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Sunday, January 31, 2016

Zika by Zita

Zika- another virus playing havoc?

It’s been around since 1947 with outbreaks in South East Asia, Africa and the Pacific Islands but now this virus has turned up in South America and neighbouring islands with 1.5 million cases confirmed.

The present episode is associated with microcephaly in children born to women who contract the disease. Except in the odd case, no association was noted but a definite relationship has been noted since 2013.

What is it really? It is a viral illness caused by an RNA virus which has as its vector the Aedes mosquito mainly egypti but albopictus and polynesiensis have also been mentioned. Patients present with mild fever, sore eyes, headache, joint pain and a red, bumpy rash. The illness lasts from a few days to a week.

The only treatment advised is rest, painkillers and drinking of plenty of fluids. Only one in five infected show symptoms but all can transmit it via the vector. Other modes are transplacental and from an infected mother during delivery. There is potential risk of transmission by transfusion of contaminated blood. Diagnosis is by detection of viral RNA. Viraemic period seems to be short but the virus has been detected in the urine for up to 10 days.

There is no vaccination or preventive drug yet. Differential includes dengue fever, chikengunya and malaria. Treatment is symptomatic but aspirin and NSAIDs are discouraged because of increased risk of haemorrhagic syndrome as well as Reye’s syndrome in children and teens.

Prevention: Public Health control measures of vector management and reduction of breeding grounds i.e. stagnant water, pots, used tyres, tree holes and rock pools are highly recommended and also keeping drinking water stoppered is important. Other simple measures are wearing of long sleeved clothes and use of mosquito nets and insecticides.

Microcephaly as the dreaded new complication has been suggested after its incidence in babies born to infected mothers significantly rose since 2013. Pregnant mothers are advised not to travel to affected areas. Mosquito control in air crafts which is already been done is a simple but important measure. Has Sri Lanka got lessons to learn from this new threat?

Sent by Zita Perera Subasinghe

References:


24 comments:

  1. From Ceylon Today of 31.1.16.

    "Last week, Health Minister Rajitha Senaratne stressed that Sri Lankan authorities have taken action to screen all air passengers arriving from South America and Africa, at the Bandaranaike International Airport, in order to prevent the Zika virus entering the country. While stressing on the precautionary measures taken to identify people who are infected with the Zika virus, the minister said that the public need not panic about the Zika virus".

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    1. Glad to hear that! It is so easy to avoid it and it is so easy to get it. I have no doubt that Sri Lanka knows how to prevent this new invader taking a hold.
      Zita

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  2. Zita
    Thank you for that account on Zika. Who can forget the black and white striped Aedes aegypti mosquito prevalent in SL since the time we can remember. They bite mostly at dawn and dusk. Prof Dissanayke's lectures come to mind of vectors, virulence and vermin. Let us hope we can keep the disease away from our shores after taking the necessary precautions.

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    1. Nihal, indeed it was the mention of Aedes egypti that caught my attention about Zika virus. It's strange that some terms never leave us and they are associated with familiar pictures of the lecturer and his mannerisms and the place or the time we heard it!
      Zita

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  3. A very useful update by Zita on Zika. Let us hope that all necessary precautions are being taken as Lucky has indicated.

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    1. Thanks Mahendra! Zita can come to Sri Lanka but let's keep Zika out!
      Zita

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    2. Mahen
      Don't drink water after 7pm. It will keep you awake.

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  4. I am writing this 3 days later.
    Zita Pereda Suba news genava!

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  5. So little is understood about Zika. Now there is a scare that it could be transmitted by body fluids and sexual contact. The World Health Organization has declared it a global health emergency. A vaccine seems to be 3 years away.

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    1. Nihal I am glad you mentioned that mode of transmission as that's something very new, and a case has been reported just a couple of days ago.
      Zita

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  6. Hi Zita,
    Thank you for that insight
    When I first saw the news item, I 'read ' it as ZITA VIRUS & at a second glance got it right!!
    "SHOULD HAVE GONE TO ZITA PERERA SUBASINGHE" to have my eyes tested in the first place!!!
    As to A.eagypty,we have had first hand encounter with it when we visited SL in 2007. Farina & I both went down with an attack of Chikungunya. I got away very lightly at the time, but my Farina had it bad--- so much so she thought the her "end was nigh'. On gradual recovery her shin of her both hands and feet --- ATHA-PAYA, peeled off like removing gloves & socks!!! No wonder she had those thoughts!!!.
    Really she got it pretty bad & I too was very concerned.
    As for me I now have pretty bad APR and now I wonder if it is the chikungumya or it is just NR (Narki Rudawa)??? Will never know??
    As for Zika vurus the the 'white' world is getting their knickers & pants 'hot'& into a twist when it affects them. Initially they thought "oh it is only a black man's disease" Most recent reports suggests that it can also be sexually transmitted!!
    White man must now be really very 'HOT' in their pants & knickers!!

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    1. You are dead right (pardon the pun) Razaque. What poor Farina experienced is exactly what they describe. I can remember it form Dengue fever too.
      And yes it is good to see it being reported in Western Literature. It's no longer a black man's disease.
      Thanks for your useful comments.
      zita

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  7. The case in Texas seems to be sexually transmitted. That will make it all the more difficult to control.

    While I write this, I am thinking of all those colleagues who never make use of the Internet. What a lively discussion it would be, if they too participate.

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    1. You are right Lucky. I think we are seeing the tip of the iceberg. I hope they bring about awareness first. Or 'going viral' will have a sadder meaning.
      Zita

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  8. Lucky,I am sure you know this already but Lama sent this link about the Texas story.
    http://www.nytimes.com/2016/02/03/health/zika-sex-transmission-texas.html?ref=todayspaper&_r=1#story-continues-3

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  9. I was hunting for "Zika" like names and Zita was the first I found and today I found another. Tata Motor Company of India was going to name its new hatchback "Zica". But because of Zika, they have decided against it. I have no idea what the new name is going to be, may be Gita!

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  10. You know what they say,' Zika by any other name' will be as terrible.
    Zita (I think I had better change my name, don't you think?)

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  11. What a timely article by Zita!
    I read in TIME magazine thatThe World Health Organization declared the spread of Zika and an associated birth defect an international public health emergency Monday, freeing funds to combat the disease.

    “This is an extraordinary event,” said WHO Director General Margaret Chan at a press conference Monday. “It poses a public health threat to other parts of the world and a coordinated international response is needed.”

    Chan cited the pattern of the disease’s spread, the lack of a vaccine, and the large global population of mosquitoes that can carry the virus as factors that contributed to the declaration.

    The declaration, only the fourth in WHO’s history, comes just days after the organization said the total number of cases could hit 4 million by the end of the year. The virus has spread rapidly throughout the Americas infecting people in more than 20 countries. Officials in Brazil, the hardest hit country, have estimated 1.5 million infections. WHO was criticised for waiting months after an Ebola outbreak hit West Africa to declare an international public health emergency in 2014.

    Officials noted that their concerns centre around a possible relationship between Zika and microcephaly, a birth defect characterised by shrunken heads and brain damage, and not Zika itself. The Zika virus, first discovered in 1957, was thought to be harmless for decades before the link with before the link with microcephaly emerged in recent months.

    Countries across North and South America have taken precautions to stem the spread for the virus. El Salvador called on women in the country to hold off on pregnancy for two years. The U.S Centres for Disease Control and Prevention (CDC) issued travel warnings for much of Latin America telling pregnant women to avoid the area.

    WHO officials said they were not calling for restrictions on travel to affected countries but advised travellers to take precautions to protect themselves from mosquito bites.

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    1. Thanks! You have provided valuable facts to add to the story of Zika. It is only by making facts known to all involved in health care that we are going to triumph over another new but not so new attack by a nasty virus.
      Zita

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  12. Hello everyone, I just read all of your comments, and I've been following the story on the general media. Thank you Zita, for posting the original article that got the discussion started. I am waiting to see if there will be special precautions when travelers start arriving in Brazil for the Summer Olympics. I know that ALL aircrafts coming in to Colombo International Airport have to spray the aircraft with an aerosol to kill any mosquitoes that they may have inadvertently transported. This is a Sri Lankan Government requirement, which has been in existence for a while. I don't think we need any new species of mosquitoes in Sri Lanka. The airline is required to show the empty canisters to the airport authorities. They are required to use 4 canisters per flight. This bit of trivia is from my resident Civil Aviation expert (My brother, retired Captain of Singapore Airlines and Sri Lankan Airlines, who now works in the Civil Aviation Department)

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    1. Thanks, Srianee! You are making a very important point, i.e. that of the safety of visitors against this virus during the summer Olympics. Because of the difficulty in controlling who comes from where, I think they will have to advise that no one gets pregnant during that time! Or those who are pregnant will keep away.
      I agree we don't want Zika to visit Sri Lanka. We are very hospitable but not to this virus!
      Zita

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  13. That is a relief, coming from such a reliable source.

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