Zika virus and pregnancy in Dubai
Zika virus and pregnancy in Dubai
What is Zika virus ?
How is Zika virus transmitted ?
Zika virus is spread by the yellow fever mosquito Aedes aegypti . The specific mosquito can carry a number of other viruses as well like denque fever yellow fever. It is recognised by the white markings on its legs and a specific mark that resemble the music instrument lyra on it thorax . The mosquito has originated in Africa and now is spread in most subtropical regions throughout the word
How do I know if I am infected ?
Symptoms of Zika virus infection in pregnancy
- It is a self limiting infection that usually lasts a few days
- Only one in 5 people who are infected with the virus do actually become ill
Diagnosis of Zika virus infection
- Diagnosis is not easy and is based on a very high index of suspicion
- Symptoms are very similar to those from dengue fever or chinkungunya . Both these viruses are transmitted from the same species of mosquitoes as Zika
- Travel history during pregnancy in areas where zika virus is prevalent is important. CDC is regularly updating its travel information and this can be found online at http://wwwnc.cdc.gov/travel/notices/
- Blood tests can help the diagnosis
Treatment for the pregnant mother with Zika virus infection
- There is no specific medication or vaccine to treat or prevent Zika virus infection during pregnancy
- Ensure good hydration
- Paracetamol is safe to take during pregnancy in mothers with Zika virus infection to relieve some of the symptoms
- In pregnant mothers with laboratory evidence of zika virus disease during pregnancy follow up by a fetal medicine specialist is recommended. Ultrasound scans are performed in 3-4 weeks interval looking for specifically for evidence of microcephaly or cerebral calcifications
Pregnancy advice and Zika virus
Pregnant women considering travelling in an area affected by Zika virus
- Pregnant women should be advised against travelling to areas known to be affected by zika virus. There are no vaccines or medication that can be used in pregnancy to prevent Zika virus.
- The mosquitos responsible for transmitting Zika virus are most active during the day so appropriate measures to avoid mosquito bites should be taken . Wearing long sleeve shirts and long sleeve pants as well a appropriate use of insect repellants is strongly advised
Testing of pregnant women with a possible infection by Zika virus
- To date there is no commercially available test specific for Zika virus . Blood test utilising reverse transcription polymerase test can be used in symptomatic patients . In the US this is facilitated by the local health care departments
Effect of Zika virus to the baby
There is increasing evidence linking Zika virus infection during pregnancy and fetal microcephaly.
What is microcephaly? The term microcephaly is used to describe a fetal head size that is smaller than expected at a certain gestational age. Different cut of points are used but most will take 3 standard deviations from the mean. This means that the circumference of the fetal head is less than the 0.3 % expected for the gestation
The size of the fetal head is mostly dependent on the growth of the fetal brain. Most cases of microcephaly are due to genetic factors. However acquired microcephaly is well described due to infections like toxoplasmosis and rubella. Zika virus has been associated with the increased rate pregnancies affected by fetal micropcephaly in Brazil .
What is the treatment for microcephaly. There is no treatment for microcephaly as this is the result of the damage that has already happened to the fetal brain.
Fetal and Maternal Medicine Consultant
Genesis Perinatal Care Clinic Dubai
Further updated information
Interim Guidelines for Pregnant Women During a Zika Virus Outbreak — United States, 2016
“Aedes aegypti” by Muhammad Mahdi Karim (www.micro2macro.net) Facebook Youtube – Own work. Licensed under GFDL 1.2 via Commons – https://commons.wikimedia.org/wiki/File:Aedes_aegypti.jpg#/media/File:Aedes_aegypti.jpg
“Zika.Virus.Rash.Arm.2014” by FRED – Own work. Licensed under CC BY-SA 3.0 via Commons – https://commons.wikimedia.org/wiki/File:Zika.Virus.Rash.Arm.2014.jpg#/media/File:Zika.Virus.Rash.Arm.2014.jpg