Zika Virus infection in pregnancy is a self-limited disease that generally lasts a few days up to two weeks. However, there may be a risk of microcephaly or abnormal neurologic development in the fetus. It is unknown at this time whether the timing of the infection in pregnancy or the severity of the symptoms in the pregnant person influence the risk to the fetus. Travellers are recommended to have early consultation with a health care provider regarding questions about Zika virus in pregnancy.
Nova Scotia recommendations for screening pregnant persons is oulined in the Zika Virus Testing Algorithm, and are summarized below.
Screening Criteria:
- All pregnant individuals with a potential exposure to Zika virus require assessment, regardless of whether they develop symptoms.
- Potential exposure is defined as personal travel to a Zika affected area any time after the date of the last known menstrual period or unprotected sexual contact with a male partner who has traveled to a Zika affected area in the last 6 months.
- Refer to the Public Health Agency of Canada for the most recent travel health notices for updates about Zika Virus destination specific advisories.
Screening and Referral Process:
- Asymptomatic individuals with a potential Zika Virus exposure:
- Referral to IWK Health Fetal Assessment and Treatment Center (FATC).
- Offer Zika virus serology, as described in the Zika Virus Testing Algorithm.
- The Zika Virus Clinical Information Data Sheet must be completed and sent with the specimens to the Department of Pathology and Laboratory Medicine, Central Zone.
- Symptomatic individuals with a potential Zika Virus exposure:
- Referral to IWK Health Fetal Assessment and Treatment Center (FATC) .
- Blood collection for both Zika virus RNA detection and serology, and urine specimens Zika virus RNA detection, as described in the Zika Virus Testing Algorithm.
- The Zika Virus Clinical Information Data must be completed and sent with the specimens to the Department of Pathology and Laboratory Medicine, Central Zone.
*The timing of Zika virus serology is important. For an asymptomatic pregnant person, serology should be completed NO SOONER than three weeks following the last exposure. At this time Zika serology for male partners is not being offered in Canada.
FATC Referral:
- Incude the following informaiton in the FATC referral:
- Date of the last know menstrual period (LMP) LMP.
- Circumstances of exposure in the context of gestational age (travel history or history of unprotected sexual contact with a male with potential exposure to Zika virus).
- The presence or absence of symptoms consistent with Zika virus in the pregnant person or their partner, including the timing of the appearance of symptoms, if any.
- Whether or not a blood sample has been sent for Zika serology and, if so, the date the sample was collected.
- The FATC referral form can be found HERE. A new form must be printed for each referral (due to the barcode) and the form must be faxed to FATC at 902-470-7987.
Prevention:
The risk of Zika virus is low in Canada but travelers to areas affected by current outbreaks should protect themselves from potential infection.
- Individuals should protect themselves frommosquito bites by using appropriate insect repellant, wearing protective clothing, and using mosquito nets.
- Public Health Agency of Canada recommends that those who are pregnant or considering becoming pregnant avoid travel to areas affected by current outbreak. Public Health Agency of Canada travel health notices.
- There is evidence that Zika virus can be transmitted sexually:
- Persons who may become pregnant should wait two months after returning from a Zika affected area before trying to conceive.
- Persons who are pregnant or may become pregnant should avoid sexual contact or use condoms with a partner who has recently travelled to a Zika affected area, and for at least six months after returning from the Zika affected area.
Additional Information:
- Public Health Agency of Canada - Laboratory Testing Recommendations for Zika Virus (2016, March)
- Canadian Pediatric Society - Fever in the returning child traveller: Highlights for health care providers (2024, January)
