Mosquito Borne Virus That Attacks Baby Foetuses Might Be Spreading Across India

Arelatively unknown and mild, but extremely deceptive, mosquito-borne virus that attacks the foetus in an infected pregnant woman, may be spreading the disease quietly, not only across Bengaluru, but even all over the country.

And nobody seems to be aware of it

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No, not even the National Centre for Disease Control (NCDC) under the Union ministry of health & family welfare or the National Vector Borne Disease Control Programme (NVBDCP), which are the nodal agencies for monitoring disease outbreaks and issuing guidelines through the ministry; let alone the state health authorities. There is no commercially available test to specifically detect this virus called Zika. There is no cure for the illness caused by the virus. But this virus has become a source of a major health concern with Brazil and Colombia reporting several hundreds of cases of newborns being born with very small heads, a condition called microcephaly. At least two deaths in Brazil and one in Colombia have already been reported in December over microcephaly.

This condition has been found by researchers to be caused by the Zika virus which is able to cross the placental barrier after entering the womb from the mother's bloodstream and infect the foetus - a feat which the dengue virus cannot perform, according to Scott Weaver, an expert on mosquito-borne viral diseases at University of Texas Medical Branch (UTMB), Galveston, who has been in Brazil to investigate the cases.

What is even more worrisome is that the Zika virus fever has very similar symptoms and diagnosis as the dengue fever, easily leading medical practitioners to diagnose a Zika fever case to be a dengue case and treat it accordingly, completely missing the target.

In fact, the Zika virus is closely related to dengue virus and both are transmitted by the same mosquito - the Aedes aegypti - which is widely present across the world

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According to a report by the US Centers for Disease Control & Prevention, in India (as much as in Pakistan, Vietnam and a host of African countries) the evidence of Zika virus transmission is from studies that detected virus antibodies in healthy people. This indicated the presence of the Zika virus in those samples, although without specifically detecting them. The antibodies are large Y-shaped proteins which function to identify and help remove foreign antigens or targets such as viruses and bacteria. Every different antibody recognises a specific foreign antigen, in this case the Zika virus.

In India, Bengaluru (with 1,249 dengue cases in 2015) in particular has much to worry about a possible outbreak that could threaten unborn babies with microcephaly if the mothers are infected

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The city has a large domestic and tourist population that travels to and from other countries considering it's the country's hub for information technology, science and defence research, hosting several international events through the year. NCDC officials admit that the infection could easily spread from one to the other with the mosquito biting an affected person and then biting a healthy individual.

Researchers have found that the virus is deceptive because in adults it expresses only through a mild fever with symptoms similar to dengue and chikunguniya but no hospitalisation is required. But if a pregnant woman gets infected, although she too would suffer a mild fever with no need for hospitalisation, the virus can attack the foetus to cause irreparable damage if not tested and diagnosed in time.

The Zika virus is causing much concern worldwide

The US, through its Centers for Disease Control & Prevention (CDC) has even issued an alert titled "Interim guidelines for pregnant women during a Zika virus outbreak" to alert its citizens to this disease and make them aware of tests for screening pregnant women and the measures to prevent being bitten by an Aedes aegypti. Sadly, health officials in India seem to believe there is no cause for worry. Although NVBDCP is the central nodal agency for the prevention and control of vector borne diseases like malaria, dengue, lymphatic filariasis, Kala-azar, Japanese encephalitis and chikunguniya all over, no mention of Zika virus appeared anywhere on its website.

NVBDCP director Dr AC Dhariwal, when informed about the situation in Brazil and Colombia and how the Zika virus could spread to India to affect newborns, told Bangalore Mirror in a matter-of-fact tone: "The Zika virus is not being handled by the NVBDCP. You had better talk to the National Centre for Disease Control." The NVBDCP falls under the NCDC. But here's the shocker: When NCDC was contacted, it was clear there were no plans to take any measures to prevent a possible outbreak until a shocking case of microcephaly surfaced. "There are no cases reported in India, so why is there a cause for concern?" said Dr N Balakrishna, joint director and officer-in-charge of NCDC's Bengaluru branch. "Until any cases are reported, no measures can be taken. We are not putting any measures in place. But I have been reading literature on the disease. And in case there is a fear of this disease, there will be health officials posted at the airports and seaports to check for cases."

But the worry is that the virus may have begun attacking with the cases being mistaken to be those of dengue rather than Zika virus fever.

And no one knows...yet!

What is Zika?

Zika virus is a member of the Flaviviridae virus family and the Flavivirus genus, transmitted by Aedes mosquitoes. In humans, it causes a mild illness known as zika, Zika disease, or Zika fever, which since 1950s has been known to occur within a narrow equatorial belt from Africa to Asia. In 2014, the virus spread eastward across the Pacific to French Polynesia, then to Easter Island and in 2015 to South America, Central America, and the Caribbean and is now considered pandemic.

Symptoms

* About 1 in 5 people infected with Zika virus become ill

* The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis. Other symptoms include muscle pain, headache, pain behind the eyes, and vomiting

* The illness is usually mild with symptoms lasting for several days to a week

* Severe disease requiring hospitalisation is uncommon

* No death due to Zika has been reported in adults

THE US CDC ALERT & GUIDELINES

* Maternal-foetal transmission of Zika virus has been documented

* In a pregnant woman with laboratory evidence of Zika virus in serum or amniotic fluid, serial ultrasounds should be considered to monitor fetal anatomy and growth every 3-4 weeks. Referral to a maternal-foetal medicine or infectious disease specialist with expertise in pregnancy management is recommended.

* Because there is neither a vaccine nor medications available to prevent Zika virus infection, it is recommended that all pregnant women consider postponing travel to areas where Zika virus transmission is ongoing.

* If a pregnant woman travels to an area with Zika virus transmission she should be advised to strictly follow steps to avoid mosquito bites.

* Mosquitoes that spread Zika virus bite both indoors and outdoors, mostly during the daytime; therefore, it is important to ensure protection from mosquitoes throughout the day.

* Mosquito prevention strategies include wearing long-sleeved shirts and long pants, using US Environmental Protection Agency (EPA)-registered insect repellents, using permethrin-treated clothing and gear, and staying and sleeping in screened-in or air-conditioned rooms.

* There is no commercially available test for Zika virus. Testing for Zika virus infection is performed at Centers for Disease Control & Prevention (CDC) and several state health departments. Health care providers should contact their state or local health department to facilitate testing and for assistance with interpreting results.

* For a live birth with evidence of maternal or foetal Zika virus infection, the CDC recommends examination of the placenta and umbilical cord; testing of frozen placental tissue and cord tissue for Zika virus RNA; and testing of cord serum for Zika and dengue virus IgM and neutralizing antibodies.

To Avoid mosquito bites

* Use insect repellents

* If you use both sunscreen and insect repellent, apply the sunscreen first and then the repellent

* Do not spray insect repellent on the skin under your clothing

* Treat clothing with permethrin or purchase permethrin-treated clothing

* Always follow the label instructions when using insect repellent or sunscreen

* When weather permits, wear long-sleeved shirts and long pants

* Use air conditioning or window/door screens to keep mosquitoes outside

* Use a mosquito bed net

* Empty standing water from containers such as flowerpots or buckets

Zika: Biggest concern

Zika virus has been known to be mild. But if it infects a pregnant woman, the foetus can be in extreme danger. The virus is known to be able to cross the placental barrier after entering the womb from the mother's bloodstream and affect the foetus. In Brazil and Colombia several cases of Microcephaly (babies born with very small brain) have been linked to Zika virus attack.

The virus is deceptive because in adults it expresses only through a mild fever with symptoms similar to dengue and chikunguniya and no hospitalization is required. But if a pregnant woman gets infected, although she too would suffer a mild fever with no need for hospitalization, the virus can attack the foetus to cause irreparable damage if not tested and diagnosed in time.

Diagnosis

* The symptoms of Zika are similar to those of dengue and chikungunya, which are diseases caused by other viruses spread by the same type of mosquitoes.

* See your healthcare provider if you develop the symptoms described above.

* If you have recently travelled, tell your healthcare provider.

* Your healthcare provider may order blood tests to look for Zika or other similar viruses like dengue or chikungunya viruses.

Treatment

* There is no medicine to treat Zika.

Treat the symptoms:

* Get plenty of rest

* Drink fluids

* Take medicines, such as acetaminophen or paracetamol, to relieve fever and pain

* Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided until dengue can be ruled out to reduce the risk of haemorrhage