News, Your Health Seth Stratton | one year ago

Zika Virus: Your Top Questions Answered

As researchers learn more about the Zika virus – how it spreads, why it’s dangerous and what its long-term effects are – many of us are still left with basic questions.

Editor’s note: This is the third article of a three-part series -- read the first and second articles -- related the Zika virus.  A few of the experts at Carolinas HealthCare System – Catherine Passaretti, MD, medical director of infection prevention; Stephanie Strollo, MD, hospital epidemiologist; and Grant Campbell, MD, certified obstetrician/gynecologist – have answers.

1. What is the Zika virus and what are its symptoms? 

Zika is a viral infection spread mainly by the bite of the Aedes aegypti mosquito. Common symptoms (fever, rash, muscle aches, joint pain and eye redness) usually appear within two weeks of traveling to an area with Zika. However, 80 percent of people do not display any symptoms.

2. How do I get Zika?

The most common cause of Zika is being bitten by an infected Aedes aegypti mosquito. Zika can also be spread through the following:
  • Sexual contact including vaginal, anal and oral sex, and through the sharing of sex toys
  • Through bodily fluids such as blood, semen or vaginal secretions
  • Pregnant women can pass on the virus to their fetus

3. Are there cases of the Zika virus in the United States, and is the mosquito that carries it here?

Yes to both. The carrier mosquito lives in 30 states, including North Carolina. There are more than 43 locally-acquired mosquito borne cases of Zika in South Florida. In addition, there are more than 2,900 cases of Zika in people who traveled to affected areas.

4. What areas do I need to avoid when traveling?

Pregnant women, women who wish to become pregnant and their partners are encouraged to avoid areas with Zika. This includes many areas in Central and South America, Cape Verde, the Caribbean, Mexico, specific areas in South Florida, the Pacific Islands, and Singapore. Check with the CDC for the latest travel restrictions. If travel is unavoidable, the best prevention is to avoid mosquito bites.

5. What is the danger of Zika infection during pregnancy, and what trimester is the most dangerous time to be infected?

Zika during pregnancy has been linked to birth defects and brain abnormalities. Pregnant women can be infected with Zika in any trimester, but the impact of the infection is likely greater earlier in a pregnancy.

6. If I'm pregnant and think I have been infected, when should I be tested?

Pregnant women who live in or have a history of travel to an area where Zika virus transmission is ongoing should be tested for Zika virus if they have any of the following:
  • Travel to an area with Zika virus transmission within the prior 12 weeks;
  • Report any symptoms of Zika within two weeks of being bitten by mosquitoes or returning from a Zika-affected area;
  • Have ultrasound findings of microcephaly or intracranial calcifications;
  • Pregnant women who have had unprotected sex with a partner returning from a Zika-affected area.
In addition, providers may consider testing individuals who did not travel to a Zika-affected area but have had at least three Zika virus infection symptoms (fever, rash, muscle aches, joint pain and eye redness) in the past 14 days not explained by another medical issue AND have a history of mosquito bite(s) within two weeks of their symptoms.

7. What happens if I'm pregnant and I test positive?

Pregnant patients should have ongoing ultrasound evaluations to look for signs of microcephaly (small head) or other brain defects. Keep in mind, a false-positive test is possible.

8. How long should a woman infected with Zika wait before trying to conceive and will it harm future pregnancies?

Women diagnosed with Zika should wait at least eight weeks after symptoms appear before trying to conceive either naturally or with fertility treatments. Men diagnosed with symptomatic Zika virus infection should wait six months after symptoms resolve before attempting to conceive.  There is no data to show that previously infected people will have issues with future pregnancies.

9. Are there any other conditions associated with Zika?

In addition to microcephaly and brain development, Zika has been associated with developmental and eye abnormalities in the fetus and neurologic defects including Guillain Barre Syndrome and acute disseminated encephalomyelitis in infected individuals.

10. Can I breastfeed if I have the Zika virus? a

While elements of the Zika virus have been detected in breast milk, there have been no reported cases of Zika virus transmission from breastfeeding. Because of the benefits of breastfeeding, mothers are encouraged to breastfeed even in areas with the Zika virus.