As the Zika virus spreads throughout Puerto Rico, the U.S. Centers for Disease Control (CDC) and Prevention are distributing Zika prevention kits to pregnant women and working with local officials to test insecticides to help prevent this from turing into a major epidemic. With 157 confirmed cases in Puerto Rico and others reported in the Caribbean and elsewhere, the CDC recommends that all pregnant women consider postponing travel to areas where Zika virus transmission is ongoing.
Zika virus was first discovered in 1947 and is named after the Zika forest in Uganda. In 1952, the first human cases of Zika were detected and since then, outbreaks of Zika have been reported in tropical Africa, Southeast Asia, and the Pacific Islands. Because the symptoms of Zika are similar to those of many other diseases, many cases may not have been recognized. The virus is in the same family as West Nile, Dengue, and yellow fever.
The virus is transmitted by mosquitoes known as the “Asian Tiger” mosquito. This species of mosquito has been found in the Southern part of North America, Central America, the Caribbean, the Northern parts of South America, and parts of Africa and Asia.
The Zika virus can be spread by mosquitoes, by sexual contact, and from mother to child while pregnant.
No local mosquito-borne Zika virus disease cases have been reported in United States, but there have been travel-associated cases. Local mosquito-borne transmission of Zika virus has been reported in Puerto Rico, the US Virgin Islands, and America Samoa.
Zika virus disease is usually a mild self-limiting viral illness with symptoms lasting from a few days to a week. The most common symptoms are fever, rash, joint pain, and conjunctivitis (red eyes). Other common symptoms include muscle pain and headache. The illness is usually mild, with symptoms lasting for several days to a week after being bitten by an infected mosquito.
People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. For this reason, many people might not realize they have been infected, and 80% of cases go undiagnosed. Once a person has been infected, he or she is likely to be protected from future infections.
Zika virus usually remains in the blood of an infected person for about a week but it can be found longer in some people. However, there have been cases of Guillain-Barre Syndrome reported in patients following suspected Zika virus infection. Guillain-Barré Syndrome (GBS) is a rare disorder in which a person’s own immune system damages their nerve cells, causing muscle weakness and sometimes paralysis.
Pregnant women can be infected with Zika virus in any trimester of pregnancy. Data in pregnant women infected with Zika virus is limited. No evidence exists to suggest that pregnant women are more susceptible to Zika virus infection or experience more severe disease during pregnancy.
The Brazil Ministry of Health is also investigating the possible association between Zika virus and a reported increase in the number of babies born with microcephaly (small head in some cases shows slowed brain development). However, it is not known how many of the microcephaly cases are associated with Zika virus infection. For this reason fetuses and infants of women infected with Zika virus during pregnancy should be evaluated for possible congenital infection and neurologic abnormalities.
Pregnant women with a history of travel to an area with Zika virus transmission and who report two or more symptoms consistent with Zika virus disease during or within 2 weeks of travel, or who have ultrasound findings of fetal microcephaly or intracranial calcifications, should be tested for Zika virus infection in consultation with their state or local health department. Testing is not indicated for women without a travel history to an area with Zika virus transmission.
If a pregnant woman travels to an area with Zika virus transmission, she should be advised to strictly follow steps to avoid mosquito bites. Mosquitoes that spread Zika virus bite both indoors and outdoors, mostly during the daytime. Proper protection is encouraged to ensure protection from mosquitoes throughout the entire day. Mosquito prevention strategies include wearing long-sleeved shirts and long pants, using U.S. Environmental Protection Agency (EPA)–registered insect repellents, using permethrin-treated clothing and gear, and staying and sleeping in screened-in or air-conditioned rooms. When used as directed on the product label, insect repellents containing DEET, picaridin, and IR3535 are safe for pregnant women.
There is no vaccine to prevent or specific medicine to treat Zika infections. The goal of treatment is to relieve symptoms associated with the virus including ensure adequate rest, drinking lots of fluids to prevent dehydration, taking medicine such as acetaminophen (Tylenol) to relieve fever and pain. Use of medicines containing aspirin and other non-steroidal/anti-inflammatory drugs (Motrin, Advil, Aleve, Ibuprofen) should be avoided.
For more information about Zika virus visit the Center for Disease control at www.cdc.gov or your local state health department.