Everything pregnant mums in Singapore need to know about Zika virus
If you are a pregnant mum in Singapore or are currently trying to conceive, here's everything you need to know about the Zika virus and how it can affect you and your unborn child
Pregnancy is a joyous yet nerve-racking experience for all expecting mothers as you eagerly keep track of your baby’s growth and development, and anxiously go for prenatal check-ups and scans to make sure that everything’s alright.
Or if you’re currently trying to conceive, you might be avoiding certain things and going through great lengths to prepare your body to be in optimal condition for your pregnancy.
But with the recent Zika infection outbreak in Singapore, and the first case of a pregnant mum getting infected, mothers-to-be now have one more thing to worry about.
So what exactly is the Zika virus and the risks that all expecting mums and those planning to conceive should be aware of?
What can you do to protect yourself and your unborn child from this potentially life-threatening virus infection?
theAsianparent spoke to Dr Christopher Chong, Obstetrician & Gynaecologist at Gleneagles Hospital, who offers his expert medical advice to all expectant mums and women currently trying to get pregnant.
If a mosquito bites a person infected with Zika virus, it can then pass that virus to the next person it bites.
The Centers for Disease Control and Prevention (CDC) has also confirmed that it can be passed from person to person via sexual transmission even before they show any symptoms, while they are experiencing the symptoms, and after their symptoms have ended.
According to the National Environment Agency (NEA), the first imported case of Zika virus infection in Singapore was reported in May 2016, and the patient was a 48-year-old male Singapore Permanent Resident who had travelled to Brazil.
By the end of August 2016, there were 115 cases of local transmission, including the first case of a pregnant woman who lived in the same household as another person also diagnosed as positive for Zika virus.
Symptoms of Zika virus infection
According to Dr Chong, most people with a Zika infection will show no symptoms.
But if symptomatic, the symptoms are typical of viral infections, which include:
- Joint pain
- Bone aches
- Conjunctivitis (red eyes)
- Flu-like symptoms
These symptoms usually develop 3 – 12 days after a mosquito bite and can last for 4 – 7 days.
Although a majority of people don’t display any symptoms of a Zika infection, Dr Chong says that it is not necessary for pregnant women to go get checked unless they show symptomatic signs.
What are the effects of Zika virus on your unborn child? Go to the next page to find out
What to do if you think you’re infected
If you think you are infected with Zika virus and are showing signs of infection, the National Environment Agency (NEA) advises you to seek immediate medical attention where your condition will be assessed and you can get a referral to be tested.
Alternatively, you could also go directly to any hospital’s emergency department.
Your blood or urine can then be checked for Zika through the the reverse transcriptase-polymerase chain reaction (RT-PCR) test.
This test is only able detect Zika infection in your blood within five to seven days of onset of symptoms and in your urine within 14 days, so it is important that pregnant women displaying symptoms to get tested as soon as possible.
The Zika Clinical Advisory Group of Singapore has also advised the Ministry of Health (MOH) to offer tests, free of charge, to pregnant women who display symptoms of Zika, not just limited to the outbreak area, but across the nation.
But if you are pregnant and tested positive for Zika virus, Dr Chong explains that it is not easy to thoroughly test your baby for signs of infection as this will involve invasive procedures which has a risk of miscarriage.
Getting yourself tested would suffice at the initial stage and you will also be admitted to a public hospital to be closely monitored by an O&G doctor.
Currently there is no available treatment for Zika virus infections in Singapore, nor is there a vaccine or anti-viral medications.
If you are pregnant and have tested positive for Zika virus and choose to terminate your pregnancy, this is a personal choice between you and your partner which should be carefully made after consulting with your doctor.
Effects on your unborn child
Pregnant women who are infected with Zika can pass the virus to their baby, that may cause a rare neurological condition called microcephaly.
Babies affected by this nervous system disorder will be born with significantly smaller heads and often will have:
- Developmental issues
- Poor growth
- Poor feeding
- Mental retardation
- Brain damage
But microcephaly is not just due to Zika virus as it can also be caused by other infections such as down’s syndrome and rubella (german measles), a problem with the mother’s genetics, toxic chemicals (like lead), malnutrition, exposure to drugs and alcohol, or an injury to the brain after birth.
Dr Chong says that not all Zika infected pregnant mums will have babies with microcephaly, such as the recent case of baby Micaela Mendoza who is currently being closely monitored by doctors in the USA.
“The foetus of a person with Zika infection does not necessary get infected or have microcephaly [and] the percentage [of this occurring] is not known”, he explains.
Go to the next page to learn how you can prevent getting infected by Zika virus
Will Zika affect your future pregnancies?
Dr Chong’s advice for women who are trying to conceive is, “Singapore has just reported some clusters and the severity is still too soon to tell, so unless there are special reasons, your pregnancy should be postponed [until] the spread or control is clearer”.
He says that currently there are no known long lasting effects on a woman should she get infected by the virus, nor is there any evidence that her future pregnancies will result in any birth defects.
Women who have been infected by Zika virus are advised to wait at least eight weeks after they first showed symptoms before trying to conceive.
As Zika virus can remain in body fluids such as vaginal secretions, urine, blood, and even longer in semen, if you are attempting to get pregnant but your male partner has been infected with Zika, it is advised that you wait six months before trying.
How to prevent getting infected
There are several ways you can prevent yourself from getting infected by Zika virus:
Dr Chong says that it “May be prudent to close windows and use the air-conditioner in the present period while awaiting the outcome of the disease spread in Singapore”.
Aedes mosquitoes (which can transmit Zika virus) feed at their peak at dawn and dusk, so it is is best to stay indoors during these times.
You can choose to install wiring mesh or mosquito screens on your windows and door grilles to prevent any mosquitoes from entering your house.
It is also advised not to go to any of the affected areas in Singapore.
In addition to wearing long sleeves and long pants to avoid getting bitten by mosquitoes, you should also slather on some mosquito repellent.
Although some pregnant women may steer clear away from DEET, an active ingredient found in most insect repellents, experts advise that in such an outbreak of mosquito-borne viruses like Zika, you should use a repellent that contains high amounts of DEET and to also reapply it as often as necessary.
Whether you are already pregnant or currently trying to conceive, it is best to refrain from having intercourse with your partner if he is infected with Zika virus, or suspected of an infection.
If necessary, then it is recommended that you use condoms or other protective barriers to reduce the chance of infection.
Dr Chong advises women who are trying to conceive to “postpone having a child in endemic areas or if an area shows a rise in Zika infections, [until] the infection problem is well under control”.
This campaign by the National Environment Agency (NEA) encourages the public to help prevent mosquito breeding by doing the following five simple steps:
1. Change water in vases or bowls regularly
2. Turn over any water storage containers (such as buckets) when not in use
3. Remove any water from your flower pot plates
4. Cover your laundry bamboo pole holders when not in use
5. Clear your roof gutters and put in Bti insecticides every month
Dr Chong urges everyone to, “Take precautions against mosquitoes. Play a part in the country’s efforts in preventing Zika or generally mosquito related diseases”.
What are the health consequences of Zika on infants, toddlers and older children? Read our next article about Zika and kids for more insight from medical experts