Health Ministry wakes up to Zika threat belatedly

By Dilanthi Jayamanne


The Epidemiology Unit yesterday briefed the public on the danger of Zika virus which had already affected Singapore (330 cases), Indonesia (over 300) and Thailand (about 200). Several cases were reported during the last two weeks from Malaysia, and the Philippines.

 Chief Epidemiologist, Dr Paba Palihawadana said that so far Brazil had reported the most number over 8,000 suspected new infections in March. She said he Aedes mosquito, which spread the virus was already present in the country. It was the same vector which spread dengue, chikungunya and yellow fever, she warned.

 Dr Palihawadana said the virus could also be sexually transmitted. However, only 20 per cent infected with the Zika virus would develop the clinical disease.  The most common symptoms were acute onset of fever, maculopapular rash (type of rash characterized by a flat, red area on the skin that is covered with small confluent bumps), joint pain and non-purulent conjunctivitis, with other common symptoms like headache and muscle pain. The disease lasts for approximately two to seven days. She observed that severe illness requiring hospitalisation was uncommon.    

 Some countries had reported increasing incidence of micro-cephalic (birth defect where the baby’s head is much smaller than expected) and Guillain-Barre syndrome (a disorder in which the body’s immune system attacks part of the peripheral nervous system) during outbreaks. She warned that pregnant women should be cautious and seek medical assistance immediately if any of the aforesaid symptoms was present.

 The Chief Epidemiologist observed that there was no widely available tests to detect Zika virus infection because it was related to dengue and yellow fever. However, the Health Ministry had established diagnostic facilities for the Real Time Polymerase Chain Reaction (RT-PCR) test at the Medical Research Institute (MRI), she added.

 Patients with mild illness could be managed at a hospital OPD or at home according to the decision of the physician. Resting was important. Severe cases should be admitted to hospital. She warned that taking aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS) was not recommended to overcome the infection.

 Dr Palihawadana stressed the need for investigations to rule out the possibility of dengue as the two conditions shared similar clinical indications.

She urged the public to keep their environment clean of all possible breeding sites for the Aedes mosquito. All travellers to the affected countries showing symptoms of Zika virus disease within two weeks from returning should consult a doctor. Personal protective measures to avert mosquito bites such as using mosquito repellents, wearing clothes which cover as much of the body as possible, using physical barriers such a screens, closed doors and windows  and sleeping under nets were advisable, Dr. Palihawadena said. Pregnant mothers planning to travel to affected countries should consider postponing their visit considering the risks. Pregnant women or women who were expecting pregnancy should use barrier contraceptive methods to avoid sexual transmission of Zika virus from suspected or diagnosed partners.

 Infected patients had to use bed nets to avoid spreading the disease while all suspected Zika virus disease patients should be reported to their respective MOH officer, she said.       

 Last week the World Health Organisation (WHO) raised the alarm in Colombo by calling for vigilance in the South East Asian Region against the vector born disease Zika. Regional Director for South-East Asia, Dr Poonam Khetrapal Singh urged regional countries to strengthen surveillance not only since the vector Aedes mosquito was already present in regional countries, but also since the disease had reached countries like Singapore, Indonesia and Thailand in Asia.

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