Congenital Zika: Difference between revisions

From IDWiki
No edit summary
No edit summary
 
Line 11: Line 11:
 
{| class="wikitable"
 
{| class="wikitable"
 
!Trimester
 
!Trimester
 
!Congenital Anomaly
!Any Microcephaly
 
!Congenital Zika Syndrome
 
 
|-
 
|-
 
|first
 
|first
|10%
+
|8-13%
|7%
 
 
|-
 
|-
 
|second
 
|second
|3%
+
|3-5%
|1%
 
 
|-
 
|-
 
|third
 
|third
|4%
+
|3-5%
|1%
 
 
|-
 
|-
 
|overall
 
|overall
|6%
+
|5-10%
|3%
 
 
|}
 
|}
   

Latest revision as of 11:11, 20 September 2020

Background

  • Infection with Zika virus
  • Mostly transmitted by mosquitoes (mainly Aedes aegypti), but can be sexually transmitted
  • Present in most of South and Central America including the Caribbean, sub-Saharan Africa, the Indian subcontinent, southeast Asia, and the Pacific islands
  • Transmission
    • Detectable in serum of pregnant women for 10 weeks after symptom onset
    • Detectable in semen for up to 188 days after symptom onset (but only 69 days for replication-competent virus)
      • Longest documented duration from symptom onset to sexual transmission is 32 to 41 days
Trimester Congenital Anomaly
first 8-13%
second 3-5%
third 3-5%
overall 5-10%

Clinical Manifestations

  • Cranial morphology due to a disruption in the fetal brain sequence
    • Severe microcephaly
    • Overlapping cranial sutures
    • Prominent occipital bone
    • Redundant scalp skin
  • Brain anomalies
  • Ocular anomalies (25 to 55%)
    • Chorioretinal atrophy or scarring
    • Focal pigmentary retinal mottling
    • Optic nerve atrophy
    • Microphthalmia, cataracts, and intraocular calcifications
  • Congenital contractures (5 to 15%)

Diagnosis

  • Testing is only indicated for returned travellers with compatible symptoms
    • CATMAT recommends against routine testing of asymptomatic pregnant women
  • Molecular testing is the mainstay of diagnosis
  • Serology also possible

Prevention

  • For asymptomatic men and women: no recommendations
  • For women who have confirmed infection: wait 2 months after returning from the risk area before trying to conceive
  • For men who have confirmed infection: wait 3 months after returning from the risk area before trying to conceive
  • For men with compatible symptoms or confirmed infection and a pregnant partner: use barrier protection for the duration of pregnancy

Further Reading