The outbreak of the Zika virus has caused the World Health Organization (WHO) to declare the virus as ‘meeting the conditions for a Public Health Emergency of International Concern’. Some areas, such as Central and South America, have declared a state of emergency, and in February 2016 the Centers for Disease Control and Prevention (CDC) elevated its response efforts to a level one activation, the highest response level at the agency. Doctors have described the Zika virus outbreak as ‘a pandemic in progress’ and are advising women in affected areas to postpone getting pregnant.
The Zika virus was first identified in Uganda in 1947, where the virus was detected in monkeys. The first case of human infection was in Nigeria in 1954, and although cases appeared in other countries, most outbreaks were small, therefore the Zika virus was previously not thought to be too hazardous to human health.
The virus spreads via the aedes mosquitos, which are generally found throughout the Americas (except in Canada and Chile, where temperatures become too low for the mosquitos to survive). When an aedes mosquito bites and drinks the blood of an infected person, the same mosquito can then infect other people they bite.
Before 2015 the Zika virus outbreaks occurred in areas of Africa, Southeast Asia, and the pacific Island. In May 2015 the Pan American Health Organization (PAHO) issued an alert in response to the first confirmed Zika virus infections in Brazil. The outbreaks are now occurring in many countries, including the Commonwealth of Puerto Rico, the U.S. Virgin Islands, American Samoa and, as of March 2016, the Zika virus has spread to some U.S. states. The CDC reports that outbreaks of the Zika virus will continue, and it will be difficult to determine how and where the virus will spread.
Although the Zika virus is mainly spread by mosquitos, as previously mentioned—and for most people who contract the disease it is a very minor infection and isn’t dangerous—there have been recent reports that the Zika virus can also spread through sexual intercourse, but the risk is thought to be low. Deaths caused by the Zika virus are uncommon, and only one in five people infected show symptoms. If symptoms do occur, they’re usually mild and last around two to seven days. Commonly reported symptoms include itching, eye pain, headaches, a rash (which can be itchy), a mild fever, joint pain (with possible swelling, mainly in the smaller joints of the hands and feet and conjunctivitis.
The biggest concern of the Zika virus is microcephaly in babies. Microcephaly causes infants to have a below-average head size, which is often caused by the brain failing to grow at a normal rate. The Zika virus impacts babies’ development in the womb and causes microcephaly. A child born with microcephaly will have a head circumference measuring less than 32cm at birth, whereas a healthy infant’s head circumference is around 34.5cm. The severity of microcephaly varies, but it can be deadly if the brain is so underdeveloped that it cannot operate the functions that are fundamental for life. Children that do survive face intellectual disability and development delays. Some babies who have died had the virus detected in the brain, and it was also detected in the placenta and amniotic fluid. Microcephaly affects approximately 25,000 children in the U.S. each year, and there is evidence to suggest that pregnant women who contract the Zika virus at any stage of their pregnancy may have an increased risk of giving birth to a baby with microcephaly.
At present, there is no specific treatment for the Zika virus symptoms. The NHS recommends drinking plenty of water and taking paracetomal to relieve any pain caused by symptoms. If you are pregnant and have travelled to a country where there is an ongoing Zika virus outbreak, even if you have no symptoms, see your GP or midwife and inform them of where you (or your partner) have been. If you or your partner have traveled to a country where the outbreak is, it’s recommended that you wait at least 28 days after returning home before you try to get pregnant, and to use condoms during this time.
The U.S. Centers for Disease Control say that the Zika virus can stay in the blood for approximately one week (and may be present in semen for two weeks) and advise that ‘the virus will not cause infections in a baby that is conceived after the virus is cleared from the blood. There is currently no evidence to suggest that Zika-virus infection poses a risk of birth defects in future pregnancies.’
Although there is currently no specific treatment or vaccination for the Zika virus, the BBC has reported that a vaccine for the Zika virus could be possible within months. The Zika vaccine could be ready for human trials later this year, according to Dr Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases. There are plans to start testing a DNA vaccine by September 2016, with human trials starting in America soon (approximately 100 Americans have been diagnosed with the Zika virus after returning from affected countries). Dr Fauci said, ‘We will have a vaccine ready to go into humans to test—not to distribute—but to test for safety and whether it induces a response that you can predict will be protective. Phase one trials will likely start towards the end of this summer or early fall.’
If you are planning to travel to a country where the Zika virus is, seek travel advice from your GP/practice nurse or a travel clinic, ideally six to eight weeks before your trip. To reduce the risk of infection, take steps to prevent mosquito bites. Use insect repellent that contains ‘DEET’ (N, N-diethyl-meta-toluamide) on exposed skin, after sunscreen has been applied. DEET can be used by pregnant or breastfeeding women in concentrations of up to 50 percent, and for infants and children older than two months. It should not be used for babies under two months. Be sure to keep your skin as covered as possible by wearing loose clothing that covers your arms and legs, and sleep under a mosquito net.
[Sources: WHO, NHS, BBC, CDC]
