Zika virus threatening the world health
By Dr Brighton Chireka
It’s barely a month after the world celebrated almost eliminating Ebola virus that we are now faced with another virus . The World Health Organization (WHO) reports that the Zika virus has now spread through both South and Central America. WHO expects 3-4 million people to be infected in 2016. Experts agree that future outbreaks and potential pandemics may occur, but the lessons learned from previous ones should enable a faster response. The key is to identify the virus, estimate its threat and its potential to spread across a population as quickly as possible. Having done that there is need to then put a pandemic preparedness plan into action. Is this happening with this new virus ? The virus will reach other countries like China and even South Africa. What should we do when a case is confirmed in our area? The message is that we should not panic and here is the reason why?
Before I answer that we need to look at this new virus called Zika.
What is the Zika virus?
The Zika virus is a mosquito-born infection, which is not harmful in most cases. However it may be harmful in pregnancies as it is linked to birth defects – specifically microcephaly.
What is microcephaly?
Microcephaly is a condition where a baby’s head is much smaller than expected. During pregnancy, a baby’s head grows because the baby’s brain grows. Microcephaly can occur because a baby’s brain has not developed properly during pregnancy or has stopped growing after birth, which results in a smaller head size. Microcephaly can be an isolated condition, meaning that it can occur with no other major birth defects, or it can occur in combination with other major birth defects.
More on Zika virus
It was first detected in the Zika forest of Uganda in 1947, and has circulated in Africa and South and South East Asia without many documented outbreaks reported. In the last few years, Zika outbreaks have been reported in the Pacific region, and the virus has now spread to South and Central America, and the Caribbean. WHO has warned that Zika virus is likely to spread to all countries in the Americas where the climate is suitable for the affected mosquitoes. Currently, this is thought to be all the countries in the Americas (including the Caribbean) with the exception of Chile and Canada.
What symptoms does the virus cause?
Most people don’t have any symptoms. If symptoms do occur, they are usually mild and last around two to seven days. Commonly reported symptoms include:
a low-grade fever
joint pain (with possible swelling, mainly in the smaller joints of the hands and feet)
rash, which is sometimes itchy
conjunctivitis (red eyes)
So how does the Zika virus spread ?
Most cases of the Zika virus are spread by infected mosquitoes biting humans. Unlike the mosquitoes that spread malaria, affected mosquitoes (the Aedes mosquito) are most active during the day (but especially during mid-morning and late afternoon to dusk).
There has been ONE case where Zika virus may have occurred through sexual intercourse and a small number of cases have occurred by transmission from an expectant mother to her unborn child via the placenta.
So how can we reduce our risk of contracting the Zika virus?
Our world has become a global village with people travelling from one continent to the other daily. This increases the risk of spreading the virus and it’s partly the reason why I have compiled do this article. Special mention goes to the WHO and National health services (NHS ) UK for the detailed up on Zika virus.
Before travelling, seek travel health advice from your General Practitioner (GP)/practice nurse or a travel clinic ideally six to eight weeks before you go.
To reduce your risk of infection with Zika virus, you should avoid being bitten by an Aedes mosquito. The most effective bite prevention methods, which should be used during daytime and nighttime hours, include:
using insect repellent that contains N, N-diethyl-meta-toluamide (DEET) on exposed skin – the repellent is safe to use during pregnancy and should be applied to skin after sunscreen is applied
wearing loose clothing that covers your arms and legs
sleeping under a mosquito net in areas where malaria is also risk
What risks does the Zika virus pose in pregnancy?
There is evidence to suggest that pregnant women who contract the virus during pregnancy (at any stage) may have an increased risk of giving birth to a baby with microcephaly.
Current advice is that women who are pregnant or planning to become pregnant should discuss their travel plans with their doctor and if already pregnant to consider postponing travel to any region where a known outbreak of the Zika virus is occurring. If travel is unavoidable then they should take scrupulous insect bite avoidance measures.
I am pregnant and have visited a country where there is an ongoing Zika virus outbreak. What should I do?
If you are pregnant and have a history of travel to a country where there is an ongoing Zika virus outbreak, see your GP or midwife and mention your travel history even if you have not been unwell. Your midwife or hospital doctor will discuss the risk with you and will arrange an ultrasound scan of your baby to monitor growth.
If you have experienced Zika symptoms either during or within two weeks of returning home, see your GP or midwife or mention your travel history. Your midwife or hospital doctor will discuss the risk with you and will arrange an ultrasound scan to measure your baby’s growth and brain development. If there are any problems you will be referred to a specialist fetal medicine service for further monitoring. If you are still experiencing Zika symptoms your GP will arrange for you to have a blood test to check for Zika virus.
I am trying to get pregnant and have visited a country where there is an ongoing Zika virus outbreak. What should I do?
If you are trying to get pregnant and have a history of travel to a country where there is an ongoing Zika virus outbreak, see your GP or midwife and mention your travel history even if you have not been unwell. It is recommended that you take folic acid supplements for 28 days before trying to conceive.
If you have experienced Zika symptoms either during or within two weeks of returning home it is recommended that you wait at least six months after full recovery before you try to conceive.
Even if you have not been unwell, it is recommended that you wait at least 28 days after you return home from a country where there is an ongoing Zika virus outbreak before you try to conceive.
My partner has visited a country where there is an ongoing Zika virus outbreak. What should I do?
Sexual transmission of Zika virus has occurred in a small number of cases, but the risk of sexual transmission of Zika virus is thought to be very low. If your partner has travelled to a country where there is an ongoing Zika virus outbreak, condom use is advised:
for 28 days after his return home if he had no Zika symptoms
for six months following recovery if he experienced Zika symptoms or a Zika virus infection has been confirmed by a doctor
For advice on the options available to you on other methods of contraception, speak to your GP or community sexual health clinic.
What if I am worried that my baby has been affected by the Zika virus?
Speak to your midwife or doctor for advice. If you are still concerned after receiving assurances from your healthcare professional and feel anxious or stressed more than usual, you can ask your GP or midwife for referral to further counselling.
How is the Zika virus diagnosed and treated?
The Zika virus can be diagnosed with a blood test in people who are currently/actively displaying symptoms of Zika virus infection.
There is no specific treatment for the symptoms of the Zika virus. Drinking plenty of water and taking paracetamol may help relieve symptoms. The use of aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen is not recommended, as there is a potential risk they could trigger excessive bleeding.
If you feel unwell on return form a country with an ongoing outbreak of Zika virus, but which also has malaria, you should seek urgent (same day) advice to help rule out a diagnosis of malaria.
If you remain unwell and malaria has been shown not to be the cause, seek medical advice.
I hope I have managed to answer most of your questions and hope that WHO and all stakeholders are working together to combat this virus.
You may want to read about Ebola as well.
This article was compiled by Dr. Brighton Chireka who is a GP and a Health Commissioner in South Kent Coast in the United Kingdom. You can contact him at: firstname.lastname@example.org and can read more of his work on his blog at Dr Chireka blog
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Dr Chireka has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. Views expressed here are personal.
Information to compile this article came mostly from www.nhs.uk