Zika Explained

Last summer, my husband and I were poring over Frommer’s books and travel blogs, planning our trip to South America. We couldn’t wait to explore the streets of Buenos Aires and the beaches of Uruguay. Our biggest concern was making sure we didn’t miss any of the must-see beaches, monuments, and restaurants. Not once did we give any thought to mosquitoes, DEET, or to a disease called Zika virus. Planning travel now is a different story.

Shortly after we returned from our adventures in South America, the Centers for Disease Control and Prevention (CDC) issued a travel alert warning of Zika transmission in countries in Central and South America. Luckily for us, Argentina and Uruguay were absent from that list (and still are), but the concern for Zika virus is very real. Here is what you need to know.

The CDC website is a great source of reliable up-to-date information. I used this page for the majority of the content of this post. It is important to note, the information discussed below is accurate as of July 11, 2016. Please monitor the CDC’s website for updates as the recommendations and advisories can change at any time.

Transmission, Diagnosis and Treatment

Zika virus is primarily spread through the bite of a mosquito, specifically the Aedes species. A mother can pass the virus to her fetus during pregnancy. The virus is also spread through sexual contact, specifically from a man to his sexual partners as the virus is transmitted through semen. There have been cases of transmission through blood transfusion reported in Brazil as well. While many people infected with Zika virus will not have any symptoms, the most commonly reported symptoms are fever, rash, joint aches, red eyes (similar to pink eye). These usually appear within a few days to 2 weeks after exposure to the virus.

If you develop symptoms of Zika within two weeks of returning from a country with active transmission of the virus, see your physician. There are blood and urine tests available to diagnose Zika virus infection, and your doctor will determine the most appropriate next step. There is currently no treatment for Zika. The symptoms usually last 3-7 days and remain fairly mild. People infected with Zika don’t usually require hospitalization and the disease rarely leads to death.

Zika in Pregnancy

Zika is especially concerning in pregnancy. A pregnant women infected with Zika virus can spread the virus to her fetus and infection in a fetus is associated with increased risk of developing microcephaly. Microcephaly is a condition in which the baby’s head and brain are smaller than expected. Microcephaly has been linked to multiple problems including seizures, vision and hearing impairment, and developmental delay. Unfortunately, there is a great deal that we don’t yet know about Zika and pregnancy. It is unclear how likely a pregnant woman is to pass Zika to her fetus. If the fetus is infected, we don’t know how likely the fetus is to develop microcephaly or other birth defects.

A pregnant woman who has traveled to an area with active Zika transmission should notify her obstetrician immediately to discuss further testing. Interpreting test results is often difficult and a negative test does not definitively rule out infection. She will likely have additional testing done to monitor the fetus including ultrasounds looking for microcephaly and possibly an amniocentesis to help determine if the fetus has been infected with Zika. There is no evidence that prior Zika infection poses any risk to future pregnancies.

Prevention

Currently, there is no vaccine for Zika virus. Preventing mosquito bites is key in areas with active Zika transmission. Wearing long sleeves and pants is important. The CDC recommends using an EPA-approved insect repellant. During the first week of infection, mosquitoes can spread the virus from an infected person to a non-infected person. Therefore, it is important for people returning from areas with Zika transmission to take steps to prevent mosquito bites for 3 weeks.

The CDC issues travel notices for countries with Zika transmission. Prior to travel, review these notices and recommendations. Pregnant women should avoid travel to places with active Zika transmission. If travel is a must, pregnant women should discuss their plans with their obstetricians prior to departure.

The recommendations to prevent sexual transmission of the virus are complex. I have tried to simplify these below:

• Pregnant women: if the man has traveled an area with Zika transmission, the couple should use condoms consistently or abstain for sex for the duration of the pregnancy.
• Nonpregnant women: if the man has traveled to an area with Zika transmission AND has symptoms of Zika or confirmed diagnosis of Zika, the couple should use condoms or abstain from sex for 6 months after onset of illness.
• Nonpregnant women: if the man has traveled to an area with Zika transmission but has not developed symptoms, the couple should use condoms or abstain from sex for 8 weeks following departure from the area.

In summary, our understanding of Zika is constantly growing and evolving. Stay updated on the latest travel notices and advisories through the CDC’s website. Discuss any concerns or questions with your healthcare provider.