The World Health Organisation on Friday, based on a report by the Indian government’s Ministry of Health and Family Welfare (MoHFW), confirmed the first three cases of Zika Virus – all from Gujarat’s Ahmedabad. The international body has also confirmed the evidence of circulation of the virus in the country.
On May 15, the cases (between November 2016 and February 2017) were reported by the MoHFW in two pregnant women, aged 22 and 24, and an elderly man, 64, from Bapunagar area and the patients tested positive for Zika by the Gujarat government-run BJ Medical College (BJMC).
The Gujarat government kept the first cases of Zika Virus hidden
The state government did not make the vital news of Zika cases public. It intriguingly kept it a secret from people, and even the local authorities, including the municipal commissioner and the mayor of the city. As reported by The Times of India, the neglect on the part of the Gujarat government was apparently because the cases coincided with the Vibrant Gujarat Global Investment Summit.
“The two pregnant women had delivered healthy babies and the 64-year old senior has shown no complications at all,” senior-most bureaucrat in Gujarat, JN Singh, told the BBC. He added that the government “consciously did not go public with the cases” as the number of cases didn’t rise.
Incidentally, the Gujarat government on Sunday also cited a “mistake” by the WHO in reporting the first case and said that the patients belonged to separate localities.
Many independent public health professionals in India were shocked and condemned the Gujarat government for failing to inform the public of the deadly disease after they were detected. Critics also say that the government lied to the Parliament that only one case of Zika virus was detected as part of a routine laboratory surveillance in January 2017.
The WHO said in its report, “These findings suggest low-level transmission of Zika virus and new cases may occur in the future. Efforts to strengthen surveillance should be maintained in order to better characterize the intensity of the viral circulation and geographical spread, and monitor Zika virus-related complications.”
As cases of Zika virus are reported in India, here’s all you need to know about the disease, as described by WHO:
What is Zika?
Zika virus is a mosquito-borne flavivirus transmitted primarily by Aedes mosquitoes, the same mosquito that transmits dengue, chikungunya and yellow fever.
The virus was first identified in Uganda in 1947 and is named after the Zika forest of the country.
What are its symptoms?
The virus can show symptoms similar to other arbovirus infections such as dengue. They include mild fever, skin rash, conjunctivitis, muscle and joint pain, malaise or a headache and body ache. These symptoms are usually mild and last for 2-7 days. But only about 20% of patients show symptoms that usually last up to a week.
The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days.
How is Zika transmitted?
Zika virus is primarily transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. They usually bite during the day, peaking during early morning and late afternoon/evening.
The Aedes mosquito is a weak flyer; it cannot fly more than 400 meters. However, it may be possible for the mosquito to be transported from one place to another accidentally and introduce Zika virus to new areas.
Sexual transmission of Zika virus is also possible, while other modes of transmission such as blood transfusion are being investigated.
How is it diagnosed?
Infection with Zika virus may be suspected based on symptoms and recent history of travel (e.g. residence in or travel to an area with active Zika virus transmission). A diagnosis of Zika virus infection can only be confirmed through laboratory tests on blood or other body fluids, such as urine, saliva or semen.
The three cases in India were diagnosed in the following manner –
Case 1: During the Acute Febrile Illness (AFI) surveillance between 10 to 16 February 2016, a total of 93 blood samples were collected at BJ Medical College (BJMC), Ahmedabad. One sample from a 64-year-old male presenting with febrile illness of 8 days’ duration (negative for dengue infection) was found to be positive for Zika virus.
Case 2: A 34-year-old female had delivered a clinically well baby at BJMC in Ahmedabad on 9 November 2016. During her hospital stay, she developed a low grade fever after delivery. No history of fever during pregnancy and no history of travel for the past three months was reported. A sample from the patient was referred to the Viral Research & Diagnostic Laboratory (VRDL) at the BJMC for dengue testing and thereafter found to be positive for Zika virus. She was discharged after one week (on 16 November 2016). The sample was re-confirmed as Zika virus positive by RT-PCR and sequencing at NIV, Pune.
Case 3: During the Antenatal clinic (ANC) surveillance between 6 and 12 January 2017, a total of 111 blood samples were collected at BJMC. One sample from a 22-year-old pregnant female in her 37th week of pregnancy was tested positive for Zika virus disease.
How is it treated?
Zika virus disease is usually mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice.
Currently, there is no vaccine for Zika infection.
What are the complications it poses during pregnancy?
Zika virus can be passed from a pregnant woman to her fetus. Infection during pregnancy can cause a birth defect called microcephaly and other severe fetal brain defects.
Microcephaly is a condition where a baby’s head is smaller than those of other babies of the same age and sex. Microcephaly happens when there is either a problem in utero, causing the baby’s brain to stop growing properly, or after birth when the head stops growing properly. Children born with microcephaly often have developmental challenges as they grow older.
Based on a newly published systematic review of current research, WHO has reaffirmed its position that Zika virus infection during pregnancy is a cause of congenital brain abnormalities, including microcephaly.
What are the precautionary measures you can take at home?
Mosquito breeding: Check mosquito breeding in and around your house. The mosquito that carries Zika virus – Aedes aegypti – breeds in fresh water so do not let water collect in birdbaths, planters, unused bottles, containers, discarded waste, tyres, etc.
Grow plants that are known to repel mosquitoes such as citronella, basil, lemon grass, lavender, mint, rosemary, etc.
Mosquito bites: Protection against mosquito bites is a key measure to prevent Zika virus infection. This can be done by wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as window screens or closing doors and windows; sleeping under mosquito nets; and using insect repellent (creams, gels, electronic mosquito repellents, patches, incense sticks and bed nets) containing DEET, IR3535 or icaridin, according to the product label instructions.
Sexual transmission: Zika virus can be transmitted through sexual intercourse. This is of concern due to an association between Zika virus infection and adverse pregnancy and fetal outcomes.
WHO recommends that sexually active men and women be correctly counseled and offered a full range of contraceptive methods to be able to make an informed choice about whether and when to become pregnant in order to prevent possible adverse pregnancy and fetal outcomes.
Women who have had unprotected sex and do not wish to become pregnant due to concerns about Zika virus infection should have ready access to emergency contraceptive services and counseling.
Pregnant women should practice safer sex (including correct and consistent use of condoms) or abstain from sexual activity for at least the whole duration of the pregnancy.
Pregnant women living in areas with ongoing Zika virus transmission should attend their regular antenatal care visits in accordance with national standards and comply with the recommendations of their health-care providers. They should also start antenatal care visits early for diagnosis and appropriate care and follow-up if they develop any of the Zika symptoms or signs.
Why is it important for Indians to fear Zika?
India provides fertile climate for the aedes egypti mosquito to grow and multiply. The monsoons have arrived in the country and unclean roads and potholes filled with rainwater provide a lush breeding ground for the mosquito.
Furthermore, special care needs to be taken as the birth rate in India is high and Zika can cause birth defects and neurological problems in newborns.
The Logical Indian urges everyone to take note of symptoms of Zika and report if signs show. We also urge the government to keep the general public informed if any new cases are reported. It is the job of a sound public health policy to take the community into confidence. It is disturbing that the Gujarat government kept the first cases hidden from the public and such negligence on the government’s part should never be repeated.