This site is a resource for tips and tools for excellence in care for women. It is dedicated to happenings at the Women's Health Education Program of Drexel University College of Medicine. WHEP's programming includes innovative education of health professionals, community outreach, community participatory research and networking with like-minded people interested in overcoming gender health disparities.
Every year about this time, commercials advertising getaways
to Caribbean, Central and South American destinations seem particularly
enticing.But before you pack your bags,
know what you might encounter besides palm trees and tropical breezes – these
days, the talk is all about arboviruses.These are viruses spread by mosquitos and ticks and can cause
potentially debilitating, sometimes fatal diseases. So it’s important to take
appropriate precautions (light weight long-sleeved clothing, a good mosquito
repellent, and a strong dose of common sense) when you travel to endemic
For the last few weeks we’ve been inundated with reports about Zika virus, an arbovirus that may be linked to microcephaly in infants of infected pregnant women.Though a causal relationship has not been definitively confirmed, circumstantial evidence linking a 20-fold increase in cases of microcephaly in Brazil where concomitant Zika virus transmission is ongoing is creating panic.
Zika is not the first, nor is it likely to be the last
arbovirus that has generated alarm in the Americas.It joins West Nile virus, dengue and chikungunya,
all of which spread from Africa eastward to the western hemisphere.Because the presenting symptoms can overlap
somewhat, distinguishing between these viral syndromes can be difficult.Zika infection does not result in hemorrhagic
fever or death the way dengue can.In
fact, most often it is very mild or asymptomatic.However, it may present with an initial
flu-like illness (fever, arthralgia, conjunctivitis) and rash characteristic of
the other viruses.
So why all of the concern?Two reasons:an observed increase
in cases of Guillain-Barre syndrome (a paralyzing neurologic syndrome) and
fetal microcephaly (small brain size) in areas where Zika infection has become
established.In fact, if a causal relationship
is proven, Zika would be the first flavivirus to have teratogenic effects.
There have also been recent reports of
sexually transmitted Zika virus infection.It is not yet clear how effectively it might be spread through blood and
other body fluids, but the CDC and WHO have issued multiple advisories urging
precaution and use of barrier protection (condoms) when engaging in sexual
Given the potential for congenital Zika virus infection,
pregnant women are strongly urged to avoid travel to endemic areas.In addition, if a pregnant woman’s male
partner has recently traveled to these areas, condoms should consistently be
used during sexual intercourse.There
are no commercially available tests at this time, but if Zika infection is
suspected, testing of serum samples (RT-PCR and serologies) can be performed at
the CDC.If positive, fetuses should be
monitored for the development of microcephaly or brain calcification via serial
ultrasound.No vaccines or specific
antiviral treatment are currently available.