Dr Shelly Singh, Senior Gynecologist Rosewalk Hospital
As the first case of Zika virus is reported in Delhi at the RML hospital, there’s widespread buzz and panic about the virus and its effects in pregnant women.
Let’s attempt to understand more about it.
Zika virus was first detected in Uganda in 1947 and is transmitted by the bite of the Aedes mosquito ( Aedes aegypti and Aedes albopictus); these mosquitoes are found all over the world especially in tropical and subtropical areas and are both day and night biters.
Zika virus causes outbreaks in Central, South and North America and also in and around West Africa. Because of increasing globalisation and international travel, it is likely that there may be infections reported in many more regions.
When the mosquito bites a person infected with the Zika virus, it infects the mosquito, which in turn infects another person by its bite. It enters the person’s bloodstream and causes symptoms of the infection.
The virus can also be transmitted from an infected person to another by unprotected sexual intercourse. Blood transfusion and organ donation by an infected person are also means of transmission.
During pregnancy, an infected mother can spread it to the unborn foetus. This is a dangerous form.
Risk factors
Living in areas where infections are rampant increase the chances of Zika virus infection. Moreover, unprotected sex with partners who have lived or travelled recently from endemic areas also run the risk of getting infected.
Symptoms of Zika virus infection
Remember this infection is very mild. In fact, 4 out of 5 people infected are completely asymptomatic. Infections begin 2 days to 2 weeks after the bite of an infected mosquito. Symptoms are similar to dengue and like many viral fevers last about a week. Most people have a mild fever, rash, severe body ache, a feeling of being unwell, joint pains and red eyes or conjunctivitis.
There is headache, eye pain and maybe accompanying abdominal pain too. Most people recover completely; however, some may have late-onset neurological complications as well as Guillain Barre syndrome even in people who never really had any symptoms of the disease.
Pregnant girls infected with the virus may have a spontaneous miscarriage, preterm births and stillbirths.
Congenital Zika syndrome is a serious birth defect in infants born to mothers who were infected during pregnancy.
These include microcephaly( a much smaller brain and head size) with a partly collapsed skull. There may be brain damage and reduced brain matter, eye damage, hypertonus( too much muscle tone )leading to reduced body movement and joint problems. So as you can see, the virus causes very mild symptoms in the pregnant woman but there are huge ramifications on the unborn baby.
Diagnosis of Zika virus infection
This can be done by RT PCR using the infected person’s serum, urine and throat samples. If the RNA of the virus is detected, it confirms the infection.
Treatment of Zika virus infection
All that is needed is plenty of rest, oral fluids and hydration, paracetamol and over the counter medicines for fever and pain.
Prevention
Currently, there is no vaccine or antiviral treatment for this virus, so prevention by other means is the best bet. Prevent yourself from mosquito bites.
If you are pregnant or attempting to get pregnant, you must not travel to countries where Zika virus outbreaks are common. You must wait two to three months to try to conceive if you have travelled to these regions.
Practising safe sex is important; more so if your partner lives in or has travelled to areas where outbreaks are common.
You must protect yourself from mosquito bites by wearing protective clothing like full-sleeved clothes, long trousers, shoes and socks.
You must use mosquito repellents and if you live in areas that are heavily infested with mosquitoes, you must use a mosquito net as well.
You must make sure that you destroy mosquito habitats such as stagnant water in coolers, flower pots, containers, used automobile tyres.
As is the norm with dengue prevention, you must follow a weekly regime of emptying standing water sources in and around your home. Using oil over drains and other areas which harbour these mosquitos also help to reduce their population and hence chances of infection.