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Common mosquito borne viruses- should they all be considered in pregnancy?

Posted on 5 March, 2020 at 0:40


 

In 2015-2016 the world was awakened to the affects of the Zika virus in pregnant women and the devastating risk of microcephaly. Since that time the world has evolved into discussing the risks associated with mosquito transmitted Zika virus with pregnant travellers visiting high risk countries. The levels of risk in some countries has fallen as the attention to bite avoidance and counter-measures has increased. Now in 2020 the attention is currently on coronavirus and what are implications for global public health, yet does the risk from other mosquito borne infections remain consistent?

 

At the time of writing the global number of infections due to coronavirus is calculated around 80,000; yet in one country last year 30,000 cases of dengue were reported last year. The levels of Aedes borne infections (dengue, chikungunya) are increasingly being reported and appear to be rising, although this has to be balanced against a case for improved health reporting.

 

With the risk of these virus infections being spread pregnant women in high risk areas a recent paper has reflected on the levels of risk for dengue and chikungunya infections as well as Zika ( Dengue, Zika and chikungunya during pregnancy: pre- and post-travel advice and clinical management- Journal of Travel Medicine, 2019, 1–13).

 

In this paper the researchers have reviewed the pre and post travel advice of the 3 infections. Their main findings are that dengue may be associated with complications due to its infection risk of post-partum haemorrhage. Zika continues to be teratogenic and chikungunya although of lower risk during pregnancy carries a risk of infection at the time of labour. Therefore the risks from Zika continue and the risks associated with dengue may not be realised fully as the impact of risk from haemorrhage are not fully realised.

 

This impacts on the travel health professional in the advice they provide. Countries reporting a risk of dengue need to be highlighted to pregnant traveller due to the associated risks of potential haemorrhage. Whilst Zika, more importantly, highlights the teratological risks. All viruses have documented evidence of foetal transmission during pregnancy.

 

Therefore, although coronavirus is capturing the headlines currently, there is a need to be increasingly aware of mosquito borne viruses which have higher reported levels and their infection in pregnancy.

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