Ines Garcia-Garcia, Lourdes Garcia-Fragoso, Melanie Rodriguez and Leticia Gely
University of Puerto Rico, USA
Ines Garcia-Garcia has completed her Medical Training at the University of Puerto Rico. She is Board Certified in Pediatrics Specialty and in the Neonatal-Perinatal Medicine Sub-specialty. She is a Professor at the University of Puerto Rico, School of Medicine. She has published in reputed journals and books, including articles related to intrauterine exposure to viral infections and congenital anomalies. She actively participates in Graduate Medical Education Programs. She is a Member of national and international research and academic associations. She has participated as a Speaker in multiple professional meetings in the United States, Latin-America and Europe.
The recent emergence in America of Chikungunya and Zika has added new febrile viral diseases which impact susceptible women in childbearing age and with a high rate of vertical transmission, which can occur in asymptomatic women. Both diseases are caused by viruses transmitted primarily by Aedes mosquitoes, found throughout much of the tropical and subtropical regions of the Americas. Some reports warn that climate change will worsen vector-borne disease threat. Chikungunya fever was first identified in Puerto Rico during an outbreak in 2014. 10 newborns where admitted from mothers with chikungunya-like symptoms within 5 days after delivery. The most prevalent symptoms in those babies were irritability and maculopapular rash. 3 babies were admitted from mothers with symptoms more than 5 days from delivery. Symptoms like fever, irritability and rash where not present, but they presented central nervous system lesions. At present, health officials reported that 1,726 people have been infected with Zika in Puerto Rico, including a total of 191 pregnant women. Only one case of microcephaly has been reported. These outbreaks prompted our Neonatal-Perinatal Service to characterize clinical manifestations of the diseases, develop guidelines for diagnosis and management of suspected intrauterine exposed fetuses. Health care professionals need to be familiar with the surveillance system, perform history taking focusing on febrile viral illnesses during pregnancy, recognize women at risk for chikungunya and Zika infections, and follow the protocols established by the local and state Health Authorities, including neurodevelopmental follow-up of affected offsprings.