Features  |   March 2017
Zika Virus: Points to Ponder?
Author Affiliations
  • Charles J. Chase, D.O.
    Committee on Obstetric Anesthesia
Article Information
Infectious Disease / Features
Features   |   March 2017
Zika Virus: Points to Ponder?
ASA Monitor 03 2017, Vol.81, 18-19.
ASA Monitor 03 2017, Vol.81, 18-19.
An insidious infectious disease has captured world attention and generated fear in the hearts of all pregnant women. Unless you have been living on Mars with no communication to planet earth, the word “Zika” immediately comes to mind. Unfortunately, it is most likely only a matter of time before this disease presents to your OB unit. So how does one treat a patient with active Zika infection?
To understand treatment, one must understand the pathogenesis of the virus. Zika is a member of the flavivirus genus of viruses. This genus includes West Nile virus, dengue virus, tick-borne encephalitis virus, yellow fever virus, Zika virus and several other viruses that may cause encephalitis.1  Flaviviruses are named from the yellow fever virus. Flavus means yellow in Latin (remember ligamentum flavum?). Typical of flavivirus, Zika is a single-stranded RNA virus transmitted by vectors, specifically in this case the Aedes species of mosquitos commonly found in many areas of the United States. Of note, Aedes Aegypti and Aedes Albopictus actively bite both during daylight and evening hours and make themselves at home both indoors and outdoors. Other modes of transmission include sexual relations (both semen and vaginal fluids), maternal-fetal transmission and blood transfusions. Zika RNA is also present in urine, amniotic fluid, saliva and breast milk; however, no cases of transmission from mother to infant through breast milk have yet been documented.2,3  Of concern, West Nile Virus, also a flavivirus, is transmitted via milk ingestion to the newborn.4  Despite this finding, breastfeeding recommendations are unchanged to date.
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