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Pregnancy and the Zika Virus: What You Need to Know

April 15th, 2016

Most people infected with Zika virus won't even know they have the disease because they won't have symptoms.If you’re pregnant or trying to become pregnant, the recent news coverage of the Zika virus — and its link to birth defects in infants born to mothers who have the virus — may be a concern for you. While there’s currently no vaccine to prevent the virus, there are some precautions you can integrate into your family planning methods to reduce your risk of getting and transmitting the Zika virus.

The Zika Virus in the U.S.

The Zika virus is most commonly spread through the bite of an infected mosquito. Transmission through sexual intercourse, from mother to fetus, and blood transfusion have also been reported. Symptoms of the Zika virus, including rash, fever, joint pain and conjunctivitis (red eyes), appear in only one out of every five infected people.

  • Mosquitoes — The type of mosquito that’s spreading the virus, the Aedes, has been found in U.S. states such as Florida and Hawaii, along the Gulf Coast, and as far north as Washington, DC, when the weather is hot. Once the mosquito bites a person infected with the Zika virus, it carries that person’s blood with it to the next person it bites.
  • Sexual Transmission —Zika virus has been detected in semen for longer durations than it was detected in blood, however the length of time Zika virus persists in the ejaculate is not known. The reported cases of sexual transmission have come from men who were symptomatic, with transmission occurring before, during, and after symptoms. It is not yet known whether men who have no symptoms of Zika virus infection can transmit the virus through sexual intercourse. Therefore, CDC is recommending use of condoms, not only for men known to have Zika virus, but also for men who have travelled to a region with active Zika virus transmission.
  • Cell and Tissue Donation – In response to the possible risk of Zika virus transmission through human cells, tissues, and cellular and tissue-based products, the FDA has updated donor screening recommendations to include risk factors for Zika virus. Donors who have medical diagnosis of Zika infection, travel to an area of active Zika transmission, or sexual intercourse with a male who has either of these risk factors within the past six months are ineligible to donate.

While the reported cases of Zika virus in the Continental US have come from travelers returning from areas of active Zika virus transmission, the CDC is preparing for the possibility of mosquito-borne transmission during the upcoming heat of the summer.

What the Zika Virus Means for Pregnant Women

Pregnant women do not appear to be at increased risk to acquire or more severely affected by the Zika virus. The primary concern for pregnant women who contract the virus during pregnancy is transmission to the fetus, which causes birth defects, most notably microcephaly and other fetal brain defects. Microcephaly is a lifelong condition in which a person’s head is smaller than expected. It can range from being mild, when the person’s primary condition is that their head is small, to severe, with associated developmental delays, seizures, intellectual delay, hearing loss or vision problems.

As the number of reported cases of Zika virus increased in 2015, health officials in Brazil noted a significant increase in newborns with microcephaly. Major health organizations around the world began studying the link between the virus and the condition. In April 2016, CDC concluded Zika virus is a cause of microcephaly and other fetal brain defects, and recommended pregnant women and their partners take steps to avoid the infection. CDC has reported no evidence of congenital infection in pregnancies conceived after the virus is no longer detectable in the mother’s blood.

Zika Virus Response and Prevention

The CDC, the World Health Organization and other health agencies are studying cases of the virus to better understand how it’s transmitted and how to prevent it.  In April of 2016, American Society for Reproductive Medicine issued a guidance on Zika Virus.

Recommendations include:

  • Women who have Zika disease symptoms should wait at least 8 weeks after symptoms appear, and men should wait 6 months, before attempting reproduction.
  • Men and women with possible exposure to, but not showing symptoms of, Zika should also wait 8 weeks.
  • These same timelines should be used for sexually intimate couples using their own eggs and sperm in fertility treatments.
  • Testing for Zika virus is complicated, not universally available, and routine serologic testing is not currently recommended.
  • In areas of active Zika virus transmission, the use of contraceptive methods to prevent unintended pregnancy is essential.

The CDC publishes travel notices listing areas where Zika is active. If you live in or need to travel to a region where the Zika virus has been found, you can take steps to reduce your chances of contracting the disease:

  • Protect yourself. Wear long-sleeved shirts and pants, stay inside buildings with screened windows, and apply and reapply bug repellent as directed. Repellents containing DEET, picaridin, IR3535, when used as directed, are considered safe for use by pregnant women.
  • Talk to your partner. Ask your partner to be tested for the virus before attempting conception, or before intercourse if you’re already pregnant. At this time, the CDC has confirmed that sexual transmission of the Zika virus is possible, so they’re recommending that men who live in or have traveled to a region with the Zika virus should use condoms if having sex with a pregnant woman.
  • Talk to your doctor. The CDC recommends that if you’re pregnant and have recently traveled to an area with reports of the Zika virus, such as some of the Caribbean islands, Puerto Rico, Mexico or South America, you should talk to your doctor immediately, even if you don’t show any symptoms. Your doctor can help determine your risk and any testing or next steps necessary. This is also vital if you’re considering fertility treatment in the near future.

If you’re concerned about the Zika virus and family planning, talk to your doctor about ways to protect yourself.

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