As the Zika virus continues to make its steady trek across our region, there are more questions than answers, particularly for pregnant women bombarded by news reports of the unfolding epidemic.
Last week, Barbados confirmed that seven people were infected with the virus spread by an infected Aedes aegypti mosquito, three of whom are pregnant.
An unwelcome development and concern for the mothers, especially if like the rest of us they are paying attention to Brazil, with its images of babies with microcephaly –– a condition where the infant has a small head or the head stops growing after birth.
“We are very aware of the fact that with everything in the news right now of course someone who is pregnant is going to be concerned, but I think you have to try to put that into perspective,” says Dr Juliet Skinner, clinical director of the Barbados Fertility Clinic, who strongly advises against panic.
“I don’t think that we understand and know Zika,” she said, expressing concern that pregnant women were being misled into thinking that if they are infected with Zika, their babies will have microcephaly.
“That is a statement that is absolutely by no means true.”
She explained that microcephaly which has been around for decades is similar to other antenatal infections, including rubella and chicken pox, which also cause defects.
“With chicken pox, for example, the risk [for a defect] seems to be between seven and 20 weeks. That risk is between 0. 5 per cent and one per cent in the earlier part of pregnancy –– that’s up to the end of the first trimester.
“Between seven and 12 [weeks] if you were to get chicken pox in pregnancy, you could have a baby with an anomaly. Between 12 or 13 weeks and up to 20, shall I say that risk goes a little bit higher, up to about two per cent.
“But really, really important for those patients right now who are pregnant, 98 to 99 per cent of women with confirmed infection of other types of infection that can cause brain anomalies have a perfectly healthy baby.”
Dr Skinner further explained that a pregnant patient with Zika would be monitored to a greater degree and doctors could discover the unusual.
“Microcepaly can be in many cases be picked up on an ultrasound.
“Ultrasounds can also be conducted as well later on, maybe in the end of the second trimester, and certainly the third, so that there is a level of reassurance for the patient and antenatal recognition for the doctors and paediatricians in question.”
Turning to the developments in Brazil, Dr Skinner said a closer analysis of the high cases of microcephaly showed a number of different factors should be considered before a clear link with Zika could be established.
“There is the issue of a vaccination that was implemented as a mandatory vaccine in 2014. There is also the issue of genetically modified mosquitoes that were released in 2012, that were actually not effective at their goal –– which was to shorten the lifespan and control the mosquito population itself. Actually it virtually did the opposite.
“And indeed I saw a report from today, as the analyses are continuing to be done, that ultimately question that really and truly the microcephaly rise is not just last year. That whatever is going on in Brazil actually predates Zika by a considerable length of time, and the year that they used was actually 2012.”
Dr Skinner says the situation in Brazil and Barbados are very different, and she suggests that any outbreak of Zika here will be reasonably short-lived.
In the meantime, she is advising all citizens to follow the precautions issued by the health authorities, including wearing insect repellant and seriously reducing mosquito breeding.
“Clean up your yard. The ministry is doing their bit; they are continuing to fog and continuing the fogging programme which can also reduce the mosquito population substantially . . . . I think we are hopefully going to find that the outbreak of Zika is going to pretty short-lived.
“With the WHO [World Health Organization] having made the steps now to generate the funds to those research projects, I think there are going to be an awful lot of answers coming and it will be very interesting to see what the facts on Zika are in six months’ to a year’s time.”