Written By THT Editorial Team
Reviewed by Prof Dr. Kishor Adhikari, Coordinator MPH, School of Public Health & Department of Com Medicine, Chitwan Medical College
Zika virus is an emerging mosquito-borne viral infection that has caused serious public health concerns worldwide. The virus was first identified in 1947 in Uganda, but gained global attention during the outbreaks in 2015-2016, especially in Latin America and the Caribbean, where it was linked to severe birth defects and neurological complications (10). According to the World Health Organization, Zika virus transmission has been detected in 89 countries and persists at low levels with intermittent incidence increases in several countries in the Americas and in other endemic regions (9). Zika virus is primarily transmitted by Aedes mosquitoes and can also be transmitted through sexual contact and from mother to fetus during pregnancy. Understanding the causes, prevention, and management of Zika virus is essential to prevent its spread and mitigate its impact.
Causes of Zika Virus:
Zika virus is caused by the Zika virus, a member of the Flaviviridae family, which also includes dengue, yellow fever, and West Nile viruses. It is primarily transmitted to humans through the bite of infected Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus, which are active during the day and breed in urban and semi-urban areas (1). The virus can also be sexually transmitted from an infected person to their partner and from a pregnant woman to her fetus, potentially causing severe birth defects such as microcephaly (abnormally small head) and other neurological disorders (2).
Impact of Zika Virus:
Zika virus has a significant impact on public health, especially for pregnant women and their fetuses. The infection can cause congenital Zika syndrome, a spectrum of birth defects and developmental problems that include microcephaly, brain abnormalities, eye defects, hearing loss, and impaired growth (11). Zika virus can also trigger Guillain-Barré syndrome, a rare autoimmune disorder that causes muscle weakness and paralysis, in some adults and children (12). Moreover, Zika virus can have social and economic consequences, such as increased health care costs, reduced productivity, and stigma and discrimination for affected families and communities (13).
Prevention of Zika Virus:
Preventative measures are crucial in controlling the transmission of Zika virus. Some examples of preventative measures include:
Mosquito Control: Reducing mosquito populations and preventing mosquito bites are essential for preventing Zika virus transmission. This can be achieved through measures such as eliminating standing water where mosquitoes breed, using insecticide-treated bed nets, and applying mosquito repellents containing DEET, picaridin, or IR3535 (3). Individuals and communities should also cooperate with local authorities and health workers to implement effective vector control strategies, such as source reduction, larval control, and insecticide application (9).
Safe Sexual Practices: Zika virus can be sexually transmitted. Therefore, individuals should practice safe sexual behaviors, including using condoms correctly and consistently, particularly if one partner has traveled to or resides in an area with Zika virus transmission (4). Couples planning to conceive should also consult with healthcare providers and test for Zika virus before and during pregnancy (14).
Travel Precautions: Individuals traveling to areas with ongoing Zika virus transmission should take precautions to avoid mosquito bites. Pregnant women and couples planning to conceive should consult with healthcare providers and consider postponing travel to areas with active Zika virus transmission (5). Travelers should also follow the travel advisories and recommendations issued by the relevant authorities and agencies, such as the World Health Organization and the Centers for Disease Control and Prevention (15).
Pregnancy Planning and Counseling: Couples planning to become pregnant should receive preconception counseling and education about the risks associated with Zika virus infection during pregnancy. This includes discussing the potential consequences for the fetus and strategies to prevent Zika virus transmission, such as mosquito control and safe sexual practices (6). Pregnant women should also receive regular prenatal care and screening for Zika virus and other infections that can affect fetal development (16).
Management of Zika Virus:
There is currently no specific antiviral treatment or vaccine for Zika virus infection. Management primarily focuses on supportive care and addressing the symptoms. Some key aspects of Zika virus management include:
Symptom Relief: Rest, hydration, and over-the-counter pain relievers can help alleviate the symptoms associated with Zika virus infection, such as fever, rash, joint pain, and headache (7). However, aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided until dengue infection is ruled out, as they can increase the risk of bleeding complications (17).
Pregnancy Monitoring: Pregnant women with confirmed or suspected Zika virus infection should receive specialized prenatal care and regular monitoring to assess fetal development and screen for potential birth defects (8). Ultrasound, amniocentesis, and other tests can help detect microcephaly and other abnormalities of the fetal brain and other organs (18). Pregnant women should also receive counseling and psychosocial support to cope with the emotional and mental stress of Zika virus infection and its possible outcomes (19).
Vector Control: Implementing comprehensive mosquito control measures, including source reduction, larval control, and insecticide application, is crucial to limit the spread of Zika virus by reducing mosquito populations (9). Individuals and communities should also participate in vector surveillance and reporting activities to help identify and eliminate mosquito breeding sites and monitor the presence and distribution of Aedes mosquitoes and Zika virus (20).
Conclusion:
Zika virus is an emerging mosquito-borne viral infection that has caused serious public health concerns worldwide. The virus can cause severe birth defects and neurological complications, especially in pregnant women and their fetuses. Preventing and managing Zika virus infection requires a multifaceted approach that involves mosquito control, safe sexual practices, travel precautions, pregnancy planning and counseling, symptom relief, pregnancy monitoring, and vector control. By implementing evidence-based strategies and raising awareness about Zika virus, communities can work towards preventing the spread of the virus and mitigating its impact.
REFERENCES
(1) Zika virus. World Health Organization. Retrieved from https://www.who.int/news-room/fact-sheets/detail/zika-virus
(2) Zika virus: Prevention. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/zika-virus/basics/prevention/con-20178180
(3) Prevent mosquito bites. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/zika/prevention/prevent-mosquito-bites.html
(4) Zika and sexual transmission. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/zika/transmission/sexual-transmission.html
(5) Zika travel information. Centers for Disease Control and Prevention. Retrieved from https://wwwnc.cdc.gov/travel/page/zika-travel-information
(6) Zika and pregnancy. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/pregnancy/zika/index.html
(7) Zika virus: Symptoms and causes. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/zika-virus/symptoms-causes/syc-20353639
(8) Zika virus: Diagnosis and treatment. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/zika-virus/diagnosis-treatment/drc-20353643
(9) EPI-WIN digest 7 – Zika virus disease. World Health Organization. Retrieved from https://www.who.int/publications/m/item/epi-win-digest-7-zika-virus-disease
(10) [Zika virus disease: A public health emergency of international concern]. World Health Organization. Retrieved from https://www.who.int/emergencies/zika-virus/en/
- (11) [Congenital Zika syndrome]. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/pregnancy/zika/testing-follow-up/zika-syndrome.htm
- (12) [Zika virus and Guillain-Barré syndrome]. World Health Organization. Retrieved from https://www.who.int/csr/resources/publications/zika/guillain-barre-syndrome/en/
(13) [The social and economic impact of Zika virus]. World Health Organization. Retrieved from https://www.who.int/bulletin/volumes/96/4/18-020418/en/
(14) [Zika virus testing for pregnant women]. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/pregnancy/zika/testing-follow-up/testing-and-diagnosis.html
(15) [Travelers’ health: Zika travel information]. Centers for Disease Control and Prevention. Retrieved from https://wwwnc.cdc.gov/travel/page/zika-travel-information
(16) [Zika virus infection and pregnancy]. World Health Organization. Retrieved from https://www.who.int/reproductivehealth/zika/en/
(17) [Zika virus: What you need to know]. World Health Organization. Retrieved from https://www.who.int/emergencies/zika-virus/articles/what-you-need-to-know/en/
(18) [Zika virus infection: Diagnosis and management]. World Health Organization. Retrieved from https://www.who.int/csr/resources/publications/zika/diagnosis-management/en/
(19) [Psychosocial support for pregnant women and for families with microcephaly and other neurological complications in the context of Zika virus]. World Health Organization. Retrieved from https://www.who.int/reproductivehealth/zika/psychosocial-support/en/
(20) [Zika virus: Vector control operations framework for emergency response]. World Health Organization. Retrieved from https://www.who.int/publications/i/item/9789241511211