Dr. Bill Goodnight is an associate professor of maternal-fetal medicine at UNC OB-GYN.
Does Zika virus cause miscarriage?
Recent case reports have demonstrated the Zika virus found following an early miscarriage. This is not entirely unexpected as other viral infections have been associated with early pregnancy complications (parvovirus, CMV) and supports that the fetus is most sensitive to infection in the first half of pregnancy.
There are some precautions women can take. Those attempting pregnancy or currently pregnant should use the same Zika precautions as recommended for all — avoid travel to affected areas, use insect repellant and avoid intercourse with partners with Zika exposure risk or use a condom with intercourse.
Whether Zika can cause or miscarriage remains unproven, but this does suggests an association. However, this does not change recommendations for testing and does not suggest that all miscarriages should be tested for Zika virus.
Were the new cases in Florida acquired there?
There are four cases in Florida, three men and one woman, all in one part of one county, that appear to be locally acquired, not a travel-related infection. This means the human infection came from mosquito bites in Florida, implying that some mosquitos in Florida now carry the Zika virus. Casual person-to-person transmission of Zika does not appear occur.
This was not all that unexpected, as we know that the range of the mosquito that carries the Zika virus includes Florida, the South East and southern U.S. It is recommend that pregnant women continue to practice avoidance techniques to avoid risk of acquiring Zika. Sleep in air-conditioned or screened areas, use insect repellant, avoid travel to areas with active local transmission and use condoms for intercourse with partner who may have Zika exposure.
Should pregnant women cancel vacations to Florida this summer?
The CDC does not currently include Florida in its Zika travel advisory, but if in the next few weeks these cases are confirmed, pregnant women may need to consider avoiding unnecessary travel to Florida. In addition, those living in Florida should continue to use mosquito avoidance practices. The most up to date information on areas where pregnant women should limit travel includes the CDC website: www.cdc.gov and the Florida health department website.
What’s new with Zika?
The most recent CDC updates (as of 7/25/16) include changes in the type of maternal testing — RT-PCR test is used for the detection of the virus in urine and serum, and can now be done up to two weeks after exposure.
Ultrasound monitoring remains unchanged and includes a detailed anatomic evaluation and follow up ultrasounds based on results of maternal testing (if done) and potential for exposure: http://www.cdc.gov/zika/pdfs/testing_algorithm.pdf