Just when we think we have pesky germs under control, there is another one trying to terrorize us. This time it’s Zika virus. Before I get into what you should know about Zika virus, let me give a short background of a couple other mosquito-transmitted virus outbreaks.
In 2008 there was a major resurgence of dengue fever in the world, with not even the United States being spared; there was an outbreak in Florida and outbreaks were also noted in Hawaii.
Then in late 2013, chikungunya fever exploded in Latin America and the Caribbean with hundreds of thousands of cases over the ensuing months. I narrowly escaped this outbreak myself, having left the Caribbean in summer of 2013. But several of my family members were not so fortunate, including my 90 plus year old grandmother. Fortunately, she is a strong woman and recovered remarkably well for her age. Again, the Unites States were not spared as there was transmission of the virus in Florida.
Now to the virus of the day. In May 2015 a mostly unheard of virus emerged in Brazil, Zika virus. I had not heard of this virus until just a few months ago after reading about it in the news. The scary thing about this virus, is the suspicion that there is a link to birth defects in babies born to infected mothers. Zika virus has now been found in several South American countries and in two Caribbean countries to date, namely Martinique and Puerto Rico.
Should the rest of us be concerned about this virus, the rest of us being, those in countries where Zika virus infection has not yet been identified? My answer to this question is…yes, and no.
Yes, we should all be somewhat concerned about Zika infection because the mosquito responsible for transmitting the virus to us humans has a wide presence including throughout the Caribbean, in the United States, particularly the warmer, southern states, and of course in Asia and Africa.
No, we don’t need to be very concerned about Zika virus because the infection it causes is rather mild. If, however, it is proven to be the cause of birth defects, then a whole new light will be put on the situation. Fingers crossed.
Below are 7 or the most frequently asked questions about Zika virus, and their answers.
1 – What is Zika fever?
Zika fever is a viral illness caused by Zika virus. This virus was first discovered in the Zika forest in Uganda in the 1940s. It was not a frequent cause of infection until over the past decade, where is has caused small outbreaks in southeast Asia, Africa, and the Pacific Islands, and most recently to some parts of Latin America and the Caribbean. It is transmitted from human to human by a mosquito (Aedes species). The mosquito takes a blood meal from an infected person, then bites an uninfected person, injecting the virus into their body.
2 – What are the symptoms of Zika fever and how long do they last?
Symptoms usually occur 3 to 12 days after being bitten by an infected mosquito. They include mild fever, a rash, tiredness, aches in the muscles and joints, headache, and red, irritated eyes (conjunctivitis). Symptoms of infection usually last 2 to 7 days and recovery is usually complete, with no residual effects. In the Brazil outbreak, there was a report of one death, a person with lupus taking steroids (resulting in a weakened immune system). Of interest, only 1 in 5 persons infected with Zika virus, develops symptoms of infection.
3 – Does Zika virus cause malformation of unborn babies?
In Brazil, there was an increase in the number of babies born with abnormally small heads (microcephaly) last year. Because this happened at the same time as the Zika virus outbreak, there is currently concern in Brazil, that Zika virus is the cause. However, a definite link has not been proven. Zika virus was not found in all the babies with small heads. Furthermore, there are other causes of microcephaly, such as genetic abnormalities, exposure to toxins, and other viral infections. It is interesting that other mosquito borne infections (such as dengue and chikungunya) have not been associated with deformed babies. The association of Zika fever and microcephaly remains under investigation.
4 – How is Zika fever treated?
There is no specific antiviral medication to treat Zika fever. Treatment is symptomatic, with medication (often acetaminophen/paracetamol type medication) given for fever and pain, along with plenty fluids and rest. Aspirin and other anti-inflammatory medications should be avoided in case in case the illness happens to be a dengue infection, since these medications increase the risk of bleeding in dengue fever.
5 – How can Zika virus infection be prevented?
Unfortunately there is no vaccine to prevent Zika infection. Prevention of infection entails avoiding mosquito bites. The Aedes mosquito bites during the day. Covering skin with long clothing is advised but often not feasible in hot climates. Insect repellent should be applied to exposed areas of the skin. Uncovered water vessels should not be kept outside the house as these are breeding grounds for mosquitos. If a person is sick with Zika fever, they should avoid being bitten by mosquitos during the first 7 days of illness, as the virus is present in their blood at this time. If a mosquito bites an infected person, it becomes infected and can transmit infection to another person in the household.
6 – How would you know if you have Zika fever and not one of the other mosquito borne infections or even the flu?
There is a blood test to confirm presence of Zika virus in the blood during the first week of illness, or presence of the antibodies against the virus, after the first week of illness. The results however, will take at least a couple of weeks to be ready. Certain features characterize different infections. For example, with chikungunya there is severe joint pains often with swelling; with dengue there is severe pain behind the eyes and sometimes more severe blood count abnormalities; with the flu (influenza infection) there is a higher fever, sore throat, cough and stuffy nose. Medical attention should be sought by any ill person, and be sure to inform your doctor if you visited a country where Zika virus infection has been identified.
7 – Why is Zika virus only now showing up and it’s been around for over 60 years?
It is complicated and probably due to a combination of factors. With increased warming in some parts of the world, there are less water reservoirs and forests, therefore mosquitos in their quest for survival, are encroaching closer to human habitats where there is always water (mosquitos need clean bodies of water to complete their life cycle). Then there is the fact that people are more mobile than ever, with increased financial ability to travel to far away places. Because the Aedes species of mosquito are present almost worldwide, one infected person visiting a country can introduce the Zika virus into the mosquito population after one or more bites. Regarding Brazil, it is felt by some, that the Zika virus was introduced during the world cup of 2014.
I think it is only a matter of time before Zika virus reaches the other countries of Latin American and the Caribbean, much like chikungunya did. The virus will probably also eventually end up in some of the warmer states of North America as well. Hopefully, an easily preventable cause of the microcephaly cases in Brazil will be found, rather than Zika virus. If that is the case, then I don’t believe Zika will be as big a threat to our health as some of the other mosquito borne infections. Unfortunately however, we live in a globalized world and there is no escaping new infections emerging and re-emerging as time goes on.
*An earlier version of this article stated incorrectly “Of interest, 1 in 5 persons infected with Zika virus, does not develop symptoms of infection.” It should have stated “Of interest, only 1 in 5 persons infected with Zika virus, develops symptoms of infection.”