Zika Virus and Perinatal Outcomes: Beyond the Myth

Review Article

Austin Gynecol Case Rep.2016; 1(1): 1004.

Zika Virus and Perinatal Outcomes: Beyond the Myth

Matevosyan NR*

Seton Hall University School of Law, Emory University, USA

*Corresponding author: Naira R Matevosyan, Seton Hall University School of Law, New European Surgical Academy, Emory University, USA

Received: June 28, 2016; Accepted: July 20, 2016; Published: July 22, 2016

Abstract

The World Health Organization defines the recent outbreak of Zika infection as a Public Health Emergency of International Concern (PHEIC). An attempt was made to contribute to a comprehensive screening protocol for Zika in pregnancy, based on systematic assessment of the empirical data. A total of 34 published articles, randomly located in the major scholarship portals (Pubmed, LILACS, SCOPUS) and conferring to the level I-IIA evidence, are sampled to inform clinical, serology, imaging, and histology findings from 8,389 singleton pregnancies. Results of a comparative analysis between the Zika-positive and Zika-negative pregnant women presented with macopapular rash suggest that active Zika virus infection is predictive to the adverse perinatal outcomes: prematurity, fetal growth restriction, microcephaly, and Guillain-BarrĂŠ syndrome. Temporal analysis between the viral peak lags, the first acute rash in women, and perinatal outcomes, support such associations.

Keywords: Zika virus; Flavivirus; Microcephaly; Guillain-Barre syndrome; White brain damage

Introduction

Outbreaks of a mosquito-borne flavivirus, known as Zika Virus (ZIKV), are consistently described in South America [1-5], Puerto Rico [6], French Polynesia [7-9], Southeast Asia [10-12], Federated States of Micronesia [13,14], and other parts of the Oceania [15,16]. Present in Africa and Asia decades ago, the ZIKV infection is currently moving to South and Central America [17,18]. It is anticipated, that Zika virus will spread to all other countries in the Americas that have dengue carrying Aedes mosquitoes—that is, all except Canada and Chile [15,17].

Based on the reported clusters of microcephaly, cerebellar hypoplasia, and Guillain-BarrĂŠ syndrome in neonates born to the ZIKV-affected mothers [18-23], the World Health Organization defines Zika infection as a Public Health Emergency of International Concern (PHEIC) [24-26].

Yet, vertical transmission of ZIKV remains ambiguous. Unlike other arboviral or tourism-infections such as Dengue (DEN), Chikungunya (CHIK), West Nile Virus (WNV), St. Louis Encephalitis (SLE), or La Crosse Encephalitis (LAS), Zika infection causes a fairly mild fever, headache, arthralgia, myalgia, and rarely it manifests in maculopapular rash, acute exanthematous illness, or conjunctivitis. About the 80% of persons infected with ZIKV are asymptomatic and the fatality is thought to be rare [27-31]. Evolving findings suggest a presence of Zika virus in the semen, a significant challenge to be addressed for better understanding of teratogenicity and congenital anomalies [32].

Aim

To contribute to a comprehensive screening and diagnostic protocol for ZIKV in pregnancy, based on a systematic assessment of published empirical data.

Sampling

A total of 34 published articles, conferring to the level I-IIA evidence, are randomly identified in the major research portals (Pubmed, SCOPUS, LILACS) to inform clinical (obstetrical, neurological), serology, imaging, and histology findings from 8,389 Zika-affected pregnancies.

Inclusion criteria: rash, and singleton pregnancies.

Exclusion criteria: