Congenital Zika Virus Syndrome

________________________________________________________________________

KEY POINTS

• Congenital Zika virus syndrome (CZVS) is a group of conditions that affects a baby who was exposed to the Zika virus during the pregnancy. Zika virus infection can be spread to a pregnant woman by mosquito bites or by having unprotected sex. It is not known how long the Zika virus stays in body fluids such as blood and semen.
• Zika virus infections in pregnant women can infect the baby and cause serious birth defects.
• The Centers for Disease Control and Prevention (CDC) recommends that women who are pregnant, or who might become pregnant, should NOT travel to areas where Zika virus has been reported.

________________________________________________________________________

What is congenital Zika virus syndrome?

A pregnant woman who has Zika virus can pass the virus to her baby before birth or around the time of birth.

Congenital Zika virus syndrome (CZVS) is a group of conditions that affects a baby who was exposed to the Zika virus during the pregnancy.

Congenital Zika virus infection means that the baby gets an infection when born or shortly after birth. The baby may not have some of the physical problems seen with CZVS at first, but the baby may develop problems later.

What is the cause?

Zika virus may be passed from a woman to her unborn baby, which can cause serious birth defects. Anyone can be infected with the Zika virus when bitten by an infected Aedes mosquito. These mosquitoes pass the virus to you when they bite you.

Aedes mosquitoes are found in the US in some southern and central states, as well as in the Caribbean, Central America, South America, Africa, southern Europe, and Southeast Asia. This kind of mosquito tends to bite both during daytime and at night. Mosquitos in some parts of the US have infected people with Zika virus.

Zika virus may also be spread by contact with infected blood such as by blood transfusion, organ transplant, or the sharing of needles or syringes contaminated with blood. Zika virus is also spread through sexual contact.

The disease can be spread by people who do not have any symptoms and may not know they carry the virus. It is not known how long the Zika virus stays in body fluids such as blood and semen after you are exposed to the virus.

What are the symptoms?

A baby born with suspected CZVS may have physical and mental problems including:

• A small head and brain that has not developed properly
• Eye damage that affects vision
• Joint problems, including club foot, which is a problem with how a baby’s foot develops
• Problems with muscle tightness, which may affect the baby’s ability to move

As these babies grow, they may have problems with eating, vision, hearing, and learning. They may have seizures, delays in walking and talking, and other problems. Some children are affected more severely than others. If the brain is badly damaged or the baby has a severe infection, the baby may die.

How is it diagnosed?

Before your baby is delivered:

• You should be asked about exposure to Zika virus at every prenatal visit. If you have symptoms of Zika virus, or if you have ongoing possible exposure, you should have blood tests for Zika virus 3 times during your pregnancy, even if you don’t have symptoms.
• You should be tested right away if:
  • You have symptoms of Zika virus
  • The prenatal ultrasound shows that the baby might have CZVS
• If you have Zika virus symptoms or test positive for Zika virus, your baby should have tests within 2 days of birth.

After your baby is delivered:

• You baby’s healthcare provider will ask about your pregnancy and examine your baby including:
  • Measuring your baby’s head
  • A neurological exam
  • An eye exam
• Tests may include:
  • An ultrasound of the head
  • A newborn hearing test
  • Neurological tests
  • Blood tests

How is it treated?

There is no medicine that cures Zika virus or CZVS. Treatment may include:

• Working with medical specialists, therapists, teachers, and social workers to help with:
  • Breathing issues because of weak chest muscles
  • Feeding and nutrition issues because of swallowing problems and weak muscles
  • Neurological problems such as seizures
  • Heart problems
  • Infections from other causes
  • Delays with sitting, crawling, or walking because of muscle tightness or problems with the bones
  • Delays with speaking and learning
  • Hearing or vision problems
  • Emotional and social support for the caregivers and family members
  • Accessing community services

Your baby will need ongoing care, and the types of specialists and therapists needed may change over time. Your toddler or older child should also have regular visits for routine health care such as vaccines and dental checkups.

How can I take care of my baby?

Follow the full course of treatment prescribed by your baby’s healthcare providers. Ask any questions you have about how to take care of your baby at home. Make sure you know when your baby should come back for follow-up care.

How can I help prevent Zika virus for myself and for my baby?

Zika virus infections in pregnant women can infect the baby and cause serious birth defects. The Centers for Disease Control and Prevention (CDC) recommends that women who are pregnant, or who might become pregnant, should NOT travel to areas where Zika virus has been reported.

If you are pregnant and live in or must travel to areas with risk of Zika, use condoms the right way from start to finish every time you have oral, vaginal, or anal sex. Another option is to not have sex during your entire pregnancy. Also, protect yourself from mosquito bites.

Take these precautions to avoid mosquito bites:

• If you are planning to travel:
  • Schedule travel to tropical areas during seasons when mosquitoes are less active.
  • Stay in places that are clean, insect-free, and have air conditioning, window screens, or mosquito nets.
• Avoid wearing perfume or other scented products because they can attract mosquitoes.
• Wear long pants and long-sleeved shirts.
• Use an insect repellent whenever you are outdoors. Don't use more repellent than recommended in the package directions. Don't put repellent on open wounds or rashes. Don’t put it near your eyes or mouth. When using sprays for the skin, don’t spray the repellent directly on your face. Spray the repellent on your hands first and then put it on your face. Then wash the spray off your hands.
  • Adults should use repellent products with no more than 35% DEET. Wash it off your body when you go back indoors.
  • Picaridin may irritate the skin less than DEET and appears to be just as effective.
  • Spray clothes with repellents because mosquitoes may bite through thin clothing. Products containing permethrin are recommended for use on clothing, shoes, bed nets, and camping gear. Permethrin-treated clothing repels and kills ticks, mosquitoes, and other insects and can keep working after laundering. Permethrin should be reapplied to clothing according to the instructions on the product label. Some commercial products are available pretreated with permethrin. Permethrin does not work as a repellent when it is put on the skin.
  • In some studies, oil of lemon eucalyptus, a plant-based repellent, provided as much protection as repellents with low concentrations of DEET, but it hasn't been as well tested as DEET. Oil of lemon eucalyptus should not be used on children under age 3.
• Install or repair window and door screens so it is harder for mosquitoes to get indoors.
• Mosquitoes lay eggs in water. To reduce mosquito breeding, drain standing water. Routinely empty water from flowerpots, pet bowls, clogged rain gutters, swimming pool covers, buckets, barrels, cans, and other items that collect water.

To prevent sexually transmitted disease, choose not to have sex, or use latex or polyurethane condoms the right way during foreplay and every time you have vaginal, oral, or anal sex. Use condoms for at least 3 months after the last possible exposure.

Zika virus has been shown to live in a male’s semen longer than in other body fluids. If a male has been diagnosed or has had symptoms of Zika virus, he should continue to use condoms for at least 3 months.

For more information, contact:

• Centers for Disease Control and Prevention
  800-232-4636
  https://www.cdc.gov