Jamaica and the world are faced with the potential outcome of neurological complications, including microcephaly, in children of women infected with the Zika virus. Microcephaly is a condition where babies are born with small heads and associated cognitive impairment. Pregnant women are at the same risk of exposure to the Zika virus as the general population. One in every five infected persons will show symptoms of the illness.

We are still unsure of the number of infected pregnant women who will have babies with microcephaly, but based on research and experience from other countries the assumption is that 10 per cent of pregnant women exposed to the Zika virus may have a child with microcephaly. I want to stress that at this stage this is an assumption as we really do not know what the exact proportion is.

Women of childbearing age are therefore being encouraged to delay pregnancy for six months to one year as the development of a vaccine against the Zika virus is on the horizon. If you are pregnant, you are being advised to seek antenatal care immediately and make every effort to protect yourself from being bitten by mosquitoes.

The Ministry of Health (MOH) is consistently surveying the situation and continues to be guided by the WHO/PAHO and CDC guidelines, which are continually being updated.

As part of the Ministry of Health’s Phase 2 Zika response, specific focus is being placed on pregnant women and therefore we have been putting several measures in place: All pregnant women attending public antenatal clinics receive mosquito nets; all pregnant women presenting with at least one symptom of Zika virus infection are routinely tested for the Zika virus as part of our heightened surveillance; all pregnant women suspected of being infected with the Zika virus are referred to a high risk antenatal clinic for close follow-up. We have also been providing counselling and psychosocial support to pregnant women and their families who are affected by Zika and will continue to make this service available to all those who may need it, regardless of their Zika status.

As part of the Ministry of Health’s phase 3 Zika response, an expert group — including neurologists, psychologists, psychiatrists, behavioural paediatricians, paediatricians and early childhood educators — has been tasked with preparing guidelines to assist the MOH in addressing the needs of mothers and their children born with microcephaly or any other neurological complications related to the Zika virus infection.

Jamaica has an excellent track record in managing high-risk pregnant women through the Prevention of Mother to Child Transmission Programme — and has in place a platfor throughwhich public health nurses and midwives are placed strategically at all the major high-risk clinics including St Ann’s Bay, Victoria Jubilee, Cornwall Regional, Spanish Town hospitals and the University Hospital of the West Indies (UHWI), among others. The group has been briefed and trained recently to follow and monitor pregnant women exposed to Zika. They, along with obstetricians, midwives and other staff at the high-risk and general antenatal clinics are being trained to manage these pregnant women and their infants. The list of those suspected and confirmed to have Zika is passed to this team of nurses who will provide support to these women, ensuring the requisite monitoring is carried out throughout the pregnancy.

Clinical management protocol guidelines for the management of pregnant women, Guillain-Barrè Syndrome, the infected child, as well as psychosocial support for pregnant women and families affected by the Zika virus have been created by the MOH and distributed to all healthcare professionals. Over 500 public and private healthcare providers have received face-to-face training in the use of these guidelines between June and July 2016.

As part of efforts to strengthen clinical capacity to deal with possible Zika complications, the Ministry of Health has also prepared intensive care units and high-dependency areas at various hospitals. Additional ventilators have been procured and repairs are being made to others that are not presently functioning.

In a bid to strengthen laboratory capacity, the ministry has ordered an additional PCR (polymerase chain reaction) machine dedicated to Zika virus testing for the UHWI virology lab. ELISA test kits have been procured, in collaboration with PAHO, to allow for testing of persons for whom the initial 3-5 day window for PCR testing may have been missed.

Dr Christopher Tufton is Jamaica’s minister of health.