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Global standards for Zika testing needed, doctors say

A woman stands near a poster to explain about the Zika virus, the Health Ministry office in Jakarta

(Copyright Reuters 2016)

– Although the mosquito born Zika virus often results in mild flu-like symptoms, severe congenital abnormalities associated with the disease can still justify travel advice and require global standards, a new study suggests.

The World Health Organization on Friday said the Zika outbreak is no longer a public health crisis, which makes the virus in the same category as other mosquito-born diseases such as malaria and yellow fever.

This ended up in an emergency declaration since February by clusters of brain damage, and birth defects in babies born in areas where the virus would spread.

“I think the travel advice still should hold,” said Dr. Davidson Hamer, a global health researcher at Boston University who led the new study.

“While the epidemic has slowed in the Americas, there continues to be a threat of Zika there, and the increasing recognition (and local outbreaks such as in Singapore) in Southeast Asia and the South Pacific, means that there is a constant danger in many parts of the world,” Hammer added by e-mail.

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The current research makes use of data provided by the GeoSentinel Surveillance Network to assess the size and characteristics of Zika virus infections caught by the global travelers.

Zika virus has spread rapidly throughout Latin America and the Caribbean since the initial identification in the Americas in Brazil in 2015, the researchers note in the Annals of Internal Medicine.

Although infections are asymptomatic or relatively mild in about 80 percent of the cases serious complications have been described, including neurological disorders such as Guillain-Barré syndrome, and inflammation in the spinal cord and the brain. The virus has also been linked to miscarriage, premature delivery, serious birth defects and infant mortality.

The researchers examined the data on 102 patients cases reported to the surveillance network with a Zika diagnosis between January 2013 and February 2016. This included 64 confirmed Zika cases, 13 probable cases, and 16 clinically suspected cases.

Of the 93 patients with proven or possible Zika cases, 62 percent were female and half had at least 41 years old.

About half of these travellers were tourists, while 39 percent visit friends or relatives, and 8 percent was on a business trip.

The top five countries where Zika virus was acquired Suriname (22 percent), Colombia (17 percent), Brazil (11 per cent), Martinique (11%) and Venezuela (8 percent).

Half of the travellers had spent at least 22 days in the country where they contracted the virus.

Among the 93 confirmed or suspected Zika cases, 72 people had tests for the virus done on at least one bodily fluid, and 57 of the persons tested were positive, the study found. The virus was detected in blood only in 30 patients in the urine only in 10 patients, in the blood and urine in 12 patients, in the urine and saliva in 2 patients in the urine and the semen of a patient, and in semen alone in 2 patients.

The researchers found nine cases in the blood test for Zika were negative, but the virus was detected in other fluids.

These test results highlight the need for a standardized diagnostic screening for Zika virus that can be used worldwide, said Mark A. Wainberg, a microbiologist at McGill University in Montreal, who is not involved in the study.

“The use of (blood) test is problematic and confuses Zika dengue and chikungunya,” two other viruses transmitted to humans by mosquitoes, Wainberg said.

While people do not necessarily need to cancel travel plans or panic, they still need to take measures to prevent contracting the virus, Wainberg said via e-mail.

“The use of repellents and do what can be done to prevent mosquito bites is a good idea,” Wainberg said.

Recent evidence also suggests Zika can be transmitted by sexual contact.

That means that women who are pregnant or planning to become pregnant soon after the trip, have to postpone travel to areas where the virus spreads – and so should their male partners, Hammer said. If they do that to areas where Zika is a known problem, they should use condoms to avoid pregnancy for at least two to six months after the trip.

 

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