Zika Virus Reported In Pregnant Woman In India: Know About Its Causes, Symptoms And Treatments

What Is Zika Virus Infection?

Zika virus infection is a vector-borne disease spread by the bite of an infected mosquito called Aedes. Zika virus is a single-stranded RNA virus of the genus Flavivirus and family Flaviviridae, a family that includes dengue virus, yellow virus, West Nile Virus and chikungunya virus. [1]

Zika virus has two major lineages at different locations: African and Asian. In many people, the infection causes mild symptoms and is self-limiting, while in some, it can cause severe symptoms like brain and nervous system complications. Newborns may face certain birth defects if the infection is transmitted to them through infected mothers.

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How Is Zika Virus Infection Transmitted?

The transmission of the Zika virus to humans takes place when infected Aedes mosquitoes (like Aedes aegypti and Aedes albopictus) bite humans and transfer the virus in their bodies. These mosquitoes are females and typically lay eggs on stagnant water sources like buckets, flower pots or animal dishes. They need human blood for the development of their eggs. [2]

When Aedes mosquitoes bite an infected person (mostly during the daytime), the virus gets in their bodies, which then get transmitted to another person whom they bite the next time. The mosquitoes are infected only when the host has the infection in their bodies, probably during the first week of infection.

Some of the other ways in which the Zika virus infection is transmitted include:

• Sexual contact or having sex with the infected partner. [3]
• Bodily fluids like urine, saliva, blood, amnio fluid, cerebrospinal fluid and breast milk.
• During blood transfusion or organ transplantation. [4]
• Maternal-to-fetal transmission causing intrauterine transmission of infection to newborns. [5]

Symptoms Of Zika Virus Infection

The symptoms of Zika virus infection occur only in around 20 per cent of infected individuals and the majority of them remain asymptomatic. Also, the symptoms are quite similar to dengue and chikungunya virus infection.

Some of the common symptoms of Zika virus infection include: [1]

• Low-grade fever
• Skin rashes
• Small raised bumps
• Arthralgia or pain in the joints.
• Non-purulent conjunctivitis, watery discharge from the eyes without redness, fever or pain.
• Headache
• Stomach pain
• Diarrhoea
• Swelling
• Nausea
• Pain in the muscles

The symptoms mainly start 2-12 days after the bite and usually get resolved in between 2-7 days. [6]

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Zika Virus Infection During Pregnancy

Zika virus may be mild and asymptomatic in many individuals, however, in pregnant women, the infection can be fatal to newborns as it is associated with severe congenital disorders, called congenital Zika syndrome (CZS).

The disorders include central nervous system injury, fetal growth restriction (like microcephaly), cognitive decline, placental insufficiency, and also, fetal death.

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Zika virus infection in pregnant women can occur at any trimester, however, if the infection gets diagnosed in the first trimester, it can put mother and their families to opt for an abortion, which is against their ethics. [7]

Zika Virus In India

According to a study, earlier on 15 May 2017, the first three laboratory-confirmed cases of Zika virus infection in India have been reported in India by the Ministry of Health and Family Welfare from the Bapunagar area (Ahmedabad), followed by a case in Chennai.

The report also adds that this may not be the first case in India, as in 1954, NIV has detected Zika virus antibodies in a few samples from Bharuch district. However, due to its similarity with dengue and other flaviviruses, it was difficult to confirm the test of Zika in India based on serology (identification of antibodies in the blood). [8]

Also, the patients from Gujarat and Chennai have no travel history to Zika endemic locations, suggesting that the infection might be present from before in the country, in a silent and low-key ecological niche.

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Later, in India, around 35000 samples were tested of people with febrile illness, out of which only four cases have been yielded, while out of the testing of 18000 mosquitoes, the virus was detected in none.

This shows that though Zika infection agent is present in India, its count is very low compared to other affected countries like Brazil.

To Note: The case of a pregnant woman who has recently been diagnosed in India with Zika has gained attention because the infection is considered to have made a comeback after four years, that too amid the COVID-19 pandemic.

Complication Of Zika Virus Infection

Some of the known complications of Zika virus infection include:

Diagnosis Of Zika Virus Infection

Zika virus infection is often confused with dengue or chikungunya infection. In areas where Zika is prevalent, the diagnosis is easier. The first step for diagnosis is answering questions related to your travel history to Zika endemic areas, having sex with an infected person, or any recent events of blood transfusion or organ transplantation.

Some of the diagnostic methods include:

• RT-PCR: To detect the RNA of the Zika virus or IgM antibodies in humans.
• Urine and saliva test: To look for RNA of the virus as it is present in these bodily serums for a longer duration.
• Prenatal evaluation: It includes an ultrasound of the fetal in pregnant women who are suspected to have been infected with Zika.

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Treatment Of Zika Virus Infection

The symptoms of Zika virus infection can only be managed to treat the condition, as there are no specific treatment options available. It includes:

• Anti-malarial: It includes anti-malarial medications like chloroquine to inhibit the transmission of the virus to newborns. However, this medicine is still not FDA approved. [10]
• Acetaminophen: It is a drug to ease fever and pain.
• Supportive care: Like best rest and increasing the consumption of fluids to prevent the risk of dehydration and flush out the infection.

How To Prevent The Spread Of Chikungunya Virus

How To Prevent Zika Virus Infection

• Avoid mosquito bites by wearing long and full-sleeve tops and bottoms.
• Stay indoors, especially if you stay in Zika endemic areas.
• Use mosquito nets during nighttime.
• Drink as much water to stay hydrated.
• Have safe sex by using condoms.
• Avoid having sex with an infected partner.
• Avoid stagnant water in your areas.

Remember: There is no vaccine available or antiviral therapy for Zika. Therefore, prevention is the best way to stay away from the infection.