A little over a week ago, I posted a description of a now looking to become pandemic virus: Zika (you can read the previous description here). Zika virus has been around for decades, with a few cases here and there, but recently, a surge in the virus in South America has had Health Organizations scrambling to determine the threat against the global population.

Zika virus is now spreading to more countries and new advisories are going out:

• The first case of Zika in the United States was confirmed in Texas, and transmitted through sexual intercourse.
• First pregnant woman in Spain confirmed with Zika virus
• CDC has stated that limiting sexual activities with a pregnant partner if living or travelling to Zika infected areas.
• Florida’s Governor Issued a State of Emergency in the counties that 12 confirmed Zika cases are- None of which were infected in the United States.
• Brazil has found Active Zika virus in urine and saliva.
• El Salvador advises its citizen to avoid pregnancy for up to 2 years.
• New York has 11 confirmed cases of Zika.
• Pennsylvania has two confirmed cases
• Delaware has 1 confirmed case
• Ohio has 1 confirmed case
• Indiana has 1 confirmed case
• WHO states that as many as 3 to 4 million people are infected in Central and South America
• CDC issued Travel alerts to 28 countries.
• Three deaths of individuals with Zika virus in Venezuela (caused by complications not currently linked to infection).
• 52 cases of travel acquired Zika virus confirmed in United States

The World Health Organization convened its first emergency meeting to discuss the Zika virus, its epidemiology, clinical signs and symptoms, spread, and link to neurological disorders and microcephaly. The committee then submitted guidelines to be approved:

• The increased and enhanced surveillance of microcephaly and Guillain-Barre syndrome in areas with outbreaks of Zika or with potential to become an area
• Research into the etiology of microcephaly and Guillain-Barre syndrome to determine causal links.

They also issued additional recommendations in precautionary measures:

Zika virus

• Surveillance enhancement
• Prioritization of  new diagnostics.
• Risk communications should be enhanced to address
  • population concerns
  • enhance community engagement
  • improve reporting
  • ensure application of vector control and personal protective measures.
• Control measures and PPE should be implemented.
• Education of Pregnant women or those intending to become pregnant in how to reduce risk.
• Resources should be provided to pregnant women exposed to virus

Longer-term measures

• Appropriate research and development efforts into vaccines, therapeutics and diagnostics.
• Increase in health services preparation for potential increase in neurological or congenital birth defects.

A recent article from Bogoch et al. has determined a potential transmission map for how the Zika virus might spread. Taking into account the number of people who travel in and out of Brazil, the researchers determine that the rest of Central and Northern South American countries will see a drastic increase, as well as the Caribbeans, Florida and will continue to spread up through the Eastern Seaboard of North America.

Bogoch et. Al.  2016. Anticipating the international spread of Zika virus from Brazil. The Lancet.

Conclusion:

The most important thing to remember about Zika virus is that it normally does not lead to death. The majority of individuals infected do not display symptoms and are not sick. the recent rash of Zika infection is unprecedented and researchers around the world are working faster diagnostics tests, treatment options and vaccines.