Zika virus and Pregnancy:
Zika virus (ZIKV) is an emerging mosquito-borne pathogen first described in 1952, after being isolated from a sentinel rhesus macaque monkey in 1947 and a pool of Aedes africanus mosquitoes in 1948 from the Zika forest in Uganda. Since it was first reported, only a small number of cases had been described in Africa and Asia until 2007 when there was a large outbreak on Yap Island in the Federated States of Micronesia. In October 2013, ZIKV was detected in French Polynesia affecting ~10% of the total population.
About Virus: ZIKV is an approximately 11-kb single-stranded, positive sense ribonucleic acid (RNA) virus from the Flaviviridae family,most closely related to the Spondweni virus.(Thailand) Two major lineages, African and Asian, have been identified through phylogenetic analyses. Transmission occurs via mosquito vectors from the Aedes genus of the Culicidae family, the same mosquito that transmits dengue, chikungunya and yellow fever. Non vector transmission including potential sexual transmission and through monkey bite are also reported. Mother to child transmission during pregnancy or during delivery is also a potential route of transmission.
Outbreaks in 2015: In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infections in Brazil. (CDC)Currently, outbreaks are occurring in many countries, including Columbia, Venezuela, Paraguay, EL Salvador etc. As of 28th January 2016, twenty three countries in the Americas have reported cases (WHO). Due to widespread international travel, there is risk of spread of outbreak across the world. Cases are being reported among travellers from other continents including Europe.
The incubation period of ZIKV disease is not clear, but is likely to be a few days. About 1 in 5 people infected with Zika are symptomatic. Symptoms typically begin 2 to 7 days after being bitten by an infected mosquito. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days (WHO).
Zika virus is diagnosed using PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as Dengue, West Nile and Yellow fever (WHO).
NCDC, Delhi and NIV, Pune are two operational diagnostic facilities in India, In addition to these two operational diagnostics centres 10 new facilities will become operational by end of February, 2016. These are located in the states of Tamil Nadu, Kerala, Puducherry, Karnataka, West Bengal, Uttar Pradesh, Gujarat, Madhya Pradesh, Odisha and Assam.
Personal protective measures including use of protective clothing, mosquito repellents, eliminating household aedes mosquito breeding sites.
Integrated Vector Management (IVM) including chemical, biological and environmental vector control.
Non-essential travel to the affected countries to be deferred/ cancelled.
Pregnant women or women who are trying to become pregnant should defer/ cancel their travel to the affected areas.
Persons with co-morbid conditions (diabetes, hypertension, chronic respiratory illness, Immune disorders etc) should seek advice from the nearest health facility, prior to travel to an affected country.
According to CDC (centers for disease control and prevention) about 1 in 10 pregnant women with confirmed Zika had a fetus or baby with birth defects. https://www.cdc.gov/vitalsigns/zika-babies/index.html
Md. Kausar Neyaz, Ph.D
February 10, 2016