Since Kerala reported the first case of Zika virus in a pregnant woman on July 8, a statewide alert has been issued, and experts have been asked to monitor cases. Zika virus infection can be caused by Zika virus (ZIKV), which is a human flavivirus carried by mosquitoes. It can be transmitted mainly through the Aedes mosquito, which bites in the early morning or even late at night.
zika virus, unlike dengue and chikungunya, it is also transmitted through bodily fluids such as blood, and semen, or even organ transplants. “It is well known that vertical transfer from mother to baby can occur in pregnancy,” said Dr Aruna Muralidhar, senior consultant obstetrician and gynecologist, Fortis La Femme Hospital, Richmond Road, Bengaluru.
According to the World Health Organization (WHO), it was first identified in Uganda in 1947 in monkeys. It was later identified in humans in 1952 in Uganda and the United Republic of Tanzania.
The incubation period, which is the time between exposure to the virus and symptoms, can be seen in 3-14 days, according to the WHO. Some people infected with the virus may have no symptoms, while others may experience symptoms such as fever, a mild rash or body aches. In extreme cases, a person may also exhibit persistent headaches and eye infections for 2-7 days, said Dr Manjeeta Nath Das, senior consultant, internal medicine, Columbia Asia Hospital, Palam Vihar Gurugram.
“About 80 percent are asymptomatic. Symptoms are usually mild in symptomatic people and last about 2 to 7 days and resolve,” says Dr Aruna.
What are the risks in pregnancy?
According to experts, if infection occurs in pregnancy, there is a risk of miscarriage and certain birth defects. The most common fetal defect is microcephaly or a small head, said Dr Aruna. “The combination of microcephaly and certain neurological problems is called congenital Zika syndrome. However, this does not affect every fetus born to Zika-positive mothers. It is reported in about 10 percent of cases especially if Zika infection occurs in the first trimester,” he said.
According to WHO, an increased risk of neurological complications is associated with Zika virus infection in adults and children, including Guillain-Barré syndrome, neuropathy and myelitis.
WHO also states that congenital Zika syndrome includes other malformations including extremity contractures, high muscle tone, eye abnormalities, and hearing loss. The risk of congenital malformations after infection in pregnancy is unknown; an estimated 5–15 percent of infants born to mothers infected with the Zika virus during pregnancy have evidence of Zika-related complications. Congenital malformations occur after symptomatic and asymptomatic infections.
However, as per WHO, “Research is ongoing to investigate the effect of Zika virus infection on pregnancy outcome”, and the effect of infection on other neurological disorders in children and adults.
There is no vaccine for Zika virus infection. Treatment is usually symptomatic with paracetamol, hydration and rest. Also, avoiding aspirin or NSAIDs (nonsteroidal anti-inflammatory drugs or painkillers) during an infection is recommended.
According to WHO, pregnant women who live in areas with Zika transmission or who develop symptoms of Zika virus infection should seek medical attention for laboratory testing and other clinical care.
Dr Aruna advises steps to be taken during Zika outbreaks or otherwise to prevent infection
*Safe mosquito repellent
*All anti-mosquito measures in and around the house including full clothing
*Use barrier contraception if partner is infected with Zika or exposed to Zika.
*Avoid travel to Zika-affected areas.
You can also use mosquito nets and door curtains to keep mosquitoes away from your home. Make sure there are no objects and materials around your home that can become a breeding ground for Aedes mosquitoes during the rainy season, says Dr Rajesh Kumar, internal medicine, Paras Hospitals Gurugram.
Dr Surabhi Siddhartha, consultant obstetrician and gynecologist, Motherhood Hospital Kharghar also mentioned some simple steps to take.
“To prevent this, don’t let water pool near the house and prevent mosquito breeding, do regular fogging, wear long sleeves and use insect repellent. As with other viral infections, treatment is symptomatic. So, prevention is better than cure for this infection,” said Dr Surabhi.
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