I’m definitely not an alarmist! I traveled with my own children in the early months of their lives, often to relatively remote locales with minimal resources at hand. I have, like many of my patient families, tried to be prepared while traveling, but never neurotic about travel in general. I want to see the world with my children, not in their absence. But just as we would avoid a war-torn region, disease risk at your travel destination needs to be considered.

Unfortunately, the Zika virus warrants our attention and if you are pregnant, perhaps a change to your travel itinerary. This virus is transmitted via mosquitos and generally results in a relatively mild syndrome – often just a fever, muscle aches, red eyes and a rash. There is no treatment, but as it is self-limited and sometimes subclinical, people often fail to realize they have been infected. However, in a pregnant woman, the fetus too can be affected and resultant brain damage has been clearly shown to occur. In fact, microcephalic (small head) newborns are being born with alarming frequency in areas hit by the Zika virus. Tragically, some fetuses fail to survive the insult altogether. Due to this deleterious secondary effect of infection, the CDC is officially warning pregnant women against travel to areas struggling with an outbreak of this virus. In addition, the CDC is now providing clear recommendations regarding conception attempts post travel to areas endemic with Zika.

Specifically, ‘women with a confirmed Zika infection should wait at least 8 weeks after symptom onset to attempt conception, and men afflicted with Zika should wait at least 6 months after symptom onset to attempt conception (as the virus lives in semen for an extended period of time). Women and men with possible exposure to the virus but without clinical illness should wait at least 8 weeks after exposure to attempt conception. Possible exposure to the Zika virus is defined as travel to an area where Zika infection is known to occur, or sex without a condom with a man who traveled to or resided in an area of active transmission.’*

The Zika virus, of course, is not the only virus capable of negatively affecting an unborn baby via transmission through an infected mother. I have patients that contracted confirmed cytomegalovirus and parvovirus infections in utero, with some resultant sequelae- namely deafness and profound fetal anemia. However, these cases are very random and thankfully rare. Most of us have immunity to both these diseases, acquired in our youth through a simple fever virus well before we become pregnant.  The trouble with the Zika virus, by comparison, is that we personally have never seen it – we are completely immune naïve to this virus and no vaccine currently exists to protect us from it.

According to this data, if you are pregnant, it makes sense to avoid these regions. In my opinion, it is simply not worth the exposure. Of course, if it is unavoidable then wear repellant (Picaridin or DEET), lightly colored pants/shirts and avoid being out at dusk. There is so much we can’t control when we are pregnant and despite our best efforts, we become ill, or suffer a fall, or some other unavoidable event occurs that puts our unborn baby at risk. We can only do the best we can, but at this point in time, we can control this specific risk by simply avoiding travel to these areas.

9+ months of pregnancy may feel like forever, but luckily it is not!!!

Latin America and the white sand beaches of the Caribbean will still be there…

 

*http://www.cdc.gov/mmwr/volumes/65/wr/mm6512e2.htm

http://www.cdc.gov/zika/pregnancy/question-answers.html

http://www.nytimes.com/2016/01/14/health/zika-virus-cdc-travel-warning-brazil-caribbean.html?WT.mc_id=SmartBriefs-Newsletter&WT.mc_ev=click&_r=0