Background
- Isolated in Africa first in 1947 -South Pacific’s / Brazil since May 2015
- Increased microcephaly / neurological disorders and GB syndrome
- Cases in Dallas of sexual transmission
- BMJ regular updates at http://www.bmj.com/freezikaresources
Clinical
- Mild self-limiting illness x 2 weeks ¼ only are symptomatic but all are at risk of complications
- If contracted in early pregnancy – worse prognosis
Investigations
On return from an endemic area – advice for pregnancy women – need to see OBGYN for:
- Baseline Fetal USS
- If normal repeat in 4 weekly for the entire pregnancy
- Unlikely to see any anomaly before 20 weeks
If symptomatic – serology and urine test for Zika
- Viral RNA – blood x 5/7
- Urine x 2 weeks
Advice - Going to an endemic area
- Women – don’t go
- Contraception, double barrier, no conception
- Don’t conceive for at least 4 weeks post return
- Men low personal risk
- Suspected or confirmed cases - Male to female transmission possible – avoid conceiving a child for up to 6 months post return
- If asymptomatic still need to use a condom for up to 28 days post return
- Immunity after infection – immunoglobulin in the short term – no vaccine yet
Links
- https://www.hpsc.ie/A-Z/Vectorborne/Zika/
- https://www.hpsc.ie/A-Z/Vectorborne/Zika/Factsheet/Listofaffectedcountries/
- https://www.hpsc.ie/News/MainBody,15521,en.html
- https://www.hpsc.ie/A-Z/Vectorborne/Zika/Guidanceforhealthcareprofessionals/File,15757,en.pdf
- https://www.hpsc.ie/A-Z/Vectorborne/Zika/Guidanceforhealthcareprofessionals/File,15758,en.pdf
- http://www.bmj.com/freezikaresources
- http://www.bmj.com/content/352/bmj.i1062