Monitoring babies of mums with Zika 'can fill info gap'

Doctors say tracking the children till age 3 offers optimal time to detect abnormalities

A new national programme to monitor babies of mothers infected with Zika during pregnancy will not only help babies suffering Zika-related developmental problems, but will also help advance medical knowledge, doctors said.

The Ministry of Health (MOH) said last Tuesday that it has set up the monitoring programme to address the risk of microcephaly in babies infected with Zika while in the womb.

Babies with microcephaly have abnormally small heads and may develop conditions such as intellectual disability, abnormal facial features and problems with speech and movement, as well as glaucoma and hearing loss.

Under the MOH programme, babies will be monitored until three years of age, but the duration may change as knowledge improves, said Professor Arijit Biswas, clinical director of the Department of Obstetrics and Gynaecology at the National University Hospital.

The monitoring will include vision and hearing tests, and infants suspected to have problems will be referred to specialists for further evaluation and treatment, said Prof Biswas, who heads the Clinical Advisory Group on Zika and Pregnancy set up by MOH.

NEED TO FIND OUT MORE

Singapore is going to fill the gap... There's a wealth of information there, and this will help the general population and the whole world.

DR LEONG HOE NAM, an infectious disease specialist at Mount Elizabeth Novena Hospital, on how the monitoring programme will lead to a better understanding of Zika's effects.

Why monitor the babies for three years?

A period of three years is an optimal duration, as most abnormalities can be detected by then and it is still feasible in terms of resources and cost, said Dr Leong Hoe Nam, an infectious disease specialist at Mount Elizabeth Novena Hospital.

A shorter period may be insufficient for differentiating normal slow learners from those who really have problems.

Dr Leong said that although microcephaly can be diagnosed at birth, monitoring is still important because it is not yet known whether babies at risk of Zika-related developmental problems will necessarily exhibit microcephaly.

This is where Singapore has an opportunity to contribute to a better understanding of Zika's effects on babies, by monitoring a control group of unaffected babies and comparing them with Zika-affected ones, said Dr Leong.

"No one knows... no one has found anything, because no one has tried looking for anything," said Dr Leong. "Singapore is going to fill the gap... There's a wealth of information there, and this will help the general population and the whole world."

For parents of such babies, Dr Leong said that while many of the microcephaly-related conditions are not fully curable, all is not lost.

"You maximise the potential (of the child)," said Dr Leong. "For example, if he has problems hearing well, you teach the person how to lip-read... If he cannot see, then you try to develop the sense of acute hearing."

Physiotherapists trained in looking after children will also be able to assist parents, he added.

MOH said that as of Dec 27, 17 pregnant women were known to have had Zika. Four of them have given birth and their babies show no signs of microcephaly.

One case of Zika in the general population was reported on Dec 28, the National Environment Agency website shows.

MOH said a low rate of Zika infection would probably continue, as Singapore is a travel hub and the Aedes mosquito that carries the virus is present here.

The ministry said people should remain vigilant and continue with their efforts to reduce mosquito breeding.

A version of this article appeared in the print edition of The Straits Times on January 03, 2017, with the headline 'Monitoring babies of mums with Zika 'can fill info gap''. Print Edition | Subscribe