Originally published on March 2, 2016, but continues to be updated with the latest information on the Zika virus.
The Zika virus is on the minds of many women, particularly pregnant women and women trying to become pregnant, which my patients are trying to do. On November 28, 2016, Texas health officials confirmed the first local transmission of Zika virus in the state, at Brownsville.
So my patients’ concerns are natural and well founded, and they are wise to be doing everything possible for a healthy pregnancy and baby.
Since the Zika virus can be spread from mother to her fetus, the primary concern is for the health of the unborn child, specifically the risk of microcephaly. This birth defect can result in abnormality of the child’s brain and head size and shape. Neurological disorders can be serious and include seizures and slow development.
According to preliminary findings from the US Zika Pregnancy Registry, only 6 percent of infants or fetuses in Zika-associated pregnancies have documented signs of Zika-related birth defects. For expectant mothers who reported Zika exposure or symptoms in the first trimester, the percentage of birth defects was slightly higher at 11 percent.
In November 2016, the Journal of the American Medical Association identified a number of birth defects that are directly linked to the Zika virus that they refer to as congenital Zika syndrome. These birth defects include:
- Severe microcephaly, including a partially collapsed skull and an abnormally small sized head
- Damage to the back of the eye with increased pigment and a specific pattern of scarring
- Joints with a restricted range of motion, such as clubfoot
- Reduced brain tissue with a specific calcium deposit pattern indicating brain damage
- An abundance of muscle tone, limiting movement soon after birth.
However, not every pregnant woman infected with the Zika virus has a baby with microcephaly. The Centers for Disease Control (CDC) reports that the connection between Zika infection and microcephaly is not adequately understood at this time, and more studies and laboratory analysis are needed.
The most practical prevention step one can take is to not travel to an area with a Zika infection problem. If a woman does travel to such an area, she should take appropriate precautions to prevent mosquito bites in the first place, by wearing mosquito repellant and long sleeves/pants, as well as staying indoors and using air conditioning as much as possible.
If the male partner of a pregnant woman has traveled to or lives in an area with Zika, the couple is advised to use a condom or abstain from intercourse for the remainder of the pregnancy.
I encourage people to go to the CDC website for more information. Their webpage, “Questions and Answers: Zika Virus Infection (Zika) and Pregnancy” has excellent information for pregnant and pre-pregnant women.
As of September 2016, the CDC updated their travel guidelines to include 11 countries located in Southeast Asia that have reported local transmission of Zika or border countries with known Zika transmission. Pregnant women should consult with their healthcare provider before traveling to these countries and avoid any travel that is not essential to these countries.
The American Society of Reproductive Medicine (ASRM) released a guidance document for healthcare providers who care for women and men of reproductive age that may have exposure to the Zika Virus.