Pediatric Associates of the NW Blogs

Zika Virus- What You Should Know As Summer Approaches

Scott Spencer, MD, MPH
May 05, 2016 09:35AM

 

Here in Portland and across the country there has been a high concern for the risk of Zika virus infections in pregnant women causing birth defects. Fortunately, there have been no Zika infections spread or acquired in the continental United States.  Nevertheless, female travelers who are pregnant or who are trying to get pregnant need to be concerned about the risk of acquiring  Zika infection in certain countries.  

The Center for Disease Control (CDC) recommends no travel by pregnant women to areas known to carry a risk of Zika virus. The CDC recommends extreme caution to prevent getting the Zika infection in women who are trying to get pregnant.  There is no end date to this recommendation at this time. 

Experts now confirm (1) that if a woman who is pregnant gets the Zika virus infection, it can put her fetus at risk for birth defects. One birth defect, called microcephaly, is especially concerning as it can put the newborn baby at risk for seizures, vision or hearing problems, as well as developmental disabilities. It is not known yet how much the baby is at risk if the mom develops a Zika infection.  

The Zika virus is transmitted primarily by a specific type of mosquito called the Aedes species mosquito. This mosquito lives in certain areas (see below), and can bite primarily during the day, but also at night. The Zika infection can also be transmitted through sexual contact, primarily from men to women through the sperm.  A male may not know he is infected, and still transmit the infection.  Finally, the infection can be spread via blood transfusions.  A person infected by Zika can transmit the infection for a period of time by sexual transmission or by blood transfusions. This period of time may be up to 6 months (2). At this point, it is not thought that Zika virus is directly transmitted from person to person (accept in the case of sexual transmission/blood).  

Most people who are infected with Zika have no symptoms.  Some have mild symptoms for a few days including the most common symptoms of fever, rash, joint pain, and conjunctivitis (red eyes).  There is no specific treatment for Zika infection, and there is no specific treatment to prevent Zika infections from spreading from a pregnant woman to her fetus. Children and adults are at low risk of developing significant illness from Zika. 

The Zika virus has fortunately not spread in the continental United States.  However, as of April 6th 2016, there have been 346 cases of travel associated Zika infections reported in 47 states. Travel associated means that the infection was acquired in another country and then the person traveled to the United States. Of the 346 cases of travel associated cases, 32 were women who were pregnant.  

Zika infections have spread in the US territories of Puerto Rico, the US Virgin Islands and American Samoa, where the Aedes mosquito lives.  In addition, the Zika virus has also spread to Mexico, Central and South America, including the islands of Cuba, Dominican Republic, Haiti, Jamaica, Aruba, and other surrounding Central American islands as well as Pacific Islands (Fiji, Micronesia, Marshall Islands, New Caledonia, Samoa, Tonga) and Cape Verde in Africa. The CDC has more specific information for each country.  There is a general exception that since the specific mosquito cannot live above 6,500 feet, that risk of mosquito transmission from Zika is minimal if the travelers stay above this elevation. 

For specific information about each country, please visit the CBC website at - http://www.cdc.gov/zika
If you suspect you have been infected with the Zika virus, it is recommended that you seek care with your medical provider.  They will be able to test or direct you to get tested for the Zika virus if appropriate. 

If you are pregnant or are trying to get pregnant and considering a trip to any of the above areas, please visit this CDC website for more information: http://www.cdc.gov/zika/pregnancy/index.html

1. American Academy of Pediatrics News, April 13, 2016. 
2. Uptodate: Patient information: Zika virus infection, updated March 30th 2016.