Zika Virus in Pregnancy

ShareThis

Zika Virus and its potential effect on pregnancy and the unborn baby have erupted in the news. Many parents are now concerned that their baby will be harmed if the mother becomes infected or if the father is infected as it can live in the sperm for up to 60 days studies have shown.
The concerns for the presumed exposure , infection in pregnancy, and neonatal microcephaly has led some countries in central and south America to issue travel and pregnancy warnings. These concerns now exist in southern Florida as well.

WHAT WE KNOW;
1.Zika virus is a Flavivirus that is similar to Dengue and Chikungunya.

2.Transmission of the virus is primarily through the bite of an infected Aedes species mosquito. This species of mosquito tends to be fairly aggressive and bites throughout the daytime hours.

3. 80% of cases of Zika virus are asymtomatic (exhibiting no symptoms).

4. Brazil has seen an increase in cases of Zika virus and a 15-20 fold increase in cases of microcephaly (very small underdeveloped brains) in newborn babies.

5. Previous epidemics of Zika virus have not been associated with fetal microcephaly.

6.Even with just over 3,000 cases of microcephaly reported in Brazil , this represents only a small fraction of the 3 million births per year in that country (aprox. 1-500 births per year). Less than 1% pf babies are actually affected.

WHAT WE DO NOT KNOW:

1.There is a a possible association but no proof of cause and effect that Zika virus infection in pregnancy directly cause microcephaly.

2. We do not know actual incidence, attack rates, and true risks of exposed women.
Epidemiology looks backwards in time and frequently fear is greater than the future reality.

3. There was speculation that there would be some presence of the virus in the United States which it has but only 43 cases reported of locally acquired (US/Florida) and travel associated (outside US) is 3,314. Sexually transmitted 28. Two babies have been born in US with microcephaly but was not locally acquired.

4. Based upon embryology and other types of congenital fetal infection that would adversely affect the brain, may likely happen around the 8th week to week 28. However neither WHO or CDC has made specific recommendations.

AUSTIN PERINATAL RECOMMENDATIONS/DR. DAVID BERRY

1. Avoidance of travel to these countries while pregnant (particularly 8-28 weeks) and use of mosquito repellant in mosquito prone areas. (I personally like to use more natural bug sprays which can be found at any healthfood store. I may also post a homemade recipe on a future blog).
2. Austin Pernatal Asscociates does not recommend termination of pregnancy for potential exposures due to low prevalence of overt fetal microcephaly.

3. APA does recommend serial ultrasound monitoring and CDC testing for overtly symptomatic patients including blood test and amniocentesis when indicated.

4. Consider 28-30 week ultrasound for all fetuses until further information can be elucidated about transmission, actual fetal risks, and attack rates in pregnancy.

Ref. Taken from Handout from Austin Perinatal Associates/David L. Berry Austin, Texas