Preventing Zika Virus Infection during Pregnancy Using a Seasonal Window of Opportunity for Conception
PLOS BIO. Published: July 28, 2016 http://dx.doi.org/10.1371/journal.pbio.1002520
Micaela Elvira Martinez
- It appears that Zika exposure rate is reduced by 1/2 or perhaps 2/3 by timing of pregnancy
- Note: Fewer than half of pregnancies are planned on average.
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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.
Author Summary
Scientific consensus has now 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. Like related flavivirus infections, ZIKV transmission is likely to be seasonal. I propose that the risk of ZIKV infection to pregnant women can be reduced using a window of opportunity for conception that will align sensitive periods of gestation with the low-transmission season for ZIKV.