Zika threat in India: WHO report confirms 3 cases were detected in Ahmedabad in January, govt says no need to panic

Three cases of Zika virus were reported in Ahmedabad in January this year, the A WHO report citing Union health ministry said on Saturday. 

According the report published on 15 May 2017, three laboratory-confirmed cases of the disease were been reported by the ministry of health and family welfare in Bapunagar area of the district.

The routine laboratory surveillance detected a case of Zika virus disease through RT-PCR test at BJ Medical College. The etiology of this case has been further confirmed through a positive RT-PCR test and sequencing at the national reference laboratory, National Institute of Virology (NIV), Pune on 4 January 2017. Two additional cases (case 1 and case 3), have then been identified through the Acute Febrile Illness (AFI) and the Antenatal clinic (ANC) surveillance. The Zika cases are reported below in chronological order:

However, the health ministry clarified that there is no need to panic. 

"Only 3 Zika virus cases have been detected in around 50,000 tested and no mosquitoes are positive," ANI quoted health ministry sources as saying on its Twitter handle.

"India strengthened its surveillance system in past few years, so we are able to detect and contain new infections, both pregnant ladies&children are safe. Close watch on everything,nothing to worry," the health ministry said.

Gujarat health minister Shankar Chaudhary too confirmed that the cases were reported in Ahmedabad earlier this year. 
"Few Zika cases were reported earlier; we took action in accordance with guidelines of WHO&Govt of India," Chaudhary said adding that there are no cases of Zika virus in Gujarat at present. There is no need to worry.

Case 1: During the Acute Febrile Illness (AFI) surveillance between 10 to 16 February 2016, a total of 93 blood samples were collected at BJ Medical College (BJMC), Ahmedabad, Gujarat State. One sample from a 64-year-old male presenting with febrile illness of 8 days’ duration (negative for dengue infection) was found to be positive for Zika virus at BJMC, Ahmedabad. This is the first Zika positive case reported through AFI surveillance at BJMC, Ahmedabad, Gujarat State.

Case 2: A 34-year-old female, delivered a clinically well baby at BJMC in Ahmedabad on 9 November 2016. During her hospital stay, she developed a low grade fever after delivery. No history of fever during pregnancy and no history of travel for the past three months was reported. A sample from the patient was referred to the Viral Research & Diagnostic Laboratory (VRDL) at the BJMC for dengue testing and thereafter found to be positive for Zika virus. She was discharged after one week (on 16 November 2016). The sample was re-confirmed as Zika virus positive by RT-PCR and sequencing at NIV, Pune.

Case 3: During the Antenatal clinic (ANC) surveillance between 6 and 12 January 2017, a total of 111 blood samples were collected at BJMC. One sample from a 22-year-old pregnant female in her 37th week of pregnancy has been tested positive for Zika virus disease.

Also Read: Key proteins that make Zika virus deadly identified

Public health response

# National Guidelines and Action Plan on Zika virus disease have been shared with the States to prevent an outbreak of Zika virus disease and containment of spread in case of any outbreak.

# An Inter-Ministerial Task Force has been set up under the Chairmanship of Secretary (Health and Family Welfare) together with Secretary (Bio-Technology), and Secretary (Department of Health Research). The Joint Monitoring Group, a technical group tasked to monitor emerging and re-emerging diseases is regularly reviewing the global situation on Zika virus disease.

# All the international airports and ports have displayed information for travellers on Zika virus disease.

# The airport health officers along with airport organizations, National Centre for Disease Control, and the National Vector Borne Disease Control Programme are monitoring appropriate vector control measures in airport premises.

# The Integrated Disease Surveillance Programme (IDSP) is tracking for clustering of acute febrile illness in the community.

# In addition to National Institute of Virology, Pune, and NCDC in Delhi, 25 laboratories have also been strengthened by Indian Council of Medical Research for laboratory diagnosis. In addition, 3 entomological laboratories are conducting Zika virus testing on mosquito samples.

# The Indian Council of Medical Research (ICMR) has tested 34 233 human samples and 12 647 mosquito samples for the presence of Zika virus. Among those, close to 500 mosquitos samples were collected from Bapunagar area, Ahmedabad District, in Gujarat, and were found negative for Zika.

# The Rashtriya Bal Swasthya Karyakram (RBSK) is monitoring microcephaly from 55 sentinel sites. As of now, no increase in number of cases or clustering of microcephaly has been reported from these centers.

# Risk communication materials are being finalized by the Central Health Education Bureau, in consultation with UNICEF.

Also Read: Zika has shaped pregnancy intentions among women in Brazil: Survey

WHO risk assessment

This report is important as it describes the first cases of Zika virus infections and provides evidence on the circulation of the virus in India. These findings suggest low level transmission of Zika virus and new cases may occur in the future. Efforts to strengthen surveillance should be maintained in order to better characterize the intensity of the viral circulation and geographical spread, and monitor Zika virus related complications. Zika virus is known to be circulating in South East Asia Region and these findings do not change the global risk assessment. WHO encourages Member states to report similar findings to better understand the global epidemiology of Zika virus.

The risk of further spread of Zika virus to areas where the competent vectors, the Aedes mosquitoes, are present is significant given the wide geographical distribution of these mosquitoes in various regions of the world. WHO continues to monitor the epidemiological situation and conduct risk assessment based on the latest available information.

Also Read: Zika Virus: New structure discovered by Purdue University researchers

WHO advice

Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people. 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.

Basic precautions for protection from mosquito bites should be taken by people traveling to high risk areas, especially pregnant women. These include use of repellents, wearing light colored, long sleeved shirts and pants and ensuring rooms are fitted with screens to prevent mosquitoes from entering.

WHO does not recommend any travel or trade restriction to India based on the current information available.

Also Read: Zika virus could be transmitted by 35 mosquito species, says study