Trying to Conceive? Here's What You Need to Know about the Zika Virus (Updated)

By Jamie Stone Feingold, MSN, NP-C, WHNP-BC

The Zika Virus is receiving ubiquitous news coverage. Every few days a new story comes out with updated guidelines for specific populations. To women who are trying to become pregnant, particularly those undergoing fertility treatment, the data can be confusing and frightening. In an effort to streamline the coverage of Zika, we have compiled relevant information below.

What is Zika Virus?
Zika Virus is a virus that is transmitted by the Aedes species mosquito and causes Zika virus disease.
The main concern of Zika virus is its ability to cause microcephaly in a fetus if a mother contracts the virus during pregnancy. Microcephaly is a condition where the baby’s head is much smaller than expected. Babies who are born with microcephaly can have severe developmental delays, seizure and difficulty seeing or hearing, as well as other disabilities. Zika virus can also cause other severe fetal brain defects when contracted during pregnancy.

How do I get Zika Virus?
Zika virus is transmitted by the Aedes species mosquito. A mosquito becomes infected when they bite a person who has Zika virus. The infected mosquitos transmit the virus to an uninfected person through bites. Aedes species mosquitos lives in warm, populous areas near standing water and bite people during the day and night times.
Zika virus can also be transmitted from mother to fetus. If a pregnant woman is infected at any point during her pregnancy, she can pass Zika virus on to her unborn child. If she is infected near to the time of childbirth, she can pass Zika virus to her baby during delivery.

Zika virus has also been shown to be transmitted sexually. Men who have shown symptoms have been found to transmit the virus through their semen before, during and after the onset of symptoms. There have been no reported cases of transmission of Zika virus through blood transfusions in the United States, but there are multiple cases in Brazil that are currently under investigation.

What are they symptoms of Zika Virus?
Most people who are infected with Zika will not know it. However, for those who do become symptomatic, the most common complaints are fever, joint pain, rash and conjunctivitis (red eyes). These symptoms are typically not severe enough to warrant hospitalization, and people very rarely die of Zika. The incubation period for Zika is not known, but symptoms typically last a few days to a week. The virus can survive in the blood of an infected person for up to a week and sometimes longer after a bite, and once a patient is infected with Zika, it is believed that they will have immunity from future infections.

If you have the symptoms of Zika and have recently travelled to an area where Zika is known to be endemic, you should notify your healthcare provider so that they may run the appropriate tests for Zika virus and to rule out other viruses similar to Zika including Chikungunia and dengue.

Is there any treatment for Zika Virus?
The treatment for Zika Virus relies on the treatment of the symptoms. Plenty of fluids and rest are suggested and Tylenol may be taken to reduce fever and joint pain. It is recommended that patients avoid taking aspirin and NSAID (such as ibuprofen or naproxen) until a diagnosis of dengue is ruled out.
Currently there is no vaccine available for Zika virus.

Areas with Active Zika Virus Transmission
The Center for Disease control is updating their website with countries and territories with active Zika transmission as needed. Currently, many countries in South and Latin America have reported active transmission of the virus. US territories including Puerto Rico and the US Virgin Islands have also report active transmission. For a map of the affected areas, please visit the CDC’s Map of All Countries and Territories with Active Zika Virus Transmission.

What if I’m trying to become pregnant?
For women who are hoping to become pregnant, the emerging data of Zika virus can be confusing and difficult to navigate. Recently, the American Society for Reproductive Medicine published guidelines for becoming pregnant in the presence of this outbreak.

For women who are known to have been infected with Zika virus (having symptoms of Zika after a known exposure or testing positive for Zika), the ASRM suggests that they wait at least 8 weeks before attempting reproduction. For men with known Zika virus disease the ASRM recommends that they wait at least 6 months prior to attempting reproduction, and that they use a barrier method of contraception (such as condoms) to prevent infecting their partner during that time.

For women and men with possible Zika virus exposure but no apparent symptoms, the ASRM recommends waiting at least 8 weeks before attempting to become pregnant. There is not current evidence to suggest that a woman with a resolved Zika infection will pass it on to her offspring. For people who are living in areas with current active Zika Virus Transmission, the ASRM suggests preconception counseling and individualized care. If you are living in or traveling to one of these areas are not attempting to become pregnant, appropriate birth control methods should be utilized to avoid an unintended pregnancy that many be affected.

How do you test for Zika Virus?
Testing is complicated and expensive, and access can be limited depending on your location. It is the responsibility of the health care provider to identify the tests that are available in their community, the limitations of these tests, which patients will be allowed testing by these testing facilities, and whether testing is covered by insurance. Routine testing of the blood or semen is not currently recommended.

References:
ASRM Guidance Document on Zika Virus
Center for Disease Control: Microcephaly
Center for Disease Control: Zika Virus
Center for Disease Control: Zika and Pregnancy
Center for Disease Control: Areas with Active Zika Transmission