With the winter holidays behind us and this exceptionally cold winter, many of us have our eyes on a sunny beach for spring break. The media reports decreased concerns for Zika infection and less stringent testing guidelines for pregnant women and couples trying to conceive. This reflects a decrease in the incidence of Zika in the Americas and an evolving understanding of the infection. Although certainly a relief for many women and families, it is not a ‘free and clear’ for all couples to spend their spring break vacation on any sunny beach.
The CDC makes it easy to see where there are risks of Zika infection with this color coded map.
What We Know About Zika:
- Pregnant women infected with Zika are at increased risk for having babies with brain damage and microcephaly, hearing loss, vision problems and difficulty moving their limbs, but we can’t predict which infected women will have affected fetuses or not. Some babies may be born appearing normal and develop Zika-related problems later.
- Zika is spread by mosquito bites from infected mosquitos or by having sexual relations with someone who is infected with Zika.
- Persons infected with Zika may have no symptoms.
- There is no vaccine nor treatment for Zika infection.
- There are tests for Zika infection in humans, but no test is 100% accurate.
- There were 2,364 pregnant women with laboratory evidence of Zika infection in the US and DC between 2015 and 2017.
- 1 out of 10 pregnant women confirmed to have Zika infection had a fetus or baby with Zika-related abnormalities in 2016 in North America.
- All persons (including pregnant women) with Zika symptoms, which can be found here, and possible Zika exposure should get tested for Zika infection.
- It is recommended that anyone who travels to an area with Zika risk use mosquito repellant for 3 weeks after returning to reduce the risk of transmitting Zika to a domestic mosquito that could then bite and infect another person
What You Should Know If You are Pregnant or Trying to Become Pregnant:
Pregnant women should not travel to areas with risk of Zika infection or have unprotected sex with someone infected with Zika. Sex includes vaginal, anal, or oral sex, and the sharing of sex toys.
If a pregnant woman must travel to an area with active Zika transmission, she should follow precautions to reduce her risk of mosquito bites such as using endorsed insect repellants, wearing long clothes, keeping screens and windows closed. More information on preventing mosquito bites can be found here.
Asymptomatic pregnant women with ongoing Zika infection risk should be offered testing.
Pregnant women or women trying to conceive who had possible Zika exposure but never manifested symptoms of ZIka infection do NOT need to be tested. This is a recent change in the guidelines.
If a woman travels to an area with Zika risk or has confirmed Zika infection she should consider waiting 8 weeks from symptom onset or departure from the area of risk before trying to conceive.
If a male partner travels to an area with Zika risk or has confirmed Zika infection he should wait 6 months before trying to impregnate his partner.
If a partner of a pregnant woman travels to an area with Zika risk they should abstain from sex, use condoms 100% and not share sex toys to avoid potential infection of the pregnant mom for the duration of the pregnancy.
Although we do not anticipate having widespread Zika-infected mosquitos in St. Louis this summer, mosquitos carry other illnesses such as West Nile and pregnant women should practice good mosquito bite prevention. Using insect repellants with DEET is highly effective and using DEET as an insect repellant is considered generally safe in pregnancy. More information about DEET can be found here. You can use this tool to find the right insect repellant for you.
So Where Can I Go From Here?
Fortunately, there are many beautiful domestic and international beaches that do not have Zika infection risk, but you may need to be a little more selective in your searches if you are pregnant, trying to get pregnant or planning to start trying to conceive soon. You may use the CDC map or choose to have a travel agent help you identify Zika-free locations that meet your desired features. Some may just chose a North American mountain or snowy 2018 spring break location and avoid the whole Zika discussion!
If your spring break destination is one with Zika risk, be sure you have discussed your personal reproductive plan with your OBGYN so you are armed with all the information you need. Many patients choose to delay conception to achieve personal travel goals; we all know traveling is easier before having kids! Your OBGYN can help you find the right personalized form of contraception to give you the family planning control you desire, but spring is just around the corner so don’t wait too long!
Rosanna Gray-Swain, MD, is a board-certified Ob/Gyn physician at West End Ob/Gyn. She can be reached at 314-286-2620 for appointments.