As Zika Virus spreads across the globe, the anxiety that it might be transmitted, not just by the Mosquito, but through breastmilk or bodily fluids also spreads. The lack of research in the area makes the issue hotly contested.
However, despite the lack of evidence, the WHO has, in 2016, published behavioural guidelines for pregnant and feeding mothers concerning the spread of Zika. 

Zika virus is a mosquito-borne virus transmitted by Aedes mosquitoes; the same mosquito also transmits other vector-borne diseases – dengue, chikungunya and yellow fever. Currently, there is no treatment or vaccine to protect specifically against Zika virus infection

The first large outbreak of disease caused by Zika infection was reported from the Island of Yap (Federated States of Micronesia) in 2007. In July 2015 Brazil reported an association between Zika virus infection and Guillain-Barré syndrome. In October 2015 Brazil reported an association between Zika virus infection and microcephaly. 

Countries that have past or current evidence of Zika transmission (as of January 2016) United States Centers for Disease Control and Prevention
Countries that have past or current evidence of Zika transmission (as of January 2016). United States Centers for Disease Control and Prevention

What’s it go to do with Early Life Nutrition? 

Whether Zika can be transmitted through breast milk is a highly debated, and topical issue. The frequency of virus detection, virus kinetics and size of viral load of Zika virus in breast milk is largely unknown. A recent systematic review, published in May 2016 by Colt et al of literature on transmission of Zika virus through breast milk and other breastfeeding-related bodily-fluids, reviewed three cases of ZIKV infection among lactating mothers near the time of delivery. They found that: 

  • Two of the three (2/3) associated newborns had evidence of ZIKV infection. ZIKV was detected in breast milk of all three mothers. 
  • Breast milk detection results were positive in all mothers (3/3) by RT-PCR, one was positive by culture (1/3), and none were tested for ZIKV-specific antibodies. 
  • Serum samples were ZIKV positive in all mothers (3/3), and sweat was not tested for ZIKV. 

Colt et al concluded that: 

“While ZIKV was detected in the breast milk of all three mothers, the data are not sufficient to conclude ZIKV transmission via breastfeeding. More evidence is needed to distinguish breastfeeding transmission from other perinatal transmission routes.” 

 WHO Guidelines 

Despite the inconclusiveness of research, the WHO published this year guidelines on infant feeding in Zika affected areas. The WHO state that the purpose of these guidelines is to provide a recommendation to guide governments, ministries of health, policy-makers and health-care workers in regions affected by transmission of Zika virus, in the development of local and national protocols and policies on infant feeding, including breastfeeding practices in areas of Zika virus transmission, and their implementation. 

Read the Guidelines 

In summary, the WHO recommend: 

“Infants born to mothers with suspected, probable or confirmed Zika virus infection, or who reside in or have travelled to areas of ongoing Zika virus transmission, should be fed according to normal infant feeding guidelines. They should start breastfeeding within one hour of birth, be exclusively breastfed for six months and have timely introduction of adequate, safe and properly fed complementary foods, while continuing breastfeeding up to two years of age or beyond.” 

They add that mothers and families of infants born with congenital anomalies (e.g. microcephaly), or those presenting with feeding difficulties, should be supported to breastfeed their infants by health professionals, communities and families.

References 

WHO (2016) Infant Feeding in Areas of Zika Virus Transmission http://apps.who.int/iris/bitstream/10665/208875/1/9789241549660_eng.pdf?ua=1

WHO (2016) Factsheet on Zika Virus http://www.who.int/mediacentre/factsheets/zika/en/

Colt S, Garcia-Casal MN, Peña-Rosas JP, Finkelstein JL, Rayco-Solon P, Prinzo ZW et al. Transmission of Zika virus through breast milk and other breastfeeding-related bodily-fluids: a systematic review . Bull World Health Organ E-pub: 02 May 2016. doi: http://dx.doi.org/10.2471/BLT.16.176677