risks of zika virus

the greatest risk really seems to be inthat first trimester of pregnancy so for women who are trying to becomepregnant or who are pregnant the biggest concern is really to avoidexposure to the virus and that is best done right now by limiting travel to those areas wherewe know that zika virus is being transmitted and if you're in those areasto avoid mosquito bites as much as possible we don't have definitive proof of howzika actually is transmitted from the mother to the fetus

there is transmission or passage of thevirus from the maternal blood stream into the fetal blood stream across theplacenta at least one study that shown that you can find high levels of thevirus in the placenta and the membranes of a fetus that's been infected withzika virus and so that probably represents a place where the virus isharbored or stays for a long period of time and provides continued exposure tothe virus for both the mother and the baby women who are traveling and it's mainlyto the tropical areas and subtropical areas should discuss this with theirphysician prior to going on these trips

ideally if they're pregnant or planningto become pregnant in the near future the current recommendation is to delaythat travel any pregnant woman who has traveled to an area where zika virustransmission has been reported should notify their doctor immediately uponreturning the current recommendations are for pregnant women who have traveledto these areas or who have spent a considerable amount of time in the theseareas those women should have testing regardless of whether they havesymptoms or not in any woman who is symptomatic sheshould immediately notify her physician so that they can begin the process ofevaluating her and her fetus to

determine if there is significant riskof transmission at least as of today all of the zika virus infections that havebeen reported in the united states have been associated with travel to thecountries where the virus transmission has been documented there has not been adocumented case where someone has acquired zika virus much less a pregnantwoman acquired zika virus in the united states from a mosquito or in the absenceof a travel history so at least as of today that risk ofanyone who is bitten by mosquitoes in the united states of acquiring zika isvery low right now if one of my patients were to come to me and say that she hada trip planned to one of the countries

or regions where zika virus transmissionhas been reported and she was currently pregnant i would recommend to her thatshe delay that trip or cancel that trip to the time when she's no longerpregnant while there are things that can be done to reduce the risk of mosquitobites it still may not be perfect and there still is that theoretical risk ofexposure while initially everyone focused on microcephaly meaning a smallhead measurement what we know is that there are a lot ofother effects that can occur with zika virus as well the virus seems to affect the braintissue and

kills or prevents the brain tissue fromgrowing normally it seems to provoke through that process an immense immune response that can affect the brain tissue as well as other developingtissues and so there are certain brain and other than just microcephaly thereare other brain abnormalities that can occur there are problems that can occurin the eyes and with the retina hearing loss has been reported there's also an increased risk ofstillbirth and it's thought to be related to the fact that there are suchhigh viral levels in the placenta that then affect the placental function andmay lead to stillbirth there

microcephaly itself has a lot ofdifferent causes and the ultimate determination of what the impact ofmicrocephaly is on that child's long-term outcome depends on the causeand depends on what the underlying problems in the brain are most infantsthat have microcephaly and the brain abnormalities to the extent of what's been describedwith zika virus will have severe neurologic issues there i think they maybe at increased risk for seizures certainly developmental delay and anumber of other neurologic abnormalities making a diagnosis of zika virus

prior to birth we have no treatmentsthat we can particularly use it's a matter of symptomatic treatment for themother and surveillance for that mother and that may be through the remainder ofpregnancy following birth for infants that areborn with microcephaly related to zika virus there's no particular treatments that can be done to reversethe effects of the viral infection but the interventions are related towardswhatever the symptoms that that baby is born with are and then a matter of earlyintervention and addressing any special needs that that child has from an earlytime point on when an individual whether

it be a man or a woman but especiallyfor a woman per se who has a zika virus infection she will have that virus inher bloodstream for around one to two weeks she will then have the virus thatwe believe is circulating in her body through other organs and tissues and shemay shed that for a another up to two weeks or so while during pregnancy theplacenta may harbor the virus and allow it to be present for a longer period oftime after delivery that virus is typically clear it should not have anyeffects on future pregnancies the insect repellents that are on the market thatinclude deet or picaradin are thought to be safe

the insect repellents that contain deethave different concentrations of deet within them but the most common onesthat are out there have concentrations that are less than thirty percent andall the data that we have on deet suggest that it is safe to use duringpregnancy that there have been no adverse feel effects or birth defectsassociated with its use for pa caradin there has not been anythingassociated with increased risk of birth defects with its use either so both seem to be safe to use duringpregnancy spray it on clothes as opposed to sprayingit on their skin

to try to decrease some of the absorptionthat they might get and it will still help repel the insects for couplestrying to conceive right now one of the things that remains unknown is how long zika virus can be shed in male semen andso right now the best recommendation that we can make in terms of avoidingzika virus exposure in early pregnancy is for any couple that is trying toconceive or for any woman who is early pregnant that they avoid travel to areaswhere zika virus transmission has been documented and that if the male partnerhas traveled to these areas where zika virus transmission has occurred thatthey either abstain from intercourse or

use condoms regularly and correctly toavoid that exposure