Zika virus: Five things to know

Transmission electron micrograph (TEM) of Zika virus. Credit: Cynthia Goldsmith/Centers for Disease Control and Prevention

09 feb 2016--A concise "Five things to know about.... Zika virus infection" article for physicians highlights key points about this newly emerged virus in CMAJ (Canadian Medical Association Journal)
Zika virus is transmitted by Aedes mosquitoes, which are active during the day. They also transmit dengue and chikungunya viruses. Physicians should be alert to symptoms in travellers returning from Central and South America, Mexico and the Caribbean. Zika virus may be linked to Guillain-Barré syndrome and microcephaly in babies born to women infected with Zika virus.
A blood test is used to diagnosis Zika virus infection. Acetaminophen may be used to alleviate pain and fever in affected patients.

More information: Canadian Medical Association Journal, www.cmaj.ca/lookup/doi/10.1503/cmaj.151486


Provided by Canadian Medical Association Journal

Zika virus, a wolf in sheep's clothing

The world's latest health scare is a seemingly minor illness that carries a killer wrapped inside: Zika, the mosquito-borne virus sweeping Latin America, usually lasts less than a week, except when it derails a whole life.

25 jan 2016--Zika, which resembles a light case of the flu, is often so mild that people don't realize they have it.
But health officials in Latin America say the tropical fever is linked to neurological problems and a surge in microcephaly, a condition in which babies are born with abnormally small heads. The defect can cause brain damage and death.
The outbreak has led authorities in some countries to urge couples not to get pregnant, while the US Centers for Disease Control (CDC) has warned pregnant women to avoid traveling to 22 affected countries.
Here are some questions and answers on the virus.

What's Zika?

The virus was first identified in a monkey in Africa in 1947. Its name comes from a forest in Uganda where the first infected rhesus monkeys were found. Within several years the virus had jumped to humans in Uganda and Tanzania, according to the World Health Organization (WHO).
Like dengue fever and chikungunya, two similar diseases, Zika is transmitted by mosquito species found in tropical and sub-tropical regions: Aedes aegypti and Aedes albopictus, or tiger mosquitoes.

How do I know if I have it?

In 70 to 80 percent of cases, the disease goes unnoticed. The symptoms resemble a mild case of the flu—headache, muscle and joint pain, and mild fever—plus a rash.
Symptoms usually last two to seven days.

Why are experts worried?

The disease is suspected of causing two serious complications: neurological problems and birth defects in babies born to infected women. But while there appears to be a connection with Zika, researchers have not definitively confirmed a causal link.
The main neurological complication is Guillain-Barre syndrome, a disorder in which the immune system attacks the nervous system, causing weakness and sometimes paralysis.
Most patients recover, but the syndrome is sometimes deadly. Cases linked to Zika have been reported in Brazil and French Polynesia.
Microcephaly and other brain deformities in newborns have also been reported, particularly in Brazil. Microcephaly cases in the giant South American country surged from 163 per year on average to 3,893 after the Zika outbreak began last year. Forty-nine of those babies have died.

What's the treatment?

There is no vaccine for Zika, and no specific treatment—patients simply take pain-killers and other medication to combat the symptoms.
The virus is transmitted through mosquito bites, so prevention entails fighting mosquitoes and avoiding contact with them. Health officials recommend covering up, using insect repellant and keeping windows closed or screened.
Authorities have responded to the outbreak by fumigating and cleaning up the standing water where mosquitoes breed.
Authorities in Brazil, Colombia, Ecuador, El Salvador and Jamaica have advised couples to avoid pregnancy for the time being.
In Brazil, authorities have announced a crackdown on mosquito breeding grounds ahead of the Olympics, which will bring hundreds of thousands of travelers from around the world to Rio de Janeiro in August.

Where is Zika now?

The virus was first reported in Africa, Asia and the Pacific before leaping to the Americas last year.
It is now spreading locally in some 20 Latin American and Caribbean countries, as far north as Mexico. Brazil has been the hardest hit.
Travelers have also brought it back to the US states of Florida, Hawaii and New York. A woman in Hawaii gave birth to a baby with microcephaly after traveling to Brazil.
So far there have been no locally transmitted US cases reported, though the Aedes aegypti mosquito's habitat stretches into the United States.
The European Centre for Disease Prevention and Control (ECDC) says on its website that "there is no evidence of transmission (of) Zika virus in Europe to date and imported cases are rare."

FURTHER INFORMATION:

- www.cdc.gov/zika/
- ecdc.europa.eu/en/healthtopics/zika_virus_infection/Pages/index.aspx
-www.paho.org/hq/index.php?option=com_topics&view=article&id=427&Itemid=41484

Fight against little-known Zika virus applies lessons from Ebola

While the world's attention has been focussed on Ebola, another outbreak has been spreading in a number of countries across the world. Now, Oxford University infectious disease specialists are applying the lessons from the Ebola outbreak to try to support local medics and researchers to get ahead of this new pathogen.

14 jan 2016--Zika, carried by the Aedes mosquito, has been known about for some years, typically causing mild illness and a rash. Now, however, reports from South America suggest that it is causing birth defects in newborn babies of women who have had Zika.
The outbreak came to the attention of two Oxford-based organisations: The Global Health Network (TGHN), an online science park that guides and supports medical research around the world, especially in low and middle income countries and ISARIC, a global network of researcher groups whose aim is to enable research in disease outbreaks
Professor Trudie Lang explained: 'I was at an ISARIC meeting about Ebola when Fernando Bozza of the Oswaldo Cruz Foundation told us about the Zika outbreak He asked what we knew about the Zika outbreak. The answer was not much.
'He briefed the ISARIC team and it was clear this was another situation where the research community had to come together to ensure that evidence was gathered as early as possible this time, and that we should apply the lessons from Ebola that we were discussing at that very meeting.'
Zika has been known about since the late 1940s but major outbreaks were not recorded until a 2006 occurrence on the pacific island of Yap. In 2013 there were 30,000 cases in French Polynesia.
However, the South American outbreak is particularly concerning because if its apparent effect on foetal development. Dr Fernando Bozza said: 'Zika Virus has been reported in Brazil since April 2015 and up to mid-December, nine other countries in the Americas have reported local Zika transmission.
'In November, the Brazilian Ministry of Health reported an unusual increase in cases of microcephaly, with a causal link between Zika infection during pregnancy and congenital abnormalities. 2,401 microcephaly cases are under investigation in Brazil, with 134 cases confirmed related to Zika virus infection. Investigations are also ongoing to assess a possible relation between Zika and Guillain-Barré Syndrome and other neurological events.'
With Zika becoming a more serious disease, The Global Health Network recognised the need to move as rapidly as possible into obtaining data, which requires the integration of research into the medical and public health response. Developing research tools and strategies is key and this needed a resource for agreeing research priorities and sharing research documents
Professor Lang said: 'Medical research is vital to understand, manage and hopefully stop the outbreak. However, if samples and patient information are to be used for research purposes then protocols are needed that have been given ethical approval by regulatory authorities and patients need to be informed and asked for their consent. Robust studies need to be planned and this all takes time to put into place. However, a lesson from Ebola was that it can be done faster. The researchers in the affected regions are poised to run and lead these studies, and the international research community, through ISARIC, is working to support them and provide any input and external expertise that is needed.
'The Global Health Network's website for Zika has been set up for the local research community. It will make available documents like case record forms and consent forms, as well as sharing research priorities. By providing a common and open sharing space that is driven by the regional researchers in Brazil and other countries it should be possible to speed up getting this crucial data that is needed to understand, manage and eventually treat Zika virus infection.'
The hope is that a joined up approach, where frontline health organisations are supported by a global network, will mean Zika is understood quicker and that work on treatments can begin sooner.

More information: The site is at: zikainfection.tghn.org/


Provided by University of Oxford