I practice in Tennessee, and though no locally-transmitted cases of Zika virus have been reported here, our phones are ringing off the hook with pregnant patients who are utterly terrified. Their reaction is understandable: You can’t turn on the TV or scroll through your newsfeed lately without being bombarded by frightening images of babies with birth defects and headlines of the coming “Zika plague.” And, in a general sense, the alarm is warranted – Zika is a serious and immediate health threat in areas where the virus is spreading. But how scared should you be when no evidence of spreading Zika has been found where you live?
Here’s how I’m responding to the questions my scared patients, not living in Zika territory, are asking.
What is Zika?
Zika is a virus that causes a mild flu-like illness. It is transmitted by mosquitoes, but also can be transmitted sexually. The most common symptoms are rash, red eyes, fever and/or joint pain; however, many people will have no symptoms at all. For most adults, getting Zika just means feeling crummy for a couple days, with no lasting effects. But for pregnant women, Zika is much more dangerous – it’s been found to be one of the rare illnesses that crosses the placenta and can infect a fetus. The virus attacks the baby’s brain and nerves and can cause severe birth defects and even stillbirth. There is no vaccine or treatment for Zika virus.
When in pregnancy does Zika affect the baby?
Zika affects the development of the baby’s nerves and brain, so there is no “safe” time in pregnancy to get the virus. Luckily, not all babies born to moms with Zika are affected. Of women who contract Zika virus during their pregnancy between 1-29% of babies are affected, with even fewer (1-13%) having severe microcephaly (abnormally small head).
Will Zika spread further into the U.S.?
As an OB/GYN, this is a difficult question to answer because we really don’t know. The mosquito that transmits the virus does live in the southeast region of the U.S., so it is quite possible for it to continue to spread. However, we don’t know for sure if or when it might happen.
Should I get pregnant?
If you or your partner have recently traveled somewhere where Zika is spreading, wait 2 months after you return before trying to conceive – for men, this means using condoms for 2 months after travel. Men who were actually diagnosed with Zika infection are being advised to use condoms for 6 months.
And, it probably goes without saying, if you or your partner are planning to travel somewhere with locally-transmitted Zika cases, you should wait until you are finished traveling to that area before getting pregnant (and then follow the timing guidelines mentioned above). You can check the WHO website for the most up to date information on where Zika has spread.
If neither you nor your partner has traveled somewhere Zika has been found, and if you’re not planning to travel, then you should be fine to conceive. The angst comes into play for those women who live in the areas of the country that are very near locally active Zika. Since we can’t know when or if it will spread further into the U.S., the decision as to whether to conceive will have to be made individually based on risks and benefits. We also have to take into account that we do not know how long Zika will continue to be active. For some women, their biological clocks have them on too tight of a schedule to “wait out” the Zika.
How can I protect myself?
The most important way to protect yourself is to avoid traveling to an area of active Zika infection – and that goes for your partner, too. If either, or both, of you MUST travel, then use precautions:
- Use mosquito repellent that contain: DEET, Picaridin, IR3535, Oil of Eucalyptus, Para-menthane-3,8-diol
- Wear long sleeves
- Stay indoors with screens on windows
- After returning, women should wait 2 months before trying to conceive. Men should use condoms for 2 months (6 months if they were infected with Zika)
If you are pregnant and must travel to a Zika-affected area, or if you find out that an area you traveled to within the last 3 months now has locally-transmitted Zika virus cases, then contact your doctor or local health department for a blood test.
For those not traveling to, or living in, Zika-affected areas, there’s no official word from the CDC on what precautionary measures to take. I encourage my patients here in Tennessee to make an informed decision based on the risk – and being that we are in an area where there are no documented locally-transmitted cases, the overall risk of transmission is extremely low.
Zika virus is scary and there is a lot we don’t know yet. The medical community is very concerned with how it will affect our patients, so we are following the CDC and WHO updates closely. The current best practice remains to avoid Zika-affected areas if at all possible, and if not, take the recommended precautions and follow up closely with your provider.