Feb. 4, 2016
Recently there has been a lot of media reporting on the Zika virus. ONA has put together an easy FAQ about the Zika virus to help assist you with risk assessment and patient inquiries.
What is the Zika virus?
The Zika virus is a virus that is spread by the Aedes mosquito. This is the same mosquito that is responsible for the transmission of dengue, yellow fever, and chikungunya. The mosquito isn’t native to Oregon, but we may see patients in Oregon who have been traveling from areas where they can be exposed.
What are the symptoms of Zika?
The most common symptoms are fever, rash, joint pain and conjunctivitis. The illness is generally mild and is rarely fatal. The most risk is to pregnant women in the first and second trimesters. Symptoms will begin to appear 2-7 days after being bitten by the Aedes mosquito. The virus remains active in your blood for up to 2 weeks, making it important to continue to avoid mosquito bites so that further cases of Zika can be prevented. Only about 1 in 5 people who contract Zika will actually get sick.
How is Zika transmitted?
The virus is transmitted primarily through the bite of an infected Aedes mosquito. These particular mosquitos are aggressive daytime biters, although they do also bite at night. It can also be passed from a pregnant mother to her unborn child during pregnancy and around the time of birth. Zika can also be spread sexually. As such, if a pregnant woman has a partner that has traveled to a region with Zika activity, it is recommended they abstain from sex or use condoms every time they have vaginal, anal or oral sex for the duration of their pregnancy, If your partner has had Zika or Zika symptoms you should stop attempting to become pregnant until more research has been done.
What countries have Zika?
The Centers for Disease Control and Prevention (CDC) has a map of where Zika is currently being reported. Prior to 2015, outbreaks were limited to areas of Africa, Southeast Asia and the Pacific Islands. In May 2015, the virus was found in Brazil. There have been no locally transmitted cases in the United States – that is to say that the mosquitos that are in the US are not currently carriers or transmitters of the virus – however there have been several cases of travelers returning from Zika countries that have been infected while abroad.
How can people prevent becoming infected with Zika?
There is no current vaccination for Zika, although many companies are in the process of developing one. Currently, the best practice to prevent transmission is to avoid traveling to countries that are known to have a Zika outbreak. If you must travel, wear long sleeved shirts and long pants. Stay in places with air conditioning or that use window and door screens. Use United States Environmental Protection Agency (EPA) registered insect repellents. For a list of EPA-registered insect repellents please visit the EPA website here.
If you are traveling with infants and children, do not use repellent on babies younger than 2 months. Instead, dress them in long sleeves and long pants, use mosquito netting on cribs, strollers and carriers. You can also treat clothing with permethrin, or buy clothes already treated with permethrin and sleep under a mosquito net if you are outside or unable to protect yourself from bites.
Does Zika cause birth defects in pregnant women?
There have been reports of microcephaly in babies born to mothers infected with Zika. Knowledge of this link is evolving, but caution should be taken if you are pregnant or intend to become pregnant. If you are pregnant, consider postponing travel to any region with known Zika outbreaks. If you must travel, you should strictly follow the above steps to prevent mosquito bites during your trip.
What should I include in my assessment of pregnant patients?
Ask all pregnant women about recent travel, especially to areas with documented Zika activity. Ask all pregnant women about the presence of symptoms consistent with the Zika virus during or within two weeks of travel. In those with recent travel be alert for ultrasound findings for fetal microcephaly or intracranial calcifications.
What should be done if infection with Zika virus is confirmed?
In a pregnant patient with laboratory evidence of Zika, fetal growth and anatomy should be monitored via serial ultrasounds and referral to maternal fetal medicine or infectious disease is recommended. In a non-pregnant patient supportive care measures should be utilized and the person should avoid further mosquito bites to reduce additional transmission of the disease until symptoms have abated.
- For further information and for continued updates please visit the CDC website here
- Lucey, D. R., & Gostin, L. O. (2016). The Emerging Zika Pandemic: Enhancing Preparedness. JAMA.
- Hennessey, M. (2016). Zika virus spreads to new areas—region of the Americas, May 2015–January 2016. MMWR. Morbidity and Mortality Weekly Report, 65.
- Yakob, L., & Walker, T. (2016). Zika virus outbreak in the Americas: the need for novel mosquito control methods. The Lancet Global Health.
- Bogoch, I. I., Brady, O. J., Kraemer, M. U., German, M., Creatore, M. I., Kulkarni, M. A., ... & Watts, A. (2016). Anticipating the international spread of Zika virus from Brazil. The Lancet.
- Petersen, E. E. (2016). Interim guidelines for pregnant women during a Zika virus outbreak—United States, 2016. MMWR. Morbidity and mortality weekly report, 65.
- Schuler-Faccini, L. (2016). Possible Association Between Zika Virus Infection and Microcephaly—Brazil, 2015. MMWR. Morbidity and Mortality Weekly Report, 65.
- McCarthy, M. (2016). Zika virus outbreak prompts US to issue travel alert to pregnant women. BMJ, 352, i306.
- Goorhuis, A., von Eije, K. J., Douma, R. A., Rijnberg, N., van Vugt, M., Stijnis, C., & Grobusch, M. P. (2016). Zika virus and the risk of imported infection in returned travelers: implications for clinical care. Travel Medicine and Infectious Disease.