THE LATEST SCARE – ZIKA VIRUS AND PREGNANCY

For the last two months, the world is shocked by news of microcephalic babies born after suspected Zika virus infected mothers in South America. These babies have smaller than normal head circumference, with high probability of brain damage, blindness or even deafness. It affects more than 2000 pregnant mothers in South America and the government has advised women to postpone pregnancy for six to eight months in order to avoid potential infection.

Zika virus, is a member of the family Flaviviridae, together with dengue and chikungunya viruses. The main transmission is via mosquito bites, mainly the Aedes Aegypti and A. Albopictus. Majority of patient infected with Zika virus are asymptomatic while others presented with mild rash, fever, muscle pain and conjunctivitis. All these symptoms last for about one week. Only a few cases need hospitalization while Gullain- Barrre syndrome has been associated with this infection.

Testing of Zika virus infection in symptomatic pregnant mother can done using immunoglobulin M and neutralizing antibody. When congenital infection is suspected, an amniocentesis can be used to look for Zika virus RT-PCR.

Currently, there is no specific antiviral treatment available for Zika virus disease. The current treatment is generally supportive, including hydration, analgesia and anti-pyrexia.

 Recommendation for pregnant mothers

The CDC recommends that all pregnant mothers should consider avoiding areas where Zika virus transmission is ongoing. For those who have to travel to these endemic areas, a strict adherence to prevention from mosquito bite must be followed. This includes wearing long sleeved shirts and long pants, using insect repellent and staying in screened-in or air-conditioned rooms.

The viremia period for Zika infection is about one week. This virus will have been removed from the body’s circulation after this short period. Any pregnancy after this interval is unlikely to be harmed by Zika virus.

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Author: Dr Ng Soon Pheng

Dr. Ng Soon Pheng MD(USM), M.Med (O&G), Fellow Reprod Medicine (Singapore), AM (Mal) Dr. Ng Soon Pheng qualified from University Kebangsaan Malaysia (UKM), Malaysia. After obtaining his post graduate degree, Dr. Ng Soon Pheng continued his clinical fellowship training in the field of IVF in Singapore. He was also the recipient of Yayasan Sultan Iskandar (Johor) Scholarship for the fellowship stint. Dr. Ng Soon Pheng has more than 10 years of working experience in the field of Obstetrics and Gynaecology in the public and university hospital, with special interests in infertility. He was an Associate Professor with the Department of O&G in Universiti Kebangsaan Malaysia (UKM) specialising in infertility. Dr. Ng Soon Pheng is currently Consultant Obstetrician and Gynaecologist with special interests in infertility at Columbia Asia Hospital - Puchong.