Wednesday, 3 February 2016

The Looming Threat of Zika Virus


Brazil grappling with money laundering scams, drinking water crisis and political unrest is now racing towards a health epidemic of dangerous proportions, the Zika Virus. The South American country all set to unveil Rio Summer Olympics, biggest sporting fiesta on the planet in over six months is now grappling with health emergency, Zika virus. Brazil emerged as epicenter of Zika virus (ZIKV), a mosquito-borne disease transmitted by Aedes sp. Zika virus, a member of flavi viridae family and is related to yellow fever, west Nile and dengue fever virus. Zika is not contagious. The vital modes of transmission modes are blood transfusions and mother-to-child transmission. While the virus was believed to migrate through sexual contact, there is no conclusive research evidence as yet.

The virus was first identified and isolated from a caged Rhesus monkey in Zika forest of Uganda in 1947. In 1952 researchers isolated Zika Virus from the serum of an affected human being in Uganda and Tanzania. Only 20% of the people infected by Zika virus will develop symptoms. The symptoms are similar to those exhibited by other arbo virus like dengue and common symptoms include fever, skin rashes, conjunctivitis, muscle and joint pains, malaise and headache. Symptoms are mild and last for 2-7 days and hence no specified treatment is recommended. Medicines used to treat common cold and fever are usually prescribed. In absence of causalities dedicated research to develop vaccines weren’t initiated on large scale. But now with recent outbreak of the epidemic in Brazil, pharmaceutical majors are now focusing attention towards vaccine development. Researchers believe that it would take at least 5 years to develop vaccine for Zika virus. Thus far, the only preventive measure against Zika virus is effective control of vector (mosquito) population.

WHO is predicting an outbreak and major countries have issued travel advisory asking pregnant women from traveling to affected countries. Zika is speculated to spread to both Americas except Canada and Chile. Since May 2015 the viral infection has spread to 21 countries. Lack of immunity among the population and prevalence of Aedes mosquito, the carrier of the disease led to surge in infection levels. Unfortunately controlling spread of disease in highly interconnected world has now become an arduous task. Mosquitoes are now considered the worst enemies of mankind for being vectors of several devastating diseases like Malaria, dengue fever killing hundreds and thousands of people.

Environmentalists said that urbanization and deforestation created ideal conditions for the multiplication of disease causing vectors. Following explosive spread of Zika virus, Brazilians are under intense international pressure to curtail the vector population. They have adopted a judicious mix of old and new mosquito controlling strategies to contain the viral transmission. Genetically engineered mosquitoes harboring a lethal gene are released in the outskirts of cities. GM mosquitoes breed with native population and the gene when passed onto the offspring dies before reaching adulthood. Consequently, the vector population is now precisely kept under check. Biotech companies have now devised genetic overdrive methods like spreading sterility trait in Aedes to rapidly control virus carrying vectors. Another approach is infecting mosquitoes with Wolbachia bacterium, which prevents mosquito from carrying the virus. Bacterium is passed onto the subsequent generations through infected eggs thus the lethal effects of mosquito bites are overcome.

First well documented case of Zika virus was described in 1968 when no potential fatalities were reported. Three potent lineages of Virus were identified- two from African and one from Asian. From 1951 to 1981 human infections were reported in African countries and in parts of India, Indonesia, Malaysia, Thailand, Philippines and Vietnam. The viral strains now found in Americas bear close similarities with the French Polynesian strains. The virus for several decades remained benign since its first. The first major outbreak of Zika occurred in Yap island of Federated States of Micronesia. By 2013 it spread to French Polynesia where the infected persons were diagnosed with severe neurological problems including the occurrence of rare disorder Guillain Barre Syndrome. It is an auto-immune disease that occurs when the immune system attacks the peripheral nerves causing muscle weakness, tingling, loss of sensation and eventually total paralysis. Within span of three months of viral infection, 40 such cases were reported in Yap island. Incidentally the virus caught the attention of researchers as it spread to Australia, France, Japan, Norway and Easter Island.

In 2014, the viral genome was decoded. The single stranded positive RNA virus with the help of host cell machinery replicates and churns out smaller proteins-which includes the capsid, membrane, envelope and seven non-structural proteins. The virus infects the host cell, invades the immune system and takes over dendritic cells. Researchers believed that the three lineages of the virus might have evolved from Uganda in 1920 and through series of recombination events, it has become more adaptive. In May 2015, the virus made its first appearance in South America in Brazil. Perhaps it was imported into the region during the FIFA cup of 2014 and was spread through the bite of Aedes sp mosquitoes. Health experts estimated that by around 2015 around million people might have been infected. Since the outbreak of disease in 2015 there has been whopping increase in the birth of babies with microcephaly in Brazil. While Zika virus was suspected to have caused the birth defect, definite links are not yet established.  But viral traces are found in the amniotic fluid, placental tissues, miscarried babies and in the brains of the babies died of microcephaly immediately after birth. While strong links suggests that Zika virus had caused the genetic-defects in the newborn babies, the immune responses of Zika virus are hard to detect. Zika virus is becoming hard to detect because of its similar immune responses as of dengue virus and most of the Brazilian population are exposed to dengue virus too. Researchers opine that the relatively mild Zika virus due to continued genetic changes is now predisposed to acquire disease-sparking capabilities.

With disproportionate increase in number of microcephalic infants in Brazil researchers are more worried about the resurgence of a viral outbreak. Microcephaly is characterized by four malformations-loss of large degree of brain tissue, unusually smooth and wrinkleless brains, numerous calcium deposits and smaller cerebellums. Unfortunately microcephalic condition of the fetus in most cases, cann’t be detected with ultrasound scans during the first 20 weeks in expectant mothers. It is towards the end of second trimester usually genetic defects can be detected with ultrasound. By 24 weeks aborting a foetus is risky and not legally approved.  Sometimes microcephalic condition remains undetected and appears when babies are born. The affected children display varied mental disabilities- intellectual abilities are stunted, communication is hindered. They may be profoundly disabled and might be confined to wheel chairs for the rest of their lives. In wake of the severity of the disease, Centre for Disease Control and WHO advised women to delay pregnancy and asked to avoid travelling to the affected regions. With Zika virus gradually transcending the boundaries of Latin American countries, US is now highly worried at the propensity of Zika becoming a pandemic in Americas. Health experts as of now, squashed such worries and believed that Zika by and large might cause localized infections in few clusters in US if any. The robust health and sanitation system is geared up to avert any major health threat to US. On the contrary, Indian health experts expressed severe concerns about a possible Zika outbreak as the country regularly encounters outbreak of dengue and chikungunya caused by the bite of Aedes aegypti mosquito, carrier of Zika virus. Traces of Zika were detected in India in 1952-53 but there was no reported outbreak. With 26 million children born every year India is at high risk.
 
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