The World Health Organization has declared the spread of Zika virus an international public health emergency and has freed funds to combat the disease.
“This is an extraordinary event,” said WHO Director General Margaret Chan at a press conference on Monday. “It poses a public health threat to other parts of the world and a coordinated international response is needed.”
Margaret Chan cited the pattern of the disease’s spread, the lack of a vaccine, and the large global population of mosquitoes that can carry the virus as factors that contributed to the declaration.
The declaration, only the fourth in WHO’s history, comes just days after the organization said the number of cases could hit 4 million by the end of the year. The virus has spread rapidly throughout the Americas infecting people in more than 20 countries.
Officials in Brazil, the hardest hit country, have estimated 1.5 million infections.
The Zika virus is spread to people through mosquito bites and causes genetic mutation in babies. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week.
Key facts
Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
There is no specific treatment or vaccine currently available.
The best form of prevention is protection against mosquito bites.
The virus is known to circulate in Africa, the Americas, Asia and the Pacific.
Introduction
Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.
Signs and Symptoms
The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days.
During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.
Transmission
Zika virus is transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.
Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013 (Yap and French Polynesia, respectively), and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). In addition, more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus.
Diagnosis
Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever.
Prevention
Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.
This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.
Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.
During outbreaks, health authorities may advise that spraying of insecticides be carried out. Insecticides recommended by the WHO Pesticide Evaluation Scheme may also be used as larvicides to treat relatively large water containers.
Travellers should take the basic precautions described above to protect themselves from mosquito bites.
Treatment
Zika virus disease is usually relatively mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available.
WHO response
WHO is supporting countries to control Zika virus disease through:
Define and prioritize research into Zika virus disease by convening experts and partners.
Enhance surveillance of Zika virus and potential complications.
Strengthen capacity in risk communication to help countries meet their commitments under the International Health Regulations.
Provide training on clinical management, diagnosis and vector control including through a number of WHO Collaborating Centres.
Strengthen the capacity of laboratories to detect the virus.
Support health authorities to implement vector control strategies aimed at reducing Aedes mosquito populations such as providing larvicide to treat standing water sites that cannot be treated in other ways, such as cleaning, emptying, and covering them.
Prepare recommendations for clinical care and follow-up of people with Zika virus, in collaboration with experts and other health agencies.
