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We posted recently on the outbreak of the Zika virus and the possibility that the virus causes birth defects in unborn children. As of that post, just a month ago, the virus was most recently found widespread in Brazil (starting in May 2015), coming from Africa and Asia. A few cases had been seen in the United States. Now, however, it looks like those numbers are growing.
The CDC has released a warning regarding travel to those areas where the Zika virus is prevalent. Women, particularly those who may be pregnant, should take extra precautions. The World Health Organization (WHO) is meeting to consider whether the virus, present in 25 countries, warrants a concentrated global response as a public health emergency.
On January 26, the CDC released guidelines for healthcare providers.
The first step, particularly for obstetricians and family doctors, is to determine whether a pregnant woman was potentially exposed to the Zika virus. Patients should be questioned about recent travel, and doctors should review the CDC’s website on travel notices. Right now, there are warnings about South America, Central America, the Caribbean, Samoa, Cape Verde and Mexico.
Second, women and their unborn babies should be evaluated according to recent standards. The mother and child should then be evaluated. For the mother, doctors should determine if she has had two or more symptoms (acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis) within two weeks of travel (unfortunately, there is some data which indicates that 80% of those infected have no symptoms). For the baby, the ultrasound should be evaluated for evidence of microcephaly (abnormally small head) or intracranial calcifications.
If those findings are positive, laboratory testing is required to confirm a diagnosis. Additionally, when a Zika-virus has been confirmed, the health care provider should make a report to the CDC.
There isn’t much data yet, and the virus requires more study. However, doctors and scientists are concerned that there may be a correlation between infection by the Zika virus and development of microcephaly in a developing fetus. Microcephaly is the abnormally slow development of the head—usually under the first percentile for the baby’s age. Babies born with microcephaly often have seizures, intellectual disability and shorter life expectancy.
There is no known cure—instead, the regular ultrasounds are required (often in consultation with a maternal-fetal specialist) to monitor the progress of the baby and to determine if the Zika virus is causing any problems. If so, supportive care is required—including, potentially, informed consent about options to abort the pregnancy.
In light of the warnings by the CDC and other governmental agencies around the world, women who are pregnant or who may become pregnant should be particularly careful when traveling to areas of the world where the Zika virus is present. If there is any possibility of infection, consult with your doctor. If you have questions about microcephaly or the Zika virus, contact us at (440) 252-4399, or send us your questions online.
