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Table of Contents   
EDITORIAL COMMENTARY  
Year : 2016  |  Volume : 9  |  Issue : 4  |  Page : 217-218
Standardized management of Zika virus infection during pregnancy


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

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Date of Web Publication28-Jun-2016
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Standardized management of Zika virus infection during pregnancy. Ann Trop Med Public Health 2016;9:217-8

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Standardized management of Zika virus infection during pregnancy. Ann Trop Med Public Health [serial online] 2016 [cited 2019 Oct 23];9:217-8. Available from: http://www.atmph.org/text.asp?2016/9/4/217/184814
Zika virus disease has been declared as a public health emergency of international concern owing to its extensive magnitude and its potential to spread to any part of the world.[1] Pregnant women residing in or traveling to regions with warm climates have an equivalent risk of being infected with the virus as the rest of the population.[2] It has been observed that the infection with the Zika virus during pregnancy is a mild disease and might even go undetected.[2] However, a simultaneous upward trend in the number of cases of congenital microcephaly, Guillain-Barré syndrome, and other neurological complications in the affected regions have significantly raised concern for the pregnant women, their family members, health professionals, and even program managers.[1],[2]

Even though the association between Zika virus infection and fetal microcephaly is yet to be confirmed, causality is suspected owing to the presence of evidence of maternal-fetal transmission during pregnancy and the isolation of the virus from the neurological tissues of infants with microcephaly.[3],[4] Acknowledging the involved risk of Zika virus infection during pregnancy, a set of guidelines have been released to reduce the risk of maternal Zika virus infection, nature of antenatal care for infected women or women residing in affected regions, and to adequately manage the potential complications during pregnancy.[1] However, the ultimate aim is to sensitize the health professionals who will be coming in contact with the pregnant women, and even assist in the formulation of specific national/local protocols related to the antenatal care.[1],[5]

From the prevention perspective, similar sorts of measures have been recommended as for the general population, but the necessity is that all the preventive measures (vector control, personal protective measures to prevent mosquito bites, and safe sexual practices or practicing abstinence throughout pregnancy) have to be emphasized at each and every contact with a pregnant woman.[5] However, the presence of infection is confirmed by reverse transcription polymerase chain reaction in maternal serum/urine/saliva or by detection of IgM antibodies against the infection.[2]

As far as management is concerned, in the absence of an effective drug or vaccine, offering rest, and advocating the use of personal protective measures to decrease the risk of viral transmission to other people remains the primary strategies.[1],[5] Owing to the resource constraints, the World Health Organization does not recommend currently to test for virus among all the pregnant women, but to offer a first-trimester ultrasonography scan to assess fetal morphology.[1] The antenatal mothers are counseled to come to the health center for the scheduled visits or to report to the health personnel on developing any symptoms suggestive of the infection (viz., fever, rash, myalgia, arthralgia, etc.).[1] Further, routine investigations should be performed to rule out other diseases known to present with congenital birth defects.[2]

However, if the fetal microcephaly is detected on ultrasound and the virus is also isolated in maternal serum or amniocentesis, the women should receive special care and counseling in a higher center.[1],[5] Based on the extent of severity and risk of fetal brain abnormalities and the prognosis, the women and the family should be counseled regarding the options available for the management of pregnancy.[1],[2],[5]

To conclude, infection with the Zika virus during pregnancy has emerged as a major public health concern in the affected nations and thus it is the need of the hour to manage the infected pregnant women based on the standardized and evidence-based protocol in all settings.

 
   References Top

1.
World Health Organization. Pregnancy management in the context of Zika virus – Interim guidance. Geneva: WHO Press; 2016. p. 1-7.  Back to cited text no. 1
    
2.
Burke RM, Pandya P, Nastouli E, Gothard P. Zika virus infection during pregnancy: What, where, and why? Br J Gen Pract 2016;66:122-3.  Back to cited text no. 2
    
3.
Schuler-Faccini L, Ribeiro EM, Feitosa IM, Horovitz DD, Cavalcanti DP, Pessoa A, et al. Possible association between Zika virus infection and microcephaly – Brazil, 2015. MMWR Morb Mortal Wkly Rep 2016;65:59-62.  Back to cited text no. 3
    
4.
Besnard M, Lastere S, Teissier A, Cao-Lormeau V, Musso D. Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014. Euro Surveill 2014;19. pii: 20751.  Back to cited text no. 4
    
5.
Oduyebo T, Petersen EE, Rasmussen SA, Mead PS, Meaney-Delman D, Renquist CM, et al. Update: Interim guidelines for health care providers caring for pregnant women and women of reproductive age with possible Zika virus exposure – United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:122-7.  Back to cited text no. 5
    

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Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, 3rd Floor, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.184814

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