1. Zika Virus and Maternal Health
Amrit Ahluwalia, Charlotte Berry, Sydney Kamen

2. Zika Virus Single stranded RNA Virus
Genus Flavivirus, Family Flaviviridae
Closely related to dengue, yellow fever, Japanese encephalitis and West Nile viruses
Transmitted to humans primarily by Aedes (Stegomyia) species mosquitoes

3. Zika Virus Transmission Cycles

4. What is Zika Virus?
Disease spreads primarily through the bite of an Aedes mosquito infected with Zika virus.
4 out of 5 people don’t even know they have Zika.
Symptoms are mild and last for several days to a week.

5. Where is Zika Virus?
Prior to 2015, Zika outbreaks occurred in Africa, Southeast Asia, and the Pacific Islands.
Currently outbreaks are occurring in many countries in the Americas.

6. How is Zika Transmitted?
Zika can be transmitted through:
Mosquito bites
From a pregnant woman to her fetus
Sexual intercourse
Blood transfusion

7. How Zika Affects Pregnant Women
Zika infection during pregnancy can
cause microcephaly and other severe
fetal brain defects.
Previous infection will not necessarily
affect future pregnancies.
No reports of infants getting Zika
through breastfeeding.

8. What is Microcephaly? Clinical finding of a small head when
compared to infants of same sex and age
Reliable assessment of intracranial brain volume
Often leads to cognitive and/or neurologic issues
Difficult birth defect to monitor
because of inconsistent definition
and use of terminology

9. What We Do Not Know Sexual transmission
How long virus persists in men who had Zika
If asymptomatic men can have Zika virus in their semen and transmit Zika through sex
Zika & Microcephaly
Magnitude of risk between maternal Zika virus infection and microcephaly
Impact of timing of infection in pregnancy or severity of illness on microcephaly risk

10. Current State of Zika in Nicaragua
Confirmed presence of Zika infected mosquitos
First cases confirmed on Jan. 27
First child born with microcephaly on Aug. 27
2,005 confirmed cases of Zika infection
1,083 confirmed cases of Zika in pregnant women
-No complications, including death, reported
“The virus is spreading geographically to previously unaffected areas” -WHO

11. Prevention from Vector Transmission
-Currently no vaccine for Zika
-Remain at elevations above 6,500 ft.
-Cover exposed skin with long shirts/pants
-Best if neutral in color (light brown, grey)
-Insect repellent
-Approved for use by pregnant women, although caution should be exercised in the case of children under the age of three
-Equip houses with screens and beds with nets
Map detailing regions of nicaragua below 6,500 feet

12. Prevention from Sexual Transmission
Use condoms, other contraceptive barrier methods
Can be transferred vaginally, orally and anally
Practice abstinence while in areas affected by Zika
Contradictory to previous understanding, transmission is possible both from women to men and vice versa

13. Prevention from Blood-borne Transmission
-Wear personal protective equipment if you come into contact with blood
-Could include mask, gown, or gloves
- Avoid getting blood transfusions in Zika infected areas

14. Special tips for travelers
-Many do not feel sick or display symptoms when infected
-It is possible to remain contagious for up to 3 weeks
-Avoid mosquito bites to minimize spread of disease
-Remember to continue using barrier contraceptive methods even after return
Approximate map of Zika transmission worldwide

15. Plan for Nicaragua

16. Zika in Hormiguero: What We Know
No regional data on Zika incidence in Nicaragua
Talked to Dr. Eileen Granahan
Last year treated similarly to Chikungunya and Dengue
Diagnosis may be given at the clinic and then patient referred to hospital in Siuna for confirming tests
Locals have knowledge about these viruses because they live with them

17. 3 Steps Compile research and information to bring to Nicaragua
Administer surveys and collect/analyze data
Ethnographic interviewing to explore areas of interest in survey data
3 Steps

18. Step 1: Infographic
edu/ahluwalia_lacs20_f a16/about- nicargua/infographic/

19. Step 1: Handout (translated to Spanish)

20. Step 2: Survey for Clinic
What do you know about Zika Virus?
Where did you learn about Zika Virus?
Do you know how Zika Virus is transmitted?
Are you taking any precautions regarding mosquitoes or sexual health due to risk of Zika?
What is your preferred method of contraception?
Are you concerned about contracting Zika?
Do you know anyone who has contracted Zika?
What questions do you have about Zika virus?

21. Step 2: Survey for Casa Materna
What do you know about Zika Virus?
Where did you learn about Zika Virus?
Do you know how Zika Virus is transmitted?
Do you know how Zika affects women and their babies?
Are you taking any precautions regarding mosquitoes or sexual health due to risk of Zika?
What is your preferred method of contraception?
What are your thoughts on abortion?
Have you ever considered or undergone an abortion?
What changes do you want to see regarding women’s health in Nicaragua/the Casa Materna?
What questions do you have about Zika virus or women’s health?

22. Step 3: Ethnographic Interviewing
Analyze survey data to find areas of further interest
Disconnect between facts and locals’ knowledge
Shared concerns or curiosities
Various notable trends or comments
Use interviewing to uncover reasons for the responses
Delve into topics to get personal stories and opinions
Access to viewpoints that are rarely represented
Could provide insight in how to better present and educate rural populations
Also how to better treat them and instill healthy practices

23. Sources http://wwwnc.cdc.gov/travel/notices/alert/zika-virus-nicaragua
america/#.WCNOcHeZPVo