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PubMed This is a summary of 78 peer-reviewed journal articles Updated
Infectious Disease

Understanding Zika: Risks for You and Your Family

At a Glance

For most adults, Zika virus is a mild or symptom-free illness. The primary risk is to pregnant individuals, as the virus can be passed to the fetus and cause severe birth defects like microcephaly. If you traveled to a risk area while pregnant, consult your obstetrician to discuss next steps.

If you are a traveler or someone planning a family, hearing about the Zika virus (a virus spread primarily by mosquitoes) can be deeply unsettling [1]. It is natural to feel anxious when health news focuses on risks to pregnancy and long-term development. Understanding the reality of the virus—how it behaves in most adults versus how it affects a developing fetus—can help you navigate these concerns with clarity and focus.

A Tale of Two Realities

The impact of Zika depends almost entirely on who is infected. For the vast majority of people, the virus is a minor event, but for a developing fetus, the stakes are significantly higher.

For Most Adults and Children

In healthy, non-pregnant adults, Zika is generally a mild illness [2]. In fact, many people do not even realize they are infected because they have no symptoms at all. When symptoms do occur, they typically include:

  • Low-grade fever [2]
  • A flat, red rash often covered with small bumps [2]
  • Arthralgia (joint pain) [2]
  • Conjunctivitis (red, irritated eyes) [2]

While rare, some adults may experience neurological complications, such as Guillain-Barré syndrome, but the vast majority of people recover fully without long-term issues [2][3].

For the Developing Fetus

The primary medical concern regarding Zika is vertical transmission, which occurs when a pregnant person passes the virus to their fetus [4].

This can lead to Congenital Zika Syndrome (CZS), a group of birth defects that includes:

  • Microcephaly: A condition where a baby’s head is much smaller than expected because the brain did not develop properly [4][5].
  • Intracranial calcifications: Calcium deposits in the brain that signal damage to brain tissue [6].
  • Severe joint limitations and eye abnormalities [7][8].

Research suggests that infection during the first trimester carries the highest risk for these severe outcomes [9][10]. Roughly 25% of fetuses exposed to Zika during pregnancy become infected, and of those, about one-third experience severe complications [11]. This means the vast majority (over 90%) of babies exposed to Zika in the womb do not develop severe complications.

Future Immunity

The good news is that once you recover from a Zika infection, you are likely immune to future infections. This means a past infection protects any future pregnancies you may have from the virus.

If You Are Pregnant and Already Traveled

Many pregnant women only learn about Zika risks after they have returned from a trip. If this is you, do not panic and do not blame yourself. Navigating public health warnings retroactively can feel terrifying and induce a lot of guilt. Instead of focusing on the past, your next step is to talk to your obstetrician about your travel history. They will help you navigate Navigating Zika Testing and Diagnostics and set up a plan for Medical Management and Long-Term Care.

How Zika Spreads

There are three primary ways the virus moves:

  1. Mosquito Bites: The most common path is through the bite of an infected Aedes species mosquito [1][12].
  2. Sexual Transmission: Zika can stay in bodily fluids and be passed through vaginal or anal sex, even if the person who traveled has no symptoms [1][13].
  3. Pregnancy: The virus can pass from a pregnant person to the fetus [14].

For a deeper dive into prevention, see Stopping the Spread: Prevention and Transmission.

In this guide

4 chapters

01

Zika Symptoms and Potential Complications

Learn about Zika virus symptoms like rash and fever, plus serious complications including Guillain-Barré Syndrome (GBS) and Congenital Zika Syndrome (CZS).

02

Stopping the Spread: Prevention and Transmission

Learn how to prevent Zika virus transmission through mosquito bites and sexual contact. Understand travel risks, safe repellents, and family planning timelines.

03

Navigating Zika Testing and Diagnostics

Learn about Zika virus testing options, including PCR and antibody tests. Understand pregnancy guidelines, cross-reactivity with dengue, and test accuracy.

04

Medical Management and Long-Term Care

Learn about medical management for Zika virus. Understand acute treatments, why avoiding NSAIDs is critical, pregnancy ultrasounds, and long-term infant care.

Common questions in this guide

What are the common symptoms of a Zika virus infection?
In healthy adults, Zika is generally a mild illness, and many people experience no symptoms at all. When symptoms do occur, they usually include a low-grade fever, a flat red rash with small bumps, joint pain, and red, irritated eyes.
Can Zika be transmitted through sex?
Yes, Zika virus can be transmitted sexually. The virus can remain in bodily fluids for an extended period and be passed through vaginal or anal sex, even if the infected person never showed any symptoms of the illness.
How does Zika affect a developing fetus during pregnancy?
If a pregnant person passes the virus to their fetus, it can lead to Congenital Zika Syndrome. This includes severe birth defects like microcephaly, calcium deposits in the brain, and eye or joint abnormalities, especially if infection occurs in the first trimester.
Does a past Zika infection protect me in future pregnancies?
Yes, once you recover from a Zika infection, you are likely immune to future infections. This means having had the virus in the past protects any future pregnancies from a new infection.
What should I do if I traveled to a Zika risk area while pregnant?
Do not panic, but do speak with your obstetrician or a maternal-fetal medicine specialist about your exact travel dates and locations. They can help arrange appropriate testing, discuss your true level of risk, and set up a personalized monitoring plan.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.What is the baseline rate of congenital defects even without Zika, so I have a realistic frame of reference?
  2. 2.Can we review my exact travel dates and locations to confirm my true level of risk?
  3. 3.If I am trying to conceive, exactly what date is it safe for my partner and me to start trying based on our travel history?
  4. 4.Could you refer me to a maternal-fetal medicine specialist to guide me through this uncertainty?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (14)
  1. 1

    Male-to-Male Sexual Transmission of Zika Virus--Texas, January 2016.

    Deckard DT, Chung WM, Brooks JT, et al.

    MMWR. Morbidity and mortality weekly report 2016; (65(14)):372-4 doi:10.15585/mmwr.mm6514a3.

    PMID: 27078057
  2. 2

    Postnatally Acquired Zika Virus Disease Among Children, United States, 2016-2017.

    Lindsey NP, Porse CC, Potts E, et al.

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2020; (70(2)):227-231 doi:10.1093/cid/ciz195.

    PMID: 30855072
  3. 3

    Guillain-Barré Syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study.

    Cao-Lormeau VM, Blake A, Mons S, et al.

    Lancet (London, England) 2016; (387(10027)):1531-1539 doi:10.1016/S0140-6736(16)00562-6.

    PMID: 26948433
  4. 4

    Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy - U.S. Territories, January 1, 2016-April 25, 2017.

    Shapiro-Mendoza CK, Rice ME, Galang RR, et al.

    MMWR. Morbidity and mortality weekly report 2017; (66(23)):615-621 doi:10.15585/mmwr.mm6623e1.

    PMID: 28617773
  5. 5

    Zika Virus and Birth Defects--Reviewing the Evidence for Causality.

    Rasmussen SA, Jamieson DJ, Honein MA, Petersen LR

    The New England journal of medicine 2016; (374(20)):1981-7 doi:10.1056/NEJMsr1604338.

    PMID: 27074377
  6. 6

    Placental infection by Zika virus in French Guiana.

    Pomar L, Lambert V, Madec Y, et al.

    Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology 2020; (56(5)):740-748 doi:10.1002/uog.21936.

    PMID: 31773804
  7. 7

    Zika virus infection in children: epidemiology and clinical manifestations.

    da Silva Pone MV, Moura Pone S, Araujo Zin A, et al.

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 2018; (34(1)):63-71 doi:10.1007/s00381-017-3635-3.

    PMID: 29110197
  8. 8

    Pathology of congenital Zika syndrome in Brazil: a case series.

    Martines RB, Bhatnagar J, de Oliveira Ramos AM, et al.

    Lancet (London, England) 2016; (388(10047)):898-904.

    PMID: 27372395
  9. 9

    Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy - Brazil, 2015.

    Kleber de Oliveira W, Cortez-Escalante J, De Oliveira WT, et al.

    MMWR. Morbidity and mortality weekly report 2016; (65(9)):242-7 doi:10.15585/mmwr.mm6509e2.

    PMID: 26963593
  10. 10

    Factors associated with the development of Congenital Zika Syndrome: a case-control study.

    Lima GP, Rozenbaum D, Pimentel C, et al.

    BMC infectious diseases 2019; (19(1)):277 doi:10.1186/s12879-019-3908-4.

    PMID: 30902046
  11. 11

    Maternal-fetal transmission and adverse perinatal outcomes in pregnant women infected with Zika virus: prospective cohort study in French Guiana.

    Pomar L, Vouga M, Lambert V, et al.

    BMJ (Clinical research ed.) 2018; (363()):k4431 doi:10.1136/bmj.k4431.

    PMID: 30381296
  12. 12

    Zika Virus -10 Public Health Achievements in 2016 and Future Priorities.

    Oussayef NL, Pillai SK, Honein MA, et al.

    MMWR. Morbidity and mortality weekly report 2017; (65(52)):1482-1488 doi:10.15585/mmwr.mm6552e1.

    PMID: 28056005
  13. 13

    Zika Virus in the Male Reproductive Tract.

    Stassen L, Armitage CW, van der Heide DJ, et al.

    Viruses 2018; (10(4)) doi:10.3390/v10040198.

    PMID: 29659541
  14. 14

    Dynamics and optimal control of a Zika model with sexual and vertical transmissions.

    Huo HF, Fu T, Xiang H

    Mathematical biosciences and engineering : MBE 2023; (20(5)):8279-8304 doi:10.3934/mbe.2023361.

    PMID: 37161197

This page provides general educational information about Zika virus and pregnancy risks. Always consult your obstetrician or maternal-fetal medicine specialist for advice regarding your specific travel history and pregnancy.

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