The first
outbreak of Zika virus occurred in South America occurred in Brazil in May 2015
subsequently in October Columbia confirmed 156 cases of Zika in 13
municipalities.[1] Neurological abnormalities and other adverse
pregnancy outcomes are associated with Zika infection in first and second
trimester of pregnancy.
A recent
surveillance report from the Colombian Instituto Nacional de Salud (INS) suggested
that Zika infection in the last trimester of pregnancy does not cause any
structural fetal defect. The report of this study was published in recent
online edition of New England Journal of Medicine.[2]
A total of 65,726
cases of ZVD were reported in Colombia during the study period from August 9,
2015, through April 2, 2016. Out of these 2485 (4%) were found positive on
RT-PCR assay. Zika infection was widespread in Colombia with 11,944 pregnant
women affected, of which 1484 (12%) were confirmed on RT-PCR assay.
Out of
11,944 infected pregnant women, INS had complete data on for a subgroup of 1850
women correlating gestational age and the onset of symptoms of Zika infection.
Out of these 1850 women, 616 women got infection in third trimester and in
nearly 89-90% of these women no congenital anomalies were detected at birth.
The
remaining women were infected in first and second trimester, so they still had
ongoing pregnancy when the cut-off date of the study was reached.
The number
of cases reported in the study does not show the true magnitude of the Zika
infection as the surveillance system does not include asymptomatic women or
those women who do not go to healthcare provider.
The authors
stressed the importance of healthcare providers in educating the patients about
the vector and sexual mode of transmission of the Zika infection.
The INS and
CDC jointly are implementing intensified surveillance in places with Zika
infections to determine the full spectrum of disease in mother and infants in
relation to gestational age at infection.
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