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Zika Virus infection in pregnancy: Risk of small brain size in babies

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23 Aug, 2018

Zika is a viral disease, spread by the Zika virus (ZiV), which is a member of the virus family Flaviviridae. The virus is transmitted by the bite of the infected Aedes species mosquitoes (which are daytime active), and it can also be transmitted sexually. This Zika virus was first isolated in 1947, from the Zika forest of Uganda; and hence the name. It is similar to a very mild form of dengue fever. A mild and temporary infection by Zika Virus generally causes symptoms like fever and rashes. There is no specific treatment and usually, Paracetamol and rest are advised.

The biggest danger from the Zika virus is to pregnant women and their fetuses. Zika infections in pregnant women can lead to congenital defects in their newborns such as Microcephaly, in which, the brain of the newborn is small and underdeveloped. A newborn infant can also present with microcephaly if the mother has experienced any of these conditions during pregnancy – drug/ alcohol abuse, diabetes or untreated phenylketonuria, rubella, cytomegalovirus or chicken pox infections, exposure to radiation or certain toxic chemicals.

 

Common symptoms of a child with Microcephaly, aside from a smaller head include high-pitched cry, poor feeding, convulsions, increased movement of the arms and legs (spasticity), hyperactivity, developmental delays, mental retardationAs the child grows older, his or her face continues to grow while the skull does not. This causes the child to develop a disproportionately large face, a receding forehead and a loose, often wrinkled scalp. The rest of the body is often underweight and proportionately smaller than normal.

Currently, there are no treatments proposed to return a child’s head size or shape back to normal. Treatments can only help in reducing the severity of the associated neurological dysfunctions. (Like early childhood intervention programs under the guidance of speech, physical & occupational therapists/ medications to control hyperactivity, seizures and other symptoms)

 

Three laboratory-confirmed cases of Zika virus disease were reported in Ahmedabad District, Gujarat, by Ministry of Health and Family Welfare-Government of India (MoHFW) on 15th May 2017. However, the infections were mild and there were no adverse clinical events.

As per guidelines issued by the Government of India to prevent and control Zika, the 'Integrated Disease Surveillance Programme' needs to track clustered cases of flu (which are people having fever, chills and joint pain) by gathering data from communities and hospitals. Surveillance for Zika also involves looking for people who have traveled to areas with ongoing transmissions such as Brazil and Mexico. In India, since the birth rate is very high, special care needs to be taken to avert birth defects and neurological problems in newborns due to Zika Virus

Though the presence of Zika has only been reported in 3 cases in India, a potential future outbreak cannot be denied as the country provides an optimal climate for the proliferation of the Aedes aegypti mosquito which also carries dengue and chikungunya viruses that claim 100’s of lives and infects 1000’s every year. Thus, a very rigorous surveillance programme which includes detection of ZiV in vector mosquitoes is the need of the hour.