****zika Virus Scare***

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New Delhi: The mosquito-borne Zika virus — a pathogen which was virtually unheard of till some days ago — is spreading so fast that it can infect nearly four million people in the Americas in next 12 months if not tackled well within time and the threat has now reached India.

In May 2015, Brazil reported its first case of Zika virus disease. Since then, the disease has spread within Brazil and to 22 other countries and territories in the Americas.

Pregnant women are at greater risk. According to health authorities, the virus may trigger a brain abnormality called microcephaly (abnormal smallness of the head) in new-born babies though the link is yet to be established.

A female Aedes aegypti mosquito. File image from Centers for Disease Control and Prevention via AP

Zika virus is transmitted by the bite of Aedes species mosquito which breeds in water-holding containers. Like dengue, it is a day-biting mosquito.

“India has to be on the alert because international travel from central and South America, Africa and the Caribbean Islands can potentially carry the virus into our country,” said Dr Monica Mahajan, senior consultant (internal medicine) at Max Super Specialty Hospital in the Capital.

The union health ministry said on Friday that it is making sure that India is well prepared against cases of Zika virus that has already caused much damage in the Americas.

In its latest advisory, the Indian Medical Association (IMA) has also cautioned pregnant women to avoid travelling to countries at risk of Zika virus transmission.

However, most cases are mild and only one in five humans bitten by the mosquito will develop the disease. Symptoms are similar to chikungunya and dengue but fortunately, complications are rare.

“The recent concern is two-fold: There have been cases reported in more nations compared to outbreaks prior to 2015. Secondly, there is concern about possible birth defects in case a pregnant lady gets infected,” Mahajan told IANS.

According to her, past experience with dengue epidemic shows that mosquito breeding in India is rampant and difficult to control.

“So any mosquito-borne illness tends to spread easily owing to overcrowding and hygiene issues. So till such time that diagnostic facilities are available, best option is mosquito control measures to prevent mosquito breeding,” she added.

A patient suffering from fever with rash should be protected from further mosquito bites during the first few days of illness so that he does not pass the virus into more mosquitoes and cause local transmission of disease.

“Zika virus is a vector-borne disease. Currently, it may not be here in India, but if a person lands in India with the active infection and gets bitten by Aedes mosquito and that mosquito bites other peoples this can be spread in India as well,” Dr JS Bhasin, senior consultant and HOD (peadiatric and neonatology department) at BLK Super Specialty Hospital in Delhi.

According to Margaret Chan, director general of the World Health Organization (WHO), "the level of alarm is extremely high, as is the level of uncertainty. Questions abound. We need to get some answers quickly."

WHO is set to convene an international health regulations emergency committee on Zika virus on February 1 in Geneva to ascertain whether the outbreak constitutes a public health emergency of international concern.

“Arrival of the virus in some countries of the Americas, notably Brazil, has been associated with a steep increase in the birth of babies with abnormally small heads and in cases of Guillain-Barré syndrome, a poorly understood condition in which the immune system attacks the nervous system, sometimes resulting in paralysis,” a WHO statement read.

The WHO was criticised last year for reacting slowly to Ebola epidemic that killed over 10,000 people.

“A causal relationship between Zika virus infection and birth defects and neurological syndromes has not been established, but is strongly suspected,” the WHO statement added.

The virus was first isolated in 1947 from a rhesus macaque monkey from Zika forest in Uganda.

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Why Zika virus is causing alarm in US

 

Global health officials say the Zika virus, linked to severe birth defects in thousands of babies in Brazil, is spreading rapidly in the Americas and could infect 3 million to 4 million people. The race is on to develop a Zika vaccine.

Here are some questions and answers about the virus and the current outbreak.

How do people become infected?

The virus is transmitted to people through the bite of infected female Aedes mosquitoes, the same type of mosquito that spreads dengue, chikungunya and yellow fever. The Pan American Health Organization (PAHO) said Aedes mosquitoes are found in all countries in the Americas except Canada and continental Chile, and the virus will likely reach all countries and territories of the region where Aedes mosquitoes are found.

How do you treat Zika infection?

There is no treatment or vaccine available for Zika infection. Companies and scientists are racing to develop a safe and effective vaccine for Zika, but one is not expected to be ready for months or years.

How dangerous is it?

The PAHO said there is no evidence that Zika can cause death but some cases have been reported with more serious complications in patients with pre-existing medical conditions.

The virus has been linked to microcephaly, a condition in newborns marked by abnormally small heads and brains that have not developed properly. It also has been associated with Guillain-Barre syndrome, a rare disorder in which the body's immune system attacks part of the nervous system. Scientists are studying whether there is a causal link between Zika and these two disorders.

How is Zika related to microcephaly?

Health officials have yet to establish a direct causal relationship between Zika virus infection and birth defects, but it is strongly suspected. Brazil has reported 3,700 cases of suspected microcephaly that may be linked to Zika. It is unclear whether in pregnant women the virus crosses the placenta and causes microcephaly. Research in Brazil indicates the greatest microcephaly risk appears to be associated with infection during the first trimester of pregnancy.

What are the symptoms of Zika infection?

People who get Zika virus disease typically have a mild fever, skin rash, conjunctivitis, muscle and joint pain and fatigue that can last for two to seven days. But as many as 80 percent of people infected never develop symptoms. The symptoms are similar to those of dengue or chikungunya, which are transmitted by the same type of mosquito.

How can Zika be contained?

Efforts to control the spread of the virus focus on eliminating mosquito breeding sites and taking precautions against mosquito bites such as using insect repellent and mosquito nets. U.S. health officials have advised pregnant women to avoid travel to Latin American and Caribbean countries where they may be exposed to Zika.

How widespread is the outbreak in the Americas?

The World Health Organization said Zika cases have been reported in 23 countries and territories in the Americas in the current outbreak. Brazil has been the nation most affected. Other nations and territories include Barbados, Bolivia, Colombia, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Nicaragua, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, Venezuela and the U.S. Virgin Islands, according to the PAHO.

What is the history of the Zika virus?

The Zika virus is found in tropical locales with large mosquito populations. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Southern Asia and Western Pacific. The virus was first identified in Uganda in 1947 in rhesus monkeys and was first identified in people in 1952 in Uganda and Tanzania, according to the WHO.

Can Zika be transmitted through sexual contact?

 

One case of possible person-to-person sexual transmission has been described but the PAHO said more evidence is needed to confirm whether sexual contact is a means of Zika transmission.

 

 

 

The PAHO also said Zika can be transmitted through blood, but this is an infrequent transmission mechanism. There is no evidence the virus can be transmitted to babies through breast milk.

 

 

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What other complications are associated with Zika?

 

 

 

The WHO says because no big Zika outbreaks were recorded before 2007, little is known about complications caused by infection. During an outbreak of Zika from 2013-2014 in French Polynesia, national health authorities reported an unusual increase in Guillain-Barre syndrome. Health authorities in Brazil have also reported an increase in Guillain-Barre syndrome.

 

Long-term health consequences of Zika infection remain unclear. Other uncertainties surround the incubation period of the virus and how Zika interacts with other viruses that are transmitted by mosquitoes such as dengue.

[HNY2016]

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