Zika in Puerto Rico and pregnancy: current risk and how to protect yourself

Zika is a viral infection. According to the CDC, it spreads through the bites of infected mosquitoes, through sex, from mother to baby during pregnancy, and through infected blood or tissues. Many people have no symptoms or only mild ones.

The most common symptoms are fever, rash, headache, joint and muscle pain, and red eyes (conjunctivitis). They usually last several days to a week. Rarely, Zika triggers Guillain-Barré syndrome, in which the immune system damages nerve cells and causes muscle weakness and sometimes paralysis. There is no vaccine or medicine to prevent Zika.

According to the CDC, Zika infection during pregnancy can cause serious birth defects and is linked to pregnancy loss, stillbirth and preterm birth. That is why pregnancy is when Zika matters most.

The CDC classifies Puerto Rico as an area with current or past Zika transmission but no current outbreak. For pregnant people in these areas, the CDC advises talking to a health care provider about the risks and, if you travel, preventing mosquito bites and sexual exposure.

Zika testing in pregnancy. The CDC no longer routinely recommends testing for pregnant people without symptoms; after talking with your doctor, testing may be considered. If you are pregnant and have Zika symptoms, testing should happen as soon as possible, while you still have symptoms. That decision, the test and the follow-up of your pregnancy belong to your obstetric provider.

In 2015 the Americas had their first Zika outbreak, with transmission in more than 18 countries, Puerto Rico among them. The WHO declared a public health emergency of international concern in February 2016 and ended it that November, according to the Department of Health.

According to the Department of Health’s weekly arboviral report (week 37, published September 23, 2026), no Zika cases have been reported in 2026, and there were none in 2025. The same mosquito still spreads dengue, which is circulating on the island, so preventing bites still matters.

According to the CDC:

If you are pregnant, call your obstetric provider or prenatal clinic: they decide whether you need a test and how to monitor the pregnancy. We do not provide pregnancy care.

If you are not pregnant and have a fever, rash or red eyes, Dr. Diana Nieves Castro, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, can see you by video. We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.

Until dengue is ruled out, the CDC says to avoid aspirin and other anti-inflammatory medicines (such as ibuprofen) because of the risk of bleeding; acetaminophen, rest and fluids are used for fever and pain. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.

We see adults and children of all ages; for patients under 21, a parent or legal guardian stays on camera for the whole visit with photo ID. You need to be physically in Puerto Rico during the visit. Visiting? See our care for visitors.

A doctor visit costs US$79, the same price for every age, with no membership. Request a visit online 24/7 — we confirm your time by email or text. Your card is charged when you request it, and you get a full refund if the visit can’t take place. We send you a secure video link that works on your phone, tablet or computer. The service is run by The Health Initiative, a nonprofit. Book your visit.

For your safety, with any of these signs call 911 or go to an emergency room, and don’t book a video visit. See when to go to the ER.