ZIKA! The riddle of a new virus
You have heard the news. A new virus has made its way into the United States and was recently spotted in Miami, having travelled all the way from Brazil. We don’t know yet if it is going to cause an epidemic here.
Why are we worried about this virus called Zika? Mainly because of its potential to cause congenital abnormality of the fetus if a pregnant woman gets infected. Zika is a flavivirus and belongs to the same family of viruses that cause yellow and dengue fever and Chickengunya. It is spread by mosquitoes belonging to the group called Aedes aegypti. Zika has captured the headlines because of the Olympics in Rio, Brazil, where a simultaneous Zika virus outbreak threatened to interrupt the games. Tourists and Olympic fans travelling in that direction were caught in the frenzy of the “Zika scare” and there were warnings to reconsider attending the games at this time.
The reason for Zika worry
By and large, Zika virus infection is a relatively mild condition, characterized by a few days of fever, aches and pains, sometimes skin rash and occasionally conjunctivitis. Actually, dengue and chickenguniya spread by the same class of virus are much more symptomatic and often can be debilitating. But there is one issue with Zika that we need to be fully aware of. Any pregnant woman who gets infected with the virus stands a high chance, one in three, to deliver a baby with congenital abnormalities, specifically microcephaly. The Florida Department of Health has recently confirmed the first Zika-related case of microcephaly in a child born in Florida. The mother, a citizen of Haiti, came to Florida to deliver her baby. Microcephaly is a birth defect in babies who are born with abnormally small heads and incomplete brain development. These babies often have a range of problems including developmental delay, mental retardation, intellectual disability, problems with movement and balance, hearing loss and vision problems.
The question I get asked most often in my clinic is, “What should I worry about if I accidentally catch a Zika virus?” The answer is, for the average person Zika poses no major threat, so relax. Zika is more common in tropical countries and you are more likely to catch the infection if travelling to those countries. Currently, there is a big Zika crisis in Puerto Rico and the state is under a state of health emergency. With the arrival of the virus on American soil, possibility of a Zika crisis in the mainland starting with Florida as the epicenter is a likely scenario. Already there are 14 confirmed cases in a community in North Miami, likely caused by local mosquitoes. So, it’s better to take all precautions for prevention.
Aedes egypti mosquito
The first step is to prevent getting bitten by the mosquitoes. Since the causative vector, Aedes egypti, tends to bite you during day time, one has to take proper precautions before venturing into any outdoor activities like gardening. These would include use of repellents to cover as much of your body area and wearing light colored, long sleeved shirts and pants when going out and ensuring the rooms are fitted with screens to prevent mosquitoes from entering inside the house. The old-fashioned mosquito nets can come handy too. Before I step into our yard for gardening, I douse myself with plenty of “off” or “deet.”
The second step is implementing an integrated vector management to control the transmission of pathogen. To begin with, reduce the breeding sites of mosquitoes by eliminating all the stagnant waters in and around your house. After every rain, I can see many of my outdoor plant pots, holes in the yard, gardening carts, etc., filled with water. These are fertile breeding grounds for mosquitoes and should be cleaned out as much as possible. According to the experts, the massive flooding across southeastern Louisiana during the recent weeks could bring an increased risk of Zika infection. Mosquito repellents and insecticides should be used as larvicides to treat large water collections when indicated. In our county, I see frequently the pest control trucks rolling along the roads spraying insecticides at the drainage areas, ditches and other wet spots in an effort to reduce the mosquito population. Recently, male-to-female sexual transmission of the virus has been reported, so safe sex practices should be adhered to as well.
One important caution for the women in the reproductive age group. It’s better to postpone pregnancy till the coast is clear. This is the only way to reduce high incidence of congenital abnormalities in the new born baby. Hopefully, a Zika vaccine should become available in the near future. Three such vaccines have been found to be effective in monkeys. The general advice at this time is, be prepared to face an epidemic if it materializes. Although no real crisis happened in Brazil after all the pre-Olympic scare, Puerto Rico was not spared. So, let’s not be complacent with our efforts to face the onslaught of the virus any time.
M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. His book “Stories from My Heart” was recently released. (www.amazon.com or www.bn.com).
