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Emergence of Zika Fever Poses a Public Health Concern
Prof. Dr. MAHENDRA PAL
By: Prof. Dr. Mahendra Pal

Emergence of Zika Fever Poses a Public Health Concern


Zika fever also known as Zika virus disease or Zika is an infectious disease of global public health concern. The etiologic was isolated for the first time in 1947 from a captive sentinel rhesus monkey in Uganda, Africa. Later, the virus was recovered from the mosquito, Ades africanus caught from the Zika forest of Uganda. The disease gets its name from the Zika forest in Uganda. The first massive outbreak of Zika fever was recorded from the Island of Yap in 2007. Since then, outbreaks of Zika fever have occurred in several regions of the world, such as Africa, Americas, Asia, and Pacific. Imported cases are reported from many European nations. Globally, the exact data on the prevalence, incidence and geographic distribution of Zika infection is not available. 

Disease is caused by Zika virus, which belongs to genus Flavivirus and family Flaviviridae. The virus is a non-segmented, enveloped, single stranded, positive sense RNA genome. Zika virus can be killed by potassium permanganate (0.5%), and temperatures above 60°C but is not inactivated by 10% ethanol.

Zika fever is primarily transmitted through the bite of mosquitoes of the genus Aedes. Rarely, infection can also occur by sexual contact and blood transfusion. Zika virus has been isolated from semen samples. During the outbreak of Zika virus in French Polynesia, 2 mothers and their newborns were found to have Zika virus infection within 4 days of birth. The infants appear to have acquired the infection by transplacental transmission or during delivery.

In majority of people, no symptoms are observed. Clinical manifestations in affected persons include fever, headache, skin rashes, pain in muscles, and joints, weakness, and conjunctivitis. In pregnant women, it can cause miscarriage, preterm birth besides microcephaly. Duration of illness lasts for less than a week. Mother-to-child transmission during pregnancy can cause microcephaly and other brain malformations in some babies. Infections in adults are linked to Guillain–Barré syndrome (GBS). Rarely, death can occur from sudden subarachnoid hemorrhage caused by a ruptured aneurysm.

Due to lack of characteristic clinical findings, laboratory help becomes imperative to confirm an unequivocal diagnosis of disease by employing virological (isolation of virus), immunological (enzyme linked sorbent assay), and molecular (reverse transcriptase polymerase chain reaction) techniques. Disease should be differentiated from Chikungunya fever, dengue fever, leptospirosis, malaria, Mayaro fever, measles, Rocky Mountain spotted fever, Ross River, Rubella, Sindbis fever, West Nile fever, and Yellow fever.

The disease is usually mild and requires no specific therapy. Presently, no specific antiviral drug is available for treatment. However, treatment with acetaminophen may help to relieve the symptoms. The patient is seldom admitted to the hospital.

Currently, no vaccine is available to control the disease. Therefore, certain measures, such as spraying insecticide or fumigation to kill mosquitoes, application of repellents on exposed parts, wearing of long-sleeved shirts and long trousers, treatment of clothes with permethrin, covering cribs, strollers, or baby carriers with a mosquito net, use of wire mesh on doors and windows, sleeping under a mosquito net, avoiding stagnation of water, environmental sanitation, testing of blood for Zika virus before transfusion, and avoiding visit to Zika virus affected regions are suggested to prevent Zika fever. It is pertinent to mention that area within 3-km periphery should be considered as a Zika containment area.

In India, a long-term surveillance network is required in order to estimate the impact of Zika virus on public health. It is advised that pregnant women should not travel to Zika affected areas. Further work on the reservoir, pathogenesis, molecular epidemiology, and chemotherapy should be conducted. Scientists should attempt to develop a safe, potent and low cost vaccine, which can be easily affordable by poor resource countries to immunize the susceptible population.

Prof. Dr. MAHENDRA PAL

About Author   

Prof. Dr.Mahendra Pal, Ex-Professor of Veterinary Public Health (UNDP), Addis Ababa University, Ethiopia, is an internationally renowned scientist, and a well known distinguished academician with 601 publications and 8 books. Prof. Pal also worked as Professor and Head, Department of Veterinary Public Health, Anand Agricultural University, India. He is associated as Editor and Member of many online journals. Prof. Pal guided over 67 students at DVM, MVSc, MSc, and Ph.D. level in India and Ethiopia. He is credited to develop Pal’s medium, APRM medium, PHOL stain and Narayan stain for the study of fungi,which are implicated in the clinical disorders of humans and animals. Prof. Pal elucidated for the first time the role of Cryptococcus neoformans in the mastitis of goat and buffalo, Fusarium solani in corneal ulcer of buffalo, Aspergillus fumigatus in rhinitis of camel and mule, Trichophyton verrucosum in dermatitis of deer, and Candida tropicalis in human lung empyema. He has established for the first time the prevalence of Cryptococcus neoformans in the environment of New Zealand, Nepal, and Djibouti. Prof.Pal has reported the first isolation of Candida albicans from mastitic milk,and Trichophyton verrucosum in dermatitis of camel in Ethiopia.  Prof. Pal launched the Ph.D. programme  for first time in Veterinary Public Health at Addis Ababa University, Ethiopia and also at College of Veterinary Science, Anand, Gujarat, India. His biography is published in World’s Who and Who. Prof. Pal is recipient of many award including “Distinguished Teacher Award”, “Jawaharlal Nehru Award”, “International Achievement Award”, and “ Life Time Achievement Award”. Prof. Pal delivered guest lecturers in medical and veterinary colleges in India, New Zealand, Japan, and Ethiopia. He is the “First Indian Veterinarian” who worked as “JSPS Visiting Scientist” at University of Tokyo, Japan. Considering his immense contribution, Prof. Pal is known as “Father of Veterinary Mycology” in India. Very recently, he launched “Narayan Consultancy” on Veterinary Public Health and Microbiology to give free technical advice to scientists of poor resource countries of the world.