A few days ago, WHO declared the global health emergency due to the Zika virus, as this disease has experienced an alarming increase in recent months and could be affecting thousands of newborns. Zika had already arrived in Spain and we were wondering if pregnant women were at risk and we didn't have to wait long to get an answer: the first case of Zika virus has been detected in pregnant women, in Spain and in Europe.
This is a 41-year-old woman, pregnant for about 13 or 14 weeks, who has been diagnosed with Zika virus in Catalonia. The pregnant woman had recently traveled to Colombia, and although she is not admitted she is receiving care control and, of course, will undergo more controls than usual. Not all pregnant women affected by Zika have babies with microcephaly, but the risk exists and therefore the development of the fetus must be controlled.
The figures are difficult to know, especially in Brazil, the most affected country, where a few months ago they realized that what should be an exception, the birth of babies with microcephaly, began to look more than normal. In a few months, cases of this congenital defect increased by almost 400%, surpassing 3,500 babies across the country.
But, What percentage of pregnant women who have been infected by Zika have babies with microcephaly? As we say, it is difficult to determine, because not all women who have babies with microcephaly were diagnosed with Zika when they were infected, nor have all cases of Zika been pregnant in pregnant women, nor are the exact numbers of microcephaly known. In addition, the consequences are not the same depending on the quarter in which the infection occurs. And, most importantly, the Zika-microcephaly relationship is still being investigated.
But, to walk from all these uncertainties (or precisely because of them) it attracts the attention that this woman is the first pregnant woman affected by the Zika virus in all of Europe and the most worrying case of the dozen cases detected in Spain (approximately: every week we will have a count of the number of cases in the country) since Zika is, in general, a disease from which most people recover , whose hospitalization rate is low and of zero mortality.
However, there is a sector of the population over which the risk of serious consequences increases and that is the pregnant women: there are strong suspicions that the virus is causing microcephaly problems in babies born to women who became infected with the virus during the first trimester of their pregnancy, although this is not scientifically proven yet. This is what WHO points out in this regard:
In 2015, local health authorities in Brazil also observed an increase in the number of newborns with microcephaly coinciding with an outbreak of Zika virus disease. Health authorities and agencies investigate the possible connection between microcephaly and Zika virus, as well as other possible causes. However, in order to better understand the possible link, further research is necessary.
He also tells us that in recent times, along with Brazil, countries such as France, the United States and El Salvador have provided information to the WHO about a possible association between microcephaly and some neurological disorders and Zika virus disease.
In addition to microcephaly in newborns, Guillain-Barré syndrome would be another of the diseases on which there are strong suspicions of relationship with Zika. It is a rare neurological condition that affects the central nervous system and can cause permanent paralysis. In Colombia it has been linked to the death of several people infected with Zika.
Should pregnant women worry about Zika virus?
The next question is this since, as is logical, in those like these pregnant women will have a more added concern than usual, since at this stage we are very attentive to everything that could harm the baby. In this regard, WHO recalls that health authorities they are investigating the possible link between Zika virus in pregnant women and microcephaly in your children and that
as long as there is no more information, women who are pregnant or who are planning to become pregnant should take precautions to protect themselves from bites.
Finally, they advise that if you are pregnant and suspect that you may have Zika virus disease, you should consult your doctor to closely monitor during pregnancy.
A problem added to this concern is that it can lengthen in time, since microcephaly is a congenital defect that is not easily detected in the first weeks with ultrasound, so sometimes you have to wait until the 20th week of pregnancy to confirm it The Centers for Disease Control and Prevention indicates that to detect microcephaly during pregnancy, ultrasound should be performed at the end of the second trimester or at the beginning of the third.
For their part, countries such as the United States or Spain have recommended pregnant women not to travel to countries where there is Zika. The Spanish Ministry of Health recommends postponing travel to affected areas to pregnant women or who are planning to be:
It is recommended to pregnant women or those who are trying to get pregnant and who plan to travel to areas affected by the transmission of Zika virus to postpone their trips if they are not essential. In case it is not possible to delay the trip, they must take the necessary precautionary measures to avoid mosquito bites. Insect repellents containing DEET (Diethyltoluamide) up to 50% concentrations, picaridin or IR3535 are safe for pregnant women.
The affected areas indicated by the Centers for Disease Control and Prevention (CDC) in the United States are 14 Latin American countries: Brazil, Colombia, El Salvador, French Guiana, Martinique, Guatemala, Haiti, Honduras, Mexico, Panama, Paraguay, Suriname , Venezuela and Puerto Rico. The Pan American Health Organization (PAHO) also includes Ecuador, Guyana, and in the Antilles the island of San Martín, Virgin Islands, Sa Bartolomé, Barbados, Guadalupe.
Microcephaly in newborns
If the relationship between microcephaly and Zika virus is confirmed, new safety measures will probably have to be applied, since this anomaly causes newborns to have a head that is smaller than normal. This is due to the abnormal development of the brain of the fetus in the womb or during childhood.
Infants and children with microcephaly often have difficulties with brain development as they grow and if this organ does not develop normally, a child may have neurological problems, mental retardation, visual defects ... Depending on the area of the brain attacked by the virus, children will have difficulties of one kind or another. However, there are different degrees of microcephaly, which may be mild and not so serious.
It is known that microcephaly can be due to various environmental and genetic factors such as Down syndrome, exposure to drugs, alcohol and other toxins in the uterus, and rubella infection during pregnancy. Everything indicates that this Zika virus will have to be added, which is giving so much talk these days, to the causes of microcephaly, although this does not mean that this relationship always happens.
And we will continue to hear about it. In Spain, the first case of Zika virus has been detected in a pregnant woman, which is also the first in Europe, but surely it will not be the last if the increase in the incidence of the virus continues, a little more and more widely. Do not be alarmed since its consequences are almost always mild and confirmed cases are monitored, but it is normal that during pregnancy it is another concern.
More information | WHO
In Babies and more | What is the Zika virus and what dangers does it pose for pregnant women?