ZiKa Virus questions
yet to be solved
By
authors
Rupak Bhattacharya1, Pranab Kumar Bhattacharya2, Upasana Bhattacharya3,Ritwick Bhattacharya4, Rupsa Bhattacharya5, AyisheeMukherjee5, Dalia Mukherjee5, Hindole Banerjee5 Debasis Mukherjee 5
1 BSc
(Calcutta University.), MSc(Jadavpur University.) of Residence -7/51
Purbapalli, Po-Sodepur, Dist- 24 Parganas (north), Kolkata-110, West Bengal,
India, Theoretical Physicist. No Institutional
attachment present
2 MBBS (Calcutta Univ.) Honours , M.D (Calcutta
Univ.), FIC Path (India), Professor
of Pathology, Calcutta School of Tropical Medicine, Kolkata-700073, West
Bengal, India; ----now as Professor of
Pathology at Murshidabad District Medical College, Berhampore, station Road , Murshidabad, West Bengal,
India, Member of Board of Studies(UG/PG) of West Bengal University of Health
Sciences, DD 36 Salt lake, sector -1,
Kolkata-64
3 Student and only daughter of Prof. Pranab
kumar Bhattacharya
4 B.com (Calcutta Univ.), of Residence 7/51
Purbapalli, PO-Sodepur, Dist 24 Parganas (north), Kolkata-110, West Bengal,
India
5Residence 7/51 Purbapalli, Po-Sodepur, Dist 24
Parganas (north), Kolkata-110, West Bengal, India
E-mial address
profpkb@yahoo.co.in (P. K. Bhattacharya) mobile
+91 9231510435
This article has been published in British Medical journal As Rapid Response under Title " Time for Global Action on Zika Virus Epidemic : Zika Virus questions yet to be Solved" BMJ 2016; 352 Published on 11th Feb 2016 Cite this as BMJ 2016; 352:i781//rr-0
Zika Virus is a flavi
virus, RNA virus like other RNA virus related with Yellow fever, chikengunya(
an alpha virus) Dengue, West Nile, Japanese encephalitis. Zika virus originated
first in Zika forest of Uganda, Africa, and it was first discovered in 1947 in rhesus
monkey of zika forest. It was subsequently identified in human in 1952 in Uganda
and in Tanzania. Sporadic zika virus was then reported in Africa and in
southern Asia. In 2007 Zika pandemic occurred in western pacific the America
& Africa, Cape verde , West Africa in 2013[1] . From September 2015 to February 2016
Zika pandemic involved more than
4000 people infected in Brazil, French Polnenesia documented a concomitants
epedimeic of 73 cases of GB syndrome and other multiple conditions in population approximately 2,70,000 which
may represent complication of Zika[1] Two cases also confirmed in Australia
and one in Ireland ( A man and an aged woman of 70 years) who have
recovered and both cases had history of
travelling in Zika Virus infected areas. Outbreak is likely to spread to new countries. Zika now
circulated the globe
Zika virus particles are 40nm in diameter with outer envelop
and inner dense core.
The vector of Zika Virus is ades mosquitoes. Most Zika spreads
through ades Aegypti, those do survive in cooler temperate environment and ades
Albopictus which can also survive and hibernate in cooler temperature. In
Africa Zika spread by ades Africans. These mosquitoes have a day bite or late
evening hours bite habits. The vector for Chikungunya and Dengue (DNV) are also
carried by ades Aegypti or in India by ades
Albopictus. Ades Mosquitoes breed on fresh water and household container
storage water and in garbage bags
Incubation period for Zika Virus diseases is not very well known.
So Zika Virus occur in Tropical areas where large mosquitoes population and
thus circulate in Africa, America, South Asian and Western pacific Countries.
In 2014 December Brazil
first reported Zika virus and more than 4000 people then infected. Now pandemic of Zika occurred through out
South America, Central Africa and Caribbean sea [1]. The infection
spreaded in at least 20 countries in America due to free air travelers, travelers
from Brazil or where pandemic nature spread occurred like in Europe. Asia can spread the virus. Zika is still
confined to narrow belt running across Africa to Asia [1]
The infection in 80% cases remains asymptomatic in human as
per old records. There may be mild illness; Fever (<38.5oC), Prostration,
Skin Rash (exanthema) Arthalgia, Bone pain; Joint pain, Headache,
conjunctivitis, or symptoms almost alike dengue fever or alike Chikengunya like
disease. The disease is self limiting one in most cases. Severe illness may occur
like GB Syndrome (so far 73 cases reported); autoimmune like illness,
Neurological symptoms and in Pregnancy, pregnant women giving birth with microcephaly.
However causation between microcephaly and Zika virus not yet established
though evidences of Zika virus has been found in placenta, in amniotic fluid of
mother and brain of fetuses and dead new born autopsy
There are yet no
commercially available diagnostic tests in field. Antibody to Zika Virus IGM
can be done by Mac ELISA but it may cross react with many other Flaviviruses
like Dengue, Chkengunya. Quantities RT PCR test can be done. Viral culture is
confirmatory. Diagnosis is mostly clinical.
Treatment of Zika
Virus infection is complete rest; Plenty fluid and water intake; Avoidance of
Aspirin and if GB syndrome occurs ventilators and other supportive care
required. Broad spectrum antiviral may be tried
Prevention and awareness is the best treatment. House hold
storage of water is contracting source. So control of Mosquito birth by biological ways i.e. fishes those feed on
mosquito larvae or genetically engineered
modified sterile mosquitoes larvae ,use of mosquito nets , strengthening public
care health system to control mosquito breeding
, house screening by municipality and gram panchayet for house debris, storage of fresh water
etc. Wearing of light color cloths that covers maximum part of the body
as much as possible
The question remains
yet to be solved-: whether Zika spreads through Sexual routes Saliva or urine,
with a patient’s contact who suffered from Zika Virus. So far three cases
recorded A patient was infected in Dallas, Texas in likely to have been infected
by sexual contact. The patient had not travelled to infected areas but his
partner had returned from Venezuela. Special attention is required for
Children, young adult sick’s, elderly, travelers Center for Disease control USA
provided guide line for prevention of Sexual transmission ofZika virus 2016.
Men who reside in or have travelled to an area of active Zika virus transmission and who have pregnant partner must abstain
from sexual activities or consistant and correctly use condoms during sex for
duration of pregnancy
Indian have warned pregnant woman not to travel to countries
affected by Zika virus The two mosquitos that carry Zika Virus thrive in India
and Indian patients have in past tested positive for antibodies
to Zikka. But Prevalance of Dengue and Chikengunya will make it hard to gauge
Zika’s prevalence Indian health ministry
should start screening those who arrives
on air flights from Zika affected countries like Latin America
Reference
1] Anthony S Fauci and David M Morens “ Zika virus in the
America-yet another Arbovirus threat “ Nejm January-13 ;2016 Doi 10.1056/NEJMP
1600297
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This article has been submitted for Publication in JAMA ie Journal of American Medical Association as letter to the Editor JAMA By Professor Pranab kumar Bhattacharya et al for the article The Emerging Zika Pandemic: Enhancing Preparedness by authors and now under process
This article has been published in British Medical journal As Rapid Response under Title " Time for Global Action on Zika Virus Epidemic : Zika Virus questions yet to be Solved" BMJ 2016; 352 Published on 11th Feb 2016
This article has been published in British Medical journal As Rapid Response under Title " Time for Global Action on Zika Virus Epidemic : Zika Virus questions yet to be Solved" BMJ 2016; 352 Published on 11th Feb 2016