Zika Virus Protection Tips for Pregnant/Childbearing Women

portrait“The best prevention against Zika is protection against mosquito bites and avoiding travel in countries on the CDC list,” says Michelle Lusk, CVMC Assistant Vice President.

Recently, the Centers for Disease Control and Prevention (CDC) issued travel guidance for pregnant women and women trying to become pregnant, warning them to avoid visiting places where the Zika virus is currently circulating. With Mexico and the Caribbean on the list during a time of year when many are planning warm climate get-a-ways, we want the community to be familiar with Zika virus prevention and facts.

Zika carries significant risk to pregnant women and women trying to become pregnant as it appears to be linked to a very serious and specific birth defect called microcephaly. Officials are advising pregnant women and women trying to become pregnant to consider avoiding travel to the affected areas out of concern that Zika may cause a catastrophic birth defect called microcephaly. The following Frequently Asked Questions was prepared by Catawba Valley Infection Prevention. For additional information, please contact Infection Prevention at 828.326.3610 or bookmark/visit http://www.cdc.gov/zika/.

What is Zika virus disease (Zika)? Zika is a disease caused by Zika virus that is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika.

What are the symptoms of Zika virus? People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days. However, there have been cases of Guillain-Barre syndrome reported in patients following suspected Zika virus infection. In pregnant women, there have been reports of birth defects and other poor pregnancy outcomes.

How is Zika transmitted? Zika is primarily transmitted through the bite of infected Aedesmosquitoes, the same mosquitoes that spread Chikungunya and dengue. These mosquitoes are aggressive daytime biters and they can also bite at night. It can also be transmitted from a pregnant mother to her baby during pregnancy or around the time of birth. The Center for Disease Control (CDC) is studying how some mothers can pass the virus to their babies.

How is Zika virus treated? There is no specific treatment or vaccine currently available. Treatment is based on symptoms.

How can you prevent the Zika virus? The best form of prevention is protection against mosquito bites. Prevention includes wearing long sleeve shirts and pants, using EPA registered insect repellents, and staying in places with air conditioning or that use window and door screens to keep mosquitoes outside.

Is this a new virus? No. Outbreaks of Zika previously have been reported in tropical Africa, Southeast Asia, and the Pacific Islands. Zika virus likely will continue to spread to new areas. In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infection in Brazil. Since that time, local transmission has been reported in many other countries.

What countries are experiencing outbreaks of Zika virus? Currently, outbreaks are occurring in many countries and the CDC/WHO update the map of affected areas daily. Prior to 2015, Zika virus outbreaks have occurred in areas of Africa, Southeast Asia, and the Pacific Islands. In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infections in Brazil. For the most up-to-date map of affected areas: http://www.cdc.gov/zika/geo/index.html

Should we be concerned about Zika in the United States? The U.S. mainland does have Aedes species mosquitoes that can become infected with and spread Zika virus. U.S. travelers who visit a country where Zika is found could become infected if bitten by a mosquito. With the recent outbreaks, the number of Zika virus disease cases among travelers visiting or returning to the United States will likely increase. These imported cases may result in local spread of the virus in some areas of the United States. CDC has been monitoring these epidemics and is prepared to address cases imported into the United States and cases transmitted locally.

What if I plan to travel? Travel guidance is given by the CDC & updated daily, depending on country of travel: http://wwwnc.cdc.gov/travel/page/zika-travel-information. For all travelers, take precautions to prevent themselves from mosquito bites.

What if we have a patient with suspected Zika Disease?
About 1 in 5 people infected with Zika virus become symptomatic. Characteristic clinical findings are acute onset of fever with maculopapular rash, arthralgia, or conjunctivitis. Other commonly reported symptoms include myalgia and headache. Clinical illness is usually mild with symptoms lasting for several days to a week. Severe disease requiring hospitalization is uncommon and case fatality is low.

  • For non-pregnant patients, treatment is based on symptom management. Isolation is not necessary.
  • For pregnant patients, treatment is based on current CDC guidance and at this point, includes serial ultrasounds to monitor fetal development.

What lab testing is available?

Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever. These tests are performed by the NC State Lab, but require state permission for testing.

Are we screening patients for travel history?
Travel history should be assessed in routine patient care. Specifically for Zika, Maternity Services are screening pregnant women for travel history and Zika Disease symptoms.

CVMC is currently working diligently to communicate with area OB/GYN practices and keep staff updated with information about community partner programs and screening information. There are currently no cases of Zika virus in North Carolina. For more information, contact Infection Prevention at 828.326.3610 or check online at http://www.cdc.gov/zika/.