Zika: Guidance for Women of Childbearing Age
This is the time our year that our patients are traveling to warmer climes or planning that springtime getaway. Such travel for women of childbearing age and who are pregnant or planning to become so in the near future, however, needs be considered in relation to the emerging risks of Zika Virus Disease. Areas with ongoing Zika transmission can be easily obtained at: http://wwwnc.cdc.gov/travel/notices/
On January 19, 2016, the CDC posted “Interim Guidelines for Pregnant Women During a Zika Virus Outbreak” on its website: http://www.cdc.gov/mmwr/volumes/65/wr/mm6502e1er.htm. The guidance can be distilled into four basic points:
- Include travel history and future travel plans during all visits with pregnant patients
- Pregnant women should postpone any travel to locations wherein Zika transmission is occurring
- Infection can occur in any trimester
- It is still unclear if Zika causes fetal loss and to what extent it leads to microcephaly
- Should travel be necessary, strict adherence to mosquito avoidance must be followed
- Mosquito repellent containing DEET, picardin and IR3535 are safe during pregnancy
- See: http://wwwnc.cdc.gov/travel/page/avoid-bug-bites
- Management for pregnant women with travel to areas of ongoing transmission includes:
- Fetal ultrasound for all to assess for microcephalus and/or intracranial calcifications
- Asking about Zika virus disease symptoms: acute fever, maculopapular rash, arthralgia, conjunctivitis
- Testing for infection in those with 2 or more symptoms during travel or within 2 weeks of travel (any testing should be done in conjunction with your public health department)
- A nice management flow sheet is available at: http://www.cdc.gov/mmwr/volumes/65/wr/mm6502e1er.htm
Finally, keep in mind that Zika virus disease is a rapidly evolving situation. Information and guidance is likely to change and be updated as we learn more of this mosquito-borne infection. Current information is easily available at: http://www.cdc.gov/zika/.
References
- Petersen EE, Staples E, Meaney-Delman D, Fischer M, Ellington SR, Callaghan WM, Jamieson DJ. Interim Guidelines for Pregnant Women During a Zika Virus Outbreak — United States, 2016. MMWR January 22, 2016 / 65(2);30–33. http://www.cdc.gov/mmwr/volumes/65/wr/mm6502e1er.htm
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