What do I need to know about Zika virus?

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In April of this year, the CDC announced that a Zika virus infection during pregnancy can cause microcephaly, among other birth defects, prompting health care organizations to educate women and couples about how to assess and lessen the risk of infection. Whether you are trying to conceive naturally or with the help of fertility treatments, it’s important to understand the risks associated with Zika virus.

What do I need to know?

Increasing evidence supports a link between Zika virus infection during pregnancy and adverse outcomes, including pregnancy loss, microcephaly, and brain and eye abnormalities. The virus can be spread from mother to child during pregnancy, during delivery and from one partner to another during sex. Most people infected with Zika virus are asymptomatic. However, symptoms can include fever, rash, joint pain, and conjunctivitis. These symptoms are usually mild and last for 2-7 days1.

What should I know if I am planning a pregnancy?

Zika virus has been found in countries across both Central and South America and the Caribbean2, and is primarily spread through the bite of an infected mosquito. Though there have been cases of infection reported in the US, the virus was first contracted while traveling to an affected area3. Zika virus is known to be transmitted sexually, although the data related to this risk is limited.

Women and men with possible exposure to Zika virus but without clinical illness consistent with Zika virus disease should wait at least 8 weeks after exposure before trying to conceive4. Possible exposure to Zika virus is defined as travel to or residence in an area of active Zika virus transmission. If you or your partner has to travel, the CDC shares steps you can take to prevent mosquito bites and to prevent sexual transmission of the virus.

Women who have Zika virus disease should wait at least 8 weeks after symptom onset to attempt conception and men with Zika virus disease should wait at least 6 months.

What should I know if I’m pregnant?

The level of risk for adverse pregnancy and birth outcomes associated with Zika virus infection remains unknown. However, a recent study estimated that about 1% of fetuses born to women infected with Zika virus during their first trimester were affected by microcephaly5. Another study reported that 29% of women with laboratory-confirmed Zika virus infection showed additional abnormal findings in prenatal ultrasounds6.

For pregnant couples, the CDC recommends that men who live in or have traveled to an area of active Zika virus use condoms consistently and correctly or abstain from sex for the duration of the pregnancy.

What if I’m pursuing fertility treatments?

No known Zika virus transmission has been documented during infertility treatment though transmission through donated gametes or embryos is theoretically possible. If you are traveling to a place with active virus transmission for IVF treatments, follow the CDC’s guidelines for preventing mosquito bites. If you are concerned about using donated gametes from countries with active Zika virus transmission, be aware that the FDA has made the following recommended restrictions on egg and sperm donors7:

  • Diagnosis of Zika in the past 6 months
  • Residence in, or travel to, an area with active Zika transmission within the past 6 months
  • Sexual activity within the past 6 months with a partner who is known to have lived in or traveled to affected areas, or who has been diagnosed with Zika virus

The Barbados Fertility Center has helpful tips for patients pursuing IVF that you can read, here.

How can I test for Zika? Should I?

Testing is recommended for pregnant women showing symptoms consistent with Zika virus disease. Evaluation with the potential for subsequent testing is recommended for pregnant women with possible exposure to the virus 8 weeks before conception. Currently, routine testing is not recommended for women or men who are trying to become pregnant with possible exposure to Zika virus but show no symptoms. Once a person has been infected, he or she is immune to future infections.

For further information on the Zika virus, including current areas of active virus transmission and prevention tips, please visit the CDC or FDA websites or talk to your health care provider.

References:

1.http://www.cdc.gov/zika/symptoms/index.html

2.http://www.cdc.gov/zika/geo/index.html

3.http://www.fda.gov/EmergencyPreparedness/Counterterrorism/MedicalCountermeasures/ MCMIssues/ucm485199.htm

4.http://www.cdc.gov/zika/pregnancy/thinking-about-pregnancy.html

5.Cauchemez M, Dub T, Guillemette-Artur P, et al. Association between Zika virus and microcephaly in French Polynesia, 2013–2015: a retrospective study. Lancet. Published online March 15, 2016.

6.Brasil P, Pereira JP, Raja Gabaglia C, et al. Zika virus infection in pregnant women in Rio de Janeiro—preliminary report. N Engl J Med. Published online March 4, 2016.

7.http://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatory Information/Guidances/Tissue/UCM488582.pdf

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About Author

Shannon Wieloch

Shannon Wieloch is a licensed board-certified genetic counselor at Recombine. Her primary responsibility is to provide genetic counseling to Recombine patients. She is also the current co-chair of the National Society of Genetic Counselors Prenatal Special Interest Group. Prior to joining Recombine, Shannon worked in cardiac research at The Children's Hospital of Philadelphia and in prenatal genetic counseling at The Delaware Center for Maternal and Fetal Medicine. She received a dual B.S. in biology and psychology from The University of Pittsburgh and her M.S. in genetic counseling from Arcadia University. Her passion is to provide comprehensive genetic education to medical professionals, patients and the general public.