Zika Virus: Don't Take the Risk when Pregnant or Trying to Conceive

The Zika virus — an infection transmitted by Aedes mosquitoes that is related to dengue, yellow fever and West Nile virus — is all over the news. And while symptoms of the virus are typically mild and the virus is fairly rare in the United States (approximately 1,000 cases per year), the risk for women who are pregnant is very high.

If you are pregnant or could potentially be pregnant (i.e., not using contraception), my advice is to cancel any trip to a region where Zika is present. If you have been to such a region and want to undergo fertility treatment, my recommendation is to withhold treatment for several weeks in order to allow for clearance of the virus. This is an approach recommended by the World Health Organization, the American College of Gynecologists and the Centers for Disease Control and Prevention.

WHAT IS THE ZIKA VIRUS?

First discovered in a rhesus monkey in Uganda in 1947, the Zika virus is spread through mosquito bites. There were a few isolated human cases of the virus, with fairly mild symptoms. The virus became better known in 2007 when there was a large outbreak in Micronesia that subsequently spread through the Pacific Islands and into South America in 2015. 

HOW DOES ZIKA AFFECT PREGNANT WOMEN

In adults, the symptoms of Zika virus are typically mild and include fever, rash, joint pain and conjunctivitis, with symptoms lasting from several days to a week. However, in May 2015 came the alert of a Zika virus infection in Brazil. With this outbreak came reports of Guillain-Barré syndrome and pregnant women with poor pregnancy outcomes and giving birth to babies with birth defects.zik-world-map_active_02-03-2016_web.jpg

One of the birth defects that has been linked to the Zika virus is microcephaly. Babies born with microcephaly have an abnormally small brain and skull, with varying degrees of brain damage. In Brazil, the average number of microcephaly cases was 163 per year, but as of 2016, Brazil has reported 3,530 cases, which coincides with the arrival of the Zika virus.   

HOW IS ZIKA VIRUS TRANSMITTED?

The Zika virus is transmitted through the bite of a mosquito, but that may not be the only way. In Texas, health officials announced that there is a confirmed case of the virus involving a patient who had sex with someone who had recently returned from Venezuela infected with the mosquito-borne virus.

The CDC has updated its guidance on Zika virus and now recommends that pregnant women use protection if their male sexual partner has traveled to or lives in an area where the Zika virus is circulating.

RECOMMENDATIONS IF YOU ARE PREGNANT OR UNDERGOING FERTILITY TREATMENT

This outbreak has prompted the CDC to issue a travel advisoryto affected countries, particularly among pregnant women at risk of passing the virus to their children. The CDC's general recommendations include postponing travel to countries where the Zika virus has been documented recently, a list that currently includes Barbados, Bolivia, Brazil, Cape Verde, Colombia, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Samoa, Suriname, U.S. Virgin Islands and Venezuela. There are now reported cases of the virus in Canada, as well as reported cases in Massachusetts, Arkansas, Texas, Florida, Hawaii and Virginia. Illinois is reporting three cases of the Zika virus, one male and two pregnant females. These cases represent citizens who have recently traveled to affected areas. 

For additional information, please contact my practice at (888) 900-4649 or  visit the CDC website.

Image — Countries and territories with active Zika virus transmission.Source: Centers for Disease Control and Prevention.