Zika Outbreak in India Impacts Pregnant Women
The World Health Organization (WHO) confirmed today a Zika virus (ZIKV) infection was laboratory-confirmed in a resident of Kerala state, located in southwest India, in early July 2021.
This represents the first Zika virus disease case ever reported from Kerala.
The patient was a 24-year-old pregnant woman in her third trimester of pregnancy resident in Trivandrum district.
On June 28, 2021, she was admitted to a private hospital with arbovirus like symptoms of fever, headache, and general rash.
The woman delivered her child on July 7, 2021, and was reportedly in good health, and there were no apparent birth defects in the newborn.
So far, no cases of microcephaly and/or Guillain-Barre syndrome (GBS) have been linked with this outbreak.
In the three months before delivery, she had resided in the Trivandrum district, not having traveled during that period. Among close contacts, her mother reported having fever and similar symptoms one week before ZIKV confirmation in her daughter.
On July 8, 2021, the State of Kerala issued guidelines on enhanced surveillance for ZIKV disease and sent guidance to all 14 districts.
Information, Education, and Communication activities about ZIKV disease have been strengthened immediately throughout the State. In addition, sensitization activities across the State for both health care workers and the general public are ongoing.
And ultrasound scanning centers have been directed to report incidences of microcephaly during regular antenatal scans to the Reproductive and Child Health Officer.
In the Trivandrum district, which has been declared a cluster of ZIKV disease cases, intensified vector control activities have been conducted for a week, including; extensive fogging, spraying, larvicides, source reduction, and sanitization of the surrounding areas.
Additionally, field teams visited each household to conduct active case findings, ensure elimination of mosquito breeding sites, and sensitize the community to preventive mosquito control measures and identification of ZIKV disease symptoms to seek timely medical assistance.
The WHO was requested to support the country’s updates on standard operating procedures and guidelines for syndromic and case-based surveillance; laboratory surveillance; vector surveillance; enhanced surveillance among antenatal women; microcephaly surveillance; surveillance of Acute Flaccid Paralysis (AFP) and GBS.
In India, previous ZIKV disease cases/infections have been detected in Gujarat, Madhya Pradesh, and Rajasthan states in 2018 (South-East Asian lineage), but no ZIKV-associated microcephaly has been reported.
Although this event is not unexpected, given the wide distribution of the primary mosquito vector, Aedes aegypti, and competent vector, Aedes albopictus, in Kerala and Maharashtra states, this is unusual as it is the first time that ZIKV disease cases have been confirmed in these states.
The primary vector Aedes aegypti, and competent vector Aedes albopictus, are established in the area, often in high densities. The ecological conditions are favorable for ZIKV transmission and potential endemicity.
For regions with active transmission of ZIKV, all persons with suspected ZIKV infection and their sexual partners (particularly pregnant women) should receive information about the risks of sexual transmission of ZIKV.
And for regions with no active transmission of ZIKV, WHO recommends practicing safer sex or abstinence for six months for men and two months for women who are returning from areas of active ZIKV transmission to prevent infection of their sex partners.
In addition, sexual partners of pregnant women living in or returning from areas where local transmission of ZIKV occurs should practice safer sex or abstain from sexual activity throughout pregnancy.