Over the past few weeks, Zika virus has quickly spread throughout numerous countries in the Americas, prompting serious international concern. Although the United States has yet to see any locally acquired vector-borne cases, pregnant women who have traveled to a country affected by the current outbreak, and couples who are considering traveling to an affected country before becoming pregnant have reason to be concerned.
Zika virus is transmitted through the bite of an infected Aedes species mosquito – the same type of mosquito that spreads Dengue and Chikungunya. Common symptoms of Zika include fever, joint pain, conjunctivitis, muscle pain, rash, and headache, however, more than 80% of cases are asymptomatic. Although further research is needed to fully understand the association, a link between Zika virus and microcephaly has been identified, and women of reproductive age are being urged to take extra precaution to prevent exposure.
For Pregnant Women
At the beginning of this outbreak, pregnant women returning from an endemic country had to report at least two clinical symptoms in order to qualify for a blood test that would look for signs of current infection. As of today, the Centers for Disease Control and Prevention (CDC) has updated their interim guidelines, and are now allowing serological testing for asymptomatic pregnant women who have traveled to any country affected by the current outbreak.
Testing should be done between two and twelve weeks after an asymptomatic pregnant woman has returned from traveling (within one week if the patient is symptomatic). Our office can perform this test, and results typically take at least two weeks to report out from the CDC. While the fact that this test is now widely available is welcome news, interpretation of these results can be complex. A positive antibody result may be difficult to interpret due to possible cross-reactivity among related viruses such as dengue, yellow fever, and West Nile. In conjunction with this blood test, serial ultrasound monitoring will likely be recommended, and patients should check in with their physicians directly to discuss next steps.
If you meet the travel criteria, and would like to be tested for this virus, please contact me at (415) 831-2198 or by e-mail via our secured patient portal (Kirstie Ruby, OB Coordinator) at your earliest convenience.
Pregnant women whose partners have traveled to an endemic country should also take serious precautions to prevent sexual transmission of this virus during the remainder of their pregnancy. Earlier this week, the CDC confirmed the first case of sexually transmitted Zika virus infection. As of now, experts do not know how long the virus can survive in semen, so out of an abundance of caution, new interim guidelines have been release for pregnant women and their partners who have been to a Zika endemic country.
The new recommendation states that men with a pregnant sex partner who reside in or have traveled to an area of active Zika virus transmission should consistently and correctly use condoms during sex (vaginal, anal, or oral) or abstain from sexual activity for the duration of the pregnancy. Until more is known about this virus, we are urging all pregnant women to use extra caution when being sexually active with their partners.
For Women Planning to Become Pregnant
Zika virus usually remains in the blood of an infected person for only a few days to a week. Women who are planning a future pregnancy should wait at least one month after traveling to an endemic country to attempt conception, and women who are actively trying to conceive should avoid any travel to countries affected by this outbreak.
Sexual transmission of Zika virus has been confirmed, and as of right now we do not know how long this virus can survive in semen. Men who are planning to conceive in the near future should avoid travel to any country affected by this outbreak. If a male partner has already been potentially exposed to this virus, couples should consider delaying conception until more is known about how long this virus can last in semen.
Get answers to some of the more commonly asked questions about Zika virus infection here.
Image courtesy of Flickr user Kenny Holston
Image courtesy of Flickr user Tom
