Zika virus and pregnancy: what you need to know

As Public Health England advises pregnant women and those trying for a baby to avoid travel to Zika virus affected areas, we ask what the risks really are

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There have been lots of headlines about the Zika virus over the last few years, many of which concern pregnant women and those trying to conceive.

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So, in this article, we’ll share the latest travel guidance and safety info you need to know about. We’ll keep it up to date, too, so you know what you’re reading is the latest advice. 

What are the current guidelines about Zika?

If you’re trying to get pregnant, the NHS recommends you avoid becoming pregnant during trips to moderate or high risk areas while you are there, and for 8 weeks upon your return home.

Public Health England (PHE) advises that you stop trying for a month if your partner has just come back from a country listed as a high risk or moderate risk for the Zika virus by the European Centre for Disease Control (ECDC). It suggests your partner should wear a condom for 28 days. 

In addition, if your partner has visited one of the listed countries and has been diagnosed with the Zika virus or has developed an unexplained fever with similar symptoms, you’re advised to avoid trying for a baby for 6 months. 

If you’re already pregnant, you’re advised not to visit any of the listed countries. 

The NHS says you should postpone non-essential travel to high risk countries, and to consider postponing non-essential travel to moderate risk countries until you’re no longer pregnant.

So which countries are listed as high-risk or moderate risk for Zika virus transmission?

There are currently 74 countries listed by the Foreign Office as moderate or high risk, last updated in October 2018:

  • Angola
  • Anguilla
  • Antigua and Barbuda
  • Argentina
  • Aruba
  • Bahamas
  • Bangladesh
  • Barbados
  • Belize
  • Bolivia
  • Bonaire
  • Brazil
  • Burkina Faso
  • Burma (Myanmar)
  • Burundi
  • Cambodia
  • Cameroon
  • Cape Verde
  • Central African Republic
  • Colombia
  • Costa Rica
  • Cote D’Ivoire
  • Cuba
  • Curacao
  • Dominica
  • Dominican Republic
  • Ecuador
  • El Salvador
  • Fiji
  • French Guiana
  • Gabon
  • Grenada
  • Guatemala
  • Guinea-Bissau
  • Guyana
  • Haiti
  • Honduras
  • India, particularly Rajasthan 
  • Indonesia
  • Jamaica
  • Laos
  • Malaysia
  • Maldives
  • Mexico
  • Montserrat
  • Nicaragua
  • Nigeria
  • Panama
  • Papua New Guinea
  • Paraguay
  • Peru
  • Philippines
  • Puerto Rico
  • Saba
  • Saint Kitts and Nevis
  • Saint Lucia
  • Saint Martin
  • Saint Vincent and the Grenadines
  • Samoa
  • Senegal
  • Singapore
  • Sint Eustatius
  • Sint Maarten
  • Solomon Islands
  • Suriname
  • Thailand
  • Tonga
  • Trinidad and Tobago
  • Turks and Caicos Islands
  • Uganda
  • US Virgin Islands
  • Venezuela
  • Vietnam
  • Virgin Islands (British).

We’d advise you keep an eye on the gov.uk official website, too, if you’re planning a visit abroad during your pregnancy, as their list is updated periodically.

Now, Zika is thought to have originated in Africa and spread to Asia through a particular species of mosquito – Aedes aegypti – but all previous outbreaks have been small.

In 2015 and 2016, it was reported as having an ‘explosive pandemic re-emergence’, according to the US National Institutes of Health.

However, there is no evidence that the mosquito has ever been found in the UK. 

Can I go to Florida and the US if I’m pregnant?

In July 2016, PHE advised pregnant women to consider postponing non-essential trips to the US state of Florida, after US authorities confirmed 4 cases of the Zika virus being transmitted by local mosquitoes. 

Up until this point, most Zika cases in the US were connected to people who’d caught the virus outside of the US. The state was then considered to have a ‘moderate risk’ of catching Zika.

As of January 2019, the state of Florida is deemed a ‘low risk’ Zika area, as is the state of Texas – according to the Foreign Office and the National Travel Health Network and Centre NaTHNaC.

NaTHNaC advises travellers to Florida and Texas to avoid mosquito bites, particularly between dusk and dawn, and to visit their GP if they are symptomatic upon return to the UK. 

The rest of the US, as far as we are aware, is not a risk for Zika virus. Generally, though, taking steps to avoid mozzie bites is a good idea wherever you go.

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What are the risks if I get the Zika virus when I’m pregnant?

The NHS reports that scientists have concluded there’s enough evidence to show that the Zika virus could trigger a birth defect called microcephaly.

This describes when babies are born with a very small head and an underdeveloped brain. Microcephaly can be deadly if the brain is so under-developed that it can’t sustain regular body functions.

Since the Zika virus outbreak in Brazil started in 2015, there have been a growing number of babies born there with microcephaly.

However, no direct link has actually yet been confirmed between Zika and microcephaly; it’s just that no other explanation for the surge in microcephaly cases has been found – and a number of Brazilian babies who have died were found to have the virus.

There are also some newer indications, documented in Brazil, that Zika infection in pregnancy may, additionally, be linked to serious eye abnormalities that could lead to blindness.

“A causal link between Zika infection and birth malformations and neurological syndromes has not yet been established,” the World Health Organisation (WHO) Director General Margaret Chan said at the time, “but is strongly suspected.

“The possible links, only recently suspected, have rapidly changed the risk profile of Zika, from a mild threat to one of alarming proportions.” 

How do you get infected by the Zika virus?

You get infected with the Zika virus by the bite of the Aedes aegypti mosquito – a type of mosquito that is found in all countries in the Americas (including the United States), apart from Canada and Chile. Zika is only spreading in countries that host the Aedes aegypti mosquito; it is not found in the UK.

If the Aedes aegypti mosquito that bites you has previously come into contact with the blood of an infected person it’s previously bitten, then it can transmit the virus to you.

Anyone living in a country which is host to the Aedes aegypti mosquito is at risk of catching Zika. This includes all countries in north, central and south America (with the exception of Canada and Chile).

There is also a risk that Zika will spread to countries in Asia and the Pacific which also host the Aedes aegypti mosquito.

Can I catch the infection from someone who already has it?

You cannot catch the virus just from coming into contact with an infected person but the PHE says there is a “low risk” that Zika can be transmitted sexually.

The WHO has stated that the Zika virus has been isolated in human semen, and one case of possible person-to-person sexual transmission has been noted.

While the experts look for more evidence to confirm whether or not the Zika virus can be sexually transmitted, the precautionary advice, in the meanwhile, is always to use a condom if having sex with someone who has been infected with the Zika virus less than 6 months previously or who has travelled to a country affected by the Zika virus in the past month.

“If a female partner is at risk of getting pregnant,” says the PHE, “or is already pregnant, condom use is advised for a male traveller for 28 days after this return from a Zika transmission area, [even] if he has no symptoms of fever and rash.”

And, says the PHE,  if Zika infection is confirmed, “condom use is advised for 6 months following recovery”.

What are the symptoms?

Up to 80% of those infected with the Zika virus show no symptoms at all. Others have symptoms including:

  • conjunctivitis
  • mild fever
  • headache
  • joint pain
  • rash

Symptoms can be treated but there is no cure or vaccine for the virus itself yet.

Last updated January 2019

Images: Getty Images

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