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  • Dr. Kaitlin Dupuis MD CCFP

Can't conceive of being asked about Zika on the exam? It could happen!


SNAP SAMP:

  1. How long should women with potential exposure to Zika virus wait before conceiving?

  2. How long should women with confirmed Zika disease wait before conceiving?

  3. How long should men with potential exposure to Zika virus wait before conceiving?

  4. List FIVE pregnancy-related complications associated with Zika virus infection.

ANSWERS: The Zika outbreak of 2015 is currently one of infectious diseases' hottest topics. While information on how the virus is transmitted and how the infection affects a developing fetus continues to evolve, current guidelines on preconception counselling have existed since late 2016. The Centres for Disease Control and Prevention (CDC) recommends the following:

  1. Women and men with potential exposure to the Zika virus (i.e. travel history to endemic area, unprotected sexual contact with infected partner) should wait at least eight weeks before conceiving

  2. Women with confirmed Zika disease should wait at least eight weeks after symptom onset before attempting conception

  3. Men with confirmed Zika disease should wait at least six months after symptom onset before attempting conception

  4. Clinical and epidemiological evidence suggests a strong link between maternal infection with the Zika virus and:

  • fetal brain abnormalities

  • fetal eye abnormalities

  • fetal intracranial calcifications

  • fetal microcephaly

  • pregnancy loss

Remember, women get 8 weeks, men get 6 months! BONUS EXAM TIP Did you notice the above guidelines are from the CDC? You should be focusing on CANADIAN guidelines as you study, as this is a CANADIAN exam. Not to worry - we checked for you - the above is consistent with the Canadian recommendations from PHAC except for one thing: PHAC recommends that men with potential exposure should wait six months before conceiving. CONFLICTING GUIDELINES? So what would you write on an exam if you find conflicting guidelines and you aren't sure which one to use? The CFPC's website tells you exactly what to do in their exam FAQ at http://www.cfpc.ca/certification_FAQs References: Update: Interim Guidance for Preconception Counseling and Prevention of Sexual Transmission of Zika Virus for Persons with Possible Zika Virus Exposure — United States, September 2016. https://www.cdc.gov/mmwr/volumes/65/wr/mm6539e1.htm Zika Virus Infection - Global Update (Canada) https://travel.gc.ca/travelling/health-safety/travel-health-notices/152


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