Countries involved/outbreak/

Zika Virus

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Zika Virus

Countries involved/outbreak/

Zika virus is a virus that comes from Aedes mosquitos and it first came from febrile rhesus monkey in Zika forest, Uganda in 1947 (Plourde & Bloch, 2016). Studies have suggested that Zika remained unknown for over 70 years as a harmless and sporadic case. However, during the start of 2016, the virus was marked by global alarm as an outbreak in Latin America as well as Caribbean countries. As a result, there were estimated cases of 400-1500000 in Brazil (Faria et al., 2016). The recent cases of microcephaly in Brazil reflect on the virus. Presently, there is a rare congenital disease that comes with issues in brain development that cause babies to have smaller head during birth and in majority of such cases, there is usually brain damage (Mlakar et al., 2016). It is essential to note that this association despite it being compelling, needs an extensive scientific approach to prove the causes of the congenital ZIKV infection is further research that is underway in Brazil that seeks to understand how ZIKV affects expectant mothers.

Zika Outbreak In 2016

Warm temperatures during the year 2015-2016 encouraged a strong El Nino and anthropogenic climate change which provided an environment for the spread of Zika virus in Brazil. Because of the El Nino rains, increased the ground surface temps. From the beginning of 2016, the temperatures were 1.04 degrees Celsius above the global average. It is essential to understand that while there was an increase in global temperatures, areas in South America such as southern Brazil and Uruguay had temperatures that were 0.5 below the norm. The high amounts of precipitation in 2016 was also conducive for the spread of Zika Virus. The Zika carrying mosquitoes thrived in such environments and encouraged a wide range of Zika and other diseases carried by the mosquitoes. As such, the spread of Zika began in inland Soth America before spreading to other regions in America such as United States. In 2016 , confirmed cases showed that the virus spread to 40 countries such as South America,  the Caribbean, North America,  and even in 16 western Pacific and one in Africa since the beginning of 2016

According to serological evidence, shows that there is a link between ZIKV infection and other another neurological disorder. Take, for instance, Guillain-Barre syndrome (GBS), is a neural disorder that is in the line of an autoimmune type of infectious diseases which causes acute or partial paralysis. A look into the cluster microcephaly of GBS, revealed that it mainly occurred in areas affected with ZIKV (Faria et al., 2016). As per the international Health Regulations Emergency Committee of World Health Organization, reports that ZIKV is a public emergency of concern. As such, they showed the need to create aggressive means of reducing the infection especially among pregnant women as well as those who are at the child-bearing age.

Similarly, other health organizations such as the US Centers for Disease Control and Prevention have reported that ZIKV is a level 1 activation and needs the most efficient response at the agency (Plourde & Bloch, 2016). It is critical as there three separate operational areas of surveillance, awareness, and diagnostics. CDC comes together with other governments around the world as well as their health agencies, health departments, and industry partners to create awareness about the virus, alert, and direct healthcare givers, governments, media, and the public about the threats that Zika can cause.

Epidemiological of Zika

History of Zika Incidences, distribution, and possible risk factors

Zika was first discovered in 1947 in isolates collected from a rhesus macaque monkey and later next year, in the Aedes africanus mosquitoes in Uganda but was confined for about 70 years in the equatorial zone in Africa and Asia (Mlakar et al., 2016).  Since 1952, there were reports showing that Zika could infect human beings. Outside the above zones, it was discovered again in Yap Island in 2007 and spread towards French Polynesia and other places in 2013 and reached Latin America in 2015. In North America, people started experiencing the Virus in 2016 and presently, it has spread into the Americas, Southeast Asia as well as the Pacific Islands. Prior the year 2000, the virus was discovered in Africa before spreading to other parts of the world (Beouf et al., 2016).  In 2014, Zika was discovered in continental shores in Brazil and other parts of the Americas.

Distribution

ZIKV virus was isolated from a monkey placed in Zika forest in Uganda during the time of YFV. The isolation was an African prototype strain of ZIKV. After it was found in mosquitoes in Zika forest. Despite that there was no sign of disease in Ugandan residents, the spread of antibodies in their serum was about 10-20% (Faria et al., 2016). A study on the virus reveals that there is a wide confined geographic distribution of human infection that stems from the virus, in Africa, Asia, Europe, North and South America.

Risk Factors

As of February 2017, according to the World Health Organization report, showed that people from 59 countries had the Zika Virus infection. It is essential to note that 20% of the Zika-infected persons showed signs of the infection. The true incidences of Zika infections are not easy to establish because the study on Yap lacks corroboration.  Nonethless, reports reveal that there were about 3000 cases of Zika-related defects from 29 countries in 2017. Most cases came from Brazil whereby most completed pregancies were infected and affected with Zika. Other complications are such as live borns with birth defects and preganancy loss. 

There is also the risk of microcephaly where calcium deposits in the brain cause excess fluid, brain damage, poorly formed structres, poor eye structre, hearing loss, and other neorological functions. It is also important to note that Zika attack has risen since 2007. According to serological evidence, has shown that 75% of the population had the infection in household survey. As such, 1 in 5 individuals showed signs of Zika. Because the virus is a flavivirus and occurs with other flavivirus such as dengue fever, it is challenging to establish the incidences.

Who is at risk? According to the understanding of the virus, most people in the world without initial exposure to Zika is at risk of infection. However, people living in areas that have active local transmission of Zika from mosquitoes are more susceptible. The same case applies to people who have intercourse with partners with the virus. Apart from the Yap study, there is little knowledge about why others are at risk while others are not. On the other hand, perhaps there is something special about Zika virus that makes it more viral.

Yap outbreak and random cases in Southeast Asia

After an outbreak of Jaundice in Nigeria in 1954, the human illness that results from the ZIKV infection was reported (Mlakar et al., 2016). The infection was confirmed in three patients through the virus isolation. There was a correlation that was observed during ZIKV development and jaundice outbreak. Since then till the early 2000s there were few cases of ZIKV associated illness in Africa and Asia regions such as Uganda, Nigeria, and Indonesia. However, in 2007, ZIKV resulted into an outbreak on Yap Island. 

Major characteristics were fever, arthralgia, conjunctivitis, and rash. About 73% of Yap resident got the ZIKV virus and 18% of the people infected had issues that stemmed from ZIKV infections (Plourde & Bloch, 2016). According to a sequence analysis, showed that ZIKV was introduced from Southeast Asia in Yap Island. In 2010s there were sporadic cases of the virus infection in countries such as Thailand, Indonesia, Philippines, Cambodia, and Malaysia.

Routes of Transmission of Zika Virus

The transmission of Zika virus is primarily through infected mosquitoes. The Aedes species is also responsible for the spread of other viruses such as dengue and chikungunya (Petersen et al., 2016). The mosquitoes lay eggs in stagnant water and in storage items such as buckets, bowls and such. They spread the virus by biting people and when they feed on an infected person, they spread to other people. Another possible transmission is from mother to child when the fetus is growing. Zika causes microcephaly and other brain defects. Also, Zika can be in breast milk and breastfeeding babies are at risk if their mothers nurse them. Sex is another was that Zika passes from one person to another despite others having no symptoms. Some people are carriers, they have the virus but never show any symptoms. Also, Zika can spread through blood transfusion. The laboratory and healthcare setting should be clean to avoid lab acquired infections.

The implications of an outbreak on Bentoville community

Locally, if Zika virus was to attack, the worry is that the Zika virus has negative impact on socio-economic interactions such as work, education, social interactions, and tourism (Plourde & Bloch, 2016). For example, when it comes to work, sick people are not as productive because of their failing health. During an outbreak, people fear to travel and at times, the state puts out a travel advisory. As a result, people have to cancel their international flights and other tourist activities (Beouf et al., 2016). Zika outbreak can also put to halt to school activities.

 Children born of the virus need medical attention which is also financially draining. The virus causes microcephaly which prevents children from achieving their potential. The constant watch on such children is also time consuming as well as expensive. In addition, the government has to pool resources together to assist in preventive measures. Due the nature of transmission, an outbreak will also paralyze public activities such as schooling, businesses, and such because in most cases the government calls for a quarantine. 

Reporting protocol

There are elements of information about Zika outbreak that are critical when reporting cases. The first step is to establish the number of people who have shown signs of infection, their locality, and even the sex. By providing this data, it is easy to trace the virus and find preventive means to areas with no infections.  The sex of those infected will also help shed light on how is at risk of the infection and the numbers will help establish the impact of the virus on the community. Epidemiology information about the patients’ status, likely exposure, suspected number of infection, infants, number of persons tested and such is key. There should also be laboratory and mosquito information that helps to track the virus. Another aspect to consider is the community outreach involving inquiries and other Zika related concerns. the relevant authority in community should be aware of any intervention in order to streamline processes aimed at preventing the spread of the virus. 

Zika prevention strategies

One of the ways to control Zika is through diligent management of the environment (Petersen et al., 2016). Take, for instance, it is important to clear breeding areas near homes such as bushes and maintain dry compounds to prevent vectors. By clearing potential breeding areas will help minimize the number of mosquitoes in the area as well as the vector spreading mosquitoes. Another effective strategy is to create awareness about the virus and educate the public about the significance of sanitation (Petersen et al., 2016). People are able to act on information if they are aware of the implications. For example, the awareness about transmission of Zika is significant as it will help pregnant mothers and those who are sexually active. As a result, will reduce the number of mortality rates as well as health complications that come as a result of Zika infection.  As such, the government should strive to engage the community in prevention strategies to ensure that it is a collective approach during Zika Virus prevention.

aReferences

Boeuf, P., Drummer, H. E., Richards, J. S., Scoullar, M. J., & Beeson, J. G. (2016). The global 

threat of Zika virus to pregnancy: epidemiology, clinical perspectives, mechanisms, and impact. BMC medicine14(1), 112.

Faria, N. R., da Silva Azevedo, R. D. S., Kraemer, M. U., Souza, R., Cunha, M. S., Hill, S. C., … 

& Rocco, I. M. (2016). Zika virus in the Americas: early epidemiological and genetic findings. Science352(6283), 345-349.

Mlakar, J., Korva, M., Tul, N., Popović, M., Poljšak-Prijatelj, M., Mraz, J.,  & Vizjak, A. (2016). 

Zika virus associated with microcephaly. New England Journal of Medicine374(10), 951-958.

Petersen, L. R., Jamieson, D. J., Powers, A. M., & Honein, M. A. (2016). Zika virus. New 

England Journal of Medicine374(16), 1552-1563.

Plourde, A. R., & Bloch, E. M. (2016). A literature review of Zika virus. Emerging infectious 

diseases22(7), 1185.

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