WHO confirms three Zika cases in India

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The first three cases of Zika virus infection were confirmed on Friday from Ahmedabad, Gujarat by the World Health Organization (WHO).

In its report dated May 26, 2017, the WHO said, “On 15 May 2017, the Ministry of Health and Family Welfare-Government of India (MoHFW) reported three laboratory-confirmed cases of Zika virus disease in Bapunagar area, Ahmedabad District, Gujarat, State, India. The routine laboratory surveillance detected a laboratory-confirmed case of Zika virus disease through RT-PCR test at B.J. Medical College, Ahmedabad, Gujarat. The etiology of this case has been further confirmed through a positive RT-PCR test and sequencing at the national reference laboratory, National Institute of Virology (NIV), Pune on 4 January 2017 (case 2, below). Two additional cases (case 1 and case 3), have then been identified through the Acute Febrile Illness (AFI) and the Antenatal clinic (ANC) surveillance.”

(Source: WHO, May 26, 2017)

Zika virus disease was declared as a Public Health Emergency of International Concern (PHEIC) by the WHO in February last year. And, in November 2016, the WHO declared an end to its global health emergency over the spread of the Zika virus.

Guidelines on the Zika virus disease were issued by the Ministry of Health and Family Welfare last year. NCDC, Delhi and National Institute of Virology (NIV), Pune were designated as the apex laboratories to support the outbreak investigation and for confirmation of laboratory diagnosis.

According to the WHO report, an Inter-Ministerial Task Force has been set up under the Chairmanship of Secretary (Health and Family Welfare) together with Secretary (Bio-Technology), and Secretary (Department of Health Research). The Joint Monitoring Group, a technical group tasked to monitor emerging and re-emerging diseases is regularly reviewing the global situation on Zika virus disease.

In addition to National Institute of Virology, Pune, and NCDC in Delhi, 25 laboratories have also been strengthened by Indian Council of Medical Research for laboratory diagnosis. In addition, 3 entomological laboratories are conducting Zika virus testing on mosquito samples.

The Indian Council of Medical Research (ICMR) has tested 34 233 human samples and 12 647 mosquito samples for the presence of Zika virus. Among those, close to 500 mosquitoes samples were collected from Bapunagar area, Ahmedabad District, in Gujarat, and were found negative for Zika.

However, this report has highlighted India’s vulnerability to vector-borne diseases due to its huge population, climate and people traveling into the country in large numbers. These cases provide evidence on the circulation of the virus in India suggesting low level transmission of Zika virus and chances of more cases occurring.

Dengue and Chikungunya are already endemic in the country. All these three diseases – Dengue, Chikungunya and Zika – are viral infections and share a common vector, the Aedes mosquitoes.

Dengue or Chikungunya-like symptoms with red eyes, fever with a rash or joint pain should not be ignored. Such cases could be Zika. Eliciting a travel history in such patients is very important.

There is no specific treatment. Patients should be advised to take paracetamol to relieve fever and pain, plenty of rest and plenty of liquids. Aspirin, products containing aspirin, or other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen should be avoided.

In view of the detection of Zika in India, the need of the hour is enhanced surveillance: community-based and at international airports and ports to track cases of acute febrile illness. While awareness needs to be created about the disease, the public needs to be reassured that there is no cause for undue concern.

There is no vaccine for Zika virus infection. Protection against mosquito bites is very important to prevent Zika infection. People traveling to high risk areas, especially pregnant women, should take protections from mosquito bites.

• Stay inside when the Aedes are most active. They bite during the daytime, in the very early morning, and in the few hours before sunset.
• Buildings with screens and air conditioning are safest.
• Wear shoes, long-sleeved shirts, and long pants when you go outside.
• Ensure that rooms are fitted with screens to prevent mosquitoes from entering.
• Wear bug spray or cream that contains DEET or a chemical called picaridin.