To date, there have been 544 reported cases of Zika virus infections in the US affecting people in 44 states. New York and Florida lead with 114 and 109 cases, respectively. All of these cases have been travel-associated and mosquitoes carrying Zika have not yet been found within the US. Though infection with Zika virus causes mild symptoms, or may be asymptomatic, the biggest concerns surround infection during pregnancy. There is now enough research evidence to confirm that Zika infection during pregnancy can cause fetal microcephaly and other severe birth defects such as hearing loss, eye defects, and growth impairment.
Given the fetal risk, it’s important for pregnant women to know how to protect themselves from Zika. Since there is currently no treatment for Zika, control efforts must focus on preventing infection. Public health authorities advise that pregnant women should delay travel to areas where Zika virus is present. These include the Caribbean, Central and South America, and the Pacific Islands. If travel to these areas can’t be avoided, it’s important to prevent mosquito bites. Effective measures include wearing long sleeves and pants when outdoors, using EPA-registered insect repellents, treating clothes and gear with permethrin to prevent bites through clothing, and avoiding mosquito breeding grounds. These breeding grounds are typically areas of standing water.
An additional way to control Zika virus infection is to stop sexual transmission. Men who have traveled to an area where Zika virus is present have the ability to transmit the virus to their partner through semen. It is unknown exactly how long the virus remains in the semen. Therefore, a condom should be used during every sexual encounter throughout the pregnancy or the woman should abstain from sex during the pregnancy.
If a pregnant woman travels to an area where Zika virus is present she should inform her doctor, even if she does not experience any symptoms of infection. CDC guidelines recommend a serologic test and fetal ultrasound 2-12 weeks after travel for women who are not experiencing symptoms of Zika infection. The same testing is recommended during the first week of infection in women showing symptoms of Zika. It is still unknown how likely a person is to become infected with Zika virus after exposure and how likely it is that a baby will have birth defects due to exposure.
For those who are infected by Zika virus, there is no medication to cure the infection. The course of treatment involves treating symptoms with rest and fluids and acetaminophen for pain and fever. The Zika virus remains in the blood for a week. It is necessary to prevent mosquito bites at this time because mosquitoes can become infected and spread the virus to other people. It is unlikely that a person will get infected with Zika again after an initial infection. It is also not believed that women who become pregnant after the virus has left their blood will have any increased risk of fetal birth defects.
Despite all of the research being done on Zika virus, many unanswered questions remain. With the number of cases of Zika virus infection on the rise, it is important to practice proper infection prevention and control strategies to limit the risks of Zika virus.
More information on Zika virus can be found here: http://www.cdc.gov/zika/index.html
By: Jordin Cox, PharmD Candidate 2017