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Zika Virus in Pregnancy

Zika Virus in Pregnancy. Max Brinsmead MB BS PhD October 2018. Zika Virus. Caused by a Favivirus related to yellow fever, dengue, West Nile and Japanese encephalitis

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Zika Virus in Pregnancy

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  1. Zika Virus in Pregnancy Max Brinsmead MB BS PhD October 2018

  2. Zika Virus • Caused by a Favivirus related to yellow fever, dengue, West Nile and Japanese encephalitis • First noted in central Africa in monkeys in 1947, but appeared in Pacific Islands in 2007, then noted to be spreading as a pandemic from South towards North America in 2014 • Transmitted by mosquitoes mostly Ae. aegypti • This mosquito found only in far N Queensland

  3. Zika Virus Infection • Causes a mild febrile illness in adults • Begins with headache • Maculopapular rash (variable) • Myalgia and Arthralgia • Conjunctivitis • Diagnosis • ELISA for IgM and IgG • Some cross reactivity with dengue • PCR for acute phase viral RNA • Zika virus particles and RNA • Found in fetal brain in mid trimester • With progressive microcephaly seen after maternal infection

  4. Zika Virus in Pregnancy • Apparent transplacentalwith progressive fetalmicrocepahy and brain calcifications • Transmission Risk – Emerging data • Best data from a prospective study in French American territories • Overall 13% 1st trimester and 5.5% 3rd trimester • Microcephaly rate 5.8% of which 1.6% severe • American CDC recommends that any woman who has travelled to a known endemic area and who has two or more symptoms should be tested for ZV IgG • Monitor fetus with ultrasound and • Refer to a Perinatal Specialist Unit for management • No treatment available

  5. Prevention • Pregnant women should avoid travel to areas known to harbourZika Virus • Check current maps and guidelines • Avoid mosquito bites • Very low risk of transmission in Australia as most areas do not have the appropriate species of mosquito that would act as a vector

  6. Sexual Transmission of Zika Virus • Zika Virus can be transmitted sexually • The transmission risk is LOW • But it can be transmitted before a person becomes symptomatic • And possibly by asymptomatic persons • It has been detected in semen for quite long periods • Up to 6 months after infection • Mean clearance from serum was 84 days • 95% cleared in 4 months • Women whose partner has or may have Zika are advised to avoid pregnancy • Check how long with current guidelines • Women in Zika areas are advised to use condoms or avoid sex during pregnancy

  7. Any Questions? Please post a Note on the Welcome Page to this website

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