As the Zika virus spreads from Brazil to the rest of the world creating an international alarm and affecting babies, how prepared is India?
By Ramesh Menon
A virus spread by a mosquito is terrorizing the world. Called Zika, it is causing birth defects in children like smaller heads and damaged brains. This condition, called microcephaly, which causes genetic abnormalities, is otherwise triggered by drugs, alcohol or exposure to hazardous chemicals during pregnancy. The dreaded virus can also lead to neurological defects in adults. Women have been advised not to get pregnant for two years in some of the 23 affected countries. This has created panic among those expecting babies.
“Considering that women of childbearing age and pregnant women are the prime target group for the
Zika vaccine, we consider safety as the overriding factor in development of a new vaccine.” —Dr Sumathy, director of R&D, Bharat Biotech
When patients initially started suffering from mild fever, rash, joint aches, red eyes and muscle pain, it created no alarm. But an international alarm was set off when doctors in Brazil noticed over 4,000 babies born with microcephaly. America’s Centres for Disease Control and Prevention shot off a warning asking pregnant women not to travel to countries where Zika had been detected. There is no vaccine today against Zika and neither is there any medicine or antidote for it.
Scientists have found Zika in the amniotic fluid of women carrying fetuses with microcephaly. And recently, they have also found it in semen. All this has been foxing researchers.
The spread of Zika is insidious. Mosquitoes lay several hundred eggs on the walls of containers filled with water. Some can be as small as a bottle cap. The eggs then hatch in the water and become adults within a week, ready to bite their victims and infect them.
The virus itself derives its name from the Zika forest in Uganda, Africa, where it was first identified in 1947 in Rhesus monkeys. Humans were found to have contracted it in 1952. However, it was not prevalent in the Americas till last year. In the last few years, confirmed Zika cases have been reported from Brazil, Colombia, the Dominican Republic, El Salvador, Guatemala, Mexico, Panama, Paraguay, Suriname and Venezuela.
Mosquitoes are today the world’s biggest disease carriers. There is hardly any house without a repellent. But despite the fight by scientists to eradicate this tiny insect, they have failed even to limit its growth. But that’s not surprising considering that the female mosquito is capable of giving birth to nearly 700 offspring in its life cycle of about a month.
The Aedes mosquito is a weak flier and cannot fly more than 400 meters. But, it can be transported by travelers in their vehicles. If it can survive the temperature climate of the destination they are carried to, the danger is that it may be able to reproduce there and introduce the Zika virus. A mosquito which bites a person suffering from the virus can then transmit it to other humans when it bites them.
The mosquito gets attracted to human sweat and loves biting areas around the feet. It uses its sensory organs to sniff out victims even if they are three meters away. Male mosquitoes do not bite, are vegetarians and live on the juices of leaves. Only the females use their needle-shaped mouths to suck
INDIANS WATCH OUT
India, like the rest of the world, is worried and has reasons to fear. In India, sparse medical detection facilities and ill-equipped laboratories only compound the problem. If the virus enters India, it is clear that it will have devastating consequences as mosquitoes happily proliferate in open sewers and unhygienic public spaces.
The Zika disease has the potential to spread anywhere, including India, where Aedes aegypti is widely prevalent. It could also spread due to poor immunity among the population and also due to the high volume of international travel, according to the WHO. The Aedes aegypti mosquito also causes dengue and chikungunya. According to the National Vector Borne Disease Control Programme, 97,740 Indians were affected by dengue in 2015. Nearly 13,000 were affected by chikungunya. Besides, as Indians are frequent travelers, they can easily bring the virus home. Fortunately, no case has been reported in India till now.
The union health ministry is trying to get kits from abroad to test the virus. It is looking for technical assistance from the WHO to plan treatment, tests and prevention guidelines. It is also in touch with the Centres for Disease Control to know more about the infection and prepare accordingly. It is keeping a lookout for any sudden rise in birth defects. The Pune-based National Institute of Virology is preparing tests to detect the Zika virus. The victims are bitten mostly during the day. Mosquitoes become infected when they feed on a person already infected and then spread it to others.
The United Nations has warned that the Zika virus is spreading explosively and can infect around four million people in the Americas. The Pan American Health Organization stated that the virus may spread to areas where Aedes mosquitoes are found.
In December 2015, Brazil was forced to declare a national public health emergency due to Zika. It helped the country to immediately cut red-tapism, procure insecticides and equipment to fight the mosquito and deploy 3,10,000 health workers.
Earlier, Zika virus outbreaks occurred in Africa, Southeast Asia and the Pacific Islands. Experts say that it will continue to spread as people travel around the world. The only silver lining is that scientists have discovered a way to try and limit the mosquito population.
In the southeastern Brazilian city of Piracicaba where Zika is causing havoc, everyday nearly a lakh mosquitoes are released. Sounds crazy? Not really. All these mosquitoes have been genetically engineered to transmit a lethal gene to mosquitoes that are spreading Zika. It remains to be seen if these biotech bugs can neutralize the growing population of mosquitoes that are spreading malaria, dengue and other related illness.
Meanwhile, Hyderabad-based Bharat Biotech International Private Limited claims that it has made a breakthrough in developing the first vaccine to tackle Zika. It has been working on it for a year and plans to file a patent soon. It will be called Zikavac. Dr Sumathy, director of R&D here said: “Considering that women of childbearing age and pregnant women are the prime target group for the Zika vaccine, we consider safety as the overriding factor in development of a new vaccine. The vaccine methods developed before the devastating epidemic in Brazil came to light gave us an advantage.”
The ministry of health and family welfare has been advised by the WHO to be adequately prepared in case Zika hits India. The ministry is setting up a joint monitoring group under the director general of health services to monitor Zika if and when is detected. The Indian Council of Medical Research is working on identifying research priorities and planning appropriate action. Besides, rapid response teams would be activated at central and state levels. Each of these teams would comprise an epidemiologist, public health specialist, microbiologist and a medical specialist.
An emergency meeting of the WHO said a coordinated international response was needed to minimize the threat in the affected countries and reduce the risk of it further spreading. Dr Poonam Khetrapal Singh, South-East Asia regional director, WHO, said that countries in the region where the Aedes mosquito is prevalent must strengthen surveillance and take preventive measures against Zika. WHO has declared that the emergence of the Zika virus constitutes a public health emergency of international concern. India must move fast to protect itself.