Birth defects, miscarriages as Zika infects nine in U.S.

At least two pregnant women in the United States infected with the Zika virus have chosen to have abortions in recent months, the Centers for Disease Control and Prevention reported Friday, while two others have suffered miscarriages. One woman gave birth to a infant with serious birth defects, while two others delivered healthy infants. Two are still pregnant.

The varied outcomes of nine pregnant U.S. women the agency has identified with Zika, as well as the hundreds of U.S. women that have sought out tests for the virus, underscore the angst and uncertainty that the diseases is causing as it spread through much of the Americas, particularly when it comes to worries over severe birth defects associated with illness.

One of the women who had an abortion was in her 30s and had contracted the virus during her first trimester while traveling to a Zika-affected area, the agency said. When she was 20 weeks pregnant, she learned from an ultrasound that her fetus was suffering from severe brain abnormalities. Doctors also tested her amniotic fluid and found the presence of Zika virus. “After discussion with her health care providers, the patient elected to terminate her pregnancy,” the CDC wrote in a case study released Friday. Officials did not offer details surrounding the second abortion, other than to say it involved another woman who had become infected with Zika during the first trimester of her pregnancy.

The agency said that between last August and Feb. 10, it received more than 257 requests for Zika virus testing of pregnant women in the United States. The vast majority of those cases, 97 percent, tested negative for the disease. But the CDC has been tracking nine pregnant women in the country who tested positive for Zika. All had reported symptoms of the disease – such as fever, rash, joint pain and conjunctivitis – and all had traveled to one of more than two-dozen Zika-affected countries, officials said.

Six of the infected women acquired Zika during their first trimester, the CDC reported. Of those, two experienced miscarriages and two chose to have abortions. One woman delivered a baby who suffered from “severe microcephaly,” a condition marked by abnormally small head size, as well as seizures, trouble swallowing, eye problems and calcifications in the brain. One pregnancy is ongoing, the CDC said. The agency said that while remnants of the Zika virus were detected in fetal tissues taken after both miscarriages, “it is not known whether Zika virus infection caused the pregnancy losses.” Roughly 10 to 20 percent of all pregnant women suffer miscarriages during the first trimester, officials noted.

Of the two pregnant women with Zika diagnosed during their second trimester, one gave birth to an apparently healthy baby, and another is still pregnant. The one pregnant woman who experienced Zika symptoms during her third trimester later delivered a healthy infant.

Friday’s report adds another dimension to the ongoing efforts by scientists in the United States and abroad to answer some of the many mysteries surrounding the once-obscure Zika virus. At the top of that list is determining whether – and how – the virus is linked to birth defects such as microcephaly, as well as to cases of a rare autoimmune disorder known as Guillain-Barré Syndrome. Those associations, particularly to possible problems in newborns, appear to be growing more likely over time.

“The evidence every week is accumulating and getting stronger and stronger,” Anthony Fauci, director of the National Institutes for Allergy and Infectious Diseases, told lawmakers at a Senate hearing earlier this week.

CDC director Tom Frieden said Friday that scientists are confident there is an association between the Zika virus and microcephaly. But there is much they still don’t understand, such as the risks are higher at certain points during pregnancy and whether there are other factors that can influence the likelihood of birth defects. He said researchers have undertaken studies to answer some of those questions in Brazil, where the number of microcephaly cases is highest.

“There are many things we wish we knew and are working hard to find out,” Frieden said. “This is an extraordinarily unusual occurrence ... Part of science is uncovering information step by step, trying to be sure not to overstate what the data shows.”

But Friday’s CDC report also highlights the hard questions that pregnant women face when they have been infected with the Zika virus, not to mention the religious and societal debates that have unfolded as the epidemic has spread.

Throughout Latin America, home to some of the most restrictive abortion laws in the world, there have been controversial calls to lighten restrictions on the practice in the face of the Zika virus outbreak. In El Salvador, where abortion is banned, the health minister has argued for a revision of the law because of the dangers the virus poses to fetal development. In Colombia and Brazil, there have been efforts to lift certain restrictions on abortions as the virus has spread explosively through the continent, but those efforts have encountered stiff opposition, particularly from religious authorities.

Pope Francis himself has waded into the issue, saying recently that the use of contraceptives may be morally acceptable in fighting the Zika virus. He cited the decision in the 1960s by Pope Paul VI, who allowed nuns in Belgian Congo to use artificial contraception to prevent pregnancies because they were being systematically raped. But Francis stopped short of saying abortion should be condoned.

“Abortion isn’t a lesser evil, it’s a crime,” he told reporters earlier this month. “Taking one life to save another, that’s what the Mafia does. It’s a crime. It’s an absolute evil.”

This story was originally published February 26, 2016 at 4:04 PM with the headline "Birth defects, miscarriages as Zika infects nine in U.S.."