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Article published: 9/28/2016

Article published: 9/28/2016

zika virus

It’s impossible to turn on the news without a new headline about Zika virus. Zika is a flu-like virus which is spread by mosquitos. Symptoms are non-specific and include fever, joint pain, red eyes and a sandpaper red rash all over the body. Zika virus is particularly detrimental during pregnancy as it specifically targets neurons and brain cells for injury and destruction. Acquiring Zika in the first trimester of pregnancy can have devastating consequences for the pregnancy including miscarriage, late fetal loss, hearing loss, eye defects and growth problems as well as microcephaly (being born with a small brain and small head), brain damage and paralysis. 

Though initially confined to South America, there are now more than 2,200 cases reported nationwide which are mostly acquired outside of the U.S. However there are now locally transmitted cases in Florida and Texas and Louisiana are expected to be next. The good news is that Miami, Florida seems to at least temporarily be effectively controlling the mosquito population with pesticides and that summer is almost over and mosquito populations are waning. Attempts to fully eradicate mosquitos are likely to fail given that mosquitos can live in any stagnant water including puddles which crop up with every rainstorm. 

Zika in pregnancy

Zika is particularly concerning to people of childbearing age because of the potential impact on growing fetuses. It is like several other viruses (like chicken pox, toxoplasmosis, parvo virus and other "TORCH viruses") which, when acquired in the first trimester, can cause significant problems such as microcephaly (small head) and other eye and brain problems for the baby. However, if a woman gets Zika virus before getting pregnant and her immune system successfully clears it, there are no future problems expected. If a woman who is interested in starting her family gets the virus, and has no complications, she will process it and her body will have immunity to it in the future. Her pregnancy and her baby are thought to not be at high risk after that time. This is the same concept as getting chicken pox before pregnancy vs. someone who has never had it before getting it in early pregnancy. New onset chicken pox in the first trimester can cause big problems just as new onset Zika at any point in pregnancy (but particularly the first trimester) can. 

There are some experts who would advise women of childbearing age to use birth control until they have had the virus and cleared it after 1 week, after which point there is less risk for her pregnancy. As long as Zika does not cause complications (like a type of paralysis called Guillain-Barré syndrome), it could actually be preferable for women and children to actually get Zika and clear it with their immune system. It is obviously not recommended for anyone to deliberately get Zika, only to say that it is not nearly as much of a problem to women and children after the virus is cleared out of their system. 

why men should care about zika too

The male partner who gets Zika virus carries much more of a risk. For males, the virus has been found to remain in semen for up to 6 months and perhaps longer. They are following some index case patients and continue to discover that Zika is present longer than originally projected. If a female has not have the virus and comes into sexual contact with a male that has it in his semen, the virus is sexually transmitted. If the woman is pregnant and the male transmits the virus during her pregnancy this can have consequences. The CDC is now advising males who have risk factors for Zika to abstain from sexual contact during the entire pregnancy. And if couples are considering getting pregnant, it is much more important for the male partner to protect himself from Zika because of the longer lasting implications of the virus for males. There is so much we don't know about Zika that they discover every day. So stay tuned to the CDC for more details.