptoms
NO: The CDC recommends that you do not get tested. Ultimately, this is to cut down on the number of false positives.
The first step you should take if you are worried about Zika or think you may have been exposed to it is to talk to your doctor (and the CDC also stresses that in these cases, doctors should talk to their patients and consider whether testing would be appropriate, depending on your preference as a patient, your individual risk factors and more).
Your doctor can confirm a Zika diagnosis with a blood or urine test. However, there are two things to be aware of: First, though the current Zika test is highly accurate, a negative test result doesn’t necessarily mean you don’t have Zika.
Because the virus can linger in your body (infected men can carry Zika in their semen for six months), it’s likely your doctor will order three different tests to be sure of the diagnosis.
Second, most doctor’s offices aren’t set up for testing. So if your doctor does decide to test you for Zika, he or she has to send your samples to specific federal labs in the U.S. for analyzing, meaning that it could take weeks before you get the results.
The good news is that researchers at Colorado State University are hard at work on a new Zika test. While it isn’t yet available in doctor’s offices, experts are hoping that the new test will bring us one step closer to tackling Zika for good.
If your test is positive or inconclusive:
Your doctor will consider administering an amniocentesis to check your baby for Zika infection. You may also get ultrasounds every three to four weeks for the rest of your pregnancy to check for signs of microcephaly and unusual calcium deposits in the skull.
If your test is negative:
Your doctor may administer an ultrasound to look for signs of microcephaly or unusual calcium deposits in the skull.
- If no signs are apparent, you won’t need any more testing, and you’ll continue with routine prenatal care.
- If there are signs of either microcephaly or calcium deposits, your doctor may retest you for Zika and potentially administer an amniocentesis to screen your baby for Zika.
If you’ve been infected with Zika while pregnant, your doctor might recommend that you participate in the CDC’s Zika Pregnancy Registry, a database of health information about expecting moms and babies affected by the virus. Gathering this information will help health care providers treat families currently affected and those who might be in the future.
There is no specific treatment for Zika. If you’re diagnosed, it’s important to get plenty of rest and drink lots of fluids. If you’re pregnant, your doctor will likely order extra ultrasounds to monitor your baby’s development.
Where has Zika been found?
Zika has been found in multiple countries in Africa, Central and South America, the Caribbean, the Pacific Islands, Asia and North America (including in the U.S.). If you’re pregnant or trying to get pregnant and planning to travel, check out the CDC’s Zika travel information page before making your plans.
Has Zika been found in the U.S.?
Yes, Zika has been found in the U.S. As of May 2019, there have been 5,755 cases of Zika infection reported in the U.S.
The majority of cases in the U.S. have been related to travel, meaning that the infected patients did not get the infection where they lived in the U.S.
Instead, they traveled to a Zika-affected country, were bitten by a mosquito there, and returned home. Only 231 cases in the U.S. so far have been locally transmitted (all in Texas and Florida). A total of 55 have been sexually transmitted or transmitted via other means.
Overall, though, the presence of Zika in the United States has been minor, based on blood donations that have been screened for the virus.
In fact, a 2018 study published in the New England Journal of Medicine found that out of four million Red Cross blood donations collected between June 2016 and September 2017, only nine tested positive for Zika.
What if I’ve been to or live in a place where there’s a Zika outbreak?
See your doctor! He or she can talk through any specific questions or worries you have, as well as help you determine whether getting tested for Zika is right for you.
What if my partner has recently traveled to a Zika-affected area?
Zika can be sexually transmitted, so if your partner is the one traveling, the CDC recommends taking certain precautions. Here are the most recent recommendations:
- If your male partner is the one traveling internationally and you’re currently pregnant: The CDC advises that you take steps to prevent mosquito bites and use condoms or avoid sex for the duration of your pregnancy when he returns.
- If your male partner is the one traveling but you’re not currently pregnant: Your partner should take steps to avoid mosquito bites. Use condoms for at least three months when he returns home.
What are the CDC-issued travel guidelines for pregnant women?
Previously, the CDC recommended that pregnant women avoid travel to countries or regions where Zika had been found. The 2016 Zika outbreak started in South America, and ultimately spread throughout Latin America, Mexico, the Caribbean, parts of South East Asia and Africa.
However, in February of 2019, the CDC downgraded its travel warning for pregnant women. The agency still recommends that pregnant women avoid countries dealing with active Zika outbreaks but now says that women who are pregnant or trying to become pregnant don’t necessarily have to avoid areas where there has ever been a “current or past transmission” (non-doctor speak: countries that have seen Zika outbreaks but aren’t currently experiencing one).
Instead, the agency now recommends that you speak to your doc and weigh the risks.
In the United States
Locally transmitted cases of Zika were found in Brownsville, Texas, and Miami-Dade County, Florida. That previously led the CDC to caution pregnant women against traveling there. However, in June 2017, the CDC removed its travel warning from Florida; in August 2017, it did the same for Brownsville.
As of March 14, 2019, the CDC reports that there is no current transmission of the virus in the U.S. In fact, there have been zero cases of Zika reported in 2019 so far.
Is Zika contagious?
As mentioned above, Zika can be sexually transmitted; however, it’s primarily transmitted via mosquito bites. As of now, there’s no evidence that it can be transmitted through saliva.
Is there a vaccine for Zika virus?
No, there is no vaccine for the Zika virus, though efforts to develop a Zika vaccine are in progress. A few iterations show promise, and in 2017, experts began testing them on humans. However, it’s likely to take at least two more years before we see a readily-available vaccine.
Zika and breastfeeding
To date, there are no reports of infants getting Zika through breastfeeding, which is why the CDC recommends that mothers who want to breastfeed do so, even if they live in a Zika-affected area.
What’s being done to fight Zika?
The World Health Organization (WHO) is leading global response efforts. In addition, the CDC has been working with reproductive health experts, infectious disease experts, government officials and travel health experts from all over the world to learn as much as they can about the virus — hopefully putting us one step closer to eradicating it for good.