When Singapore first announced its first case of the Zika virus in August 2016, we all knew that it would just be moments before it would affect our country as well. As of 23 September 2016, Singapore has already reported 387 cases. With the recent cases announced in Malaysia, experts have already predicted that the Zika virus would morph into a catastrophic epidemic bigger than that of our neighboring country.
In Malaysia, our Health Minister, Datuk Dr. S Subramaniam has already confirmed 4 cases of Zika infection and another 40 suspected cases. A 61-year-old gentleman from Sabah who was affected with the disease died on the 3rd of September 2016 due to heart complications. The Health Ministry states that although his death was not a result of Zika itself because he had background history of multiple comorbidities, he is the first infected Malaysian to have died.
Scientists have confirmed that the virus strain itself came from within Asia and was not imported from Brazil. Read about an introduction to the Zika Virus. Below is an update on what we additionally know about Zika thus far:
How is Zika transmitted?
- Zika is spread by the bite of an infected Aedes species mosquito (Ae. aegypti and Ae. albopictus).
- Zika can be passed from a pregnant woman to her fetus.
- Sexual contact. Canada reported its first case of transmission via sexual contact in April 2016.
- Through blood transfusion
How long does the virus stay in the body?
- There is a case report from Italy confirming a gentleman who had traveled to Haiti in January 2016, confirmed contracted the disease and noted to have persistent shedding of the ZIKV RNA in his semen for 6 months after the onset of the symptoms.
- The risk of sexual transmission is associated with high viral load excretion of ZIKV during the early phase of infection but cases of late sexual transmission as well as transmission between asymptomatic individuals have been also reported.
Do all patients infected with the virus show symptoms?
- 80% of those infected will show no symptoms or will only exhibit mild symptoms.
- They can present with fever, rash, conjunctivitis, muscle and joint pain, generalised weakness, tiredness and headache; normally lasts for several days to a week.
- Symptoms are somehow similar to dengue so high suspicion is necessary especially if one has history of travel to an affected area.
What are the complications associated with Zika?
- There is scientific consensus that Zika virus can cause microcephaly and Guillain-Barré syndrome. Links to other neurological complications are still being investigated.
- WHO also reported a range of manifestations that has been reported among babies up to 4 weeks old that had been exposed to Zika virus in utero. These include malformations of the head, involuntary movement, seizures, brainstem dysfunction such as swallowing problems, limb contractures, hearing and sight abnormalities and brain anomalies.
- Research showed the risk of developing microcephaly and other neurological complications associated with Zika is high as 13% during the first trimester of pregnancy. Scientists however do not know if miscarriages and stillbirths are the result of the infection, nor do they know at what stage of pregnancy is risk the greatest, or whether another infection that occurred at the same time might affect the risk of birth defects.
Is there a vaccine available for Zika virus?
- As of now, there are no commercially available vaccines against Zika virus.
- Three experimental vaccines are being developed at Harvard's Beth Israel Hospital and the Walter Reed Army Institute of Research . All three of the vaccines were found to be safe and protected the monkeys against infection according to the report published in Science.
- The National Institute of Health (NIH) has also launched a clinical trial of a vaccine intended to prevent Zika virus infection. Initial safety and immunogenicity data from the Phase 1 trial are expected to be completed by January 2017. If results show a favorable safety profile and immune response, NIAID plans to initiate a Phase 2 trial in Zika-endemic countries in early 2017.
How can we best prevent Zika?
- The same measures to prevent dengue infection work for Zika too including ensuring that there are no mosquito breeding areas in or near your community.
- Practise safe sex (barrier methods) with partners who have recently returned from Zika-epidemic areas.