West Nile Virus

West Nile Virus (WNV) is transmitted by infected mosquitoes. The reservoir exists in migratory birds and horses. Based on a limited number of cases, it is not possible to know if WNV infection in pregnancy results in neonatal infection or medical problems. Although one of the first reported cases of WNV infection transmitted via the placenta resulted in an infected infant with severe medical problems, it is unclear whether WNV infection caused these problems or whether they were due to other causes. A registry has been set up by the U.S. Centers for Disease Control to monitor cases of WNV infection in pregnant women. As of May 10, 2004, of the 74 women who acquired WNV while pregnant, 62 had delivered live infants, 2 had elective abortions, 5 miscarried in the first trimester, and 5 had not yet delivered. Because of ongoing concerns that intrauterine transmission can occur with possible adverse health effects, pregnant women are advised to take precautions to reduce their risk of infection by avoiding mosquitoes, especially during peak feeding times of dawn and dusk, wearing protective clothing, and using repellents. No specific treatment exists for WNV, and the consequences during pregnancy have not been well defined. Accordingly, it is not recommended that asymptomatic women be screened (60).

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