Talk about Zika virus is everywhere. Every day there is a new headline detailing the spread of the illness and its impacts on the fetuses of women who contract it while pregnant. While the new information coming out can be frightening, researchers are most concerned with what we still don’t know about the virus and its effects both short and long term. It turns out that all we know now about Zika virus is, in fact, the tip of the iceberg.

Leading the research

Researchers around the globe are working to discover all they can about Zika virus and its impacts, and one of the biggest studies is being led right here in Utah. Infectious disease specialist Carrie Byington, M.D., is the head researcher of the Utah Study, a partnership between the University of Utah and the United States Olympic Committee. This is an intensive study of the impacts of Zika on the human reproductive system. Following members of the U.S. Olympic team before, during and after their time at the 2016 games in Brazil, Byington hopes to learn more about the timeline of the disease and its long-term effects.

Zika and pregnant women

The most pressing concerns involve women who are pregnant at the time they contract Zika virus because Zika is linked to microcephaly, a debilitating birth defect characterized by a small head. The condition includes a range of problems such as seizures, developmental delays and hearing and vision loss.

Figuring out just how far into pregnancy Zika can affect the fetus is one of the biggest challenges facing researchers. It is known that the virus crosses through the placenta and affects development. However, it is not known if there is a point in fetal development where the virus is no longer a threat.

“The risk for microcephaly following Zika virus infection we believe is greatest in the first trimester,” says Byington. “That risk may extend into the second trimester, but we really need to know if it extends through the entire pregnancy.”

Planning on becoming pregnant?

Another question is how soon after infection can a woman become pregnant without having the virus harm her fetus. Currently, the Centers for Disease Control recommends a woman not become pregnant within eight weeks of being exposed to Zika virus. However, more information is needed to ensure that is the proper amount of time. “That's one of the things we're trying to look at in the Utah Study: when is it safe to become pregnant after exposure to the Zika virus?” says Byington. “We will be looking at the timing of infection and the timing of pregnancy to better see if we can identify the risk for individuals.”

The woman’s health at the time of conception isn’t the only factor. We know Zika virus can be transmitted through sexual contact, so if a woman’s partner has contracted Zika virus that could factor into conception timing. “We don't have answers to how long an individual may be infectious or may be able to spread the virus to others,” says Byington. “Patients need to know which body fluids could potentially spread the virus in a sexual manner and they need to know what the risk period for pregnancy is.”

Studies have found Zika virus still alive in semen up to two months after a man showed symptoms of the illness. Currently, the CDC is asking men who contracted the virus to refrain from unprotected sex for six months. “Our study will hopefully help to find exactly how long that virus can remain active,” says Byington. “Then we will be able to give people the best advice so that they can conceive safely and have healthy newborns.”

A vaccine in the works

Beyond understanding the impacts of Zika virus are the questions about immunity to the illness, how to provide widespread testing for it and if a vaccine can and will be developed. Right now, testing is expensive and not widely available. In Miami, the first place the virus has been detected in the United States, doctors are reporting long waits for test kits. All over the nation test results are taking weeks to be returned because of current protocols. These factors have researchers working on a better diagnostic test. “My hope is that these will come to the market so that a broader group of individuals can be screened and tested for Zika virus,” says Byington. “It's important for them to be able to know their results so that they can make informed decisions about their reproductive health.”

There are also researchers working on a vaccine for Zika virus. At Harvard’s Beth Israel Hospital and the Walter Reed Army Institute of Research, three experimental vaccines have now proven successful in tests involving monkeys, and researchers say they may be able to begin clinical tests involving humans by October. Another experimental vaccine developed by the National Institutes of Health is already being tested on humans. Previous research into vaccine production is helping speed up the process. “We know with other related viruses we have been successful in creating vaccines,” says Byington. “I feel certain that a vaccine that is safe and effective will be developed against Zika virus.”

Remaining questions

Until a vaccine is available, many are wondering if there is such a thing as immunity to Zika virus. Is it like a cold that you can catch again and again? Researchers don’t think so, but there is no real proof yet. That will come with time. “Very similar to the West Nile virus infections that happened in the last decade, we may see that the numbers of infections each summer become less and less as our population becomes exposed to Zika virus and hopefully immune to Zika virus,” says Byington.

Zika virus is likely to stay in the headlines as it progresses through the United States, and more discoveries are made. The Utah Study will play a major part in those discoveries during its two-year time span. “The hope is that by the time we are done, we will have more answers than questions,” says Byington.

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