Zika Virus: A Pandemic in Progress
Declared as a ‘Public Health Emergency of International Concern’ by the WHO, Zika virus is rapidly gaining attention world over. WHO has already claimed the emergence of Zika virus to be as serious a threat as the last Ebola outbreak.
What is the Zika virus? It is a Flavivirus, and has been among us longer than you may think. It was first discovered in rhesus monkeys, in the Zika Forest of Uganda – from where it gets its name. Human infections caused by the virus, though few and far, have been reported as early as 1950.
Today the picture is starkly different. Zika virus has become a cause of great concern in Brazil and the rest of South and Central America. Doctors in these regions are calling it a “pandemic in-progress”.
It may surprise you to know that the infection by Zika virus is not all that life-threatening. In fact symptoms are relatively mild: light fever, conjunctivitis, headache, joint pain and skin rash being the chief complaints.
However, the main cause of alarm is the Zika virus’ (now established) association with neurological deficits like microcephaly in children born to infected mothers. That, coupled with Zika’s uncontrollable spread across the tropical regions has made the virus a cause of global panic.
Since October 2015, 4700 cases of microcephaly have been reported in Brazil, whereas Brazil had fewer than 150 cases throughout the year 2014. Microcephaly is a condition where children are born with abnormally small heads (31.5-32 cm head circumference), and consequently suffer from severe mental retardation, and oftentimes premature death. The Zika virus is thought to infect neural stem cells that give rise to cortical areas of the brain.
A Pakistani perspective
How does all of the above tie in with Zika becoming a real danger in Pakistan? For one, the virus has shown a worrying propensity to spread in tropical areas. It is transmitted via the Aedes Aegypti mosquito, which is notorious for the dengue outbreaks it caused in Pakistan. The mosquito thrives in places with warm weather, lack of proper sanitation and overcrowding.
Not surprisingly the mosquito is abundant in Pakistan due to the presence of the above mentioned factors. Therefore there is a constant threat that should the Zika virus enter the country (e.g. by arrival of an infected person), there would be a catastrophic outbreak with expectant mothers at the greatest risk.
Recently, the Zika Virus has also shown to be sexually transmitted, further complicating measures aimed at restricting its transmission. Diagnosis of Zika infection can be suspected based on symptoms and recent travel history, but is confirmed only by laboratory testing for the presence of viral RNA in body fluids (blood, urine etc).
What can be done in our capacity to address this real risk for a Zika Invasion in Pakistan?
- Firstly we must ensure the virus is not allowed to enter the country. This involves careful screening of individuals arriving from affected countries, as well as advising against travel to affected countries.
- With the monsoon season expected in a few months, there should be a sanitation campaign launched to improve drainage systems and ensure that in case of heavy rainfall, water is not allowed to accumulate (thus forming a potential breeding ground for the mosquitoes).
- Stocks of mosquito repellants using DEET, Picardin should be checked.
- Awareness campaigns should be undertaken.
- In case of any reported Zika infection, the affected person should take steps to avoid further spread, such as wearing full body clothing, using mosquito repellants etc.
- If infection is suspected in a pregnant woman, ultrasound screening for fetal microcephaly should be performed, and if indicated, amniotic fluid examination.
By doing so, we can hope to be prepared for such an emergency and save precious lives in the process.
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