Pregnancy is a delicate situation. Once conception happens, the fetus develops in the woman’s uterus until it is time for birth. Like any ailment, Zika does not choose which people to infect. An infected mosquito can alter the condition of the fetus through neurological defects such as microcephaly. If you are planning to get pregnant and planning to travel as well, perhaps the following information can help you as you go on your way.
What You Know About Zika
According to the CDC, there are no vaccines that prevent Zika disease. To prevent it, you just have to follow the steps in preventing mosquito bites. The day-biting mosquitoes are the ones that spread the Zika virus. These mosquitoes also spread the chikungunya and the dengue diseases. You can also contract Zika by engaging in sexual intercourse with a man infected by the Zika virus.
Preventing Mosquito Bites
Many diseases are spread through mosquito bites. All you need to do is to prevent them from biting you. You can keep them from away through the following steps:
1.Make sure you stay in a place with installed screens on the doors and windows and air conditioning
2,Remove any source of stagnant water, which is an attractive breeding ground for mosquitoes
3.Wear long pants and long sleeved shirts
4.Use mosquito repellents that are EPA (Environmental Protection Agency)-registered. Take note of the following when you choose the repellents:
- Check the ingredients (oil of lemon eucalyptus, DEET, para-menthanediol, IR3535, and picaridin)
- Do not spray directly on your clothing or skin
- Reapply the repellent is needed
- Always read the instruction labels
- If you need to apply sunscreen, apply the sunscreen first before spraying the repellent
Observe the following if you need to protect a child from mosquito bites:
- If your child is younger than 3 years, do not use any product containing para-menthane-diol or oil of lemon eucalyptus
- Dress the child in long sleeves and long pants
- If your baby is younger than 2 months, do not use insect repellent
- Keep the insect repellent from getting in contact with the child’s irritated or injured skin, hands, mouth, or eyes
- Cover the baby carrier, stroller, and crib with mosquito net
- Spray the insect repellent on your skin first and then apply it on the child’s face
- Purchase items which have been treated with permethrin or treat your child’s gear and clothes with permethrin
- Determine how long the permethrin protection will last
- Read instructions carefully if you are treating the items by yourself
- Avoid applying permethrin directly on your skin (this chemical is just for clothing)
*** Take note that even if the travelers who came from Zika areas do not feel sick during their return to the United States, they should still follow the guidelines in preventing mosquito bites for about 3 weeks. This is to help prevent Zika from spreading to uninfected mosquitoes, which could then spread the infection to other people.
What if You Have Zika? How Can You Protect Other People from Acquiring the Virus?
Below are some pointers to remember in helping others keep away from your Zika infection:
- During the first week of the Zika infection, the virus is detectable in the bloodstream. It has been passed from one person to another through the bite of vector mosquitoes. The mosquito that carries the virus can then spread the virus to other people.
- To prevent infection from spreading to other people, you should follow the established mosquito bite prevention steps during the first week of the ailment.
- It is advisable to abstain from having sex with a man infected with Zika.
- No one knows the longevity of the virus in the semen of the infected and how long it can be transmitted through copulation.
- The virus usually stays longer in the semen than in the blood.
- Using condoms the right way from the beginning to the end of the act is an effective way to prevent Zika transmission. The act includes oral, vaginal, and anal sex. Abstinence from sex is the most effective way to be sure that the partner does not contract the Zika virus.
What to do if the Pregnant Woman Has a Partner who Traveled or Lived in a Zika Positive Area
The pregnant woman’s partner should always use condoms the right way during the entire act. This includes anal, oral, and vaginal sex. It is always best to just abstain from the sexual act during pregnancy if the pregnant woman’s partner is infected.
Travelers (pregnant or non-pregnant) returning to the US from the Zika infected area should follow the mosquito bite prevention methods for about three weeks. This is to prevent the transmission of the Zika virus to the uninfected mosquitoes.
Are You Concerned About Your Infected Male Sex Partner?
If you are pregnant or planning to be pregnant and your partner just happens to be Zika infected, condoms must always be used the right way. As you know, condoms also prevent STDs such as HIV. To be sure that you do not acquire the virus, you should just not engage in sexual intercourse.
You should have a talk with your healthcare provider if you or your male sex partner has traveled to an area infected by Zika. You should do this even if you do not manifest any symptoms.
If You are Pregnant and You are Planning to Travel
Pregnancy is oftentimes not a hindrance to visiting other places. If you are pregnant and you want to travel, check CDC’s Travelers Health website to find out if the place you want to visit has health notices.
If ever you are coming from a Zika infected area, observe mosquito bite prevention for about three weeks, so that the uninfected mosquitoes do not spread the Zika virus anymore. Fortunately, CDC has already posted maps to show how bad the Zika virus infections are in certain areas of the world.
What You Know and Do not Know about Zika
You know that:
- Any pregnant woman can be infected by a bite of a Zika infected mosquito.
- Zika is also transmitted through sexual intercourse with an infected male partner.
- A pregnant woman can pass the Zika virus to her fetus during her pregnancy and at the moment of delivery.
You do not know that:
- When a pregnant woman is exposed, you do not really know if she will be infected by the Zika virus or not.
- When a pregnant woman is infected, you do not know how the Zika virus will affect the pregnant woman or the pregnancy itself.
- You are not certain if the Zika virus will be passed to her fetus or not.
- You are not sure if the fetus will develop neurological defects or not.
- You do not really know what stage of the pregnancy Zika will harm the fetus
Microcephaly and Zika
The outbreak of the Zika virus started in May 2015 for Brazil. Recently, the officials in Brazil reported an increase of microcephaly cases in a certain number of newborn babies.
These initial reports started to establish the connection between microcephaly and the Zika virus. That is why many researchers started to study the how microcephaly is associated with the Zika virus. One recent article showed that the scientists in CDC announced that enough evidence is already available to conclude that Zika infection during pregnancy is a definite cause of fetal neurological defects in fetuses. Such conditions are microcephaly, growth impairment, eye defects, and hearing loss. To date, scientists are still studying potential health issues that the Zika infection causes during pregnancy.
Microcephaly’s Other Causes
Many reasons may give way to microcephaly. There are reported newborns that have microcephaly because of the following:
- Infections acquired while still in the mother’s womb
- The pregnant mother exposed to toxins during her pregnancy
- Alterations in the genes
It has been reported recently that pyriproxyfen, a certain pesticide, possibly has a link with the neurological defect, microcephaly. Pyriproxyfen has already been approved by the WHO to be used in controlling vector mosquitoes. It is a registered form of pesticide in countries like Brazil. They have been using pyriproxyfen for decades.
Other Problems Brought About by Zika
Aside from microcephaly, experts have detected other defects in newborns and fetuses infected with the Zika virus before they were born. They had growth impairment, eye defects, and hearing loss. There is more knowledge to acquire in the other severe brain defects linked to Zika. Data are being collected to understand how much Zika impacts children and their mothers.
Views on Your Future Pregnancies
Available evidence indicates that once Zika infection affects a non-pregnant woman does not make the future baby at risk for any birth defects once the virus leaves her circulatory system. What everyone knows is that the person affected by the Zika virus acquires immunity from future Zika infections.
Recommendations
If You are Pregnant and You Want to Travel in a Zika Infected Area
The CDC recommends that pregnant women should postpone their travel plans to Zika infected areas, since there are no prophylactic medications and vaccines for this virus. If you are pregnant and you need to go to a place where there is an ongoing Zika infection, you should follow the steps in avoiding mosquito bites. Take note that the Aedes species of mosquitoes bite during the daytime, outdoors and indoors. It is recommended that you should protect yourself from mosquito bites even during the day.
If you are Pregnant with History Travel to Areas Affected by Zika
Doctors should ask you about your recent travel. If you have traveled to a place where the Zika virus transmission is ongoing during your pregnancy, you should be tested and evaluated for Zika virus according to the CDC’s Interim Guidance. Zika has the same clinical presentation and geographic distribution as chikungunya and dengue. That is why any patient who has symptoms of Zika, is also evaluated for chikungunya and dengue.
Pregnant women undergo the Zika virus RT-PCR test, which is usually performed on the amniotic fluid. Right now, its specificity or sensitivity for congenital infection is still unknown. It is also unknown if its positive result is indicative of any subsequent abnormality in the fetus. The attending physician should discuss the benefits and risks of amniocentesis with the patients concerned. A possible intrauterine infection could be indicated by a positive RT-PCR.
Here are the tests recommended for live births that have evidence of fetal or maternal Zika infection:
- Testing of cord serum for both dengue and Zika IgM neutralizing antibodies
- Histopathologic exam of the umbilical cord and placenta
- Testing of frozen cord tissue and placental tissue for Zika RNA
- The CDC is presently developing specific guidelines for the newborns with Zika. The criteria are:
- If the woman loses the fetus, and she happens to have history of travel to a Zika affected area
- If the woman has symptoms of Zika infection within 2 weeks or during travel
- If the there are findings of microcephaly
*** If the woman is found to be positive in these criteria, then immunohistochemical staining and Zika virus RT-PCR should be done on the placenta, umbilical cord, and other fetal tissues.
*** Take note that there are no commercial tests for Zika. You can only be tested for Zika in state health departments and the CDC. The healthcare providers should alert their local or state health department, so that they could assist in various tests and result interpretation.
Treating Pregnant Women Diagnosed with Zika
There is still no antiviral treatment available for Zika. Healthcare providers only administer palliative or supportive treatment, which includes giving antipyretics (acetaminophen), analgesics, rest, and fluids. NSAIDs (non-steroidal anti-inflammatory drugs such as aspirin should not be taken during pregnancy, until dengue is ruled out. This is to significantly reduce the pregnant woman’s risk for hemorrhage.
Serial ultrasound scans should be used to monitor the growth and anatomy every 3-4 weeks if the woman is pregnant with lab evidence of Zika in the amniotic fluid or blood serum. The pregnant woman should be referred to an infectious disease specialist or a maternal-fetal medicine specialist with expertise in the management of pregnancy.
Pregnant women should be responsible enough to prevent themselves from contracting Zika. In the event of infection, they should work with their doctors to make sure that the care plan can be executed properly.
