Zika virus in Kerala: No new cases on Wednesday but capital district braces for more in coming days

Kerala’s Health Department is bracing for fresh Zika cases that may crop up from scattered locations the following days, given the phenomenal rise in vector density across districts

Even as no new cases of Zika virus (ZIKV) infection were reported from the capital district or anywhere else in the State on Wednesday, the Health Department is bracing for fresh cases that may crop up from scattered locations the following days, given the phenomenal rise in vector density across districts.

Now that clinicians are aware that cases with fever and rashes, which are negative for dengue and chikungunya (CHK) could be ZIKV, it is likely that more samples would reach the labs for testing in the coming days.

Health officials accompanying the Central team on field visits in the capital said that Aedes (mosquito) density had reached explosive proportions in many places. The reports from vector surveillance units in other districts were no different.

All health field staff have been fully engaged in COVID-related activities since the past one-and-half years to the exclusion of all other routine work, including vector control. The quiet arrival of Zika is just an example of how other diseases can silently take a foothold in the community when COVID-19 hogs all attention.

“A chunk of the lab-confirmed cases reported till now are epidemiologically linked to the private hospital at Anayara or is within a 3 km radius of it. However, apart from the fact that the first lab-confirmed case was detected here, there is no way of ascertaining how or where this pathogen was introduced first,” said a senior official.

The case of the 41-year-old pregnant woman at Sasthamangalam seems totally unrelated to the Anayara cluster and she has no travel history.

Silent transmission

“We are fairly certain that there are many undetected or unreported cases in the community and given the high density of Aedes mosquitoes everywhere, silent transmission would have been taking place for quite a while. Even if these cases reached clinicians, no follow-up would have been there or patients would not have reported back as the infection is mild and self-resolving,” he pointed out.

As there are plenty of arboviral diseases such as dengue and CHK in the community, co-infections are quite common, making it easy for ZIKV cases to be missed.

While the immediate reaction of the Health Department has been to dismiss ZIKV as just another vector-borne disease of little consequence to the general public (except pregnant women) and which can be controlled through mosquito control measures, epidemiologists have warned that the social and economic implications of ZIKV could be quite far-reaching and complicated.

“The establishment of the virus here can lead to other nations issuing travel advisories against visiting the State, which can seriously affect tourism. The Health Department should go beyond fire-fighting exercises and launch genetic-sequencing to identify the strain as well as instituting permanent surveillance measures,” they said.

Control room

Meanwhile, the Health Department has established a Zika control room where the public can report their symptoms or clarify doubts.

The Health Minister, who attended a special review meeting on Zika here, said that strong containment measures had been launched, including intensive vector control measures as well as counselling for the public.

As Aedes is an urban, indoors-loving vector, the public should take extra precautions to ensure that individual homes are not vector-breeding grounds.

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