Zika is a viral disease spread by the bite of the mosquito Aedes aegypti and Aedies albopictus. The disease can spread from a pregnant woman to her fetus and leads to birth defects, and currently no vaccines are available for this disease. The disease can also spread through a sexual intercourse or during blood transfusion. Common symptoms of the disease includes: fevers, rashes, headaches, muscle and joint pain and redness in the eyes and can last for a week. Even though the disease is not fatal, and infected people quickly grows resistance to future infections, during pregnancy the disease can cause serious defects in the fetus, such as microcephaly, or cause miscarriage or stillbirth. The disease can be diagnosed by testing the blood, saliva or urine of the infected person, for the presence of the Ribo Nucleic Acids of the virus. In Canada, as of February 2018, 4 cases of sexually transmitted and 558 cases of travel related cases of Zika have been reported since 2015, and total of 41 cases were reported among pregnant women and 2 cases of fetal abnormalities were reported caused by Zika (bbc.com; Heymann, David L., et al.).
a.The outbreak started in 2016, with the first identification of sexually transmitted case for Zika virus in Ontario, Canada. The case was not entirely unexpected because of two factors: 1) The Zika virus has the ability to survive in the semen for latest 2 months, and 2) There were 5.5 million Canadians visiting countries where Zika Virus outbreaks have occurred. This led the authorities to expect a rise in the case of sexually transmitted Zika cases. As of 2018, there were 558 cases of Zika infections, related to travels. However, the Zika infections among the Canadian patients were found to be more severe, which was not previously expected (bbc.com; Joob, Beuy, and Viroj Wiwanitkit).
b.The outbreak started from Ontario, Canada, with the report of a woman contacting the disease from her male partner, who was infected after visiting a country affected by the Zika epidemic (Borgia, Sergio, et al.). The outbreak was made possible due to the high number of Canadian travelers to countries affected by Zika, making them the carriers of the disease. The Global outbreak started in Brazil on 2016, and since then it spread to 42 countries, mainly in Caribbean and Latin American Countries, and cases of sexually transmitted Zika virus have also been reported in 8 countries. However, the first case of Zika was reported in 2011 in a scientist from Colorado on a visit to Senegal for a research (Heukelbach, Jorg, et al).
c.According to Gulich, Getahun Asebe, the outbreak of Zika was driven by several factors:
d.In terms of Geographic areas, the disease has spread widely across Africa, Asia and America as well as Pacific Islands making it a global phenomenon (Gulich, Getahun Asebe).
e.According to the World Health Organization report and BBC News, Zika has the potential to become a Global and ‘explosive ‘pandemic. With thousands of infected cases, and its spread across 20 countries, the disease has an’ explosive’ potential. This problem is made worse by the lack of any vaccines for the disease, and the various factors that drives the spread of the disease (bbc.com). According to Troncoso, Alcides, the distribution of the virus is rapidly increasing, as the virus is spread quickly, which increases the chance of it becoming a global pandemic (Lucey, Daniel R., and Lawrence O. Gostin; Russell, Philip K).
f.Outbreak of this disease can occur in any country where the environments can foster the increase in the population of mosquitoes (such as warm tropical climates), and allow quick spread of the disease from an infected to healthy individual due to close proximities to each other (such as urban areas). Outbreaks can also be fostered by the lack of proper treatment options and socioeconomic or economic factors which might challenge the provision of precautionary measures. According to the Government of Canada, there are 71 countries that are at risk of Zika outbreaks across the world (Canada.ca).
g.Identification of Zika infection is difficult since most cases can be asymptomatic, thereby preventing its accurate diagnosis. The common symptoms can include fever, headaches, rashes, joint pain, muscle pain and redness of the eyes, which are also caused by many other diseases. Effective identification can be done only after assessing the medical history, travel history, including trips made by the sexual partners. The treatment for the disease does not exist, as there are no known vaccines, and current treatment practice aims towards relieving the symptoms using rest, medication and fluid replacement therapies (Shuaib, Waqas, et al.).
h.Once an outbreak of Zika occurs in a human population different control measures can be taken to prevent its further spread and transmission. AT the population level, measures to control the vectors (mosquito) includes: basic sanitation, eliminating the source of vectors, preventing the accumulation of garbage, using various control methods (chemical, biological or physical) to control vector population. At personal levels, preventative and protective measures can include steps that can prevent mosquito bites (Falcao, Melissa Barreto, et al).
i.Managing the disease is a tricky challenge, considering the various factors that drives its prevalence, such as weather, climatic conditions, ecological factors, prevalence of the vectors, geographic distribution of the virus as well as human factors (such as travelling and sexual partnership with an infected individual). Much of these factors are out of human control (like ecological and environmental factors) which makes controlling these aspects impossibility. Furthermore, vaccines do not exist for the disease, thus making it impossible to immunize against the virus. The only precautionary measure is the approach towards reducing the vector population and preventing mosquito bites (Baud, David, et al).
j.The major challenge in the management of the Zika disease is controlling the population of the mosquitoes, acting as the vectors of the disease. This is most significant in case of mosquitoes resistant to insecticides, which prevents their effective population management and facilitating a population outbreak and thus spread of the disease. Other challenges are the accessibility to prenatal care for pregnant women infected with Zika. Similarly, challenges are faced by governments due to inconsistent communication, failure to reach populations at risk with proper information on the disease, failure to acknowledge the risk perceptions, and placing the health information of the public, up front (ianphi.org).
k.Study by Bragazzi, Nicola Luigi, et al (2017) shows that an increasing interest and reaction of the public have taken place since its outbreaks in various countries. The public opinion regarding the disease have been majorly that of concerns and worries due to the high alerts and the teratogenicity (ability to produce birth defects) of the disease. This potentially have increased the awareness of the general public towards the disease, how it spreads, and ways to prevent its transmission, which potentially can help in the better management of the disease and prevent its further spread.
l.Outside the developed countries, the awareness of Zika is also spreading quickly. This can also potentially help the governments and health authorities of those countries to make better and more effective strategies to manage the disease.
Conclusion:
Zika is a mosquito borne disease that has seen rapid growth in its spread over the last few years. The spread have been driven by several human related and environmental factors. In Canada, the spread of Zika started in 2016, with the first reported case of sexually transmitted Zika. Latest statistics shows more than 500 reported cases of Zika among Canadian travelers, and thousands of cases worldwide. Even though Zika is majorly asymptomatic and produces very common symptoms, which occurs due to various types of diseases, it does not have any vaccines, which makes its prevention difficult. Moreover, the disease is related to birth defects such as microcephaly which increases risks of stillbirth or abnormal fetus, thus increasing the burden of the disease. Since the first report of the Zika in Africa, it has spread across Americas and Asia, thereby increasing the risks of the disease. Due to the lack of effective vaccines and its global prevalence and rapid spread, it has the potential to become a global pandemic, and only strategies to prevent its spread involves precautionary measures (like preventing mosquito bites and controlling mosquito population). With a combination of governmental approaches and public awareness, it is possible that the disease be managed in a better manner and protects the well being of the people.
References:
Baud, David, et al. “Clinical management of pregnant women exposed to Zika virus.” The Lancet Infectious Diseases 16.5 (2016): 523.
bbc.com. “Zika ‘Could Become Explosive Pandemic’.” BBC News. N.p., 2016. Web. 22 June 2018.
bbc.com. “Zika Virus In Canadian Patients ‘More Severe’ Than Expected.” BBC News. N.p., 2017. Web. 22 June 2018.
Borgia, Sergio, et al. “Outbreak of carbapenem-resistant Enterobacteriaceae containing bla NDM-1, Ontario, Canada.” Clinical Infectious Diseases 55.11 (2012): e109-e117.
Bragazzi, Nicola Luigi, et al. “Global reaction to the recent outbreaks of Zika virus: Insights from a Big Data analysis.” PloS one 12.9 (2017): e0185263.
Canada.ca. “Countries With Recent Or Ongoing Risk Of Zika Virus Infection – Canada.Ca.” Canada.ca. N.p., 2018. Web. 22 June 2018.
Falcao, Melissa Barreto, et al. “Management of infection by the Zika virus.” Annals of clinical microbiology and antimicrobials 15.1 (2016): 57.
Gulich, Getahun Asebe. “Epidemiology, Driving Factors, Transmission and Control Options of Zika Virus: A Review.” Journal of Infectious Diseases & Therapy (2016).
Heukelbach, Jorg, et al. “Zika virus outbreak in Brazil.” The Journal of Infection in Developing Countries 10.02 (2016): 116-120.
Heymann, David L., et al. “Zika virus and microcephaly: why is this situation a PHEIC?.” The Lancet 387.10020 (2016): 719-721.
ianphi.org. “The Zika Virus Epidemic: Challenges And The Road Ahead | IANPHI.” Ianphi.org. N.p., 2016. Web. 22 June 2018.
Joob, Beuy, and Viroj Wiwanitkit. “Zika virus infection in Taiwan: an expectation on possible asymptomatic cases and local transmission.” Journal of the Formosan Medical Association 116.5 (2017): 406.
Lucey, Daniel R., and Lawrence O. Gostin. “The emerging Zika pandemic: enhancing preparedness.” Jama 315.9 (2016): 865-866.
Russell, Philip K. “The Zika pandemic-a perfect storm?.” PLoS neglected tropical diseases 10.3 (2016): e0004589.
Shuaib, Waqas, et al. “Re-emergence of Zika virus: a review on pathogenesis, clinical manifestations, diagnosis, treatment, and prevention.” The American journal of medicine 129.8 (2016): 879-e7.
Troncoso, Alcides. “Zika threatens to become a huge worldwide pandemic.” Asian Pacific Journal of Tropical Biomedicine 6.6 (2016): 520-52
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