Nothing can strike fear into the hearts of millions like news of a mysterious virus outbreak that has no treatment or vaccine and is especially threatening to unborn babies. The Zika virus is an infection that can cause the microcephaly birth defect in infants, resulting in the head and brain not fully developing.
It popped up on experts’ radars after thousands of babies in Brazil were born with microcephaly, and is causing such distress in South and Central America that health officials in both El Salvador and Colombia have advised women to not get pregnant until they can get this matter under control, while the CDC is warning American women to be wary if they’re traveling to certain parts of the world.
It certainly seems like we should take the Zika virus very seriously — but how much do we really know about it so far?
“Zika virus is a virus carried by the Aedes mosquito and is transmitted to humans via the bite of an infected mosquito,” says Dr. Gerardo Bustillo, OB-GYN at Orange Coast Memorial Medical Center in Fountain Valley, California. “First discovered in Ugandan rhesus monkeys in 1947, it has been associated with outbreaks in different parts of the world. Zika virus is related to other mosquito-borne viruses such as dengue virus and West Nile virus. Zika first appeared in the Western Hemisphere in early 2014, in an island off the coast of Chile. Since then, it has been detected in several countries in Central and South America. Cases have been recently diagnosed in the United States, but these individuals were infected during a recent trip to Central or South America.”
Dr. Sherry Ross, OB-GYN and women’s health expert at Providence Saint John’s Health Center in Santa Monica, California, says experts are still learning the effects of this virus on children and non-pregnant adults. “Only 1 in 5 infected people will show any kind of symptoms, and the majority will only have mild flu-like symptoms,” she says, referring to the fever, conjunctivitis, rash and joint pain. “However, I would still encourage prevention of being exposed to this virus to all age groups.”
Other common symptoms of the virus, which appear two to 12 days after a mosquito bite, include muscle aches, headache, pain behind the eyes and generalized weakness, Bustillo says. The good news is that severe disease is uncommon: The illness is usually mild, and symptoms resolve after two to seven days.
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These facts don’t, of course, take away from a terrifying one: Zika can seriously affect pregnant women, regardless of what trimester they’re in, Ross says. “If you become infected with this virus during pregnancy, it has been associated with birth defects including a small, shrunken brain and malformed head known as microcephaly,” she says. “This virus can be transmitted to the fetus as well.”
But what exactly is microcephaly, and what causes this rare condition?
“Microcephaly is a head circumference (measured in a fetus or infant) that is significantly below the mean for a given age (or gestational age in fetuses) and sex,“ Bustillo explains. "It can be the result of a multitude of causes, including genetic abnormalities, brain injury from exposure to toxins or infections during gestation (such as Zika infection) and birth complications. In at least 40 percent of cases, there is no known cause. The severity of neurologic impairment is generally related to the severity of microcephaly, and may be significant. The exact mechanism by which Zika causes microcephaly, and the magnitude of the resulting damage, is still being investigated.”
Pregnant women who have recently traveled to an area with Zika virus transmission and have symptoms of the infection (fever, rash, joint pains and/or pinkeye) should have blood testing for Zika virus infection, Bustillo says. "All pregnant women with a relevant travel history, [regardless] of the presence of symptoms, should have fetal evaluation, with serial ultrasounds looking for microcephaly,” he says. “If the ultrasound suggests the presence of microcephaly, amniocentesis may be performed for Zika virus testing.”
Zika has been found in breast milk, and the Centers for Disease Control and Prevention has confirmed the virus can be transmitted during labor, sexual contact, blood transfusion or lab exposure, but we don’t yet know if Zika can be passed on through nursing. Because data on pregnant women infected with Zika is limited, Bustillo says it’s also unknown whether every pregnant woman who contracts Zika will pass the virus on to her fetus.
Without a vaccine or treatment yet, Ross says the best prevention method is to avoid traveling to areas where Zika outbreaks are occurring. The CDC regularly updates its website, and there are currently 22 countries on the list, including Mexico, Puerto Rico, Brazil and Barbados. If you are traveling to these areas, it’s crucial that you wear protective clothing and mosquito repellent.
There is an incubation period for the Zika virus of three to 12 days. If you experience symptoms associated with the virus, visit your doctor, and treat the symptoms as you normally would. “Infected persons should get plenty of rest, drink plenty of fluids to prevent dehydration and treat fever with common medications,” Bustillo says. “The best way to prevent infection is to avoid mosquito bites. Personal protective measures include applying mosquito repellent, wearing long sleeves and long pants and staying indoors. Window and door screens and mosquito nets help to minimize contact between mosquitoes and people. Since mosquito larvae breed in standing water, every effort should be made to avoid allowing standing water to collect outdoors, as in buckets, bottles and flowerpots.” —Lisa Fogarty