Zika Virus and Pregnancy - All You Need to Know
Often, couples travel abroad for the honeymoon to discover new places and explore different culture. However, some destinations may be dangerous in terms of infectious diseases and serious health complications.
Zika virus is one of the infections that usually do not cause severe health consequences to an infected person but may lead to life-threatening conditions in newborns of exposed mothers. That is why couples that are planning to have babies are recommended to see their doctors before traveling to risky regions such as Central America, South America, Africa, and Asia. 1
What is the Zika virus?
Zika is a viral infection that is mainly spread through mosquito bites. People may be bitten by Zika transmitting mosquitos during both day and night.2 There are many locations where Zika transmitting mosquitos are found. All of them are mentioned in the following webpage of the United States Centers of Disease Control and Prevention (CDC).
Which are high-risk countries and what is my chance of being infected?
In 2019, the number of countries where people could get the Zika virus from mosquito bites was 87 roughly. The table below summarizes the number of cases and the estimated probability of getting the Zika virus for the majority of risky locations. 3, 4
| Region of the Americas | ||
|---|---|---|
| Country | Number of Cases Per Year | Chance of Being Infected |
| United States of America | 0 | 0.00 |
| Canada | 0 | 0.00 |
| Mexico | 877 | 0.67 |
| Barbados | 14 | 4.90 |
| Belize | 126 | 32.98 |
| Costa Rica | 431 | 8.70 |
| Cuba | 873 | 7.60 |
| El Salvador | 481 | 7.50 |
| Guatemala | 2300 | 13.34 |
| Haiti | 121 | 1.09 |
| Honduras | 350 | 3.72 |
| Jamaica | 1 | 0.03 |
| Nicaragua | 177 | 2.82 |
| Panama | 2752 | 66.11 |
| Saint Kitts and Nevis | 3 | 6.82 |
| Saint Lucia | 0 | 0.00 |
| Anguilla (UK) | 0 | 0.00 |
| Aruba (Netherlands) | 3 | 2.83 |
| Bermuda (UK) | 0 | 0.00 |
| Venezuela | 209 | 0.65 |
| British Virgin Islands (UK) | 0 | 0.00 |
| Guadeloupe (France) | 0 | 0.00 |
| Martinique (France) | 0 | 0.00 |
| Puerto Rico (USA) | 0 | 0.00 |
| Saint Barthelemy (France) | 0 | 0.00 |
| Saint Martin (France) | 0 | 0.00 |
| US Virgin Islands (USA) | 2 | 1.90 |
| Argentina | 57 | 0.13 |
| Bolivia | 1736 | 15.48 |
| Brazil | 19020 | 9.02 |
| Chile | 0 | 0.00 |
| Colombia | 857 | 1.73 |
| Ecuador | 4 | 0.02 |
| Paraguay | 145 | 2.10 |
| Peru | 984 | 3.02 |
| Suriname | 3 | 0.53 |
| Uruguay | 0 | 0.00 |
| Asia | ||
| Country | Number of Cases Per Year | Chance of Being Infected |
| India | 290 | - |
| Thailand | 577 | - |
| Vietnam | 23 | - |
| Africa | ||
| Country | Number of Cases Per Year | Chance of Being Infected |
| Angola | 2 | - |
| Tanzania | 0 (2016 estimates) | 0 |
| Guinea-Bissau | 4 | - |
What are the symptoms of the Zika virus?
About 80% of infected individuals have no symptoms. The rest of Zika positive people develop symptoms 5-14 days after being exposed. Zika-related signs and symptoms usually last for less than a week. 5 The table below illustrates the main symptoms of the disease.1
| Symptoms | |
|---|---|
| Symptoms |
|
| Less Common |
|
How is Zika transmitted?
As it was mentioned before, in the majority of cases, Zika is transmitted through mosquitos. However, the virus may be also transmitted through the following routes: 1, 6
- From an infected mother to a child during pregnancy
- Vaginal, anal and oral sexual intercourse
- Sex toys
Sexual Transmission of the Zika Virus
In March 2017, the Zika virus has been officially recognized as a sexually transmitted infection. Moreover, it has been found that the infected person may pass the virus to his/her sexual partner even if he/she does not experience any symptoms of Zika. 7 According to the CDC, individuals having sexual partners that traveled or lives in a risky region are at risk of Zika acquisition.
How to have sex if one partner is positive?
It is essential to use condoms while having sex with an infected partner. This is important for both partners who plan to have babies and those who don’t since about 50% of pregnancies are considered to be unintended. Also, it is recommended to avoid sharing sex toys or even stay abstinent from having sex with an infected partner. Couples should talk to a healthcare provider for more specific guidance. 7
What is the chance of passing the infection?
The semen of an infected person may contain the Zika virus for several months. Thus, the person may pass the infection to his sexual partner(s) during that period. The probability of passing the Zika infection to a sexual partner depends on several factors such as the length of the stay in a risky location and the viral load. However, no data is available on the approximate probability of virus transmission through sex. 7
Is it safe to get pregnant while visiting risky regions?
No! It is recommended to postpone pregnancy while visiting the risky region. Moreover, couples that are interested in pregnancy should try to stay abstinent or have exclusively protected sex while traveling. This practice should be continued for 2-3 months after returning home. The table below summarizes the recommendations for different case scenarios.7
Scenario #1
Male partner traveled to a risky area
He returns home (with or without Zika-related symptoms) or developed symptoms while traveling
Couple should avoid unprotected sex or stay abstinent for 3 months from that moment
Scenario #2
Female partner traveled to a risky area
She developed Zika-related symptoms while traveling
Couple should avoid unprotected sex or stay abstinent for 2 months from that moment
Scenario #3
Both partners traveled to a risky area
They return home (with or without Zika-related symptoms) or developed symptoms while traveling
Couple should avoid unprotected sex or stay abstinent for 3 months from that moment
How to prevent the Zika virus?
It is important to know that there is no any medication or vaccine that may protect from Zika virus. 2 The table below summarizes the main preventive strategies of the Zika virus. 8
| Prevention of Mosquito Bites | Prevention of Sexual Transmission |
|
|
Who Should get Tested and When?
Should I get tested after returning home?
Zika Testing should be undergone only by individuals who have disease-related symptoms and is coming back from a high-risk area. 9
Should I get tested after visiting risky areas if I plan to have kids?
No! However, it is recommended to plan pregnancy 3 months after being returned home. 8
Should I get tested if I do not have any symptoms?
NO! According to the CDC, individuals that do not have any symptoms should not be tested for Zika. However, pregnant women who have just been returned from risky areas should get tested for the Zika virus, even if they do not experience any symptoms. 9
Tests
What tests are available?
There are 2 main types of Zika tests, namely, molecular and serological testing types.9
What are the most effective tests for the Zika?
Both molecular and serological tests are known to be effective. However, different case scenarios require different types of testing. For example:
- If a Pregnant woman wants to get tested she needs to undergo molecular testing.
- If non-pregnant women or men with symptoms need to get tested for Zika, they may undergo either serological or molecular testing.9
Which tests do we perform?
In our Laboratory we perform both molecular (Zika Virus RNA, Qualitative, Real-Time RT-PCR) and serological (Zika Virus Antibody (IgM)) testing.
What to do if the test is positive?
What to do if the test is positive?
There is no specific treatment for this disease. People with Zika virus should undergo a symptomatic care to treat fever and prevent dehydration. 1
Zika-positive male vs. Zika-positive female when planning pregnancy?
The severity of the health complications caused by Zika somehow depends on the sex and health condition of the infected individual.
Usually, men do not experience any serious health complications. However, they may pass the virus to their female partner who plans to get pregnant or is already pregnant. In that case, a pregnant woman may pass the infection to the fetus. The later may be born with serious health defects such as microcephaly (the size of baby’s head is smaller than it should be) and other neurological disorders. That is why pregnant women are the most vulnerable population for the Zika virus. 10, 1
Can someone pass the Zika virus to family members?
Yes! There are different ways of infection transmission among family members. For example:1, 9
- Newborns may get the infection from their mother through the breast milk.
- Zika virus may be passed from an infected sexual partner to a susceptible one
- Zika virus may be passed to another mosquito which may bite a family member and infect him/her.
Conclusion
Zika virus is an infection spread worldwide. Though this infection does not cause serious consequences to the majority of infected people, travelers who plan a pregnancy or are already pregnant should know how to avoid the infection in order to prevent serious complications.
References
- Zika virus infection: An overview - UpToDate.
- 2. About Zika Virus Disease | Zika virus | CDC.
- Global Overview ZIKA EPIDEMIOLOGY UPDATE.; 2019.
- PAHO/WHO Data - Weekly Report.
- Zika virus. WHO
- Zika Transmission | Zika Virus | CDC.
- Sexual Transmission and Prevention | Zika Virus | CDC..
- Protect Yourself & Others | Zika virus | CDC.
- Testing for Zika | Zika virus | CDC.
- Men and Zika | Zika Virus | CDC.