Pregnant Canadian Refused Test To Diagnose Zika Virus

A woman who recently travelled to Brazil is asking to be tested for the Zika virus

A pregnant woman from Canada who travelled to Brazil in December says that her doctor has refused to test her for the Zika virus, which has lead her to consider the option of abortion. 

Without any test to ease her and her husband's minds, “We are going to be left with the option of terminating what could be a perfectly healthy pregnancy, because we are just completely unwilling to take the chance,” the woman told the National Post.

On Monday, The World Health Organization changed the status of the Zika virus, declaring it as an international health emergency

According to the guidelines on the Government of Canada’s website, a preliminary diagnosis can be made based on the woman’s destination and dates of travel, her activities and any development of the symptoms the mosquito-born virus causes, like a fever or extreme fatigue.

It is recommended that you get your blood taken in the country you are visiting, if you experience any of the symptoms while there. 

Research suggests that the virus may only be detectable in the patient’s blood for up to a week after the onset. There is also the option of taking a serum sample within the first 5 days, which detects viral RNA more effectively. Viral RNA can be found in urine and may be identified up to 10 days after symptoms begin.

However, these tests are not foolproof and have been known to come back positive because of antibodies to other viruses like dengue fever. 

It is also recommended that asymptomatic women, those who carry no symptoms or fail to notice any, be given a fetal ultrasound to spot for skull abnormalities. If results are not conclusive from those, other serial tests can be done. 

The one thing to keep in mind is that there is no definitive time frame on how early an ultrasound can detect microcephaly (smaller than average sized heads).

“Right now (current evidence) suggests it’s later in the pregnancy before you can see the changes on ultrasound,” Blake said. Unfortunately, this means that women won’t be able to get a true diagnosis or know the extent that it has affected the baby until later in pregnancy. Acquiring the news in the third trimester may result in the grief of having to get a late-stage abortion.

The Toronto woman, who remains anonymous, is now 10 weeks pregnant. “I don’t recall having any bites and I didn’t exhibit any symptoms, but I can’t definitively say I wasn’t bitten.”

In her latest visit to her family doctor, she mentioned that she had recently been to Brazil. The doctor later contacted an infectious disease specialist at a Toronto hospital. “She called me back this morning and said she was told that I wasn’t eligible for testing because I did not exhibit any symptoms,” the woman said.

“I am very upset. If the statistic was 10 percent of people infected with Zika are asymptomatic, I might be able to swallow that and do serial ultrasounds,” she said. “But 80 percent?”

“The option they’re giving me is that they will do weekly ultrasounds to detect the growth of the fetus, and see if the head ratio is progressing as it should. They’re leaving me the option of, at five months pregnancy, terminating the pregnancy. I’m not doing that—that is not an option for me. If I’m going to terminate this pregnancy it’s before 12 weeks.”

She asserted that she has never been infected with the other viruses that could contaminate the results of the test. 

“It’s frustrating and ridiculous. I am just one person—there are many pregnant women who have travelled in the past couple of months to these countries,” she said. The woman and her husband are trying to get the test in the U.S. “We want to know if we’re going to have a healthy baby,” she said.

We hope that in recent months there will be more progress made in the guidelines needed to detect the virus, and better support for those who are concerned. 

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