Zika Virus Disease ZVD : Causing Agent, Clinical Symptoms, Diagnosis, Treatment & Prevention
Introduction
- Zika Virus Disease ZVD is caused by Zika virus (ZIKV) & its usual vectors are Aedes spp. ( mainly Aedes aegypti ) Mosquitoes.
- Zika Virus Disease ZVD is menifested by (influenza-like) symptoms including mild fever (Zika fever), skin rash, conjunctivitis, muscle and joint pain, malaise or headache. These symptoms normally last for 2-7 days.
- Human infections of Zika virus are usually benign and are most likely misdiagnosed as dengue or influenza.
- Incubation period : few days (not clear)
Causative Virus
- Causing agent : Zika virus (ZIKV) – an flavivirus
- Zika virus is an emerging pathogen that is transmitted among nonhuman primates and humans by Aedes mosquitoes.
- Principal Reservoir Host(s): Nonhuman primates (Macaca, Pongo spp.)
Epidemiology
- Zika virus infection was first documented in Africa in 1947 and was later recognized in southeastern and southern Asia.
- In recent years, the number of Zika virus infections reported from Micronesia and Polynesia has increased steadily.
- In July 2015 Brazil reported an association between Zika virus infection and Guillain-Barré syndrome.
- In October 2015 Brazil reported an association between Zika virus infection and microcephaly.
Mode of Infection
- Zika virus is primarily transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions.
- Aedes mosquitoes usually bite during the day, peaking during early morning and late afternoon/evening. This is the same mosquito that transmits dengue, chikungunya and yellow fever. Sexual transmission of Zika virus is also possible.
- Other modes of transmission such as blood transfusion are being investigated.
Clinical Symptoms
- Zika virus infection is characterized by influenza-like clinical signs, including fever (Zika fever), headaches, and malaise. A maculopapular rash, conjunctivitis, myalgia, and arthralgia usually accompany or follow those manifestations.
Complications
- After a comprehensive review of evidence, there is scientific consensus that Zika virus is a cause of microcephaly and Guillain-Barré syndrome.
- Intense efforts are continuing to investigate the link between Zika virus and a range of neurological disorders, within a rigorous research framework.
Diagnosis
- 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.
Treatment
- Zika virus disease is usually mild and requires no specific treatment.
- There is currently no vaccine available for Zika virus disease ZVD.
- 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.
Control & Prevention
Control & prevention of Zika virus disease ZVD is focused on following considerations :
1. Mosquito bites : Protection against mosquito bites is a key measure to prevent Zika virus infection. This can be done by following alertness :
- 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 containing DEET, IR3535 or icaridin according to the product label instructions.
Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly. Travellers and those living in affected areas should take the basic precautions described above to protect themselves from mosquito bites.
It is important to cover, empty or clean potential mosquito breeding sites in and around houses such as buckets, drums, pots, gutters, and used tyres. Communities should support local government efforts to reduce mosquitoes in their locality. Health authorities may also advise that spraying of insecticides be carried out.
2. 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.
For regions with active transmission of Zika virus, all people with Zika virus infection and their sexual partners (particularly pregnant women) should receive information about the risks of sexual transmission of Zika virus. WHO recommends that sexually active men and women be correctly counselled 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 counselling. 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.
For regions with no active transmission of Zika virus, WHO recommends practising safer sex or abstinence for a period of six months for men and women who are returning from areas of active transmission to prevent Zika virus infection through sexual intercourse. Sexual partners of pregnant women, living in or returning from areas where local transmission of Zika virus occurs should practice safer sex or abstain from sexual activity throughout the pregnancy.
WHO Response
WHO is supporting countries to control Zika virus disease by taking actions outlined in the “Zika Strategic Response Framework”:
- Define and prioritize research into Zika virus disease ZVD by convening experts and partners.
- Enhance surveillance of Zika virus and potential complications.
- Strengthen capacity in risk communication to engage communities to better understand risks associated with Zika virus.
- Strengthen the capacity of laboratories to detect the virus.
- Support health authorities to implement vector control strategies aimed at reducing Aedes mosquito populations.
- Prepare recommendations for the clinical care and follow-up of people with complications related to Zika virus infection, in collaboration with experts and other health agencies.
