What is Zika Virus?

The Zika is a virus spread by the Aedes mosquito. The flavivirus is mosquito borne like dengue virus. The virus causes mild symptoms such as fever, headache and rash lasting for up to a week. In some cases it can also cause a mild form of conjunctivitis.

The Zika Virus is endemic to tropical regions of the world. Africa and some parts of Asia had to face the disease recently. The earliest Zika virus disease outbreaks were reported from the Pacific in 2007 and in 2013 from Yap and French Polynesia, respectively. In 2015, the massive outbreak in Brazil, led scientists to discover that Zika might be a lot more dangerous. The virus has the potential of damaging brains of fetuses and causing long-term health problems. In light of recent discoveries, the World Health Organization (WHO) declared a public health emergency on February 1, 2016.

How it is transmitted?

Zika Virus is transmitted to people through the bite of an infected mosquito from the Aedes genus. The carriers of the flavivirus is mainly Aedes aegypti in tropical regions. This is the same breed of mosquito that spreads dengue, chikungunya and yellow fever. However it is rarely transmitted through blood transfusion, perinatal, and sexual transmission. It is not in any way contagious.

What is the incubation period?

The Zika Virus has an incubation period which is generally between 2 and 7 days.

What are the signs and symptoms?

Out of 5 infected people, at least 1 person gets violently ill. Symptoms can be present from several days to weeks. The symptoms of Zika are similar to those of dengue and chikungunya, diseases spread through the same mosquitoes that transmit Zika.

Common symptoms of the Zika Virus are:

• Low-intensity fever
• Maculopapular rash
• Muscle pain
• Joint pain
• Swelling of small joints
• Headache,
• Pain behind eyes and conjunctivitis,
• Some neurological symptoms like Gillian Barre Syndrome
• Death is rare(No reported death till date)

Recent Zika outbreaks in Brazil are linked to microcephaly in babies born to mothers infected with Zika virus in first trimester of pregnancy. Ultrasound findings done at 18-20 weeks of gestation show evidence of intracranial calcification and abnormal eye findings.

How to diagnose it?

Zika Virus is difficult to diagnose based on clinical signs and symptoms alone. If a person lives or has travelled to the Zika affected area and having symptoms then they should be tested. For diagnosis a reverse transcriptase polymerase chain reaction (RT-PCR) is used. Saliva and urine samples are effective for diagnosis in first 3-5 days after symptom onset and serum in first 1-3 days. Diagnosis by serology (IgM) is difficult as the virus can cross-react with other flaviviruses such as dengue.

In pregnant females whom to test for the Zika virus?

If you stay in Zika Virus infected area or have traveled to affected area and have 2 or more symptoms within two weeks of travel then you should get yourself tested as well as get ultrasound and other test for the fetus in your baby.

What is the mode of diagnosis in pregnant female?

• RT-PCR on maternal serum and plasma
• Histopathological , immunohistochemical on placenta and umbilical cord
• Amniocentesis should be considered

What is the treatment for the Zika Virus in Pregnant women?

• Symptomatic management of the fever.
• Plenty of fluids
• Rest
• Do not take aspirin and other non-steroidal anti-inflammatory drugs. Aspirin and NSAIDs should be avoided until dengue can be ruled out to decrease the risk of hemorrhage.

What can people do to prevent becoming infected with Zika?

There is no vaccine to prevent Zika. The best way to prevent diseases spread by mosquitoes is to avoid being bitten. Mosquitoes and their breeding sites pose a significant risk factor. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.

• Use insect repellent regularly.
• Wear clothes (preferably light-coloured) that cover as much of the body as possible.
• Use physical barriers such as window screens, closed doors and windows; and if needed, additional personal protection, such as sleeping under mosquito nets during the day.
• Empty, clean or cover containers regularly that can store water, such as buckets, drums, pots etc. Other mosquito breeding sites should be cleaned or removed including flower pots, used tyres and roof gutters.
• Reduce the density of mosquitoes wherever you stay.

History of the Zika Virus

The Zika virus is not new. It was first discovered in the 1940s amongst monkeys in Uganda. Cases of the virus spreading were few and far between until 2007. The first major outbreak occurred in 2007 on Yap Island in Micronesia.

Currently the Zika virus has been reported in Brazil, Puerto Rico, the U.S. Virgin Islands, and America Samoa. The US hasn’t seen cases of local transmission yet, though some travelers who returned from Zika-affected countries have been infected.

The entire list of affected countries and territories is as follows: Barbados, Bolivia, Brazil, Colombia, Commonwealth of Puerto Rico, Costa Rica, Curacao, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Nicaragua, Panama, Paraguay, Saint Martin, Suriname, US Virgin Islands, Venezuela, American Samoa, Samoa, Tonga and Cape Verde.

What’s the link between pregnancy and Zika?

Since last year when the Zika virus reappeared in Brazil, there has been a rise in cases of microcephaly. The pregnant women who have been infected by the virus are giving birth to children suffering from microcephaly. This medical condition causes babies to be born with smaller heads and potential brain damage. The virus can affect the fetus at all stages of pregnancy, though it is believed to be most dangerous during the first and second trimester. Women living in Zika virus outbreaks locations such as El Salvador have been advised to avoid getting pregnant for the next few years, until it is completely safe. Couples also seem to be avoiding weddings and babymoons in Zika-affected zones.

Should you put off travel to Brazil and other Zika Virus affected countries?

The official word by governments of Brazil and other Zika virus affected countries is ‘caution’. Earlier this week, the government of India issued a travel advisory. For non-essential travel to the affected countries should be deferred or cancelled. Pregnant women or women who are trying to become pregnant should avoid or cancel their travel to the affected areas.

• All travelers to the affected countries/areas should strictly follow individual protective measures to prevent mosquito bites.
• Persons with health conditions like diabetes, hypertension, chronic respiratory illness, etc, should seek advice from the nearest health facility, prior to travel to an affected country.
• Travelers having feverish illness within two weeks of return from an affected country should get a health check-up. Pregnant women who have travelled to areas affectedwith Zika virus transmission should mention their travel during ante-natal visits in order to be evaluated appropriately.

Is there a vaccine I can take?

There is no vaccine for Zika yet. Progress in development of vaccine against the virus was not done largely because the virus was not considered to be a significant threat to humans earlier. For now, the best way to control the spread is through managing of mosquito populations and reducing exposure to Zika-affected territories.