Having babies in the time of Zika…

When 28-year-old Riddhima Saxena (name changed) learnt of her pregnancy, the good news was mixed with worry. She was advised by friends and well wishers to not take any chances and go for tests since her husband worked in Brazil, where the Zika virus has been raging.

The panic stems from the spread of the virus in South America, and the World Health Organisation (WHO) declaring Zika a public health emergency.

Pamela M Aaltonen, Associate Head with the Purdue School of Nursing (US) explains: “The virus, first isolated approximately 60 years ago, has now expanded well beyond its historical parameters of equatorial Africa and Asia. The current El Nino weather pattern may provide better conditions for expanded mosquito populations.”

The mosquito vector (primarily Aedes aegypti) is in India, and other parts of the globe, so there is an increased potential for a geographical spread.

But gynaecologist Sudha Marwah stresses that there is no need to panic, even for those infected, as it is not like dengue or chikungunya where the platelet count falls to levels which could prove fatal.

Experts say that most individuals infected with the Zika virus have self-limiting symptoms such as mild fever, headache, skin rash, muscle and joint pain and conjunctivitis which can last for upto seven days; some exhibit no symptoms at all.

The worrying aspect, though, is that the Zika virus is linked to a condition where babies are born with an abnormally small head size that can affect the child’s future development. This assumes significance particularly for women in Zika-virus-affected countries; they have been advised to avoid pregnancy, while those already pregnant face severe anxiety.

Purdue’s Aaltonen says that women of child-bearing age should discuss potential risks of the Zika virus with their partners and healthcare providers.

Research is still underway and there is no clear evidence if the virus affects early into a pregnancy or could even impact those women in advanced stages of pregnancy where the head of the baby has already been formed, observes Marwah.

Closer home, neighbouring China too has reported its first case of the Zika virus and many believe it may just be a matter of time when a populous country like India identifies its first case.

Aniruddha Malpani, who heads Malpani Infertility Clinic, says: “My biggest worry is that this will unleash an epidemic of anxiety and panic, which will lead to overtesting and overtreatment, especially when we don’t have the tools to diagnose this illness. Lots of women maybe pressurised into terminating a completely healthy baby because of fear and doctors will not be able to reassure them.”

Malpani adds that even doctors don’t have a good idea of the risks and prevalence, so this makes it hard for them to give sensible advice. So the word of caution that doctors give is to maintain excellent mass municipal hygiene to prevent mosquito breeding and, most importantly, not spread panic.

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