The CDC (Centers for Disease Control and Prevention) recently updated its guidelines concerning the testing of pregnant women who have a possible Zika virus infection or exposure. It must always be noted that most people with the Zika virus infection are either asymptomatic or have mild clinical symptoms. Mild clinical symptoms can be an acute onset of a fever, a rash, joint pain, and/or conjunctivitis.
There is new data suggesting that the virus can be detected in the blood and urine for 2 weeks after the infection begins. This testing of the urine and blood for the virus should be performed for:
Symptomatic pregnant women in less than 2 weeks after the symptoms begin
Asymptomatic pregnant women in less than 2 weeks after a possible exposure
After this 2-week window, blood testing should begin for the Zika virus IgM antibody, which the body makes in response to a new Zika virus infection. If this is found to be positive, there was definitely an infection and close fetal evaluation should begin.
As always, you should discuss the Zika virus problem with your health care provider so you can get the best possible care.
Are you approaching or in menopause and are concerned about its symptoms? My office manager and I are here to help! We discuss bio-identical hormone replacement therapy questions and answers. You will hear an introduction about the therapy, and I will help you understand it with more depth.
At the moment, there are no approved drugs or vaccines for the Zika infection, but scientists are working on a vaccine. Since the infection itself seems to be mild and short-lived, fluids and Tylenol are mostly recommended.
Testing to determine if you have had the virus is mainly confined to pregnant women and symptomatic travelers who have visited the areas where the virus has spread. At this time, testing is done at only a state or federal lab and getting results can take weeks.
3. How It Spreads
The Zika virus is spread by the Aedes aegypti mosquito and through sex with an infected partner. It is important for pregnant women to know the travel history of their sexual partners.
Preventing mosquito bites is the best way to protect yourself from this virus. Use the time-tested methods of bug sprays and cover-ups, and eliminate any standing water where mosquitoes can lay eggs. You should check your window screens and keep the air conditioners on if possible because mosquitoes hate the cold.
Today, the Zika virus is on the mind of almost everyone; pictures of the children affected by the virus are seen constantly in the news. Beginning today, I will try to keep us up to date on the latest information available.
The virus is named after the Zika Forest in Uganda, Africa, where it was first discovered in the late 1940s. Since then it was not considered to be a major problem because it usually caused mild flu symptoms, which soon passed rather quickly. Then last year’s reports came from Brazil about a major invasion of the virus. There were pictures of the many affected newborns that had been infected, and the resulting congenital microcephaly was seen everywhere.
Why is this virus now causing all these problems? Where has it been the last 60-70 years? Some experts believe the virus has mutated, and some think it has always been there, but was quietly going unnoticed.
As the summer approaches and the mosquitoes return, the Zika virus will certainly be a concern in the mainland of our country. Puerto Rico already reported about a 1000 confirmed cases, including approximately 100 pregnant women. With the travel season upon us, the numbers of our family and friends who will be exposed to the virus is staggering, so being aware of the latest information is paramount in our quest to be safe.
Just yesterday one of my patients asked me about the effectiveness of the morning-after pill in a woman like herself, who was overweight. I knew that obesity could be associated with a decrease in the effectiveness of the birth control pill and the morning-after pill, but I could not give her better information.
Recently, there were a few review articles showing that studies are limited. Let me give you some questions to ask your health care provider about this situation, especially since about 25% of women in the childbearing age group are considered to be obese based on their BMI:
How effective is the birth control pill in overweight women?
Being overweight, is there a pill that could be more effective?
Could a vaginal ring or IUD be a better consideration?
Is the risk of blood clots increased with the pill?
Does bariatric surgery have any effects with the use of the pill?
I hope these questions will open the door for a good discussion so that the best medical treatment plan can be established.
Depression and anxiety disorders are a common problem found in pregnant women, with about 10-15% of these women taking a class of medications known as SSRIs (selective serotonin reuptake inhibitors). Prozac and Paxil are two of the medications found in this group. Studies of the children who had been exposed to these medications while in utero have been mixed in their findings.
There is now a new study out of Finland which may shed some new light. It is published in the Journal of the American Academy of Child and Adolescent Psychiatry. The findings showed that the adolescents of women, who took SSRIs during pregnancy, had about 4 times the chance of becoming depressed by the age of 15, as compared to the children of women who suffered anxiety/depressive disorders and did not take the medications during their pregnancy.
I encourage all women who receive prescriptions for SSRIs to discuss with their health care providers the risks and benefits of these medications during pregnancy, before becoming pregnant. It is better to have a plan of care so you can have the best pregnancy for you and your baby.
Let us continue our update and review of vaginitis from my last post about this topic.
To better understand why vaginitis occurs, let us look at the vaginal environment. The lining of the vagina is made of squamous epithelial cells. These are flat and stratified, which means that there are multiple layers of these calls. These cells are rich in glycogen – a storage form of glucose. Remember, glucose is the most important simple sugar, and it is used as a source of energy for all human functions.
The squamous cells are continuously being shed from the lining and the glycogen in these becomes the energy for the lactobacilli that are naturally found in the vagina. These bacteria convert the glucose into lactic acid, which keeps the vaginal environment in an acidic state, helping to maintain the normal vaginal bacterial flora plus preventing abnormal organisms from growing.
If you disrupt the normal community of organisms, vaginitis can occur. There are many factors that can affect this natural environment:
Estrogen levels, for example, a menopausal state where estrogen levels are decreased
Different phases of the menstrual cycle
Sexually transmitted diseases
Different medications such as oral contraceptives and antibiotics