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    Zika infection in pregnancy



    Neither Dr Hamel nor Dr Hughes has a conflict of interest to report in respect to the content of this article.


    Zika virus was first identified from the Rhesus monkey in 1947 in the Zika Forest, Uganda. The virus was subsequently isolated from humans 5 years later.1 Since the 1950s 3 major outbreaks have been reported: 2007 in the Yap islands of Micronesia; 2013 in French Polynesia; and most recently in 2014–2015 in Brazil. Because the symptoms of Zika are similar to several other viruses such as chikungunya and dengue fever, it is likely that cases in other regions have occurred but have not been identified.1-3

    Prior to 2007, Zika was not reported outside of Africa and Asia, and since it was first reported in Brazil in May 2015, the virus has swiftly spread across South and Central America and into the Caribbean.1 During this time, Brazil has seen a concomitant increase in the frequency of neonatal microcephaly.2 These parallel findings suggested a link between Zika and birth defects—a relationship not previously identified. With the outbreak of Zika infection and its probable link to teratogenicity has come vast media attention. Zika was declared a Public Health Emergency of International Concern by the World Health Organization (WHO) in February 2016 and it is predicted that transmission to new countries and territories will continue during the upcoming months to years.4 In fact, in June 2016, the WHO took the momentous step of recommending that women living in Zika-endemic areas delay child-bearing.5


    Zika is transmitted to humans via the Aedes species of mosquitoes. These mosquitoes are also responsible for the transmission of dengue fever and chikungunya viruses. The Aedes mosquitoes are unique; unlike other species of mosquitoes, they are aggressive daytime biters. The primary species transmitting Zika to humans is the Aedes aegypti and the secondary species is the Aedes albopictus. The virus is transmitted during a blood meal.1 Both Aedes aegypti and Aedes albopictus have been found in the United States, primarily in the southeastern region. Aedes albopictus is the vastly more prevalent species (Figure 1).6

    Maureen S Hamel, MD
    Dr Hamel is a Maternal-Fetal Medicine Fellow at Warren Alpert Medical School of Brown University, Women & Infants Hospital, Department ...
    Brenna L Hughes, MD, MSc
    Dr Hughes is an Associate Professor of Obstetrics and Gynecology at Warren Alpert Medical School of Brown University, Women & Infants ...

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    • Anonymous
      Incorrect spelling of "premethrin". Should be permethrin.


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