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Update on Zika Virus

  • A. Kenneth Harper MD

The CDC has updated its recommendations on Zika virus including travel restrictions, evaluation for possible Zika infection and conception planning for those with possible or confirmed exposure to the virus. Infection during pregnancy risks include birth defects in babies such as microcephaly (very small head) and other developmental problems. The CDC has an excellent patient education section about Zika on their website, http://www.cdc.gov/zika/. Highlights of the most recent updates are:

  1. Zika virus (and infections) have been reported in virtually all of South and Central America, the Carribean Islands, and Puerto Rico. Zika virus has been detected in mosquitos in two limited areas in the Miami area with a small number of infections noted. So far infections elsewhere in the U.S. have occurred only after travel to or through unprotected sexual intercourse with a partner who has traveled to an area of documented Zika virus presence.
  2. It is advised that women (and their partners) who are or who may become pregnant within the next 6 months should avoid travel to areas where Zika virus is present.
  3. Women who have traveled to a high risk Zika area should avoid attempting pregnancy for 8 weeks. Women diagnosed with Zika virus infection should avoid attempting pregnancy for 8 weeks after resolution of infection. *Remember that most infections do NOT produce symptoms such as low grade fever, cough, muscle aches, or nasal drainage - symptoms very similar to a cold.
  4. Pregnant women or women planning pregnancy whose partners have traveled to a high risk area should avoid unprotected sex (use condoms or abstain from sex) for 6 months after the possible exposure. The concern is that Zika can be present in semen for up to 6 months after an infection.
  5. Testing is currently only advised for pregnant women or their partner with possible exposure through travel by the woman or her partner to a high risk area. However, anyone with possible Zika exposure who develops symptoms consistent with Zika can be tested.
  6. If travel to a high risk Zika area cannot be avoided the risk of infection can be reduced by use of long sleeved clothing, staying inside air conditioned areas as much as possible, and using mosquito repellents containing at least 25% DEET or 20% Picardin (both safe for pregnant women) when outside.
  7. So far no treatment or vaccine is available for Zika. The risk of problems in babies of women who develop Zika is unclear; in some studies it is felt that 20-30% of babies may have problems. The CDC told 60 Minutes last week that a vaccine MIGHT be available by 2018!!