The Zika Virus and Pregnancy: The Basics
Zika continues to be a concern for expectant mothers everywhere. Where do we travel (or not)? What precautions should we take? What is the real story? Dr. Natalie L.D. Mathurin shares her expertise.
Impending motherhood is a time of great happiness and anticipation for most women as images of bottles, bibs, strollers and chubby cherub cheeks flow through her thoughts. However, for the past few months another thought has intruded into the minds of potential new moms—the Zika virus. The Zika virus is a disease that is spread by the bite of an infected Aedes species mosquito.
The Zika virus is named after the Zika Forest in Uganda and was first discovered in 1947. The first human cases occurred in 1952 and cases have continued to occur throughout the world since the discovery of the virus. It has a varied presentation of symptoms, and it shares many of the same symptoms with other viruses, which makes its definitive diagnosis often difficult.
The most common symptoms of Zika infection is fever, rash, conjunctivitis—a red, inflamed eye and joint pains. Some people will have symptoms that are so mild they may not even know they have been infected. The disease is generally very mild and does not typically require hospitalization. Treatment is supportive only—there is no medication that will limit or cure Zika. It goes away over time, on its own. However, the most truly troublesome aspect of exposure to the Zika virus is the impact on fetal health during pregnancy.
Children exposed to Zika are noted to have various degrees of microcephaly (small head and brain size) and resultant abnormalities in development. The most adverse effects appear to occur with exposure to the virus during the first trimester. Initial increased incidence of the disease was noted in Brazil beginning in the spring of 2015 and most recently the World Health Organization has declared Zika transmission a public health emergency.
Women of childbearing age have been highly cautioned to avoid travel to areas where the virus has been found. The majority of the areas are within Latin America, the Caribbean, and other tropical locations but the list of affected areas is an ever changing list and the anticipation is that the list will most definitely grow. Other recent reports have confirmed the presence of the virus in seminal fluid and thus, Zika virus is now understood to be a sexually-transmitted disease, as well.
How worried should a woman be if she feels that she has been exposed to the Zika virus via travel or through sexual contact? As with all health concerns frank conversation with a health care professional is a must. If you are considering becoming pregnant or if you are pregnant, particularly if you are in the first trimester, and you are considering travel, please review your options with a clinician. If it is at all possible, postpone your trip to a later time.
If postponing your travel is not a possibility, then it is important to take precautions against mosquito bites, i.e., repellant use, mosquito nets, long sleeved shirts and long pants. Additionally, have a discussion with your partner to make sure he knows how to protect himself if he is traveling to an affected location. If you develop symptoms of fever, rash, red eye and joint pains within two weeks of traveling to an affected location it is important that you see a clinician.
Finally, try not to allow anything to overshadow the natural excitement that you will have as you move along your path towards motherhood. By taking the precautions to limit your exposure to the virus you will be well on your way to a healthy and joy-filled pregnancy.
The World Health Organization has more comprehensive and helpful information about the Zika virus and the regions where you may be at higher risk.
Natalie L.D. Mathurin, MD, MPH is the a Supervising Physician of Vulnerable Populations in New York City in the public sector.