Zika virus outbreak (2015–present)
Situation map of the outbreak as of 3 February 2016 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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As of early 2016, the most widespread outbreak of Zika fever, caused by the Zika virus, is ongoing primarily in the Americas. The outbreak began in April 2015 in Brazil, and subsequently spread to other countries in South America, Central America, and the Caribbean.
In January 2016, the World Health Organization (WHO) said that the virus was likely to spread throughout the majority of the Americas by the end of the year;[31] and in February 2016, the WHO declared that the cluster of microcephaly and Guillain–Barré syndrome (GBS) cases reported in Brazil – strongly suspected to be associated with the Zika virus outbreak – was a Public Health Emergency of International Concern.[32][33][34][35]
The virus is mainly spread by the Aedes aegypti mosquito, which is commonly found throughout the tropical and subtropical Americas, but also by Aedes albopictus ("Asian tiger"), which have become widespread as far north as the Great Lakes region of North America.[36] The Zika virus can also be transmitted through sex.[35][37]
The majority of Zika virus infections are asymptomatic, making precise estimates of the number of cases very difficult to determine.[38] In around one in five cases, infection with Zika virus results in a minor illness known as Zika fever, which causes symptoms such as fever and a rash. However, Zika virus infection in pregnant women has a suspected link with newborn microcephaly by mother-to-child transmission[39][40] and, in very few cases, GBS. A number of countries have issued travel warnings, and the outbreak is expected to have an impact on the tourism industry.[35][41]
Epidemiology
The Zika virus was first isolated in 1947 in a rhesus monkey in a forest near Entebbe, Uganda.[42] Although serologic evidence indicated additional human exposure during subsequent decades in parts of Africa and Asia,[43] before the 2007 Yap Islands Zika virus outbreak, only 14 cases of human Zika virus disease had been documented.[42] Brazilian researchers have suggested that Zika virus arrived in the country from French Polynesia during the 2014 FIFA World Cup tournament,[44] based on phylogenetic DNA analysis of the virus;[45] French researchers speculated the virus arrived shortly afterwards, in August 2014, when canoeing teams from the Zika-afflicted Cook Islands, French Polynesia, New Caledonia, and Easter Island attended the Va'a World Sprint Championships in Rio de Janeiro.[46][47] In May 2015, Zika virus was first confirmed as the cause of an outbreak of a dengue-like disease in northern, northeastern and southeastern Brazil.[48] In the district of Camaçari, and the neighboring city of Salvador, capital of the state of Bahia, a previously unknown disease that caused flu-like symptoms, followed by rash and arthralgia, was shown to be caused by the Zika virus by researchers from the Federal University of Bahia using the reverse transcription polymerase chain reaction (RT-PCR) technique.[49] The virus reached Colombia in October[50] and other countries in Latin America including the Caribbean in November and December.[51] Confirmed cases have now been reported in most of South and Central America, and the Caribbean.[52] In its spread from Africa and Asia to Oceania and then to the Americas, Zika followed the same pattern as chikungunya after 2004.[53]
Cases have also been reported that were imported from South America into Europe,[54] Canada,[55] United States,[56] China,[57] and Australia.[58]
Transmission
Zika is a mosquito-borne disease and possibly a sexually transmitted infection.[37] The resurgence of Aedes aegypti's worldwide distribution over the past 2–3 decades makes it one of the most widely distributed mosquito species.[59] In 2015, Aedes albopictus was present in tropical, subtropical, and temperate regions of the Americas, reaching as far north as the Great Lakes of North America and, internationally, living alongside Aedes aegypti in some tropical and subtropical regions.[36]
The Aedes aegypti mosquito usually bites in the morning and afternoon hours, and can be identified by the white stripes on its legs.[60] The mosquito species (Aedes aegypti, mainly, and Aedes albopictus) that can spread Zika virus can also spread dengue, chikungunya, and yellow fever.[61]
There have been reports of Zika virus transmission via sexual intercourse. In such cases, Zika virus may have been sexually transmitted from male partners ill with the disease.[35][37][62]
Possible link to infant microcephaly and other disorders
The Zika virus was first linked with newborn microcephaly during the Brazil Zika virus outbreak. In 2015, there were 2,782 cases of microcephaly compared with 147 in 2014 and 167 in 2013.[63] Confirmation of many of the recent cases is pending, and it is difficult to estimate how many cases went unreported before the recent awareness of the risk of virus infections.
In November 2015, the Zika virus was isolated in a newborn baby from the northeastern state of Ceará, Brazil, with microcephaly and other congenital disorders. The Lancet medical journal reported in January 2016 that the Brazilian Ministry of Health had confirmed 134 cases of microcephaly "believed to be associated with Zika virus infection" with an additional 2,165 cases in 549 counties in 20 states remaining under investigation.[35][64]
In January 2016, a baby in Oahu, Hawaii, was born with microcephaly, the first case in the United States of brain damage linked to the virus. The baby and mother tested positive for a past Zika virus infection. The mother, who had probably acquired the virus while traveling in Brazil in May 2015 during the early stages of her pregnancy, had reported her bout of Zika. She recovered before relocating to Hawaii. Her pregnancy had progressed normally, and the baby's condition was not known until birth.[65]
A high incidence of the autoimmune disease GBS, noted in the French Polynesia outbreak, has also been found in the outbreak that began in Brazil.[66] However, there are no laboratory confirmations of Zika virus infection in patients with GBS.[67]
Ocular disorders in newborns have also been linked to Zika virus infection.[68] In one study in Pernambuco state in Brazil, about 40 percent of babies with Zika-related microcephaly also had scarring of the retina with spots, or pigment alteration.[67]
Containment and control
Diagnosis
[70] Symptoms are similar to other flaviviruses such as dengue fever or the alphavirus that causes chikungunya,[71] but are milder in form and usually last four to seven days. Most cases (60–80%) are asymptomatic. The main clinical symptoms in symptomatic patients are low-grade fever, conjunctivitis, transient joint pain (mainly in the smaller joints of the hands and feet) and maculopapular rash that often starts on the face and then spreads throughout the body.[71] In general the disease symptoms are mild and short-lasting (2–7 days).
It is difficult to diagnose Zika virus infection based on clinical signs and symptoms alone due to overlaps with other arboviruses that are endemic to similar areas.[72] The methods currently available to test for Zika antibodies cross-react with dengue antibodies. An IgM-positive result in a dengue or Zika ELISA test can only be considered indicative of a recent flavivirus infection. Plaque-reduction neutralization tests can be performed and may be specific.[73] The Zika virus can be identified by RT-PCR in acutely ill patients.[35]
Americas
Most countries, including Colombia, Ecuador, El Salvador and Jamaica, advised women to postpone getting pregnant until more was known about the risks.[74][75] Plans were announced by the authorities in Rio de Janeiro, Brazil, to try to prevent the spread of the Zika virus during the 2016 Summer Olympics in Rio.[76] The health ministry of Peru installed over 20,000 ovitraps during the 2015 dengue outbreak. The same ovitraps will be used to monitor a potential Zika outbreak in Peru's tropical regions.[77]
Because of the "growing evidence of a link between Zika and microcephaly" the CDC issued a travel warning on 15 January 2016 advising pregnant women to consider postponing travel to Brazil as well as the following countries and territories where Zika fever had been reported: Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto Rico.[78] On 20 January 2016, the Ministry of Health of Chile published a health notice.[79] On 22 January 2016, eight more countries were added to the list of those affected: Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin, Guyana, Cape Verde, and Samoa.[80] The agency issued additional guidelines and suggested that women thinking about becoming pregnant consult with their physicians before traveling.[81] Canada issued a similar travel advisory.[76][82]
International
Governments or health agencies such as those of the United Kingdom,[83] Ireland,[75] Japan,[84] South Korea,[85] New Zealand,[86] Malaysia,[87] Philippines[88] and the European Union[76] issued travel warnings. The warnings are predicted to have an effect on the tourism industry in affected countries.[89][90][91]
To prevent the transmission of the Zika virus, WHO recommends using insect repellent, wearing long-sleeved clothes to cover the body, and using screens and mosquito nets to exclude flying insects from dwellings or sleeping areas. It is also vital to eliminate any standing water near homes to minimize breeding areas for mosquitos. Authorities can treat larger water containers with recommended larvicides.[92][93] Furthermore, the Centers for Disease Control and Prevention (CDC) recommends that containers holding water near homes either be sealed or scrubbed once per week, because mosquito eggs can stick to them.
On 1 February 2016, WHO declared the cluster of microcephaly cases and other neurological disorders a Public Health Emergency of International Concern,[32] which may reduce the number of visitors to the Rio Olympics in 2016.[94] The designation has been applied in the past to the Ebola outbreak in 2014, the outbreak of polio in Syria in 2013, and the 2009 flu pandemic.[95] South Korea held an emergency meeting in response to the WHO declaration in 2 February 2016.[85]
Responses
In January 2016, it was announced that, in response to the Zika virus outbreak, Brazil's National Biosafety Committee approved the releases of more genetically modified Aedes aegypti mosquitoes throughout their country. Previously, in July 2015, Oxitec published results of a test in the Juazeiro region of Brazil, of so-called "self-limiting" mosquitoes, to fight dengue, Chikungunya and Zika viruses. They concluded that mosquito populations were reduced by over 90% in the test region.[96][97][98] Male genetically modified mosquitoes mate with females in the wild and transmit a self-limiting gene that causes the resulting offspring to die before reaching adulthood and thus diminishes the local mosquito population.[96][99]
On 1 February 2016, the WHO declared the current Zika virus outbreak an international public health emergency.[100][101] The same day (1 February 2016) the Brazilian President released a decree that increased local and federal pest control agents access to private property required by mobilization actions for the prevention and elimination of Aedes mosquito outbreaks in the country.[102]
Some experts have proposed to combat the spread of the Zika virus by breeding and releasing mosquitoes that have either been genetically modified to prevent them from transmitting pathogens, or that have been infected with the Wolbachia bacterium, thought to inhibit the spread of viruses.[103] Another proposed technique consists in using radiation to sterilize male larvae so that when they mate, they produce no progeny.[104] Male mosquitoes do not bite or spread disease.
In February, the Brazilian federal government has mobilized 60% of the Armed Forces, or about 220,000 soldiers, to warn and educate the population of 350 municipalities on how to reduce mosquitoes breeding grounds.[105]
See also
References
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- ↑ "Countries and territories with recent local Zika virus transmission". European Centre for Disease Prevention and Control. 10 February 2016. Retrieved 11 February 2016.
- ↑ "Tests confirm Zika in American Samoa". Radio New Zealand. 2016-02-13.
- ↑ Deane, Sandy (8 February 2016). "Zika confirmed in three pregnant women". Barbados Today.
- 1 2 3 4 5 6 7 8 "Zika Americas By The Numbers". News Americas Now. 29 January 2016.
- 1 2 3 "At least 20,000 infected by Zika virus in Colombia". Al Jazeera. 30 January 2016.
- 1 2 "Neurological Syndrome and Congenital Anomalies" (PDF). Zika Situation Report. World Health Organization. 5 February 2016. Retrieved 10 February 2016.
- ↑ Gayle, Damien (13 February 2016). "Zika virus: more than 5,000 pregnant women infected in Colombia". The Guardian.
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- ↑ "Zika virus infection – Dominican Republic". World Health Organization. 27 January 2016.
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- ↑ Chang, Chris (26 January 2016). "Two pregnant Kiwi women cancel trips to Samoa after Zika outbreak". ONE News Now (New Zealand). Retrieved 2016-02-12.
- ↑ "Zika virus infection – Suriname". World Health Organization. 11 November 2015.
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- ↑ Romero, Simon (29 January 2016). "Tears and Bewilderment in Brazilian City Facing Zika Crisis". The New York Times. Retrieved 1 February 2016.
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- ↑ Musso, Didier (October 2015). "Zika Virus Transmission from French Polynesia to Brazil". Emerging Infectious Diseases (Centers for Disease Control and Prevention) 21 (10): 1887. doi:10.3201/eid2110.151125. Retrieved 8 February 2016.
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- ↑ "PRO/AH> Zika virus – Brazil: confirmed Archive Number: 20150519.3370768". Pro-MED-mail. International Society for Infectious Diseases.
- ↑ "G1 – Identificado vírus causador de doença misteriosa em Salvador e RMS – notícias em Bahia". Bahia. April 2015.
- ↑ "PRO/AH> ZIKA VIRUS – COLOMBIA (03) Archive Number: 20151102.3760111". Pro-MED-mail. International Society for Infectious Diseases.
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- ↑ Zammarchi, L; Tappe, D; Fortuna, C; Remoli, M; Günther, S; Venturi, G; Bartoloni, A; Schmidt-Chanasit, J (11 June 2015). "Zika virus infection in a traveller returning to Europe from Brazil, March 2015". Eurosurveillance 20 (23): 21153. doi:10.2807/1560-7917.ES2015.20.23.21153. PMID 26084316.
- ↑ "Zika virus warning issued to New Brunswick travellers". CBC News. 5 February 2016. Retrieved 6 February 2016.
- ↑ Sun, Lena H. (20 January 2016). "CDC: ‘Dozen or so’ cases of Zika virus among U.S. residents". The Washington Post. Retrieved 24 January 2016.
- ↑ Rajagopalan, Megha; Jim, Clare (10 February 2016). "China confirms first case of Zika virus: Xinhua". Reuters. Retrieved 10 February 2016.
- ↑ "Zika virus found in Australian travelers returning from South America, virologist says". ABC News (Australia) (Australia). 26 January 2016.
- ↑ "Aedes aegypti". European Centre for Disease Prevention and Control.
- ↑ WHO 2016 Zika virus, Fact sheet. Updated January 2016, WHO Media Centre. Accessed: 30 January 2016.
- ↑ Help Control Mosquitoes that Spread Dengue, Chikungunya, and Zika Viruses. (PDF) Center for Disease Control. August 2015. Accessed 30 January 2016.
- ↑ "Zika virus infection – United States of America". World Health Organization. 12 February 2016.
- ↑ Romero, Simon (30 December 2015). "Alarm Spreads in Brazil Over a Virus and a Surge in Malformed Infants". The New York Times. Retrieved 24 January 2016.
- ↑ Triunfol, Marcia (9–15 January 2016). "A new mosquito-borne threat to pregnant women in Brazil". Lancet 387 (10014): 96. doi:10.1016/S1473-3099(15)00548-4. PMID 26723756.
- ↑ Jr, Donald G. Mcneil (16 January 2016). "Hawaii Baby With Brain Damage Is First U.S. Case Tied to Zika Virus". New York Times.
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- 1 2 "ZIKA VIRUS (03): AMERICAS, ASIA". ProMED-mail. International Society for Infectious Diseases. 28 January 2016. Retrieved 8 February 2016.
- ↑ Ventura, Camila V; Maia, Mauricio; Bravo-Filho, Vasco; Góis, Adriana L; Belfort, Rubens (January 2016). "Zika virus in Brazil and macular atrophy in a child with microcephaly". The Lancet 387 (10015): 228. doi:10.1016/S0140-6736(16)00006-4.
- 1 2 "Understanding Zika". understandingzika.org. Retrieved 8 February 2016.
- ↑ Khaled, Dr Mohammed. "Zika Virus, Is It The New Pandemic?". Doctors Advice. Retrieved 9 February 2016.
- 1 2 Musso, D.; Nilles, E.J.; Cao-Lormeau, V.-M. (2014). "Rapid spread of emerging Zika virus in the Pacific area". Clinical Microbiology and Infection 20 (10): O595–6. doi:10.1111/1469-0691.12707. PMID 24909208.
- ↑ Fauci, Anthony S.; Morens, David M. (13 January 2016). "Zika Virus in the Americas – Yet Another Arbovirus Threat". New England Journal of Medicine: 160113142101009. doi:10.1056/NEJMp1600297. PMID 26761185.
- ↑ CDC (2016) Updated diagnostic testing for Zika, chikungunya, and dengue viruses in US Public Health Laboratories. Memorandum of 13 January 2016. CDC, Division of Vector-Borne Diseases, Arboviral Diseases and Dengue Branches. http://www.cdc.gov/zika/pdfs/denvchikvzikv-testing-algorithm.pdf
- ↑ "Zika virus triggers pregnancy delay calls". BBC News. 23 January 2016. Retrieved 23 January 2016.
- 1 2 "Pregnant Irish women warned over Zika virus in central and South America". RTE. 22 January 2016. Retrieved 23 January 2016.
- 1 2 3 "Zika: Olympics plans announced by Rio authorities". BBC. 24 January 2016. Retrieved 24 January 2016.
The Rio de Janeiro authorities have announced plans to prevent the spread of the Zika virus during the Olympic Games later this year. ... The US, Canada and EU health agencies have issued warnings saying pregnant women should avoid travelling to Brazil and other countries in the Americas which have registered cases of Zika.
- ↑ "Northern Peru braces for mosquito-borne Zika virus". Peru Reports. Peru Reports. Retrieved 28 January 2016.
- ↑ Lowes R (15 January 2016). "CDC Issues Zika Travel Alert". Centers for Disease Control and Prevention. Retrieved 16 January 2016.
- ↑ "Recomendaciones por Virus Zika" (in Spanish). Ministry of Health of Chile. Retrieved 25 January 2016.
- ↑ "CDC expands Zika travel advisory to include more countries". STAT. Retrieved 23 January 2016.
- ↑ Petersen, Emily E.; Staples, J. Erin; Meaney-Delman, Dana; Fischer, Marc; Ellington, Sascha R.; Callaghan, William M.; Jamieson, Denise J. (2016). "Interim Guidelines for Pregnant Women During a Zika Virus Outbreak — United States, 2016". MMWR Morb Mortal Wkly Rep 65 (2): 30–33. doi:10.15585/mmwr.mm6502e1. PMID 26796813.
- ↑ "Zika virus infection in the Americas". Government of Canada. 3 February 2016. Retrieved 8 February 2016.
Pregnant women, and those considering becoming pregnant, should discuss their risk with their health care provider and consider postponing travel to areas where the Zika virus is circulating.
- ↑ "Zika virus: Advice for those planning to travel to outbreak areas". ITV News. 22 January 2016. Retrieved 24 January 2016.
- ↑ "Japan to step up screening for Zika virus". The Japan Times. Kyodo, Associated Press. 2 February 2016. Retrieved 2 February 2016.
“We urge people, particularly pregnant women, to refrain from visiting sites where the disease has spread,” health minister Yasuhisa Shiozaki said.
- 1 2 "S. Korea holds emergency meeting on Zika virus threat". Yonhap News Agency. 2 February 2016. Retrieved 2 February 2016.
- ↑ Nina Burton (24 January 2016). "Zika virus prompts travel warning for Kiwis". 3News, New Zealand. Retrieved 24 January 2016.
The New Zealand Government has followed Britain's lead. Official advice recommends any women who are pregnant or plan to conceive in the near future to delay travel to countries affected with the Zika virus.
- ↑ Mazwin Nik Anis (3 February 2016). "Zika virus: Health Ministry issues travel advisory". The Star. Retrieved 3 February 2016.
Malaysia has issued a travel advisory for 26 countries and territories where cases of Zika virus infections have been reported. They are Barbados, Bolivia, Brazil, Colombia, Costa Rica, Curacao, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana and Haiti. Malaysians are also advised to avoid travelling to Honduras, Jamaica, Martinique, Mexico, Nicaragua, Panama, Paraguay, Puerto Rico, Saint Marti, Suriname, US Virgin Islands and Venezuela.
- ↑ "DOH cautions public on Zika virus". Sun Star Manila. 31 January 2016. Retrieved 2 February 2016.
- ↑ "Tourist industry on edge as Zika virus spreads". BBC News.
- ↑ "Zika affects plans for destination weddings, babymoons". The Big Story.
- ↑ Jeffrey Dastin (7 February 2016). "Exclusive: Zika virus discourages many Americans from Latin America travel". Reuters.
- ↑ "Zika virus fact sheet". World Health Organization. February 2016. Retrieved 15 February 2016.
- ↑ WHOPES-recommended compounds and formulations for control of mosquito larvae (25 October 2013)
- ↑ "PRO/AH> ZIKA VIRUS - WORLDWIDE: WHO DECLARES PUBLIC HEALTH EMERGENCY OF INTERNATIONAL CONCERN (PHEIC) 2016-02-01 20:24:23 Archive Number: 20160201.3985366". Pro-MED-mail. International Society for Infectious Diseases.
- ↑ "An Emergency Meeting on the Zika Virus". The Atlantic. Retrieved 2 February 2016.
- 1 2 "Here's how GM mosquitos with ‘self-destruct’ genes could save us from Zika virus". The Washington Post. 2016.
- ↑ "Press release: Oxitec mosquito works to control Aedes aegypti in dengue hotspot". Oxitec. 2015.
- ↑ Danilo O. Carvalho , Andrew R. McKemey , Luiza Garziera, Renaud Lacroix, Christl A. Donnelly, Luke Alphey, Aldo Malavasi, Margareth L. Capurro (2015). "Suppression of a Field Population of Aedes aegypti in Brazil by Sustained Release of Transgenic Male Mosquitoes". PLoS ONE 9 (7): e0003864. doi:10.1371/journal.pntd.0003864.
- ↑ Carvalho, Danilo O.; McKemey, Andrew R.; et al. (July 2015). "Suppression of a Field Population of Aedes aegypti in Brazil by Sustained Release of Transgenic Male Mosquitoes". PLOS Negl Trop Dis. 9 (7): 422–9. doi:10.1371/journal.pntd.0003864. PMID 4489809.
- ↑ "W.H.O. Declares Zika Virus an International Health Emergency". The New York Times. 1 February 2016.
- ↑ "Zika virus a 'public health emergency,' WHO says - CNN.com". CNN. Retrieved 1 February 2016.
- ↑ "Decreto Nº 8.662" [Decree No. 8662] (in Portuguese). Palácio do Planalto, Presidência da República. 1 February 2016. Retrieved 4 February 2016.
- ↑ Jason Gale (4 February 2016). "The Best Weapon for Fighting Zika? More Mosquitoes". Bloomberg.com. Bloomberg News.
- ↑ Tirone, Jonathan (12 February 2016). "UN Readies Nuclear Solution to Destroy the Zika Virus". Bloomberg. Retrieved 2016-02-13.
- ↑ "Brasil destina 60% das suas Forças Armadas na luta contra um mosquito". El País. 2016-02-13.
External links
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