The Zika Virus In Pregnancy And Its High Risk Of Morbidity And Mortality

The Zika virus in pregnancy and its high risk of morbidity and mortality

The Zika virus with respect to the OMG (World Cup Organization), declared the first global health emergency in 2016 trying to stop the extension of this disease, it has also been related to cases of microcephaly in babies and babies in babies andWith Guillain-Barré syndrome. Studies have also demonstrated how Zika can pass through sexual transmission.

The pathogen is presented mostly in countries with temperate climates such as the majority in South America, which have taken a lot of prevention and have promoted a program series which will aim to stop the transmitter agent using media such as mosquito eradication, evenAttend pregnant women, keeping alert all the time.

Having current data we know that in relation to infection and its consequences at the neurological level in fetal development. Which leads to the birth rate is falling considerably, since it attacks the fetus in its embryonic process. This when it occurs in mostly in countries with not so balanced economic stability or even in certain low cases it brings many problems in which we find health, social and economic problems. Not there is a vaccine for the virus this has spread allowing it to reach Europe, but only in imported cases, trying to find a way in which the infection can be stopped. (SN, 2016)

Introduction

Talk about the origin of the pathogen and how their first outbreaks were given, giving information about how people reacted and how was the impact on society in the face of such a threat at that time and time now.

Explain the Zika Transmission Method and where the agent can be found at the time of being in people. Epidemiological theoretical purposes that justify the relationship between the Zika virus and pregnancy when presenting as the cause of fetal death allegedly caused by the disease.

The essential purpose of the subject is to review data related to the virus and its consequences, describing them as presented to society and where its origins or its first outbreak were, reflecting information such as the repercussions it has brought inThe social scope and as the causal agent of malformations in babies at the time of birth, as well as guiding pregnant women to prevent virus spreading by applying an exemplification of detection system in health center, also design strategies to reducethe presence of the mosquito and minimize the possibility of outbreak in case their conditions allow them to survive. This will be done so that the reader has knowledge about the virus and how to stay prevented or at least be aware of the early state of the disease, to be able to detect it in time and counteract it. Serving as information which will help establish the prevention and control measures that are required, as well as helping to control the manifestations of the pathogen and thus be alert to any threat of this virus and guarantee the correct management of cases to reduce thetransmission risk.

The matter to be treated is vital since society must be informed of this type of pathology, in order to be able to diagnose it and that people suffering from this disease can be treated in an effective way in which its recovery is given in a wayfast.

The purpose of this essay is to capture the attention of society which may have knowledge of protection methods and how infection affects society in general, first and foremost to the child population and how to have greater prevention in people.

GENERAL

The viruses were originally described as filtrable agents, this to have a very small size, it is possible that these pass through the filters used to stop bacteria. Unlike many pathogens in charge of hurting the human body, viruses are intercellular paracites which depend on all times on a guest and cell machinery, this to carry out their replication process and consume the nutrients that you need forsurvive. We know that viruses cannot generate or lack the ability to create energy or substrate, just as they cannot manufacture their own proteins, as well as duplicate their own genome independently. Therefore, he has to adapt as a kind of paracito that enters his victim’s body to follow his biochemical processes. Approximately a virus measures between 18 and 300 nanometers. One of the most used classifications is "Baltimore classification", which divides viruses into seven groups:

• Group I: Bician DNA virus (double chain).
• Group II: Monocatenary DNA virus (positive).
• Group III: Bician RNA virus.
• Group IV: POSITIVE MONOCATENARY RNA VIRUS.
• Group V: Negative Monocatenary Virus.
• Group VI: Transcribed retro monocatenary RNA virus.
• Group VII: TRANSCRIBED RETRO BICATENARY DNA VIRUS.

Central nervous system (brain)

It is protected by 3 membranes that are the dura, arachnoid and piamadre, which is constituted by the brain and the spinal cord, it in turn is protected by bone wrap which is the skull and spine. The central nervous system presents cavities in which there is an colorless and transparent liquid that bears the name of cephalorrachide, which has very varied functions:

• Means of exchange of a certain substance
• Removal of residual products
• Maintain adequate ionic balance
• Mechanical shock absorber system

Characteristics of the central nervous system:

Gray substance:

• Neuronal bodies.
• White substances.

White substances:

• Nervous extensions.

Function

The function of the brain is the most important in the human being, since it is the one that regulates the majority of functions in the human body just with the mind. Which leads to vital functions such as breathing, keeping heart rate, also having functions such as sleeping, being hungry and having complex functions such as thinking, remembering or speaking. (Perdomo, 2018)

Location

It is located inside the skull, where there is a large amount of dough and nerve cells which are the neurons, in which it controls voluntary functions such as speaking, moving, among others and involuntary such as the functioning of the heart andof the circulatory system. (Perdomo, 2018)

Part

The parts of the brain are:

• Fontal lobe
• Parietal lobe
• Occipital lobe
• Temporary lobe
• Cerebellum
• Brain stem or brain stem
• Hippocampus
• Gray substance
• Brain

Origin of Zika

The Zika or Zikv virus has its origin in the Zika forest, Uganda, this for the first time in 1947 when isolating the serum of a mono rhesus (Macacus rhesus), while another virus transmitted by mosquito that is yellow fever that is yellow fever was investigated. After this finding was given 5 years later the first people infected with the virus in the towns of Uganda and Tanzania were reported. In 1968 there were more reported cases which led scientists to isolate the virus to be able to investigate it which resulted in the existence of two pathogen lineages which are the African and the Asian.

The virus is transmitted by means. The first outbreak that was released was in the year of 2007 caused by the Asian lineage that occurred in the federated micronesia states and to expand through some Pacific Islands. In 2013 and 2014, higher outbreaks were recorded in French Polynesia and registered neurological complications that coincided and related to Zika and Dengue, spreading through Oceania, and then arriving in America through the Easter Island, in Chile this in the year in the year2014. Although this pathology occurred in these countries, some scientists do not relate so closely responsible to Zika, since they claim that it could also be a coinfection with dengue and that in reality this was the cause of the neurological disorders mentioned. (Week, 2016)

In 2015, specifically in May the virus is present in America, reporting at least 14 states in Brazil, being more present in the northeast part of the country. The OMG launched an alert worldwide as it recognized the relationship between the virus and the increase of microcephaly and Guillain-Barré syndrome that occurred in most Brazilian states. In which a report was given to the different countries of recommendations that reinforce controls in the face of such an increase in infection, as well as a quarantine for patients infected with said virus and take into account pregnant women because it attacks theembryo. 

In 2016 there are 38 countries that confirm the expansion of viruses in its territory of the Zika virus, among which are: Barbados, Brazil, Bolivia, Costa Rica, Curacao, Ecuador, El Salvador, Guatemala, Guayana, French Guyana, Haiti,Honduras, Jamaica, Malvinas Islands, Mexico, Panama, Paraguay, Puerto Rico, Dominican Republic, Samoa, San Martin, Surinam, Venezuela, Vabra Virgin Virgins, etc. In continental Europe, until today no case related to the native origin virus is known. The outbreak initiated in Brazil reported an increase in microcephaly in newborns in several states located in the northeast part of the country in which the Zika virus was also reported in 2015. Reporting 4.784 cases of microcephaly at least 27 states, including 77 deaths in 14 states. It is estimated that where the mosquito is located there are at least 500 million people, where more than 12 have registered today.000 cases in which we include microcephaly with about 5.000 people, according to the OMG there are a total of 3 to 4 million people infected annually.

The infection does not seem to stop since the virus usually attacks areas with warm and humid weather. Not only can the human can spread from the virus;The mosquito also by chopping an infected person can take the virus and start spreading. In Europe it is a bit likely to get infected with the Zika outbreak since its weather is not so favorable for the mosquito. In this case, if so, the only countries that could be susceptible would be Spain and Italy since they are the only ones with a good climate for the hatchery of this species. (SN, Minsalud, 2016)

Cause of transmission

Generally the virus is caused by the bite of a large number of mosquito of the species or genre aedes in which we find: aedes aegypti, aedes Africanus, aedes celegenteusus, aedes furcifer, aedes luteocephalus and aedes vitattus. When the mother is infected by the pathogen, it brings complications to the baby. At the time of being in the human being, the virus can be detected in the blood, urine, semen and breast milk, as well as sexual transmission and blood transfusion.

In humans the transmission period is between 3 to 5 days from the beginning of the symptoms. Although the incubation period occurs between 3 to 12 days and the second one that occurs through the mosquito bite. (Ospina-Valencia, 2016)

Specialist

The specialist in charge of Zika’s disease is the branch of infectology, which this belongs to internal medicine, this studys infectious diseases in general, range from infectious diseases that are generated in the community that are not complicated, even diseasesinfectious that are acquired within the hospital and that may be complicated by some microorganism that is not completely sensitive to the treatments that are normally used. Infectologist can study infectious diseases that contract on trips or some areas where there are diseases that may be increased in frequency.

Normally it is responsible for studying these diseases and giving the most appropriate treatment. On many occasions these infectious pathogens are seen by a general practitioner or by an internist, however, the infectologist makes a more complete study of the cause of the infection and knows perfectly the microorganism microorganism. (Vera Blanch, 2014)

Signs and symptoms

The signs and symptoms that occur before the disease are:

• Fever less than 39 C.
• Skin rashes that usually appear on the face and expand throughout the body.
• Non -purulent conjunctivitis.
• Muscle and joint pain.
• Hands and feet inflammation.
• Attack on the general state and headaches.

These symptoms usually last between 2 and 7 days. Vomiting, diarrhea and abdominal pain are usually presented, but less frequently.

Treatment

So far there is no vaccine for the virus or a specific treatment, the treatment being the best way to handle the symptoms, with the use of acetaminophen or paracetamol to control the fever, as well as it is suggested to take liquid and a lot of rest, with theIn order to improve and recover. It is also suggested to avoid the use of aspirin since this can bring risks which are the causes of bleeding. And finally and the most important thing is to keep the patient isolated at least the first week, since this is the stage in which he can infect many more people, as well as the complete observation of the patient from the doctor.

Prevention and recommendation

• Since this occurs by mosquito bite, the use of mosquito nets with insecticide is very suggestible to be able to eradicate or stop the vector causing the transmission. As well as the use of repellent and clothing that covers the limbs very well to reduce bites.
• Also remain in places with air conditioners or have mosquito nets that do not allow the entrance of the mosquito, take measures to control the mosquito outside and inside the house.
• At the time of bedtime, sleep in beds with mosquito nets if it is in areas where the virus transmitting agent is presented.
• If you already have the Zika virus try to prevent more patients from getting infected and getting sick.
• During the first week the virus is in the blood, it can go from the infected person to the mosquito in order to continue transmitting to other people.
• An infected man can transmit infection to his partner by sexual way either male or female.
• To avoid the transfer of sexually transmitted infection, the use of condoms is recommended, throughout the sexual act (vaginal, anal and oral sex).

Staying away from sex is the best way to avoid the spread of Zika.

Diagnosis of congenital infection by Zika virus

In the monitoring protocol of congenital infection by Zika virus, the epidemiological, clinical and laboratory criteria are established to consider a case as a suspect, probable or confirmed. 

Epidemiological criteria

Fetus, morinate or mother’s newborn with a history of:

• Have been diagnosed with Zika virus infection.
• Having traveled or resided in the virus transmission zone during pregnancy.
• Having had unprotected sex with men diagnosed with Zika virus infection or who have traveled to areas with active virus transmission.

Clinical criteria

Fetus, morinate or newborn with one of the following findings:

• Microcephaly: defined as the measure of the cranial perimeter that is below two or more standard deviations of the average for age and sex or below the 3rd 3 according to the growth tables (Fenton for premature and WHO for newborns to newbornsfinished).
• Neuroimaging anomalies: intracranial calcifications, ventriculomegaly, increased extraxial fluid, neuronal migration alterations (polymicrogyria) Reduction of the volume of cerebral parenchyma, atrophy or cortical malformation, cerebellum hypoplasia, or cerebellar vermis, myelinization, hypoplasia, hypoplasia, hypoplasia, hypoplasia, hypoplasiaof the corpus callosum.
• Neurological alterations: hypertonia, hypotonia, spasticity, hyperreflexia, severe irritability and crisis. PHYSIOPATOLOGICALLY The virus affects the neuronal parent producing death, and disruption of neuronal proliferation, migration and differentiation. Some patients with confirmed or probable infection have fetal disruption sequence phenotype, characterized by severe microcephaly, marked craniofacial disproportion, prominence of occipital bone, alteration of hair implementation, short neck, redundant nucal and cranial fold, retrognathy, contractures and arthrargroMultiple (49).
• Ocular involvement: hypoplasia of the optic nerve with retinal atrophy, pigmentary alteration, cataracts, microftalmia and ocular calcifications.
• Delayed intrauterine growth (68).
• Other findings: zambos feet, arthrargosis secondary to neurological damage of central origin.

Laboratory criteria

Laboratory criteria for confirmed case.

At least one of the following:

• Nucleic acid detection by PCR in clinical sample (serum, urine, CSF or amniotic liquid)
• Positive IGM confirmed with positive serum neutralizing antibodies.
• POSITIVE IGG Persistence for Zika Beyond 18 months of life.

Laboratory criteria for probable case.

• The presence of IgM antibodies, not confirmed by neutralization in a serum sample.
• Persistence of the IgG between 6 and 18 months of age (at least two samples with similar IgG concentration). April 2017 Zika Virus Monitoring Protocol.

Based on these criteria, the following infection classification is established:

• CONGENITED CONFECTED INFECTION: Complies laboratory criteria for confirmed case.
• Probable congenital infection: suggestive clinic with laboratory criteria for probable case.
• Possible/indeterminate congenital infection: asymptomatic with PCR and IGM negative, and with IgG+ in 18 months). (SN, Aeped, 2017)

Microcephaly

The virus is related to congenital malformations of the central nervous system of the newborn according to several scientific studies, to demonstrate that in a sample of the placenta tissue and also in the amniotic liquid the presence of the virus was, this collected from a smallthat suffered from congenital malformation, which the mother had the disease during pregnancy. Some in vitro publications show the ability to infect and kill human neuronal cells and block their growth. Even so, the reason why the virus has this effect remains a mystery that scientists fail to explain clearly. We can define microcephaly as a congenital malformation which leads to a cranial circumference with 2 or more standard deviations below average for age and sex, which is equivalent to a value of 32 cm. This malformation is based on the fact that the brain does not develop as it should normally be.

Guillain barre

This occurs when the immune system is attacked by itself, affecting what is coming to be the nervous system cells. This can be given by the infection of various viruses or bacteria, but it is also related to what the Zika virus is. The main symptoms are: muscle weakness, paresthesia in arms and legs, and can affect the respiratory muscles. Fisher Syndrome is another variant of Barré’s syndrome in which alterations of eye movements, abnormal coordination and loss of tendon reflexes are presented.

Affected in the current statistical country

The Zika virus arrived in Ecuador in 2015, is a virus transmitted by the Aedes mosquito. From 2016 to what is from the year 2018 they have presented in the country 5.347 cases of Zika which is going 2.946 in 2016, 2.398 In 2017 and 3 in 2018, per epidemiological week, in addition to 21 children born with congenital malformations, which 20 presented microcephaly and 1 with a cracked lip, between what is going 1 in 2016, in 2017 with 16 and in the2018 with 4 people. The provinces with the most cases registered in this period are Manabí with 3.330, Guayas with 1.289, Esmeralda with 208, Santo Domingo de Lo Tsáchilas with 207 and the province of Los Rios with 123 infected. During 2017, 4 cases of neurological syndromes related to Zika were detected. In which among the most affected we have people between 20 to 49 years, mostly women. (Universe, 2017)

conclusion

The human being can be infected by various agents that damage the health of man. Having knowledge of each of these is very important because having enough information to create a vaccine which can eradicate the virus or at least stop the contagion. Zika is one of the most important diseases today with many others, since having a vaccine that is completeWith the signs and symptoms that it presents, since a good management will allow a good treatment and a speedy recovery for the patient.

Glossary

Eradication: complete and definitive elimination or suppression of a thing, especially something immaterial that is negative or harmful and affects many people.

Birth: number of people born in a certain place and period of time in relation to the total population.

Pathogen: which causes or produces disease.

Epidemiological: It is the study of distribution and determinants of states or events.

Repercussions: influence of a certain thing in an issue or effect that causes in it.

Malformations: congenital are anatomical alterations that occur in the intrauterine stage and that can be alterations of organs, limbs or systems, due to environmental, genetic factors, deficiencies in the collection of nutrients, or consumption of harmful substances.

Counter it: face and opposition.

Filtrable agents: too small to be seen by a conventional microscope, but by an electronic microscope.

Genoma: Set of genes and disposal of them in the cell.

Cephalorrachide: from the head and the spine or spine.

Coinfection: When a person has two or more infections at the same time.

Transfusion: Operation that consists of passing a liquid, especially blood, plasma, serum, etc., From a donor individual to another receiver.

Bibliography

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