The Ultimate FAQ on Zika Virus Infection

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Where in the U.S. are residents at risk?

The mosquitoes that spread Zika are found everywhere in North, Central, and South America except for Canada and continental Chile.

How frequent is the transmission of the virus via mosquitoes?

According to the CDC, between January 2015 to October 2018, 5,442 cases of Zika associated with travel and 231 locally transmitted cases were reported in the US. However, in 2018, no transmission of the virus through a mosquito. The CDC also said that detecting the local spread of the virus is difficult because an infected individual that will show symptoms at all may not show for up to 2 weeks after infection. Diagnosis and investigation of the suspected cases again will take weeks.

I am a pregnant woman living in an area where Zika virus is circulating, how can I protect myself?

The primary protection for every traveler is prevention against mosquito bites. Do all you can to ensure that a mosquito does not bite you. This includes proper covering of the body with appropriate clothing such that no part is exposed. The use of recommended repellants and adequate usage is also encouraged. Also, at every sleep time, sleep should be under treated nets. Prevention, they say, is better and cheaper than cure. Hence, all possible breeding sites for mosquitoes should be removed.

What measures should I put in place for my pregnancy even as I travel to a known endemic state?

It is advised that traveling, if possible, should not be until after delivery. If the travel is unavoidable, then you should speak to your healthcare provider for proper enlightenment and information about the risks involved.

How is Zika diagnosed?

To diagnose Zika, the health officer will take a good history and collect blood or urine as a specimen for test for Zika or similar viruses.

Is there any treatment for the infection caused by the Zika virus?

As of now, there is no approved vaccine or specific treatment for the infection. The treatment is aimed at providing relief for symptoms such as joint pain, headache, fever, red eyes, muscle pain, etc. The disease usually lasts for about two days to one week. The CDC recommends that infected individuals get plenty of rest and take enough fluids for proper hydration. Acetaminophen can also be taken to relieve fever and pain. A vaccine against the Zika virus is currently undergoing trials, and it is aimed at the production of antibodies that will protect against the infection and the complications associated.

Can infected mothers breastfeed their babies?

There is no established evidence of the transmission of the virus via breastmilk. The virus can be transmitted through breastmilk, but there is no established evidence to support the claim.

What is the connection between the Zika virus, pregnancy, and microcephaly?

Without any doubt, there are several causes of microcephaly in babies, which include maternal infections in pregnancy, genetic abnormalities, and exposure to teratogenic substances during pregnancy, especially during the first trimester. The CDC has said that research has confirmed that Zika can cause microcephaly in babies born to infected mothers. Microcephaly causes stunted growth in a baby's head, resulting in fatal brain damage and can, in turn, cause miscarriage or stillbirth. The research suggested that infection during the very early stage of pregnancy (the period where the baby's organs are still being formed) is associated with the worst outcomes. Ongoing studies are showing that fetuses can also be affected by the viral infection later in the pregnancy. There are also emerging proofs that microcephaly is not the only resultant effect of the Zika virus infection. A source from the CDC describes five types of congenital disabilities, which include severe microcephaly that is quite specific to the Zika virus, which means that they rarely occur with other infections in pregnancy. Congenital disabilities cause some effects in babies, which are known as congenital Zika syndrome. They are:

  • Decreased brain tissue with calcium deposits indicating brain damage
  • Damage to the back of the eye
  • Limited range of motion in joints, for example, clubfoot
  • Too much muscle tone restricting movement

As of 2018, records show that one hundred sixteen babies were born with congenital disabilities linked to Zika in the U.S.

What if I am pregnant, and I have traveled to the known Zika virus circulating zones?

The CDC suggests that it is essential that you speak with your doctor. You will be screened, and your baby's health will be checked. If you are down with any likely symptoms, other similar diseases like Dengue will be ruled out. A pregnant woman who returned from an area with the Zika virus will be tested 2 to 12 weeks after return, even if they are yet to show any symptoms.

However, if the woman is found to have the virus, the baby’s growth is monitored on ultrasound every 3 to 4 weeks.

Can Zika lead to other health conditions?

Apart from the link between Zika and microcephaly, other rare associated cases have been recorded. Guillain-Barre syndrome has been linked to Zika. It is a disorder that can cause partial or complete paralysis, which usually starts from the legs temporarily. An increase in the occurrence of this illness has been seen in areas where the Zika outbreak has been recorded, such as French Polynesia and Brazil. Studies show a link between Zika and the syndrome. Research by the CDC shows that the syndrome is strongly associated with Zika, although only a small portion of infected persons come down with the disorder.

Evidence, as given by research presented at the American Academy of Neurology conference, has shown that there might be a link between Zika and an autoimmune disorder known as acute disseminated encephalomyelitis (ADEM). Any individual with this disorder will have the immune system attacking the myelin sheath covering the nerve fibers in the brain and spinal cord in a similar fashion to multiple sclerosis.

In March 2016, doctors reported the first case of brain swelling linked to Zika in a man of 81 years who was on a South Pacific cruise. He had a fever and went into a coma. He was said to have the swelling of the membranes that cover the brain and spinal cord (otherwise known as meningoencephalitis). The Zika virus was found in his spinal cord. The man was admitted and recovered after 38 days. In that same year, the CDC announced the first death linked to Zika in Puerto Rico. The death of a 70-year-old man was as a result of severe thrombocytopenia. There was a reduction in the level of platelets in the blood, so there was internal bleeding.

How are you tested for Zika?

There are certain ways to test for the Zika virus. One is to test for elements of the virus's genetic code in people with active infections. After the body clears the infection, which is like about two weeks after symptoms appear, the test will not work correctly. The new version of this test is now in the qualified labs, according to the CDC. The FDA has approved this test because it can distinguish whether an individual has dengue, chikungunya, or Zika instead of having to do different tests. Many people do not know when they are infected because they do not have symptoms and are not eligible for this test.

The second test looks for antibodies that have been produced by the body’s immune system to fight the virus. The test can still find the antibodies in the blood even up to 3 months after the infection. This test is not very specific as it can mistakenly show that a person has had Zika also if they have been infected with other viruses such as dengue and chikungunya. A positive or indeterminate result means a follow-up test should be done by the CDC or a lab authorized by CDC. The first phase of the second test ahs been approved by the FDA and the CDC is distributing it to laboratories qualified for it.

Which countries appear in the CDC travel warning for pregnant women?

Pregnant women in all trimesters have been warned by the CDC to delay any travel to several countries and regions where Zika transmission is ongoing or has been recorded. The list changes and frequent review is needed because some countries are added while some become low risk. If a pregnant woman must travel, the CDC advises that the health care provider should be contacted, and steps to avoid mosquito bites should be strictly followed during and after the trip. The CDC has also given a "special travel consideration" for about 11 Southeast Asian countries where the spread of the Zika virus has been reported or is close to countries with the reported transmission. The consideration is that there is no travel warning for these countries. Still, pregnant women have been advised to consider rescheduling nonessential travel to these countries because the risk of Zika virus infection is uncertain. The countries are Brunei, Burma (Myanmar), Cambodia, Indonesia, Laos, Maldives, Philippines, Thailand, Timor-Leste (East Timor), and Vietnam.

How can I protect myself from the infection?

These simple steps will help protect you from the Zika virus. The first thing is the use of EPA-approved (Environment Protection Agency) insect repellent. This will help to protect you against mosquito bites. Another important thing is to get rid of anything that can hold water around the home that can encourage the breeding of mosquitoes. If you are in an area where Zika is circulating, or you are traveling to an endemic region, your clothing should be appropriate. This means that you should go for clothing items that will cover your body with no exposure. Your hands, arm, legs, and everything should be covered. The mosquito species carrying the virus can bite both within the house or outside. Hence, proper covering of the body should always be done and at all times. If you or your sexual partner have been exposed to Zika, then prevent the spread by using condoms during sex or practice abstinence, especially during pregnancy. The use of both male and female condoms reduces the chances of getting Zika from sex. For maximum effectiveness, condoms should be used from the beginning of the sexual activity till the end. This applies to vaginal, anal, oral sex, and the use of sex toys.

Will my future pregnancies be at risk if I am infected with the Zika virus?

No evidence supports that a woman who has recovered from the virus infection will have complications related to Zika in pregnancy. However, based on information about similar infections, once a person has been infected with the virus, and it has been cleared, it is likely that the individual will be protected from future Zika infections. If you intend to have a baby soon and you or your partner live or have traveled to an area with risk of Zika, talk to your healthcare provider.

Which insect repellents are effective in preventing infections caused by mosquito bites?

To prevent Zika and other mosquito-borne diseases, use EPA-approved insect repellent on uncovered skin. The repellent must contain the following: DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. For more extended protection, the active ingredients must be in higher percentages. Follow the label instructions when using insect repellent for maximum results.

How should insect repellents be used to prevent mosquito bites and the spread of the Zika virus in children?

Strict adherence to label instructions produces results. For children under three years of age, it is advisable not to use products containing oil of lemon eucalyptus or para-menthane-diol. If you want to apply the repellent on a child's face, an older person should apply onto their hands before application. Do not use the repellent to a child's hands, eyes, mouth, cuts, or inflamed skin.

What is CDC doing about Zika?

The Center for Disease Control is working hard to respond to the Zika virus outbreak. The CDC’s roles include developing laboratory tests to diagnose Zika, conducting research and studies to learn more about Zika, publish reports about the virus, monitoring and reporting cases of Zika, providing guidance to travelers and Americans living in areas with outbreaks, providing support to countries and US territories with current Zika outbreaks and more.

What should I do if I am sick or a relative is sick?

Many individuals who get infected with Zika come down with little or no symptoms, which will last for about a week. If you notice symptoms of Zika (such as fever, rash, headache, joint pain, red eyes, or muscle pain) and you reside in or have recently traveled to a region with Zika virus circulating, you should consult your doctor or healthcare provider who will ask about your symptoms and recent travel. Like we have pointed out, there is no specific treatment for Zika, but you can relieve the symptoms. In case you are diagnosed with Zika, you need to protect those around you by taking steps to prevent mosquito bites and sexual transmission of Zika virus. Zika can generally be found in the blood during approximately the first week of infection and can be passed to another person through mosquito bites. This will help prevent others from getting sick by strictly adhering steps in avoiding mosquito bites during the first week of the disease.

Is Zika similar to other mosquito-borne illnesses such as dengue, West Nile, or chikungunya fever?

All of them can cause symptoms like flu, which vary in severity and duration. For Zika, few people infected with dengue or chikungunya will show any symptoms. The same type of mosquitoes that spread Zika also spread both Chikungunya and Dengue, but many different types of mosquitoes spread the West Nile virus. Zika is one of those viruses known to be spread via sexual contact.