ZIKA virus & pregnancy
RECENTLY there has been a lot of concern about the Zika virus reaching our shores, as it spreads to other islands and countries in the Americas. There were varying reactions to the Ministry of Health’s advisory that women delay pregnancy for six to 12 months to avoid the complications of ZikV, and this article hopes to increase public awareness on the virus and its significance.
ZikV is a virus first discovered in the 1940s, with the first documented human infection in the 1950s. Since then, there have been few infections in humans until outbreaks in 2007 and 2013 (currently ongoing). It is found in two major groups, African and Asian.
It is passed to humans through the bite of an infected female Aedes mosquito (we are most familiar with Aedes aegypti). There have also been some cases of perinatal (around the time of delivery) transmission from mother to child. Although not proven definitively, it has also been suspected to be spread through sexual intercourse and blood transfusion in a few cases.
ZikV is usually a mild disease, and can present with non-specific symptoms similar to those for other mosquito-borne diseases like dengue and ChikV. People commonly experience mild fever, tiredness, rash, joint pain and redness of the eyes. It can also cause headache, pain behind the eyes, vomiting, diarrhoea, swelling of the hands and feet, sore throat, cough and sweating. Symptoms usually last two to seven days.
Severe complications, such as damage to the nervous system (Guillain-Barré syndrome) have been reported in some patients. Of most concern to Jamaican women, infection during pregnancy has been associated with an increased risk of microcephaly (small head size) in the unborn foetus and newborn babies. These babies are also found to have significant brain damage, leading to retardation and requiring long-term specialised care. This was noted in alarming numbers during the 2015 outbreak in Brazil. A definite reason why this happens has not yet been determined, but public health officials are concerned.
There is no specific treatment or vaccine against the virus. Treatment is geared at minimising symptoms using painkillers (Panadol) and antihistamine (DPH) for rashes. Infected people should get plenty of rest and drink enough fluids. Aspirin and non-steroidal inflammatory drugs (Ibuprofen and Diclofenac for example) are not recommended due to the increased risk of abnormal bleeding.
The best way to deal with ZikV is to avoid infection in the first place by preventing mosquito bites and controlling their breeding. Cover up in light-coloured, long-sleeved tops and long bottoms and apply insect repellant when going outside. Sleep under nets and cover windows with mesh where possible. Clean your yard of bushes where water can settle and empty (and scrub) as well as cover all containers that water can settle in. If you are pregnant and suspect you have ZikV, ensure you see an obstetrician immediately to allow proper follow-up of the baby for signs of abnormalities.
Ultimately, the decision of delaying pregnancy lies with the woman. You will have to weigh the risks of infection and decide if you are willing to undertake that at this time. If the decision is made to delay pregnancy until the outbreak passes, ensure that reliable contraceptive methods are used (with back-ups if necessary). If pregnancy does occur, then take every precaution to prevent mosquito bites in yourself and your partner.
Dr Anna-Kay Taylor Christmas is a consultant obstetrician and gynaecologist at the Obs and Gynae Centre, Winchester Business Centre. She can be contacted at drtaylorchristmas@gmail.com or 908-3263, 906-2265, 325-7362.
