Zika Virus

Due to extensive media coverage, pregnant women have become aware that the Zika virus has been linked to a rare birth defect called Microcephaly. There are many sources of information on this topic. In this brief article, we will pull some material from those sources and also provide some links for more information.

Introduction (adapted from the CDC)

Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon. The virus can be found in the bloodstream of an infected individual only for about 1-2 weeks. It does not linger, and there is no evidence that the same virus will show up in the body again in the future (unlike other viral diseases such as herpes, chickpox, and HIV for example).

There have been reports in Brazil of microcephaly and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant. However, additional studies are needed to further characterize this relationship. More studies are planned to learn about the risks of Zika virus infection during pregnancy. Microcephaly is when the size of the newborn's head is far smaller than expected, which unfortunately also means that brain development has likely been affected.

CDC has issued a travel notice (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing. Until more is known, CDC recommends special precautions for pregnant women and women trying to become pregnant.

Pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who do travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow steps to avoid mosquito bites during the trip. Women trying to become pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip.

Because specific areas where Zika virus transmission is ongoing are difficult to determine and likely to change over time, CDC will update their travel notice as information becomes available. Check CDC's Zika Travel Information website frequently for the most up-to-date recommendations.

March 25: Here is an update from the L.A. County Health Department:
Pregnant women are now advised to use condoms or abstain from sex for the duration of the pregnancy if their sexual partner has traveled to a known Zika transmission area.

March 7: Here is an update from the American Congress of Ob/Gyn (pdf)

The latest research reinforces an increasing consensus that the virus can have tragic consequences for pregnant women and their fetuses. More and more data is linking the virus not just to microcephaly but other birth defects as well. A new study was just published in the New England Journal of Medicine on March 4th confirming that 29% of the fetuses in women testing positive for Zika had brain abnormalities on ultrasound.

Common Questions and Answers

Is the Zika Infection harmful to me?

The illness itself is usually minimal. 80% of people who get the infection do not even know they got it. The other 20% might have mild symptoms such as fever, skin rash, headache, eye irritation, that lasts a few days. It is quite rare for this infection to cause serious illness to the person who gets it. The concern is the potential effect on the fetus of a pregnant woman who gets the virus.

I know Zika is spread by a mosquito bite. Can it be spread by sex or can I get it from a blood transfusion?

Any virus that enters the blood can travel to other places in the body. We are starting to see cases of Zika from a blood transfusion and also transmitted by sex. *Effective March 25, 2016, pregnant women are now advised to use condoms or abstain from sex for the duration of the pregnancy if their sexual partner has traveled to a known Zika transmission area.

Blood donations will not be accepted from anyone who has been to an affected area in the previous 28 days.

I have a trip to Hawaii. Should I be concerned?

There are no reports of this infection in Hawaii. The areas to avoid are Mexico, Central and South America, islands in the Caribbean and much of Central Africa. Refer to the CD travel guide for up to date information.

If I am pregnant or trying to get pregnant and my partner just came back from one of the countries on the CDC list, is it safe to have sex?

(updated March 25, 2016) Pregnant women are now advised to use condoms or abstain from sex for the duration of the pregnancy if their sexual partner has traveled to a known Zika transmission area.

I am pregnant and I traveled to Mexico a month ago. I feel fine. Do I need to be tested?

The new answer to this is YES! You DO NEED to be tested. A new guideline published Feb 12 recommends that any pregnant women who has traveled to ANY of the affected regions, as long ago as 12 weeks, needs Zika blood testing. This is a change in policy. Previously, only pregnant women who came back and had symptoms suggestive of Zika were candidates for testing. This is because so many people who get Zika have NO symptoms.

Infographic on Zika

Click the image to the right for an enlarged one-screen summary of Zika

Additional Information and Links

Los Angeles County Health Department Update #4 March 25, 2016

ACOG Update March 7 2016

New England Journal of Medicine March 4 2016

March of Dimes Page on Zika

Los Angeles County Department of Public Health Update

California Department of Public Health Fact Sheet

Pan American Health Organization Website

CDC Q&A for Clinicians

American College of Ob/Gyn Practice Advisory (pdf)

Wikipedia link to Information about ZIKA