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Zika and Pregnancy

The Zika virus is considered by the WHO as a new type of public health threat that mainly affects women and girls of child-bearing age and babies infected with the virus.

It is considered a global health risk because of the ease of travel, but one that is mainly in areas with lack of sanitation, information and health services.

Unique aspects of Zika include:

  • wide distribution of the insect vectors;
  • lack of population immunity to the strain causing the outbreak;
  • absence of vaccines, specific treatments and diagnostic tests.

The brunt of the human cost of the Zika epidemic is borne by the women and families of children born with microcephaly and other congenital syndromes linked to the virus.

These children are at risk of developing learning difficulties, developmental delays and disabilities, requiring lifelong specialised care and psychological support for both them and their families.

Protection from Zika virus

Travelling to a Zika area

The current CDC recommendations for pregnant women are not to travel to any area with a Zika outbreak. If travel cannot be avoided you should see a doctor first and protect yourself from mosquito bites.

See: cdc.gov/zika/pregnancy/protect-yourself.html#one.

Living in a Zika area

If a pregnant woman lives in a Zika area there is a risk throughout the pregnancy. CDC recommends testing during regular prenatal visits and if Zika virus symptoms appear.

There is no vaccine or medicine for treatment, so the best precaution is to prevent mosquito bites.

The Zika virus can also be transmitted through sex so the advice in both cases is to abstain or use a condom. For more information see: cdc.gov/zika/pregnancy/protect-yourself.html#two.

Avoid mosquito bites

  • wear long-sleeved shirts and trousers;
  • stay in places with air conditioning and insect screens on windows and doors;
  • use insect repellents. The US Environmental Protection Agency (EPA) has a list of registered repellents that can be used by pregnant women;
  • stay away from mosquito breeding sites or take measures to remove them, such as standing water and water-filled containers of any size.

Microcephaly

In 2016 following the outbreak of Zika in Brazil and an increase in microcephaly and other abnormalities, researchers concluded that Zika virus infection during pregnancy is a cause of microcephaly and other severe foetal brain defects.

Microcephaly is a rare condition in which the head of a foetus or baby is much smaller than other babies of the same age and sex. It can lead to developmental disabilities if it is accompanied with poor brain growth.

According to the CDC it is unknown:

  • how the virus will affect a mother or her pregnancy;
  • whether a foetus will have birth defects;
  • how likely it is that Zika will pass to a foetus;
  • if a foetus is infected, whether the foetus will develop birth defects;
  • when in pregnancy the infection might harm the foetus.

There are many possible causes of microcephaly. According to WHO the following can cause microcephaly:

  • infections in the womb: toxoplasmosis (caused by a parasite found in undercooked meat), rubella, herpes, syphilis, cytomegalovirus and HIV;
  • exposure to toxic chemicals: maternal exposure to heavy metals like arsenic and mercury, alcohol, radiation, and smoking;
  • genetic abnormalities such as Down syndrome; and severe malnutrition as a foetus.

Symptoms

The head circumference of the baby is measured after birth and compared with WHO growth standards.

Babies born with microcephaly may show no other symptoms at birth but later develop epilepsy, cerebral palsy, learning disabilities, hearing loss and eye defects as they grow older. In some cases, children develop normally.

There are no specific tests during pregnancy to determine if a baby will be born with microcephaly, but ultrasound scans can sometimes identify the condition.

Treatment

There is no specific treatment for microcephaly. Unfortunately at present there is relatively little knowledge about the Zika infection related to pregnancy, foetuses and babies.

Sources and further information