Zika Virus in Pregnancy Max Brinsmead MB BS
Zika Virus in Pregnancy Max Brinsmead MB BS Ph. D October 2018
Zika Virus Caused by a Favivirus related to yellow fever, dengue, West Nile and Japanese encephalitis l First noted in central Africa in monkeys in 1947, but appeared in Pacific Islands in 2007, then noted to be spreading as a pandemic from South towards North America in 2014 l Transmitted by mosquitoes mostly Ae. aegypti l l This mosquito found only in far N Queensland
Zika Virus Infection l Causes a mild febrile illness in adults l Begins with headache l Maculopapular rash (variable) l Myalgia and Arthralgia l Conjunctivitis l Diagnosis l ELISA for Ig. M and Ig. G l Some cross reactivity with dengue l PCR for acute phase viral RNA l Zika virus particles and RNA l Found in fetal brain in mid trimester l With progressive microcephaly seen after maternal infection
Zika Virus in Pregnancy l l Apparent transplacental with progressive fetal microcepahy and brain calcifications Transmission Risk – Emerging data l l l l Best data from a prospective study in French American territories Overall 13% 1 st trimester and 5. 5% 3 rd trimester Microcephaly rate 5. 8% of which 1. 6% severe American CDC recommends that any woman who has travelled to a known endemic area and who has two or more symptoms should be tested for ZV Ig. G Monitor fetus with ultrasound and Refer to a Perinatal Specialist Unit for management No treatment available
Prevention l Pregnant women should avoid travel to areas known to harbour Zika Virus l Check current maps and guidelines Avoid mosquito bites l Very low risk of transmission in Australia as most areas do not have the appropriate species of mosquito that would act as a vector l
Sexual Transmission of Zika Virus l Zika Virus can be transmitted sexually l l It has been detected in semen for quite long periods l l Up to 6 months after infection Mean clearance from serum was 84 days 95% cleared in 4 months Women whose partner has or may have Zika are advised to avoid pregnancy l l The transmission risk is LOW But it can be transmitted before a person becomes symptomatic And possibly by asymptomatic persons Check how long with current guidelines Women in Zika areas are advised to use condoms or avoid sex during pregnancy
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