India’s Health Ministry issued health advisory, appointing National Centre for Disease Control (NCDC); as the nodal agency for investigation of outbreak- should the situation arise. This comes in the backdrop of the World Health Organisation designating the > Zika virus and its suspected complications in newborns as a public health emergency of international concern earlier this week.
Zika virus disease is an emerging viral disease transmitted through the bite of an infected Aedes mosquito. This is the same mosquito that is known to transmit infections like dengue and chikungunya. World Health Organisation has reported 22 countries and territories in Americas from where local transmission of Zika virus has been reported. Microcephaly in the newborn and other neurological syndromes (Guillain Barre Syndrome) have been found temporally associated with Zika virus infection.
Issuing a detailed press release, the ministry said that, “The NCDC, Delhi and National Institute of Virology (NIV), Pune, would be the apex laboratories to support the outbreak investigation and for confirmation of laboratory diagnosis. Ten additional laboratories would be strengthened by ICMR to expand the scope of laboratory diagnosis.”
While Indian Council of Medical Research will identify research priorities, the health ministry has also set up a Joint Monitoring group under Director General of Health Services (DGHS) to follow the events on a daily basis.
National Centre for Disease Control (NCDC) and the Focal Point for International Health Regulations (IHR), have been charged with information sharing information with the IHR focal points of the affected countries and be in constant touch with World Health Organisation for updates on the evolving epidemic.
Public health experts maintain that poor vector control in India could lead to a possible outbreak in the region. “Since India has the mosquito responsible for spread of the virus (Aedes aegypti), the same one that causes Dengue and Chikungunya, if an infected individual comes here, infection can be spread by mosquitoes biting this person, acquiring the virus and then passing it on to those who are bitten subsequently. Since many parts of India have poor mosquito control, these areas remain vulnerable if an infected individual reaches those regions and gets exposed to mosquitoes,” said Dr. Vivekanand Jha, Executive Director, The George Institute for Global Health.
Rapid Response Teams (RRTs) shall be activated at Central and State surveillance units. In addition to strengthening laboratories, the government will also be activating Rapid Response Teams (RRTs) at Central and State surveillance units, said Health ministry.
“Each team in the RRT would comprise an epidemiologist, public health specialist, microbiologist and a medical and paediatric specialist and other experts (entomologist etc) to travel at short notice to investigate suspected outbreak,” the release added.
Integrated Disease Surveillance Programme (IDSP) through its community and hospital based data gathering mechanism would track clustering of acute febrile illness and seek primary case, if any, among those who travelled to areas with ongoing transmission in the 2 weeks preceding the onset of illness.
A majority of those infected with Zika virus disease either remain asymptomatic (up to 80%) or show mild symptoms of fever, rash, conjunctivitis, body ache, joint pains. Zika virus infection should be suspected in patients reporting with acute onset of fever, maculo-papular rash and arthralgia, among those individuals who travelled to areas with ongoing transmission during the two weeks preceding the onset of illness.