Lone case of Zika virus in Maharashtra, experts advocate caution

Photo for representational purpose. Pic/Sayyed Sameer Abedi

The government has rushed a team of health officials to Belsar village in Pune rural after a woman tested positive for Zika virus. The case comes at a time when the fear of a third Covid wave is looming large. Due to similarities in symptoms in both diseases, experts said, there is a need to check the spread of the Aedes mosquito to control Zika and speed up vaccination to lessen the impact of Coronavirus in future.

Highly placed officials said that the National Institute of Virology, Pune, had received blood samples from Belsar following a spurt in fever cases. While three tested positive for dengue, one sample was found to have Zika. A team led by Dr Pradeep Awate, head of Epidemiology of state public health department, visited the village and even spoke to the 50-year-old patient who did not have any symptoms.

"The Quick Response Team of the state health department met with local public health staff. We are on alert and do not want people to get worried. This is the first case reported in Maharashtra, but we are not taking anything lightly. Kerala had confirmed cases of Zika in the last few months," said a health official.

Also read: Maharashtra reports its first Zika virus case in Pune

Dr Subhash Hira, Professor of Global Health at the University of Washington-Seattle

Dr Santosh Bansode, HoD of Emergency Medicines at Wockhardt Hospitals, Mumbai Central, said, "Zika virus spreads through mosquitoes. If anyone is found to have Zika, we must protect that person from getting mosquito bites so that the disease won't spread to others. As such, there is no definitive treatment for Zika. Serious cases needing hospital admission are rare but the spread of the virus should be contained by keeping the environment mosquito-free." Aedes mosquitoes breed in stagnant clear water. The use of mosquito repellents should also be encouraged, he said.

The expert said doctors should screen patients for Zika in case of a sudden rise in fever in a particular area. To tackle the fast-spreading Delta variant, Dr Bansode said the thrust should be on masks, sanitisers and social distancing.

Dr Bansode added, "Now we know about Zika and the Delta variant of Covid beforehand and must keep ourselves one step ahead by taking precautions and spreading awareness among the general population. Doctors also should be more alert in the screening of patients for these two types of viruses. We should educate all our fever patients about these two viruses and once infected by them or once you get a fever what all care should be taken to contain the spread of the disease."

Zika originated from Brazil in 2007 and it causes high fever, bleeding under the skin causing dark patches, and severe, painful joint swellings, said Dr Subhash Hira, Professor of Global Health at the University of Washington-Seattle. "Zika was later shown to cause microcephaly - small skulls in a newborn from a Zika-infected mother. The culprit for its spread is the female Aedes aegypti mosquito that bites during early mornings and early evenings." He said the same mosquito also transmits dengue, chikungunya and yellow fever. "All these four viral diseases manifest with similar presenting features such as fever, joint swellings, and skin patches. The worst time of recurrence of these infections is when Covid-19 is ravaging throughout the world and Covid itself manifests with similar features. Such overlap of symptoms between the five diseases causes difficulty in diagnosis. However, all these viral diseases do not have any specific treatment, and patients are managed symptomatically", he said.

Dr Fazal Nabi, Director of Paediatrics, Jaslok Hospital

"Zika can be transmitted from the mother to the foetus causing severe congenital malformations such as microcephaly. In adults it can cause serious neurological complications," said Dr Ketan Vagholkar, Professor of Surgery at D Y Patil Medical College.

He said that in any febrile illness, one needs to first rule out Covid through the RT-PCR test. "Citizens are advised to contact their physician immediately if they experience any febrile episode, no matter how mild it may be," said Dr Vagholkar.

Paediatric expert view

Dr Fazal Nabi, Director of Paediatrics, at Jaslok Hospital said that, unlike Covid, Zika is self-limiting and most patients are asymptomatic, though there is a threat to the foetus during early trimester pregnancy.

"We can diagnose it by doing Zika virus RT-PCR blood test and antibody titres and vaccines are not available. Patients need only symptomatic and supportive care. Prevention is to avoid mosquito bites using repellents and nets and avoid mosquito breeding areas," said Dr Nabi.

With more than 55 per cent of Mumbai's population showing antibodies, Dr Nabi said, "In future, we are likely to see shorter and milder clinical presentations of Covid cases due to building up of immunogenicity in a large group of the population. To overcome and to fight with the future Covid waves, we have to vaccinate all including children."

Brazil
Where Zika originated from