23 February 2016

Southern Africa: Zika Case in Nearby South Africa Worrying

Until recently, the Zika virus was a non-issue for many people in the country but as South Africa confirms its first case, the Ministry of Health has instituted measures to avoid panic.

According to Health Minister Joseph Kasonde, authorities in South Africa have confirmed that a Colombian businessman has tested positive for the virus.

This case brings the Zika virus, which is blamed for an increasing number of babies born with defects, closer to Zambia.

Dr Kasonde said what was important in the case of avoiding the Zika virus was the destruction of mosquitoes believed to be spreading the virus.

Dr Kasonde appealed for calm among members of the public who are mindful that Zambia has a long history of mosquitoes which have caused deaths by transmitting malaria, a leading killer disease.

The World Health Organisation (WHO) recently declared the "explosive" spread of the Zika virus in Brazil and the Americas as a global health problem.

The WHO meeting in Geneva early this year declared the Zika virus as a global emergency.

WHO officials described Zika as moving "from a mild threat to one of alarming proportions."

Most cases show no symptoms, but the virus has been linked to brain abnormalities in thousands of babies in Brazil.

Dr Kasonde said the public should not panic as scientists had not conclusively linked the virus to defects in human babies, a condition which is called microcephaly.

"There is no cause to panic because it has not been proven scientifically that Zika causes microcephaly," he said.

Dr Kasonde recently informed the BBC that there was no Zika virus in Zambia. But he urged the public to take precautions.

He said members of the public should allow their homes to be sprayed under the residual spraying programme, which is normally targeted at fighting malaria, to prevent the transmission of the deadly Zika virus.

Dr Kasonde said the best form of prevention against the Zika virus was protection against mosquito bites.

Currently, Zambia has not placed travel restrictions to and from Zika virus-affected countries like South Africa and the Americas although authorities have appealed to travellers to seek professional advice on potential risks and measures to reduce exposure to mosquito bites.

In a ministerial statement to Parliament recently, Dr Kasonde encouraged women of reproductive age to observe instructions on how to prevent mosquito bites.

Since the mosquito-borne disease was first detected in Brazil in May 2015, the virus has spread to more than 20 countries.

The biggest concern is the surge in levels of microcephaly - babies born with abnormally small heads - and the rare nervous system disorder Guillain-Barre syndrome.

The link between the virus and these disorders has not been confirmed, but WHO director-general Margaret Chan said it was "strongly suspected" and was "deeply alarming".

Dr Chan warned that the situation could yet deteriorate as "this year's El Nino weather patterns are expected to increase mosquito populations greatly in many areas".

The WHO has already predicted that four million people could be infected with Zika in the Americas this year.

The WHO could also make recommendations on travel to the affected countries, tracking the spread of Zika, best practice for treating patients or efforts to fast-track the development of vaccines and cures.

According to the BBC, the Zika virus was first identified in monkeys in Uganda in 1947.

The first human case was detected in Nigeria in 1954 and there have been further outbreaks in Africa, South East Asia and the Pacific Islands.

Most of the previous outbreaks were small and Zika has not previously been considered a major threat to human health.

But in May 2015, it was reported in Brazil. Since then, the disease has spread rapidly.

It has also been reported in Barbados, Bolivia, Colombia, the Dominican Republic, Ecuador, El Salvador, French Guiana, Guatemala, Guadeloupe, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname and Venezuela.

Latest countries affected include the United States of America (USA), China and South Africa.

"Its current explosive pandemic re-emergence is, therefore, truly remarkable," the US National Institutes of Health said.

The Zika virus is spread by Aedes mosquitoes.

Health experts say Aedes are a type of mosquitoes originally found in tropical and subtropical zones, but now found on all continents except Antarctica.

Some species of this mosquito have been spread by human activity.

Aedes mosquitoes are also described as a species of yellow fever mosquito (Aedes aegypti) which can spread dengue fever, chikungunya, Zika fever and yellow fever viruses, and other diseases.

Aedes mosquitoes are found throughout the Americas except for Canada and Chile where it is too cold for them to survive.

If they drink the blood of an infected person, they can then infect subsequent people they bite.

And, unlike the mosquitoes that spread malaria, Aedes mosquitoes are mostly active during the day, so bed nets offer limited protection.

The WHO expects Zika to spread throughout the Americas, but other scientists have warned that countries in Asia could face large outbreaks too.

Deaths are rare and only one in five people infected is thought to develop symptoms.

The symptoms of the Zika virus include mild fever, skin rash (exanthema), conjunctivitis and headache. These normally last for two to seven days.

A rare nervous system disorder, Guillain-Barre syndrome, that can cause temporary paralysis, has been linked to the infection.

There is no vaccine or drug treatment. Patients are advised to rest and drink plenty of fluids.

But the biggest concern is the impact the virus could have on babies developing in the womb and the surge in microcephaly.

Microcephaly is when a baby is born with an abnormally small head, as their brain has not developed properly.

The severity varies, but it can be deadly if the brain is so underdeveloped that it cannot regulate the functions vital to support life.

Children that do survive face intellectual disability and development delays.

Microcephaly can be caused by infections such as rubella, substance abuse during pregnancy or genetic abnormalities.

Brazil had fewer than 150 cases of microcephaly in the whole of 2014, but there have been more than 3,500 reported cases since October, 2015.

The link with Zika has not been confirmed.

But some babies who died had the virus in their brain and it has been detected in placenta and amniotic fluids too.

As there is no treatment, the only option is to reduce the risk of being bitten by mosquitoes.

Health officials advise people to use insect repellents, cover up with long-sleeved clothes and keep windows and doors closed.

The mosquitoes lay their eggs in stagnant water, so people are also being told to empty buckets and flower pots.

The US Center for Diseases Control have advised pregnant women not to travel to affected areas.

In Zambia, the Ministry of Health is encouraging people to allow their homes to be sprayed under the residual spraying programme. The programme is normally targeted at killing mosquitoes which cause malaria.

The Ministry of Health is applying lessons learned from dealing with malaria to prevent a possible outbreak of the Zika virus.

Zambia has a long history of fighting malaria which is regarded as the most dangerous disease in Africa.

According to UNICEF, malaria accounts for 50 per cent of all under-five hospital admissions. Children under the age of five and pregnant women are the most affected.

Malaria also accounts for 20 per cent of maternal deaths.

Health authorities normally carry out public sensitisation on malaria, especially on how to deal with its effects on pregnant women and children under the age of five.

The Malaria Control Centre under the Ministry of Health implements anti-malaria campaigns that include distribution of insecticide-treated nets (ITNs) and the residue indoor spraying aimed at killing mosquitoes.

Unlike the Zika virus which is spread by Aedes mosquitoes, malaria is transmitted by a bite from an infected female Anopheles mosquito.

The Ministry of Health and its stakeholders are already using lessons gained from fighting malaria to dealing with the possible outbreak of the Zika virus by, among other things, encouraging the public to access residual spraying to kill mosquitoes.

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