Despite the guidelines issued by the ministry of health and family welfare (MoHFW) for mandatory testing of all pregnant women in Zika virus-affected areas, Pune Municipal Corporation (PMC) has tested only 5% of expecting mothers from these areas. Given the negligible number of expecting mothers tested, the public health department has now asked PMC to test all expecting mothers from Zika-affected areas, officials said.
In a letter sent to PMC health officer dated July 11, joint director of health services Dr Radhakishan Pawar – who is also in charge of vector-borne diseases in Maharashtra – has directed that all expecting mothers living within five kilometres of Zika-affected areas be tested for Zika virus infection. Dr Pawar has also asked the Ahmednagar and Kolhapur municipal corporations to follow the directions as both had reported one case of Zika virus each in the past.
The letter sent by Dr Pawar, a copy of which has been seen by Hindustan Times, states, “During scrutiny of your Zika virus report, it was found that a negligible number of pregnant women have been tested for the virus infection. The virus infection poses a threat to expecting mothers, and pregnant women in Zika-affected areas should be tested. The virus can cause adverse pregnancy outcomes that include congenital Zika syndrome, Guillain-Barré syndrome, and microcephaly. It is important to monitor the health of the expecting mother as well as provide timely treatment.”
The PMC has reported active Zika virus transmission in seven ward office jurisdictions namely, Karve Nagar-Warje; Hadapsar; Kothrud-Bavdhan; Aundh-Baner; Sinhagad Road; Nagar Road; and Yerawada. A total of 18 Zika virus cases have been reported since June 20 which includes 10 pregnant women. There are 2,408 expecting mothers in Zika-affected areas registered with PMC-run hospitals for antenatal care. However, only 129 (5%) of them have been tested for virus infection.
Dr Pawar said, “The PMC can get all expecting mothers tested to avoid delay in starting the treatment. If they test negative, the health officials should monitor the health of these pregnant women, their babies and keep following up as per the central government guidelines. Irrespective of whether the pregnant woman is residing in an area of ongoing Zika transmission or not, she should take all possible measures to prevent mosquito bites. All pregnant women should avoid non-essential travel to areas in active ZIKV-affected areas.”
Dr Kalpana Baliwant, health officer of PMC, said that the team is working on the ground and taking samples of expecting mothers and sending them to the National Institute of Virology (NIV) for testing. “Most of the samples sent by the PMC to NIV for testing are those of pregnant women. The problem is that expecting mothers are reluctant to give their blood samples for testing as they do not have any symptoms. We are creating awareness among the public and asking doctors to counsel pregnant women to get themselves tested for Zika virus.”
According to the MoHFW, Zika virus transmission can occur through mosquito bites, from mother to foetus, and during sexual transmission. All pregnant women residing in an area with ongoing Zika transmission should be tested for ZIKV disease. Asymptomatic pregnant women should be tested during the first antenatal visit or at the time of showing symptoms of ZIKV disease (whichever is earlier). If the initial test is negative, the pregnant mother should be tested at 28 weeks of gestation.
Furthermore, all pregnant mothers should undergo two ultrasound examinations. The first ultrasound scan should be performed at 18 to 20 weeks and the second ultrasound scan between 28 to 30 weeks of gestation. Serial ultrasonography, if required, should be at the discretion of the treating gynaecologist and concerned radiologist, according to the MoHFW guidelines.
Rohit Malhotra is a medical expert and health journalist who offers evidence-based advice on fitness, nutrition, and mental well-being. His articles aim to help readers lead healthier lives.
