Zika Virus: Obstetric and Pediatric Anesthesia Considerations

Area of Science:

• Public Health and Infectious Diseases
• Maternal-Fetal Medicine
• Anesthesiology

Background:

• Florida is an epicenter for Zika virus (ZIKV) infections in the US, with over 700 travel-related cases and 139 locally acquired infections reported by November 2016.
• ZIKV transmission occurs via Aedes aegypti mosquitoes, sexual contact, and blood transfusions, posing a risk to approximately 5 million people in the Caribbean and Latin America.
• A critical concern is the link between ZIKV infection in pregnant women and congenital abnormalities, termed ZIKA Congenital Syndrome.

Purpose of the Study:

• To prepare healthcare providers at the University of Miami/Jackson Memorial Hospital for the clinical spectrum of ZIKV effects.
• To outline safe perioperative care strategies for parturients and newborns affected by ZIKV and ZIKA Congenital Syndrome.
• To provide anesthetic implications and recommendations based on CDC interim guidelines for managing Zika-positive patients and infants with congenital ZIKV infection.

Main Methods:

• Review of interim guidelines from the Centers for Disease Control and Prevention (CDC).
• Analysis of anesthetic implications for pregnant patients and newborns with ZIKV.
• Comparative review of anesthetic management for infants with congenital malformations related to ZIKV.

Main Results:

• As of November 2016, over 4000 travel-related ZIKV infections and 139 locally acquired cases were confirmed in the US, with a significant burden in Florida.
• Federal health officials were monitoring 899 confirmed Zika-positive pregnancies, with 110 pregnant women under FDH monitoring in Florida.
• The University of Miami/Jackson Memorial Hospital is strategically located to manage ZIKV cases in identified 'hot spots'.

Conclusions:

• Anesthetic preparedness is crucial for managing pregnant patients and newborns affected by ZIKV and ZIKA Congenital Syndrome in South Florida.
• Adherence to updated CDC guidelines and specific anesthetic protocols is recommended for optimal perioperative care.
• Further research and established protocols are needed to address the unique anesthetic challenges posed by congenital ZIKV malformations.