Infectious Diseases / OB/GYN / Women's Health

Zika Virus Update — What Should Patients Know?

June 20, 2016
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A Harvard Opinion Research Program report from a survey series conducted testing public response to health emergencies in the United States shows that around four in 10 adults in households with someone considering pregnancy or already pregnant are unaware that the Zika virus is transmitted sexually.

In the same households, one in five believes erroneously that there is currently a vaccine available to prevent Zika infection, while one in four believe that Zika patients are “very likely” to show symptoms of infection. Nearly a quarter of relevant respondents are also unaware of Zika’s confirmed causal relationship with the dangerous birth defect microcephaly.

A research scientist in the Department of Health Policy and Management at Harvard Chan School, Gillian SteelFisher, PhD, says the survey she directed is aimed at furthering outreach and public discussion of Zika. The survey results enable officials to recognize lapses in the public knowledge of the Zika virus’s transmission, manifestation, and perhaps most importantly, prevention.

Evidence shared

Currently, health officials in the US are rapidly preparing a comprehensive response to Zika. In April, the CDC coordinated a national summit bridging all levels of public health to foster a discussion regarding the best course of action. Presently there are flyers encapsulating public knowledge on the prevention of Zika’s sexual transmission, and how to best protect pregnant women and women of reproductive age.

Meanwhile, updated advisories from the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine provide preventative strategies as well as management advice for reproductive-aged women. In the interim, the CDC has likewise further updated information regarding preventing venereal transmission.

What is Known

The CDC issued advisories and recommendations for men who reside in or have visited areas with active Zika transmission, as well as for their sexual partners.

The CDC recommendations advise that pregnant women and their sexual partners should always and correctly use condoms during sex (be it vaginal, anal or oral) or abstain from sex while pregnant all together. This is the most effective approach to reducing even minor risks of venereal transmission. Couples that are not pregnant but still wish to reduce transmission risk should practice much the same as the above — either consistent proper condom use or abstinence. The advised duration of consistent contraceptive measures is dependent upon whether men were confirmed as being infected with Zika or an illness that is consistent with Zika’s effects, and whether the men reside or have visited areas of transmission.

Diagnostic testing is advised if a person has possibly had sexual exposure to Zika and has developed any of Zika’s symptoms, which commonly include fever, joint pain, conjunctivitis and most often, rash. Pregnant women who have potentially been exposed sexually to Zika must undergo testing if either she or her sexual partner develops any of the aforementioned symptoms common with Zika.

The push to avoid unplanned pregnancy is especially important in endemic Zika regions. Moreover, it has put Puerto Rico under the microscope. A new report estimates that 138,000 Puerto Rican women of reproductive age are not using effective contraception despite not wanting pregnancy. As the potentially disastrous effects that Zika can have on fetal neurological growth become more evident, the need to remedy the potential threat of unplanned pregnancy is highlighted. In response, health officials have recently proposed the distribution tactics enumerated in the CHOICE project, which when applied to Puerto Rico would require distribution of a multitude of contraceptive methods to the public which would primarily utilize intrauterine contraceptives, contraceptive implants and oral contraceptives among others to lessen the risk of unplanned pregnancies. US regions not yet affected by Zika could potentially see Puerto Rico as a warning sign of the problems associated with both poor public knowledge regarding health events and inadequate provision for contraceptive use.