Zika cases in India: A shocking cover-up

Awareness is key to containing Zika. Why did the Health Ministry keep three cases secret?

May 30, 2017 12:02 am | Updated December 03, 2021 05:07 pm IST

The surveillance system put in place by the Health Ministry succeeded in identifying three adults infected with the Zika virus between November 2016 and February 2017 in Gujarat. But the Ministry acted less than responsibly by withholding the information from everyone. Even the World Health Organisation was informed about the three cases as recently as May 15, more than five months after the first case was laboratory-confirmed. Information regarding the cases came to light when the WHO posted the information on its website on May 26. By not disclosing the information in real time, India behaved as China did in the case of the severe acute respiratory syndrome (SARS) outbreak in 2003. China was then widely criticised by the global community for trying to cover up the outbreak — by doing so, the Chinese government was arguably partly responsible for SARS spreading to other countries. That none of the three Zika-infected adults or their spouses or relatives had travelled to any country with Zika virus transmission indicates that the virus was transmitted within India. Based on the local circulation of the virus, the WHO has warned that “new cases may occur in the future”, particularly as the Aedes aegypti mosquito that transmits the virus is widely found in India.

Over 34,000 human samples and nearly 13,000 mosquito samples were tested for the presence of the Zika virus, and there was monitoring for cases of microcephaly, a birth defect that has been connected to the mother being Zika-infected while pregnant. But it is not clear whether the person who brought the infection into the country (the index case) has been identified. While the bite of an infected A. aegypti is the main route of Zika virus transmission, it can also be sexually transmitted from an infected man. As the virus remains present in the semen for a long time, the WHO recommends that couples abstain from sex for at least six months after the onset of symptoms. Secrecy about Zika outbreaks, even if seen only in isolated cases, can lead to a public health disaster. Given that local transmission is already present, the A. aegypti is commonly found, and many infected people exhibit no or only mild, non-specific symptoms, up-to-date health bulletins and advisories are vital. India has the responsibility to keep the WHO and the global community informed, especially in the case of dreaded infectious diseases, for both global risk assessment and risk preparedness. The government machinery should have been on overdrive to educate and increase awareness about ways to avoid infection; the decision to keep the information under wraps to avoid creating “panic” is totally unconvincing.

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