Preventing Zika Virus Infection during Pregnancy Using a Seasonal Window of Opportunity for Conception.

Micaela Elvira Martinez

doi:10.1371/journal.pbio.1002520

Micaela Elvira Martinez

Open Access

https://doi.org/10.1371/journal.pbio.1002520

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Abstract

It has come to light that Zika virus (ZIKV) infection during pregnancy can result in trans-placental transmission to the fetus along with fetal death, congenital microcephaly, and/or Central Nervous System (CNS) malformations. There are projected to be >9,200,000 births annually in countries with ongoing ZIKV transmission. In response to the ZIKV threat, the World Health Organization (WHO) is strategically targeting prevention of infection in pregnant women and funding contraception in epidemic regions. I propose that the damaging effects of ZIKV can be reduced using a seasonal window of opportunity for conception that may minimize maternal exposure. Like other acute viral infections—including the related flavivirus, dengue virus (DENV)—the transmission of ZIKV is anticipated to be seasonal. By seasonally planning pregnancy, this aspect of pathogen ecology can be leveraged to align sensitive periods of gestation with the low-transmission season.

Highlights

Scientific consensus has been reached that intrauterine Zika virus (ZIKV) infection can result in infection of the fetus and subsequent fetal death, congenital microcephaly, and/or Central Nervous System (CNS) malformations
Preliminary data suggest miscarriage and congenital Zika syndrome (CZS) are most likely when maternal infection occurs early in pregnancy, but fetal abnormalities have been found in women infected with ZIKV during all three trimesters, indicating all trimesters are vulnerable
In April 2016, the causal link between ZIKV and microcephaly was inferred via several independent lines of evidence, including (1) microcephaly and brain abnormalities in infants born to mothers with suspected or confirmed ZIKV infection during the first or second trimester of pregnancy, (2) the rare form of microcephaly in infants with congenital Zika syndrome (CZS), distinguishing it from microcephaly resulting from other causes, and (3) birth defects occurring in women with travel-acquired ZIKV, coupled with the low probability that these events were coincident and not causal [5]

Summary

Introduction

Scientific consensus has been reached that intrauterine Zika virus (ZIKV) infection can result in infection of the fetus and subsequent fetal death, congenital microcephaly, and/or Central Nervous System (CNS) malformations. Preliminary data suggest miscarriage and congenital Zika syndrome (CZS) are most likely when maternal infection occurs early in pregnancy, but fetal abnormalities have been found in women infected with ZIKV during all three trimesters, indicating all trimesters are vulnerable.

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Conclusion