"Have you traveled outside the country lately?" is a common question asked in OB GYN offices of pregnant women lately. Suddenly we are being encouraged to cancel trips, watch for mosquitoes, and checking for Zika virus infection hot spots. This virus quickly became popularly known in nations with tropical and subtropical climates.
That is because these areas are mosquito habitats which are the great carriers of this nasty virus. The Zika virus infection can also be spread through means of sexual contact or bodily fluids. But mosquitoes are pests that spread the disease faster due to their ability to reproduce so quickly and bite people unaware there's a mosquito on them.
Needless to say the Zika virus quickly caught the attention of many expecting mothers, parents, and medical caregivers. For the majority of those people infected with Zika virus, it mimics symptoms of the common cold. Symptoms are usually mild and temporary. In 4 out of 5 people infected, there aren't even any symptoms to speak of. Another reason this disease is so tough, because it hides itself so well in our systems.
What caught everybody's attention then about this little virus that mosquitoes are spreading around? Pregnant mothers who are infected with Zika virus are the issue. Babies who are born that contracted Zika virus in the womb through their mothers have severe birth defects. These defects range in severity and in physical and mental effects.
In rare and extreme cases, some babies do not make it to term or are stillborn as a result.
15 How Does a Baby Contract Zika Virus?
Babies can contract the Zika virus infection in one of two ways: either he or she is bitten by a Zika carrying mosquito on their own or during pregnancy the mother contracts the virus which will cause severe birth defects. The virus has also been known to spread through sexual contact and blood transfusion which both could apply towards a pregnant mother more likely than a baby itself.
Although Zika virus recently spread to the United States, most cases are limited and contained. It is more common to be bitten by an infected mosquito in a tropical or subtropical climate. It has become a more common practice for doctors to ask about travel to these areas for both mom and her sexual partner.
Zika virus infection does not always show symptoms, but that doesn’t mean a pregnant woman (or anybody for that matter) could still be infected. A pregnant woman who has recently travelled somewhere that has active Zika virus transmission can take a test two to twelve weeks after her return.
Ultrasounds can also be performed to look for microcephaly or other brain abnormalities which are common side effects of the Zika virus. Amniocentesis can be used as well to screen for the Zika virus.
14 Immunity After Infection
The CDC suggests that once a person contracts Zika virus, it is highly likely that he or she will be immune from future infections. Babies who contract the virus while there are still fetuses are more likely to have lifelong complications and birth defects than people who are infected after birth. Those infected after birth are unlikely to be infected again.
Women who contract the Zika virus while pregnant and have a baby with birth defects will not necessarily have another baby with the same defects. It is unlikely that the next child will have any problems or complications especially in relation to the Zika virus infection.
Once a vaccine becomes available, it will be hopeful that more people will be immune to the Zika virus. Those who are vaccinated will be less likely to be infected and will hopefully lessen and prevent the spreading of the virus to those who cannot be vaccinated. Our own immune systems will gain resistance to the virus if infected.
13 Guillain-Barre Syndrome
Guillain-Barre Syndrome also known as GBS is suggested by CDC research to be strongly associated with the Zika virus; although, only a small portion of those who get the recent Zika virus contract GBS. Guillain-Barre Syndrome is rather rare and occurs for no clear reason. It is unlikely to develop in clusters or groups of people.
Guillain-Barre Syndrome is an uncommon sickness that affects the nervous system. A person’s immune system with this sickness damages its own nerve cells. GBS also causes muscle weakness especially in the arms and legs. In rare cases, this muscle weakness can also affect with the breathing muscles or even cause paralysis.
In addition to breathing troubles, the heart and blood pressure may fluctuate too. Half of the cases with GBS experience severe nerve pain. Slowed or weakened bladder or bowel functions are also common symptoms.
Guillain-Barre Syndrome usually lasts anywhere between a few weeks and several months. Most people who contract this illness fully recover; however, some may suffer permanent damage which is more likely if the person experiences severe symptoms early. Permanent damage is often in the form of minor weakness, numbness, or tingling. Five percent of people with GBS may experience a relapse as well.
Microcephaly is one of the most common problems caused by a mother contracting Zika virus infection during her pregnancy. Microcephaly is a birth defects that causes a baby to have a smaller head than other babies of the same age and gender. This can occur either as a result of a baby’s brain not developing correctly during pregnancy or because it stopped growing following birth. Microcephaly either occurs just by itself or in addition to other severe birth defects.
Along with abnormal head size, microcephaly has a variety of other symptoms. It can include seizures. A delay in development, usually speech or physical milestones, is common with microcephaly. Some have intellectual disabilities or problems with movement and balance. Hearing and vision problems are also common symptoms. These issues range in severeness but are usually lifelong. In severe cases of microcephaly, it can be life-threatening.
Microcephaly is not a common condition, but CDC research has concluded it is one of the most common side effects of Zika virus infection. It can either be diagnosed during pregnancy or after birth. During pregnancy, microcephaly is diagnosed by an ultrasound test in late second to early third trimester.
The ultrasound will show the baby’s head and gives a measurement of the head. After birth, microcephaly can be diagnosed by measuring the baby’s head circumference and comparing it to popular standards for that age and sex. Usually microcephaly is less than two standard deviations below the average or less than the 3rd percentile.
11 Life with Microcephaly
In some cases a newborn is labeled as microcephaly because their head is small enough for the diagnosis; however, the child shows no signs of impairment to his or her neurological function. Not all situations are so fortunate though. Some babies born with microcephaly die shortly after birth while others are stillborn.
Those who do survive for a longer time can have trouble moving their limbs along with feeding issues due to difficulty in swallowing and sucking. Developmental delays are often linked to microcephaly. Problems with hearing, speech, and vision are commonly associated and are attested to being a result of the underlying cause of microcephaly. Epilepsy, a seizure disorder, is commonly associated as well. These seizures have been linked to the reduction in life expectancy in those with microcephaly.
There is not much than can be done for a child with microcephaly. There is no miracle cure or treatment. Physical therapy along with speech therapy are begun as soon as possible to try and give the child the most improvement of their ability to function daily. Occupational therapy is often introduced as well. Highly trained caregivers are essential to support children and eventually adults who live with microcephaly.
10 Common Symptoms of Zika Virus
The most common symptoms of Zika virus other than severe birth defects if contracted with in utero are similar to that of a common cold. Fever and joint pain are usually associated with Zika virus along with muscle pains and headaches.
In addition some people experience a rash or red eyes. If contracted after birth most likely via mosquito bite, there will obviously not be any birth defects but baby may exhibit any of the common symptoms or none at all. Four out of five people infected by Zika virus show no symptoms. Those that do occur will most likely appear in the first two to seven days following being bit by an infected mosquito.
There are no medicines to cure Zika virus. Just as with most viruses, it is helpful to get a lot of rest and drink plenty of fluids. It is always important to stay hydrated. Although there is no medicine to specifically treat Zika virus, symptoms such as fever, muscle pain, and headaches can be treated with acetaminophen.
Babies who may have been exposed to Zika virus during pregnancy are often closely monitored during their first year. The doctor will pay special attention to growth and development.
Diagnosing Zika virus infection is usually suspected based on travel locations. Visiting areas that are affected can and should often lead people exhibiting symptoms to get tested. A diagnosis is confirmed through laboratory tests. Usually blood or urine is the fluid that is tested, but saliva and semen can also be used.
The ideal time to get tested is within the first two weeks that symptoms appear. There is no rapid test so a diagnosis is often delayed because the test needs to be relayed to a more sophisticated laboratory.
According to the New York Times, federal health officials said that newborns can be tested if their mothers had a chance at experiencing an outbreak or getting infected. If her own tests were positive or inconclusive, the baby should also be tested.
Note for adults: Zika virus may also be diagnosed if a sexual partner has travelled to an infected region. This is because Zika virus can be transmitted through unprotected sex.
There is no medicine or vaccine for Zika virus infection. There are many preventions that can be taken. It is suggested to avoid any still water in the home. Keep windows shut and wear clothing that will cover places that get bit. Insect repellent is suggested for adults but consult your child’s doctor before using any on a baby.
It is suggested by the CDC to avoid areas that are known for having the Zika virus outbreaks. It is advised to stay in air conditioning or screened it areas. Sleeping in mosquito nets when visiting infected places is a way to avoid bites.
Some are hoping that “herd immunity” will eventually gain strength once so many people get bitten, get the virus, and recover. Many are working on a vaccine but that can take a couple of years to be tested true and circulated. For now, acetaminophen is suggested to manage pain and fever. Hydration and rest are recommended as well if symptoms show.
More severe symptoms such as birth defects can be treated. However many of these birth defects like GBS are lifelong. Treatments usually are specific to pain management but cannot cure the problem.
7 Damage After Birth
In Sao Paulo, an infant whose mother was infected with Zika virus late in her second trimester was born without any visible birth defects. The Zika virus was revealed to be in his blood after testing and remained in the baby’s system for a couple of months.
Apparent symptoms related to the virus were shown around six months. The baby showed a common sign of brain damage which were severe muscle contractions on one side of his body.
Around six months, the infant began showing signs of developmental problems. There is no way to tell if damage happened after birth as the brain began to develop or if it happen in utero but didn’t show until then.
Doctors who studied the Zika outbreak in Brazil said that there are a range of problems that are harder to spot but are more likely to be seen as time goes on. For this reason, babies who may have been infected are closely followed especially in the first year and for many following if diagnosed.
6 The First Year with Zika Virus
There are few cases to date of a baby's first year with Zika virus. That isn't necessarily because the virus or the birth defects can be fatal, but more of a result of the fact that there aren't cases that old. There are an estimated 12-16 cases of babies born with Zika virus and about 400-600 pregnancies infected with Zika virus that are yet to deliver. That means that no one really knows the extent or the seriousness of the complications caused by Zika virus.
As of right now, medical professionals and scientists would like to keep as close of an eye as possible on children born with Zika virus. It does not matter whether they have birth defects or any signs at birth because that does not mean they will not develop over time. Following up on cases will also give them some research to base cases off of in the future.
Children who develop symptoms or were born with them will require highly trained caregivers. This includes but isn't limited to nursing staff, physical therapists, speech therapists, and occupational therapists. Other caregivers can be helpful in dealing with cognitive delays as well.
5 What We Don't Know Yet
Zika virus is a relatively new topic these days. Even as I researched to write this article, I found glaring unknowns and mysteries about the Zika virus that has shown such devastating effects to expecting mothers.
Previously it had been thought that during the first trimester was the most dangerous time for a pregnant mother to be infected but women in their third trimesters were still seeing horrifying consequences. The fetus has the highest risks associated with infections, but there is no known age when this risk lessens.
The majority of research about the Zika virus focuses on pregnant women and the fetus. Studies are common in adults as well, but there is little to be said about children either infected after birth or growing after being infected during pregnancy.
In adults, symptoms for the most part are rather similar to the common cold. So what age does that start for children? At what age does Zika virus stop being detrimental and start being a common cold type infection? As of today, there is no cure for Zika virus.
Cytomegalovirus or CMV has been linked to Zika virus. It is similar to Zika virus in the means that most people infected with CMV do not they are infected as a result of a lack of symptoms and that it may be transferred through bodily fluids.
A baby born with Zika virus that appears healthy at birth may be at risk for cytomegalovirus developing months or even years later. Once a person is infected with CMV, they will retain the virus for life. It may remain inactive while healthy but will flare up when the person's immune system is weakened.
The most common symptom of CMV in a Zika virus baby is the development of hearing loss or vision impairment. Although it is more common for symptoms to appear later, babies with cytomegalovirus can be sick at birth. Those who are sick at birth are usually very sick.
The baby may exhibit jaundice or the yellowing of the skin and eyes as well as a purple rash or purple skin splotches. An enlarged spleen or liver can be a symptom of cytomegalovirus. Pneumonia and seizures can also be displayed by a newborn with CMV.
3 Amniotic Fluid
In most situations, amniotic fluid is what keeps your baby safe, healthy, and growing. Babies drink this fluid and live in it for 40 weeks, so it's important that this fluid be made of healthy cells and biological products.
It is the fluid that fills the uterus during pregnancy. Amniotic fluid holds many different roles. It cushions and protects the baby while maintaining the temperature in the womb. Amniotic fluid also helps the growth and development of the baby’s lungs and digestive system.
Just like blood and saliva, amniotic fluid is considered a bodily fluid. This means that it can be a means of which Zika virus is spread from mother to baby. Pregnant women are most affected by Zika virus infection because it can cause severe and even fatal birth defects. The amniotic fluid surrounds the baby. It is what he or she will breath in to strengthen his or her developing lungs and swallow to help the digestive system develop.
2 Living with Zika Virus Infection
There is so much unknown about the Zika virus. Around a dozen babies have been born so far with the Zika virus and about 400 hundred pregnant women have been infected with the virus. This means that there is not a great deal of research out there and not a lot of answers for expecting mothers and fathers. Getting the diagnosis of Zika virus infection for an expecting child can be terrifying and unimaginable because no one really knows just what it means yet or what all of the effects will be.
Physical and occupational therapists are doing their best to prepare to work with those born with Zika virus if their care is necessary. Speech therapists are also gearing up should they be needed. For all preparing, it can be incredibly difficult. They are basically going in blind as they are unaware of what birth defects these babies will have or how much care will be needed.
1 Breastfeeding and Zika Virus
According to the CDC, there is currently no report of a baby contracting the Zika virus through breastfeeding. In fact, mothers are encouraged to breastfeed because the benefits of breastfeeding outweigh the risk. Nursing mothers are still suggested to use bug spray to prevent mosquito bites and the contraction of Zika virus by that means.
The WHO or World Health Organization suggests that an infant born with suspected or confirmed Zika virus infection or an infected area should still be breastfed. There are significant incentives for both mother and baby for breastfeeding including lower infectious morbidity and mortality rates.
Breastfeeding has been known to strengthen babies’ immune systems by passing antibodies from mother to baby. It encourages bonding between mother and baby. Breastfeeding also provides a means for skin-to-skin contact between mother and baby. Skin-to-skin has proven incredibly beneficial in regulating baby’s temperature and heart rate especially right after birth.
Skin-to-skin between mom and a newborn immediately following birth can actually encourage baby’s natural instinct to eat and rooting reflex to search for the breast.