Clearly, the most significant concern relative to the Zika virus is infections in pregnant women. As previously mentioned, it is becoming evident from observational data and diagnostic testing that the following facts are known about the Zika virus and Zika infection:
- The Zika virus can be passed from a pregnant woman to her fetus.
- An infection of the Zika virus during pregnancy can produce certain birth defects, including microcephaly.
- The virus primarily spreads through infected mosquitoes but can also spread through sexual contact and blood transfusions.
- No specific medicine or vaccine is currently available for the treatment or prevention of the viral infection.
Although considerable information is being uncovered about Zika virus infections during pregnancy, experts are still unclear about the mechanism of intrauterine infection, as well as the role and mode of sexual transmission in the infection of the placenta and the fetus. It does appear that infections by the Zika virus in early pregnancy can affect fetal brain growth and possibly lead to microcephaly, but infections later in pregnancy may cause less obvious, but perhaps still significant, pathology.
It is unclear if there is a safe time during pregnancy to travel to an area with Zika. It is also unclear if indeed a Zika infection will affect a woman's pregnancy or if a fetus will actually present with birth defects if a woman is infected during her pregnancy.
The CDC and other organizations, such as the World Health Organization (WHO), have issued guidelines on pregnancy management for Zika virus infections. These guidelines cover women who are pregnant, those trying to become pregnant, and those wanting to prevent pregnancy. The following is a summary of the CDC's recent guidelines:
CDC's Guidelines for Pregnant Women:
- Do not travel to those areas with Zika virus infections. If a pregnant woman must travel, talk with a physician or other healthcare provider (before and after the trip) and take steps to plan for the travel.
- Prevent sexual transmission. Women with partners who live in or have traveled to an area with Zika should protect themselves during sex by using a condom every time they have sex or by abstaining from sex for the duration of the pregnancy.
- Protect from mosquito bites. Strictly follow the steps to prevent mosquito bites (link included below), including the use of insect repellent for you and your partner, wearing long-sleeved shirts and long pants, and taking steps to control mosquitoes outside and inside your home.
- Testing symptomatic pregnant women within two weeks of traveling to an area with Zika. If a pregnant woman has symptoms of Zika virus infection within two weeks of traveling, that woman should be tested for the Zika virus. If there are no symptoms of Zika within two weeks, the CDC still recommends that pregnant women be tested.
- Testing symptomatic pregnant woman two to 12 weeks after symptom onset: If a woman should develop symptoms at any point during her pregnancy, she should be tested for the Zika virus.
- Testing asymptomatic pregnant women living in an area with active Zika transmission. If a pregnant woman lives in an area with active Zika virus infections, she may be at risk of getting Zika throughout her pregnancy; therefore, physicians or other healthcare providers can offer testing at the first prenatal visit and a second test in the second trimester. If a pregnant woman lives in an area that does not have active Zika virus infections but has possible exposure, testing may also be performed.
The following links provide current details on pregnancy management for Zika virus infections:
CDC links:
WHO link: American College of Obstetrics and Gynecology (ACOG) link:
UpToDate® link:
