Mumbai: Experts concerned over incidence of Zika virus

Regular fumigation by the civic body could control mosquito population. Pic/Shadab Khan

While cases of H1N1 have already seen a rise in Mumbai, in comparison to dengue and Chikungunya, experts are concerned as eight cases of Zika virus were reported from neighbouring Pune. As the person infected with Zika will take longer to become symptomatic, experts recommend setting up of diagnostics centres offering RT-PCR test facilities for faster detection.

Prevention is better

"As such there is no definitive treatment for Zika virus, a vector-borne disease. Serious cases needing admission to hospitals are rare in case of Zika so most cases will be mild and less serious but the spread of it should be contained by keeping the environment mosquito-free," said a health official from the state public health department.

Dr Wiqar Shaikh, professor of medicine, at Grant Medical College, said eight cases of Zika virus were recently reported from Pune, of which one is a pregnant woman. Dr Shaikh added that the transmission of Zika is low.

No symptoms

Dr Shaikh said that most people affected by the Zika virus do not develop symptoms. Zika is transmitted through Ades Egyptii Mosquitoes, which also causes dengue; it bites during the daytime and larvae of these mosquitoes are found in clean water.

Dr Wiqar Shaikh, professor of medicine, at Grant Medical College

However, those who do, suffer from skin rash, fever, conjunctivitis, muscle pain, joint pain, malaise and headache. He added that nerves and the spinal cord could be affected by Zika virus. Dr Shaikh said that Zika has been detected in human semen, urine, vaginal fluids, saliva and breast milk and therefore could be sexually transmitted. Dr Shaikh, however, said that pregnant women affected by Zika virus could give birth to pre-term babies or have miscarriages. He said a major problem with pregnant women suffering from Zika is the birth of children with microcephaly or small heads and poorly developed brains.

No specific treatment

Dr Shaikh said there is no specific treatment for Zika and treatment is mainly symptomatic. He lamented that no vaccine is as yet available for the Zika virus.

Dr Shaikh emphasised that personal protection against mosquito bites is important in preventing the spread of the Zika virus.

Dr Shaikh recommended the use of insect repellants on the skin and netting on all home windows to prevent insects from entering homes.

Tests were negative for Dengue, malaria….

"Recently, two doctors and two of their contacts in Pune were diagnosed with Zika virus infection after they developed low-grade fever, cough, sore throat, joint swellings and pain, etc. Their tests for malaria, dengue, and Chikungunya were negative. Their travel histories to far-flung countries of South America were not available; although the long incubation period of Zika virus up to six months makes travel history less relevant. During the incubation period, mosquito bites from index carriers can easily transfer the infection to several layers of new persons", said Dr Subhash Hira, Professor of Global Health at the University of Washington, USA and a member of WHO-TDR-Geneva.

Dr Subhash Hira, Professor of Global Health at the University of Washington, USA and a member of WHO-TDR-Geneva

Set up RT-PCR centres

"The infection can be eliminated with rapid mosquito control. Hence, state health authorities should set up diagnostic centres for faster detection, using RT-PCR test, as otherwise it takes longer, and affected people do not show symptoms immediately," said Dr Hira.

Dr Ketan Vagholkar, professor of surgery at D Y Patil Medical College, said municipal authorities should be requested to spray mosquito repellants periodically in residential areas, wear masks in public places and observe social distancing.

Infections during monsoon

"The recent diagnosis of Zika virus cases in Pune should serve as a warning. The onset of monsoon brings along with it a multitude of infections. To prevent the breeding of mosquitoes, care should be taken to not allow accumulation of water in the vicinity," said Dr Ketan Vagholkar, professor of surgery at D Y Patil Medical College.

Dr Ketan Vagholkar, professor of surgery at D Y Patil Medical College

Dr Vagholkar said people should avoid eating street food as well as drinking water from doubtful sources. Municipal authorities should be requested to spray mosquito repellants periodically in residential areas, wear masks in public places and observe social distancing. "To consult the physician in the event of gastrointestinal, respiratory or general systemic symptoms is the remedial measure that one can take," Dr Vagholkar said.

Paediatric expert view

Dr Fazal Nabi, director of paediatrics at Jaslok Hospital said, "Zika virus, unlike covid, is an epidemic disease. Zika virus is a viral self-limiting, short-course illness, transmitted by mosquitoes. The majority of infected patients are asymptomatic, few of them may produce symptoms like fever, rash, joint pains etc for 2 to 6 days. Zika virus during early trimester pregnancy may produce central nervous system birth defects like microcephaly (smaller head) in the fetus."

Dr Fazal Nabi, director of paediatrics at Jaslok Hospital

"Preventive care is similar to any other mosquito-borne diseases like dengue and malaria," said Dr Nabi.