Dr. Nimako: Zika virus demystified [Article]

What would you do if your priced position had the same name as a dangerous entity? Well, that was the quagmire Indian car manufacturing giant Tata had to deal with when the international health community started talking about the Zika Virus.

The name of the virus is a homophone to one of the popular hatchback models of Tata, the Zica- a contraction of ‘Zippy Car’. Tata has thus decided to change the name in subsequent productions.

This unfortunate comedy of co-incidences is going to cost Tata a few millions of dollars to turn around. You may think that is a huge bill, but it is a drop in the ocean compared to the effects of the Zika virus outbreak on affected individuals and the cost of adjustments that nations affected by the virus have to make to deal with it.

This mosquito-borne virus was first discovered in the Zika Forest (hence its name) in Uganda in 1947, accidentally, while researchers were investigating another virus, the Yellow Fever virus.

It never commanded any more attention than the recognition of its existence since the severest form of the infection was just a mild illness presenting with a headache, muscle aches and occasionally a rash and/or red, sore eyes. These symptoms resolve after 2 to 7 days, without sequelae.

You should thus not be surprised if a medical doctor had never heard of Zika Virus Infection before this outbreak. Today, however, everyone is talking about it, and it is commanding an international response from the WHO on levels comparable to that for HIV and Ebola, because of a possible link to a congenital abnormality called microcephaly. There has been a sudden increase in cases of microcephaly in some areas affected by the current Zika outbreak.

Microcephaly literally means “small head”: children born with microcephaly have unnaturally small heads, usually due to poorly developed brains. The effects of microcephaly usually persist for the lifetime of the child, effects that include delayed development and intellectual disability. Such children require significant social support and family attention, along with specialized medical care, making their care in general an energy-sapping and finance-draining exercise.

This long lasting (everlasting, if you will) effect of microcephaly is what has gotten public health officials worried and doing all possible to stop Zika in its tracks.

Interestingly though, this surge in the incidence of microcephaly has only been identified in Northeastern Brazil. Colombia has so far recorded over 25,000 cases (about a quarter of which were in pregnant women), but no significant increase in cases of microcephaly. This suggests that there may be other environmental factors beyond the Zika virus itself to consider. This is thus the major focus of the World Health Organization’s response to the outbreak: they are trying to identify the specific link between Zika and microcephaly, if any.

It is possible that the perceived association between the Zika virus and microcephaly will turn out to be one big co-incidence. But can we afford to take the risk of sitting back and relaxing? I hardly think so.

If you consider that El Salvador has asked its women to avoid getting pregnant until 2018, and Brazil is deploying military personnel to help educate the public and reduce the mosquito population in the most affected areas, you should realize that some are playing all their cards.

I think asking women to avoid getting pregnant is an exaggerated response to the outbreak, and many public health experts have said same. But is there any other way out?

Granted, we still do not know a lot about the Zika infection, but what we do know is enough to help us beat it, without necessarily inhibiting a natural process like conception:

  • The Zika virus is transmitted through the bite of the Aedes mosquito, which is different from the Anopheles mosquito that causes Malaria, but also widely distributed nonetheless. This mosquito prefers biting at dusk and dawn, unlike the night-biting Anopheles mosquito.
  • Another route of transmission is thought to be through sexual contact, as the first indigenous case in the USA is believed to have been transmitted from a man to his wife through his semen.
  • The unavoidable disrespect of international boundaries by these mosquitoes makes spread across countries very easy. The virus has affected over 20 countries so far, in 3 continents, and it seems to be spreading farther and wider by the day.
  • At the moment we do not have a vaccine against Zika Virus infection and experts say it may be as long as 10 years before it is commercially available.

Drawing from all of this knowledge, we can say that the most effective way to prevent Zika is to prevent mosquito bites. Strategies we have employed to combat Malaria thus hold applicable to Zika, and just to re-iterate, include the following:

  1. Sleep in a mosquito net. Preferably, an insecticide-treated mosquito net.
  2. Wear clothes that cover most of the body when outdoors.
  3. Use insect repellents to ward off the mosquitoes
  4. Clear all bushes and stagnant water from your surroundings to destroy the breeding grounds of mosquitoes.
  5. Regularly spray your house with insecticide.
  6. Whatever you do, do not get bitten by a mosquito.

28 days of abstinence from sex or condom use after return from a Zika-affected area is also advised until further tests disprove sexual contact as a means of transmission.

West Africa has just survived a deadly epidemic in Ebola, whose effects still linger. It would be rather unfortunate to suffer another devastating outbreak so soon after the last, an outbreak whose effects can last for the lifetime of innocent children. Brazil, Colombia, the Island of Cape- Verde (off the coast of West Africa) and the other affected countries have given us a heads-up: Let’s take a cue and act now.

By: K.T. Nimako (MB ChB)

Dr. Kojo Nimako is a private medical practitioner with an interest in public health, and Citi FM’s Chief Medical Correspondent. He is also the editor of healthbloggh.com and the Executive Director of Helping Hand Medical Outreach, an NGO focused on health education.

Follow on Twitter: @KTNimako

Send an e-mail: [email protected].com