Thursday, February 25, 2016
33,280 candidates to take Plus Two exams inTiruchi
33,280 candidates to take Plus Two exams inTiruchi: About 33,280 students — 14,887 boys and 18,397 girls — will appear for the Plus Two public examinations in Tiruchi district commencing on March 4.The examinations would be held at 100 centres across t
Wednesday, February 24, 2016
Chennai rated the safest city in India
Chennai rated the safest city in India: hennai has been rated the safest city in the country, going by the low crime rate and better law enforcement, according to a survey on Quality of Living rankings made by Mercer, a global consultancy f
Tuesday, February 23, 2016
Zika Viral Infection and Neurological Disorders
Neurological Manifestations of Zika Virus Infection
In recent years, there has been an emergence of several major viral infections with devastating neurological consequences, including West Nile virus, dengue, chikungunya, enterovirus D68, Ebola and now Zika virus. Increased global travel and climate change, leading to changing patterns of vector distribution and behavior are among the major reasons for the emergence of these infections. Zika virus is the most recent epidemic that is having devastating effects on human populations in affected regions, and is rapidly spreading across the South American continent.
Epidemiology
Zika virus was first identified from a primate in 1947 in the Zika forest of Uganda. The first human cases occurred in Africa and then in Southeast Asia in the 1960s. During the intervening years, Zika virus was associated with isolated cases or small outbreaks mainly in Africa. In 2007, there was an outbreak in Yap, the Federated States of Micronesia, where nearly three-quarters of the population was infected. This represented the largest outbreak of Zika virus infection to that point. In 2013, there was an epidemic in French Polynesia, which was associated with a reported increase in cases of the autoimmune peripheral nerve disorder Guillain-Barre syndrome, although a causal association between Zika virus and Guillain-Barre syndrome was never established.
In December 2014, Zika virus was first detected in Brazil. Although it is unknown how it was introduced into Brazil, some hypothesize that a traveler attending the 2014 football/soccer World Cup introduced the virus. The outbreak in Brazil was fast moving and large. Tens of thousands of people became ill, and likely millions of people were infected. Similar to French Polynesia, shortly after the beginning of the Zika virus outbreak, clinicians began reporting larger-than-expected numbers of Guillain-Barre syndrome. Many of these people had reported a febrile rash illness compatible with Zika in the days or weeks before their weakness onset. In addition, clinicians in Brazil noted a 20-fold increase in microcephaly in 2015, compared to previous years, with microcephalic babies born approximately eight to nine months after the first recognition of Zika virus. Some of the infants’ mothers reported a rash illness compatible with Zika virus infection while pregnant, leading to the suspicion that the microcephaly was somehow associated with Zika virus infection.
Nearly 90 percent of the cases of microcephaly occurred in the northeastern region of the country, areas experiencing some of the heaviest burdens of Zika virus infection as well. French Polynesian health authorities reported an unusual increase in central nervous system malformations in babies born during a Zika virus outbreak on the islands from 2014 to 2015. The infection has now spread across most of South America and Mexico. To date, few cases have been reported in the United States among travelers returning from Zika virus-affected regions.
Virology and Pathophysiology
Zika virus is a positive-sense, single-stranded RNA virus (genome 10.7 K nucleotides) belonging to the flaviviridae family, which includes dengue, yellow fever, Japanese encephalitis, St. Louis encephalitis and West Nile virus. It has the ability to cross the placenta and cause developmental brain abnormalities in children, suggesting that the virus likely infects neural stem cells. The severity of brain malformations may be related to the stage of fetal development at the time of infection. Microcephaly would be the most common manifestation, but if infection were to occur in earlier stages of fetal development, anencephaly or lissencephaly may occur.
The pathophysiology of ascending paralysis and myelitis in adults is unknown. However, mice injected with the virus can develop paralysis, suggesting direct invasion by the virus, although an immune-mediated, post-viral syndrome is also possible. It remains unknown if once infected and recovered if an individual develops long-term immunity or not, and if recurrent infections or relapses can occur. Questions regarding long-term viral persistence in tissue reservoirs also remain unanswered.
Transmission
The virus is transmitted by the Aedes species of mosquitoes , in particular Aedes aegypti, the vector involved with transmission of dengue, a closely related flavivirus. Additionally, experimental evidence suggests the virus can be transmitted by Asian tiger mosquitoes (Aedes albopictus) , which can survive in cold temperatures. Most arboviruses have an intermediary host or “reservoir.” For West Nile virus, birds, particularly corvids, serve as these reservoirs. For Venezuelan, Western and Eastern equine encephalitis viruses, horses serve this role, and for Japanese encephalitis virus, it is primarily pigs. However, the transmission of Zika virus generally occurs directly between humans and mosquitos. There is some evidence that human-to-human transmission may occur through sexual intercourse, and the virus has also been detected in saliva, so the potential for oral transmission also exists. The virus has been isolated from the amniotic fluid of pregnant women and blood and tissues of newborns, suggesting materno-fetal transmission. So far, an intermediary host has not been identified.
Clinical Manifestations
The majority of Zika virus infections — 80 percent — are clinically asymptomatic. Among persons who develop symptoms, Zika virus infection is generally considered to be mild, causing fever, rash and body aches. Some may develop conjunctivitis. Symptoms usually last one week.
Female Aedes aegypti mosquito
The full spectrum of neurological complications from this viral infection remains unknown. The epidemiological association between microcephaly and the infection seems strong. In Brazil, annual reported rates of microcephaly would generally be somewhere around 150 cases per year. Reportedly, between October 2015 and January 2016, more than 3,500 babies were born with the condition. CT brain scans show evidence of widespread calcification. Other malformations, such as anencephaly and lissencephaly, might also occur. It remains uncertain if other organs may be involved in addition to the brain. However, the differential diagnosis of microcephaly is broad. Hence, when presented with a patient with microcephaly, it remains important to consider other common causes, such as genetic, craniostenosis, and infections, such as toxoplasmosis, rubella, varicella zoster virus and cytomegalovirus. Intrauterine cerebral anoxia, exposure to drugs, alcohol and other toxins, malnutrition and metabolic disorders such as phenylketonuria can also cause microcephaly. Patients with microcephaly often have developmental delay, difficulty with gait and balance, mental retardation, seizures and hyperactivity.
Guillain-Barre syndrome appears to be a recurring possible complication of Zika virus infection. Following the introduction of Zika virus into French Polynesia, clinicians began reporting larger-than-expected numbers of Guillain-Barre syndrome cases on the island. Following the introduction of Zika virus to Brazil in December 2014, again, reports surfaced of large numbers of Guillain-Barre syndrome cases. In Brazil, few cases of Guillain-Barre syndrome had laboratory confirmation of Zika virus, but currently the primary method of diagnostic testing is through the detection of viral RNA through polymerase chain reaction. In Guillain-Barre syndrome, by the time the clinical features of limb weakness develop, it is unlikely that there would still be circulating virus, and, as such, detection of viral RNA would not be expected. Less commonly, some patients have been thought to have a myelitis or polio-like manifestations. Currently, it is unclear if these are all related or if indeed both spinal cord and peripheral nerves can be involved. Thus, in Brazil, epidemiologic evidence and the close temporo-spatial clustering of both Guillain-Barre syndrome and Zika virus cases provides intriguing circumstantial evidence for an association.
In other cases in which the virus was newly introduced, reported increases of Guillain-Barre syndrome cases have invariably appeared, including in Colombia, Venezuela and, more recently, El Salvador, which reported 46 Guillain-Barre syndrome cases in a five-week period from December 2015 to early January 2016. That is nearly three times more than the country would normally see in that timeframe. Laboratory substantiation of an association between Zika virus and Guillain-Barre syndrome has proved challenging, however. As noted, by the time of onset of weakness, the virus would be expected to be cleared from the body, and molecular techniques to identify the virus or viral RNA would not be expected to be positive. Detection of Zika virus-specific antibodies would provide evidence of current or prior infection. However, that method also has its challenges. Dengue virus is a closely related flavivirus to Zika, and invariably co-circulates in all areas currently associated with Zika virus. However, dengue virus infection has also rarely been associated with Guillain-Barre syndrome, and laboratory testing by serology is challenging due to the substantial cross-reactivity of antibodies between Zika virus and dengue virus.
Since these viruses are carried by the same mosquito vector and co-circulate at the same times of the year, it can be challenging to differentiate between infection with the two viruses. Development of a robust serologic assay that can reliably differentiate Zika virus from dengue and other closely related flaviviruses will be crucial in order to provide laboratory evidence of Zika-associated Guillain-Barre syndrome, as well as other late complications of Zika virus. Currently, the nature of the neuropathy is not known, as results of electrodiagnostics to determine the clinical sub-type of Guillain-Barre syndrome possibly associated with Zika virus has been rarely reported. It would be important to know if it is axonal or demyelinating and if it is immune mediated. This could affect treatment and prognosis. Recovery from demyelinating neuropathies is generally better than those due to axonal injury. Isolated reports suggest that the neuropathy may be demyelinating and may respond to treatment with intravenous immunoglobulin.
Laboratory Diagnosis
Viremia occurs only during the first few days of the illness, but if blood samples are obtained during that time, virus can be detected by polymerase chain reaction.16 Following this phase, IgM antibodies can be demonstrated by ELISA or Western blot analysis. Previous epidemics have noted that there is cross reactivity between antibodies to Zika and other arboviruses such as dengue.5 The Centers for Disease Control and Prevention (CDC) has issued guidelines for the testing of infants born with possible Zika virus infection.
Treatment and Prevention
Currently, there is no effective treatment or vaccine against the virus. Hence, prevention is key with control of mosquito populations and prevention of mosquito bites. Travel advisories have been issued for pregnant women not to travel to areas experiencing Zika virus outbreaks. For individuals who suffer from the neurological consequences of the infection, long-term supportive and symptomatic treatment is key. The socio-economic impact of the infection, particularly if the association between Zika virus and microcephaly holds true, will likely be huge and felt for decades. While the large number of cases of microcephaly is tragic, whatever the eventual cause turns out to be, it will result in large numbers of children with developmental disorders and begs for the need to train personnel in a wide variety of health disciplines, including neurology, rehabilitation, specialized nursing, social services, etc., to care for and treat this population. Ongoing surveillance for Zika virus in the Americas and elsewhere, to monitor its continued spread, as well as documentation of infection among travelers returning from affected areas will be critical. Development of more robust serologic assays that can differentiate Zika virus from other closely related flaviviruses will be an important tool to substantiate an association between Zika virus and devastating neurologic conditions, such as Guillain-Barre syndrome and microcephaly. Ultimately, the long-term epidemiologic pattern of Zika virus will be important to monitor.
In recent years, there has been an emergence of several major viral infections with devastating neurological consequences, including West Nile virus, dengue, chikungunya, enterovirus D68, Ebola and now Zika virus. Increased global travel and climate change, leading to changing patterns of vector distribution and behavior are among the major reasons for the emergence of these infections. Zika virus is the most recent epidemic that is having devastating effects on human populations in affected regions, and is rapidly spreading across the South American continent.
Epidemiology
Zika virus was first identified from a primate in 1947 in the Zika forest of Uganda. The first human cases occurred in Africa and then in Southeast Asia in the 1960s. During the intervening years, Zika virus was associated with isolated cases or small outbreaks mainly in Africa. In 2007, there was an outbreak in Yap, the Federated States of Micronesia, where nearly three-quarters of the population was infected. This represented the largest outbreak of Zika virus infection to that point. In 2013, there was an epidemic in French Polynesia, which was associated with a reported increase in cases of the autoimmune peripheral nerve disorder Guillain-Barre syndrome, although a causal association between Zika virus and Guillain-Barre syndrome was never established.
In December 2014, Zika virus was first detected in Brazil. Although it is unknown how it was introduced into Brazil, some hypothesize that a traveler attending the 2014 football/soccer World Cup introduced the virus. The outbreak in Brazil was fast moving and large. Tens of thousands of people became ill, and likely millions of people were infected. Similar to French Polynesia, shortly after the beginning of the Zika virus outbreak, clinicians began reporting larger-than-expected numbers of Guillain-Barre syndrome. Many of these people had reported a febrile rash illness compatible with Zika in the days or weeks before their weakness onset. In addition, clinicians in Brazil noted a 20-fold increase in microcephaly in 2015, compared to previous years, with microcephalic babies born approximately eight to nine months after the first recognition of Zika virus. Some of the infants’ mothers reported a rash illness compatible with Zika virus infection while pregnant, leading to the suspicion that the microcephaly was somehow associated with Zika virus infection.
Nearly 90 percent of the cases of microcephaly occurred in the northeastern region of the country, areas experiencing some of the heaviest burdens of Zika virus infection as well. French Polynesian health authorities reported an unusual increase in central nervous system malformations in babies born during a Zika virus outbreak on the islands from 2014 to 2015. The infection has now spread across most of South America and Mexico. To date, few cases have been reported in the United States among travelers returning from Zika virus-affected regions.
Virology and Pathophysiology
Zika virus is a positive-sense, single-stranded RNA virus (genome 10.7 K nucleotides) belonging to the flaviviridae family, which includes dengue, yellow fever, Japanese encephalitis, St. Louis encephalitis and West Nile virus. It has the ability to cross the placenta and cause developmental brain abnormalities in children, suggesting that the virus likely infects neural stem cells. The severity of brain malformations may be related to the stage of fetal development at the time of infection. Microcephaly would be the most common manifestation, but if infection were to occur in earlier stages of fetal development, anencephaly or lissencephaly may occur.
The pathophysiology of ascending paralysis and myelitis in adults is unknown. However, mice injected with the virus can develop paralysis, suggesting direct invasion by the virus, although an immune-mediated, post-viral syndrome is also possible. It remains unknown if once infected and recovered if an individual develops long-term immunity or not, and if recurrent infections or relapses can occur. Questions regarding long-term viral persistence in tissue reservoirs also remain unanswered.
Transmission
The virus is transmitted by the Aedes species of mosquitoes , in particular Aedes aegypti, the vector involved with transmission of dengue, a closely related flavivirus. Additionally, experimental evidence suggests the virus can be transmitted by Asian tiger mosquitoes (Aedes albopictus) , which can survive in cold temperatures. Most arboviruses have an intermediary host or “reservoir.” For West Nile virus, birds, particularly corvids, serve as these reservoirs. For Venezuelan, Western and Eastern equine encephalitis viruses, horses serve this role, and for Japanese encephalitis virus, it is primarily pigs. However, the transmission of Zika virus generally occurs directly between humans and mosquitos. There is some evidence that human-to-human transmission may occur through sexual intercourse, and the virus has also been detected in saliva, so the potential for oral transmission also exists. The virus has been isolated from the amniotic fluid of pregnant women and blood and tissues of newborns, suggesting materno-fetal transmission. So far, an intermediary host has not been identified.
Clinical Manifestations
The majority of Zika virus infections — 80 percent — are clinically asymptomatic. Among persons who develop symptoms, Zika virus infection is generally considered to be mild, causing fever, rash and body aches. Some may develop conjunctivitis. Symptoms usually last one week.
Female Aedes aegypti mosquito
The full spectrum of neurological complications from this viral infection remains unknown. The epidemiological association between microcephaly and the infection seems strong. In Brazil, annual reported rates of microcephaly would generally be somewhere around 150 cases per year. Reportedly, between October 2015 and January 2016, more than 3,500 babies were born with the condition. CT brain scans show evidence of widespread calcification. Other malformations, such as anencephaly and lissencephaly, might also occur. It remains uncertain if other organs may be involved in addition to the brain. However, the differential diagnosis of microcephaly is broad. Hence, when presented with a patient with microcephaly, it remains important to consider other common causes, such as genetic, craniostenosis, and infections, such as toxoplasmosis, rubella, varicella zoster virus and cytomegalovirus. Intrauterine cerebral anoxia, exposure to drugs, alcohol and other toxins, malnutrition and metabolic disorders such as phenylketonuria can also cause microcephaly. Patients with microcephaly often have developmental delay, difficulty with gait and balance, mental retardation, seizures and hyperactivity.
Guillain-Barre syndrome appears to be a recurring possible complication of Zika virus infection. Following the introduction of Zika virus into French Polynesia, clinicians began reporting larger-than-expected numbers of Guillain-Barre syndrome cases on the island. Following the introduction of Zika virus to Brazil in December 2014, again, reports surfaced of large numbers of Guillain-Barre syndrome cases. In Brazil, few cases of Guillain-Barre syndrome had laboratory confirmation of Zika virus, but currently the primary method of diagnostic testing is through the detection of viral RNA through polymerase chain reaction. In Guillain-Barre syndrome, by the time the clinical features of limb weakness develop, it is unlikely that there would still be circulating virus, and, as such, detection of viral RNA would not be expected. Less commonly, some patients have been thought to have a myelitis or polio-like manifestations. Currently, it is unclear if these are all related or if indeed both spinal cord and peripheral nerves can be involved. Thus, in Brazil, epidemiologic evidence and the close temporo-spatial clustering of both Guillain-Barre syndrome and Zika virus cases provides intriguing circumstantial evidence for an association.
In other cases in which the virus was newly introduced, reported increases of Guillain-Barre syndrome cases have invariably appeared, including in Colombia, Venezuela and, more recently, El Salvador, which reported 46 Guillain-Barre syndrome cases in a five-week period from December 2015 to early January 2016. That is nearly three times more than the country would normally see in that timeframe. Laboratory substantiation of an association between Zika virus and Guillain-Barre syndrome has proved challenging, however. As noted, by the time of onset of weakness, the virus would be expected to be cleared from the body, and molecular techniques to identify the virus or viral RNA would not be expected to be positive. Detection of Zika virus-specific antibodies would provide evidence of current or prior infection. However, that method also has its challenges. Dengue virus is a closely related flavivirus to Zika, and invariably co-circulates in all areas currently associated with Zika virus. However, dengue virus infection has also rarely been associated with Guillain-Barre syndrome, and laboratory testing by serology is challenging due to the substantial cross-reactivity of antibodies between Zika virus and dengue virus.
Since these viruses are carried by the same mosquito vector and co-circulate at the same times of the year, it can be challenging to differentiate between infection with the two viruses. Development of a robust serologic assay that can reliably differentiate Zika virus from dengue and other closely related flaviviruses will be crucial in order to provide laboratory evidence of Zika-associated Guillain-Barre syndrome, as well as other late complications of Zika virus. Currently, the nature of the neuropathy is not known, as results of electrodiagnostics to determine the clinical sub-type of Guillain-Barre syndrome possibly associated with Zika virus has been rarely reported. It would be important to know if it is axonal or demyelinating and if it is immune mediated. This could affect treatment and prognosis. Recovery from demyelinating neuropathies is generally better than those due to axonal injury. Isolated reports suggest that the neuropathy may be demyelinating and may respond to treatment with intravenous immunoglobulin.
Laboratory Diagnosis
Viremia occurs only during the first few days of the illness, but if blood samples are obtained during that time, virus can be detected by polymerase chain reaction.16 Following this phase, IgM antibodies can be demonstrated by ELISA or Western blot analysis. Previous epidemics have noted that there is cross reactivity between antibodies to Zika and other arboviruses such as dengue.5 The Centers for Disease Control and Prevention (CDC) has issued guidelines for the testing of infants born with possible Zika virus infection.
Treatment and Prevention
Currently, there is no effective treatment or vaccine against the virus. Hence, prevention is key with control of mosquito populations and prevention of mosquito bites. Travel advisories have been issued for pregnant women not to travel to areas experiencing Zika virus outbreaks. For individuals who suffer from the neurological consequences of the infection, long-term supportive and symptomatic treatment is key. The socio-economic impact of the infection, particularly if the association between Zika virus and microcephaly holds true, will likely be huge and felt for decades. While the large number of cases of microcephaly is tragic, whatever the eventual cause turns out to be, it will result in large numbers of children with developmental disorders and begs for the need to train personnel in a wide variety of health disciplines, including neurology, rehabilitation, specialized nursing, social services, etc., to care for and treat this population. Ongoing surveillance for Zika virus in the Americas and elsewhere, to monitor its continued spread, as well as documentation of infection among travelers returning from affected areas will be critical. Development of more robust serologic assays that can differentiate Zika virus from other closely related flaviviruses will be an important tool to substantiate an association between Zika virus and devastating neurologic conditions, such as Guillain-Barre syndrome and microcephaly. Ultimately, the long-term epidemiologic pattern of Zika virus will be important to monitor.
Zika Viral Infection and Neurological Disorders
Neurological Manifestations of Zika Virus Infection
In recent years, there has been an emergence of several major viral infections with devastating neurological consequences, including West Nile virus, dengue, chikungunya, enterovirus D68, Ebola and now Zika virus. Increased global travel and climate change, leading to changing patterns of vector distribution and behavior are among the major reasons for the emergence of these infections. Zika virus is the most recent epidemic that is having devastating effects on human populations in affected regions, and is rapidly spreading across the South American continent.
Epidemiology
Zika virus was first identified from a primate in 1947 in the Zika forest of Uganda. The first human cases occurred in Africa and then in Southeast Asia in the 1960s. During the intervening years, Zika virus was associated with isolated cases or small outbreaks mainly in Africa. In 2007, there was an outbreak in Yap, the Federated States of Micronesia, where nearly three-quarters of the population was infected. This represented the largest outbreak of Zika virus infection to that point. In 2013, there was an epidemic in French Polynesia, which was associated with a reported increase in cases of the autoimmune peripheral nerve disorder Guillain-Barre syndrome, although a causal association between Zika virus and Guillain-Barre syndrome was never established.
In December 2014, Zika virus was first detected in Brazil. Although it is unknown how it was introduced into Brazil, some hypothesize that a traveler attending the 2014 football/soccer World Cup introduced the virus. The outbreak in Brazil was fast moving and large. Tens of thousands of people became ill, and likely millions of people were infected. Similar to French Polynesia, shortly after the beginning of the Zika virus outbreak, clinicians began reporting larger-than-expected numbers of Guillain-Barre syndrome. Many of these people had reported a febrile rash illness compatible with Zika in the days or weeks before their weakness onset. In addition, clinicians in Brazil noted a 20-fold increase in microcephaly in 2015, compared to previous years, with microcephalic babies born approximately eight to nine months after the first recognition of Zika virus. Some of the infants’ mothers reported a rash illness compatible with Zika virus infection while pregnant, leading to the suspicion that the microcephaly was somehow associated with Zika virus infection.
Nearly 90 percent of the cases of microcephaly occurred in the northeastern region of the country, areas experiencing some of the heaviest burdens of Zika virus infection as well. French Polynesian health authorities reported an unusual increase in central nervous system malformations in babies born during a Zika virus outbreak on the islands from 2014 to 2015. The infection has now spread across most of South America and Mexico. To date, few cases have been reported in the United States among travelers returning from Zika virus-affected regions.
Virology and Pathophysiology
Zika virus is a positive-sense, single-stranded RNA virus (genome 10.7 K nucleotides) belonging to the flaviviridae family, which includes dengue, yellow fever, Japanese encephalitis, St. Louis encephalitis and West Nile virus. It has the ability to cross the placenta and cause developmental brain abnormalities in children, suggesting that the virus likely infects neural stem cells. The severity of brain malformations may be related to the stage of fetal development at the time of infection. Microcephaly would be the most common manifestation, but if infection were to occur in earlier stages of fetal development, anencephaly or lissencephaly may occur.
The pathophysiology of ascending paralysis and myelitis in adults is unknown. However, mice injected with the virus can develop paralysis, suggesting direct invasion by the virus, although an immune-mediated, post-viral syndrome is also possible. It remains unknown if once infected and recovered if an individual develops long-term immunity or not, and if recurrent infections or relapses can occur. Questions regarding long-term viral persistence in tissue reservoirs also remain unanswered.
Transmission
The virus is transmitted by the Aedes species of mosquitoes , in particular Aedes aegypti, the vector involved with transmission of dengue, a closely related flavivirus. Additionally, experimental evidence suggests the virus can be transmitted by Asian tiger mosquitoes (Aedes albopictus) , which can survive in cold temperatures. Most arboviruses have an intermediary host or “reservoir.” For West Nile virus, birds, particularly corvids, serve as these reservoirs. For Venezuelan, Western and Eastern equine encephalitis viruses, horses serve this role, and for Japanese encephalitis virus, it is primarily pigs. However, the transmission of Zika virus generally occurs directly between humans and mosquitos. There is some evidence that human-to-human transmission may occur through sexual intercourse, and the virus has also been detected in saliva, so the potential for oral transmission also exists. The virus has been isolated from the amniotic fluid of pregnant women and blood and tissues of newborns, suggesting materno-fetal transmission. So far, an intermediary host has not been identified.
Clinical Manifestations
The majority of Zika virus infections — 80 percent — are clinically asymptomatic. Among persons who develop symptoms, Zika virus infection is generally considered to be mild, causing fever, rash and body aches. Some may develop conjunctivitis. Symptoms usually last one week.
Female Aedes aegypti mosquito
The full spectrum of neurological complications from this viral infection remains unknown. The epidemiological association between microcephaly and the infection seems strong. In Brazil, annual reported rates of microcephaly would generally be somewhere around 150 cases per year. Reportedly, between October 2015 and January 2016, more than 3,500 babies were born with the condition. CT brain scans show evidence of widespread calcification. Other malformations, such as anencephaly and lissencephaly, might also occur. It remains uncertain if other organs may be involved in addition to the brain. However, the differential diagnosis of microcephaly is broad. Hence, when presented with a patient with microcephaly, it remains important to consider other common causes, such as genetic, craniostenosis, and infections, such as toxoplasmosis, rubella, varicella zoster virus and cytomegalovirus. Intrauterine cerebral anoxia, exposure to drugs, alcohol and other toxins, malnutrition and metabolic disorders such as phenylketonuria can also cause microcephaly. Patients with microcephaly often have developmental delay, difficulty with gait and balance, mental retardation, seizures and hyperactivity.
Guillain-Barre syndrome appears to be a recurring possible complication of Zika virus infection. Following the introduction of Zika virus into French Polynesia, clinicians began reporting larger-than-expected numbers of Guillain-Barre syndrome cases on the island. Following the introduction of Zika virus to Brazil in December 2014, again, reports surfaced of large numbers of Guillain-Barre syndrome cases. In Brazil, few cases of Guillain-Barre syndrome had laboratory confirmation of Zika virus, but currently the primary method of diagnostic testing is through the detection of viral RNA through polymerase chain reaction. In Guillain-Barre syndrome, by the time the clinical features of limb weakness develop, it is unlikely that there would still be circulating virus, and, as such, detection of viral RNA would not be expected. Less commonly, some patients have been thought to have a myelitis or polio-like manifestations. Currently, it is unclear if these are all related or if indeed both spinal cord and peripheral nerves can be involved. Thus, in Brazil, epidemiologic evidence and the close temporo-spatial clustering of both Guillain-Barre syndrome and Zika virus cases provides intriguing circumstantial evidence for an association.
In other cases in which the virus was newly introduced, reported increases of Guillain-Barre syndrome cases have invariably appeared, including in Colombia, Venezuela and, more recently, El Salvador, which reported 46 Guillain-Barre syndrome cases in a five-week period from December 2015 to early January 2016. That is nearly three times more than the country would normally see in that timeframe. Laboratory substantiation of an association between Zika virus and Guillain-Barre syndrome has proved challenging, however. As noted, by the time of onset of weakness, the virus would be expected to be cleared from the body, and molecular techniques to identify the virus or viral RNA would not be expected to be positive. Detection of Zika virus-specific antibodies would provide evidence of current or prior infection. However, that method also has its challenges. Dengue virus is a closely related flavivirus to Zika, and invariably co-circulates in all areas currently associated with Zika virus. However, dengue virus infection has also rarely been associated with Guillain-Barre syndrome, and laboratory testing by serology is challenging due to the substantial cross-reactivity of antibodies between Zika virus and dengue virus.
Since these viruses are carried by the same mosquito vector and co-circulate at the same times of the year, it can be challenging to differentiate between infection with the two viruses. Development of a robust serologic assay that can reliably differentiate Zika virus from dengue and other closely related flaviviruses will be crucial in order to provide laboratory evidence of Zika-associated Guillain-Barre syndrome, as well as other late complications of Zika virus. Currently, the nature of the neuropathy is not known, as results of electrodiagnostics to determine the clinical sub-type of Guillain-Barre syndrome possibly associated with Zika virus has been rarely reported. It would be important to know if it is axonal or demyelinating and if it is immune mediated. This could affect treatment and prognosis. Recovery from demyelinating neuropathies is generally better than those due to axonal injury. Isolated reports suggest that the neuropathy may be demyelinating and may respond to treatment with intravenous immunoglobulin.
Laboratory Diagnosis
Viremia occurs only during the first few days of the illness, but if blood samples are obtained during that time, virus can be detected by polymerase chain reaction.16 Following this phase, IgM antibodies can be demonstrated by ELISA or Western blot analysis. Previous epidemics have noted that there is cross reactivity between antibodies to Zika and other arboviruses such as dengue.5 The Centers for Disease Control and Prevention (CDC) has issued guidelines for the testing of infants born with possible Zika virus infection.
Treatment and Prevention
Currently, there is no effective treatment or vaccine against the virus. Hence, prevention is key with control of mosquito populations and prevention of mosquito bites. Travel advisories have been issued for pregnant women not to travel to areas experiencing Zika virus outbreaks. For individuals who suffer from the neurological consequences of the infection, long-term supportive and symptomatic treatment is key. The socio-economic impact of the infection, particularly if the association between Zika virus and microcephaly holds true, will likely be huge and felt for decades. While the large number of cases of microcephaly is tragic, whatever the eventual cause turns out to be, it will result in large numbers of children with developmental disorders and begs for the need to train personnel in a wide variety of health disciplines, including neurology, rehabilitation, specialized nursing, social services, etc., to care for and treat this population. Ongoing surveillance for Zika virus in the Americas and elsewhere, to monitor its continued spread, as well as documentation of infection among travelers returning from affected areas will be critical. Development of more robust serologic assays that can differentiate Zika virus from other closely related flaviviruses will be an important tool to substantiate an association between Zika virus and devastating neurologic conditions, such as Guillain-Barre syndrome and microcephaly. Ultimately, the long-term epidemiologic pattern of Zika virus will be important to monitor.
In recent years, there has been an emergence of several major viral infections with devastating neurological consequences, including West Nile virus, dengue, chikungunya, enterovirus D68, Ebola and now Zika virus. Increased global travel and climate change, leading to changing patterns of vector distribution and behavior are among the major reasons for the emergence of these infections. Zika virus is the most recent epidemic that is having devastating effects on human populations in affected regions, and is rapidly spreading across the South American continent.
Epidemiology
Zika virus was first identified from a primate in 1947 in the Zika forest of Uganda. The first human cases occurred in Africa and then in Southeast Asia in the 1960s. During the intervening years, Zika virus was associated with isolated cases or small outbreaks mainly in Africa. In 2007, there was an outbreak in Yap, the Federated States of Micronesia, where nearly three-quarters of the population was infected. This represented the largest outbreak of Zika virus infection to that point. In 2013, there was an epidemic in French Polynesia, which was associated with a reported increase in cases of the autoimmune peripheral nerve disorder Guillain-Barre syndrome, although a causal association between Zika virus and Guillain-Barre syndrome was never established.
In December 2014, Zika virus was first detected in Brazil. Although it is unknown how it was introduced into Brazil, some hypothesize that a traveler attending the 2014 football/soccer World Cup introduced the virus. The outbreak in Brazil was fast moving and large. Tens of thousands of people became ill, and likely millions of people were infected. Similar to French Polynesia, shortly after the beginning of the Zika virus outbreak, clinicians began reporting larger-than-expected numbers of Guillain-Barre syndrome. Many of these people had reported a febrile rash illness compatible with Zika in the days or weeks before their weakness onset. In addition, clinicians in Brazil noted a 20-fold increase in microcephaly in 2015, compared to previous years, with microcephalic babies born approximately eight to nine months after the first recognition of Zika virus. Some of the infants’ mothers reported a rash illness compatible with Zika virus infection while pregnant, leading to the suspicion that the microcephaly was somehow associated with Zika virus infection.
Nearly 90 percent of the cases of microcephaly occurred in the northeastern region of the country, areas experiencing some of the heaviest burdens of Zika virus infection as well. French Polynesian health authorities reported an unusual increase in central nervous system malformations in babies born during a Zika virus outbreak on the islands from 2014 to 2015. The infection has now spread across most of South America and Mexico. To date, few cases have been reported in the United States among travelers returning from Zika virus-affected regions.
Virology and Pathophysiology
Zika virus is a positive-sense, single-stranded RNA virus (genome 10.7 K nucleotides) belonging to the flaviviridae family, which includes dengue, yellow fever, Japanese encephalitis, St. Louis encephalitis and West Nile virus. It has the ability to cross the placenta and cause developmental brain abnormalities in children, suggesting that the virus likely infects neural stem cells. The severity of brain malformations may be related to the stage of fetal development at the time of infection. Microcephaly would be the most common manifestation, but if infection were to occur in earlier stages of fetal development, anencephaly or lissencephaly may occur.
The pathophysiology of ascending paralysis and myelitis in adults is unknown. However, mice injected with the virus can develop paralysis, suggesting direct invasion by the virus, although an immune-mediated, post-viral syndrome is also possible. It remains unknown if once infected and recovered if an individual develops long-term immunity or not, and if recurrent infections or relapses can occur. Questions regarding long-term viral persistence in tissue reservoirs also remain unanswered.
Transmission
The virus is transmitted by the Aedes species of mosquitoes , in particular Aedes aegypti, the vector involved with transmission of dengue, a closely related flavivirus. Additionally, experimental evidence suggests the virus can be transmitted by Asian tiger mosquitoes (Aedes albopictus) , which can survive in cold temperatures. Most arboviruses have an intermediary host or “reservoir.” For West Nile virus, birds, particularly corvids, serve as these reservoirs. For Venezuelan, Western and Eastern equine encephalitis viruses, horses serve this role, and for Japanese encephalitis virus, it is primarily pigs. However, the transmission of Zika virus generally occurs directly between humans and mosquitos. There is some evidence that human-to-human transmission may occur through sexual intercourse, and the virus has also been detected in saliva, so the potential for oral transmission also exists. The virus has been isolated from the amniotic fluid of pregnant women and blood and tissues of newborns, suggesting materno-fetal transmission. So far, an intermediary host has not been identified.
Clinical Manifestations
The majority of Zika virus infections — 80 percent — are clinically asymptomatic. Among persons who develop symptoms, Zika virus infection is generally considered to be mild, causing fever, rash and body aches. Some may develop conjunctivitis. Symptoms usually last one week.
Female Aedes aegypti mosquito
The full spectrum of neurological complications from this viral infection remains unknown. The epidemiological association between microcephaly and the infection seems strong. In Brazil, annual reported rates of microcephaly would generally be somewhere around 150 cases per year. Reportedly, between October 2015 and January 2016, more than 3,500 babies were born with the condition. CT brain scans show evidence of widespread calcification. Other malformations, such as anencephaly and lissencephaly, might also occur. It remains uncertain if other organs may be involved in addition to the brain. However, the differential diagnosis of microcephaly is broad. Hence, when presented with a patient with microcephaly, it remains important to consider other common causes, such as genetic, craniostenosis, and infections, such as toxoplasmosis, rubella, varicella zoster virus and cytomegalovirus. Intrauterine cerebral anoxia, exposure to drugs, alcohol and other toxins, malnutrition and metabolic disorders such as phenylketonuria can also cause microcephaly. Patients with microcephaly often have developmental delay, difficulty with gait and balance, mental retardation, seizures and hyperactivity.
Guillain-Barre syndrome appears to be a recurring possible complication of Zika virus infection. Following the introduction of Zika virus into French Polynesia, clinicians began reporting larger-than-expected numbers of Guillain-Barre syndrome cases on the island. Following the introduction of Zika virus to Brazil in December 2014, again, reports surfaced of large numbers of Guillain-Barre syndrome cases. In Brazil, few cases of Guillain-Barre syndrome had laboratory confirmation of Zika virus, but currently the primary method of diagnostic testing is through the detection of viral RNA through polymerase chain reaction. In Guillain-Barre syndrome, by the time the clinical features of limb weakness develop, it is unlikely that there would still be circulating virus, and, as such, detection of viral RNA would not be expected. Less commonly, some patients have been thought to have a myelitis or polio-like manifestations. Currently, it is unclear if these are all related or if indeed both spinal cord and peripheral nerves can be involved. Thus, in Brazil, epidemiologic evidence and the close temporo-spatial clustering of both Guillain-Barre syndrome and Zika virus cases provides intriguing circumstantial evidence for an association.
In other cases in which the virus was newly introduced, reported increases of Guillain-Barre syndrome cases have invariably appeared, including in Colombia, Venezuela and, more recently, El Salvador, which reported 46 Guillain-Barre syndrome cases in a five-week period from December 2015 to early January 2016. That is nearly three times more than the country would normally see in that timeframe. Laboratory substantiation of an association between Zika virus and Guillain-Barre syndrome has proved challenging, however. As noted, by the time of onset of weakness, the virus would be expected to be cleared from the body, and molecular techniques to identify the virus or viral RNA would not be expected to be positive. Detection of Zika virus-specific antibodies would provide evidence of current or prior infection. However, that method also has its challenges. Dengue virus is a closely related flavivirus to Zika, and invariably co-circulates in all areas currently associated with Zika virus. However, dengue virus infection has also rarely been associated with Guillain-Barre syndrome, and laboratory testing by serology is challenging due to the substantial cross-reactivity of antibodies between Zika virus and dengue virus.
Since these viruses are carried by the same mosquito vector and co-circulate at the same times of the year, it can be challenging to differentiate between infection with the two viruses. Development of a robust serologic assay that can reliably differentiate Zika virus from dengue and other closely related flaviviruses will be crucial in order to provide laboratory evidence of Zika-associated Guillain-Barre syndrome, as well as other late complications of Zika virus. Currently, the nature of the neuropathy is not known, as results of electrodiagnostics to determine the clinical sub-type of Guillain-Barre syndrome possibly associated with Zika virus has been rarely reported. It would be important to know if it is axonal or demyelinating and if it is immune mediated. This could affect treatment and prognosis. Recovery from demyelinating neuropathies is generally better than those due to axonal injury. Isolated reports suggest that the neuropathy may be demyelinating and may respond to treatment with intravenous immunoglobulin.
Laboratory Diagnosis
Viremia occurs only during the first few days of the illness, but if blood samples are obtained during that time, virus can be detected by polymerase chain reaction.16 Following this phase, IgM antibodies can be demonstrated by ELISA or Western blot analysis. Previous epidemics have noted that there is cross reactivity between antibodies to Zika and other arboviruses such as dengue.5 The Centers for Disease Control and Prevention (CDC) has issued guidelines for the testing of infants born with possible Zika virus infection.
Treatment and Prevention
Currently, there is no effective treatment or vaccine against the virus. Hence, prevention is key with control of mosquito populations and prevention of mosquito bites. Travel advisories have been issued for pregnant women not to travel to areas experiencing Zika virus outbreaks. For individuals who suffer from the neurological consequences of the infection, long-term supportive and symptomatic treatment is key. The socio-economic impact of the infection, particularly if the association between Zika virus and microcephaly holds true, will likely be huge and felt for decades. While the large number of cases of microcephaly is tragic, whatever the eventual cause turns out to be, it will result in large numbers of children with developmental disorders and begs for the need to train personnel in a wide variety of health disciplines, including neurology, rehabilitation, specialized nursing, social services, etc., to care for and treat this population. Ongoing surveillance for Zika virus in the Americas and elsewhere, to monitor its continued spread, as well as documentation of infection among travelers returning from affected areas will be critical. Development of more robust serologic assays that can differentiate Zika virus from other closely related flaviviruses will be an important tool to substantiate an association between Zika virus and devastating neurologic conditions, such as Guillain-Barre syndrome and microcephaly. Ultimately, the long-term epidemiologic pattern of Zika virus will be important to monitor.
Monday, February 22, 2016
‘Evolution Park’ coming up at Anna Science Centre
‘Evolution Park’ coming up at Anna Science Centre: Visitors to Anna Science Centre – Planetarium here will soon have an informative models on the evolution of life over the ages, providing visual treat and ensuring scientific approach in understanding
Lakhs take a holy dip on Mahamaham day
Lakhs take a holy dip on Mahamaham day: Lakhs of pilgrims participated in the Teerthavari ritual and took a holy dip in the Mahamaham tank and the Cauvery on the occasion of the Mahamaham here on Monday. With the elaborate safety measures i
Monday, February 15, 2016
Tiruchi sets the benchmark
Tiruchi sets the benchmark: Tiruchi city, which faced a tough competition from leading cities to retain the top ranking this year, has once again hogged the limelight by notching up national-level third position in the Swach Bha
Tiruchi walks away with Swachh Bharat honours
Tiruchi walks away with Swachh Bharat honours: In the pan-India Swachh Bharat survey commissioned by the Ministry of Urban Development, Chennai has been ranked 37, but three other cities from the State are ahead of the capital city. Tiruchi has co
Sunday, February 14, 2016
Odathurai bridge thrown to public
Odathurai bridge thrown to public: The new road over bridge across the railway level crossing at Odathurai along the banks of the Cauvery in the city was finally thrown open to traffic on Sunday, with Chief Minister Jayalalithaa declar
CM declares open Coleroon bridge
CM declares open Coleroon bridge: A new bridge across the Coleroon, resembling the Napier Bridge in Chennai with bowstring arches, was declared open for public use on Sunday.The vital bridge connecting the island of Srirangam wedged b
Bharathidasan University imposes ‘seminar tax’
Bharathidasan University imposes ‘seminar tax’: A section of the faculty members of the Bharathidasan University is upset over the imposition of what it has dubbed as “seminar tax” by the State institution.The university Registrar C. Thiruchelvan o
K.K. Nagar bus terminus inaugurated
K.K. Nagar bus terminus inaugurated: The newly built bus terminus at K.K. Nagar in the city was declared open on Saturday, fulfilling a long-felt need of the local residents.Although it had emerged as one of the prime residential localit
Friday, February 12, 2016
Hand in hand
Hand in hand: Parenting has changed over the years, constantly redrawing the picture on what constitutes a ‘good’ upbringing. Grandparents are not just old folks on stand-by to babysit their grandkids for an hour o
Wednesday, February 10, 2016
De-worming Day: tablets distributed
De-worming Day: tablets distributed: Children and adolescents in the age group of 1 to 19 were distributed albandezole tablets on Wednesday on the occasion of National De-worming Day.Collector K.S.Palanisamy inaugurated the distribution
Tuesday, February 9, 2016
New buildings, statues unveiled
New buildings, statues unveiled: Chief Minister Jayalalithaa on Tuesday inaugurated various buildings, unveiled statues of freedom fighters and poets, including a high mast lamp set up near the memorial of former President A.P.J. Abd
CM unveils statue
CM unveils statue: Chief Minister Jayalalithaa unveiled a statue of Tamil language martyr Keezhapazhuvur Chinnasamy installed at Kambarasampettai here through video conferencing from Chennai on Monday.The statue has bee
Government ITI takes off at Tiruchi Prison
Government ITI takes off at Tiruchi Prison: Convicts serving lengthy terms have now been provided with an avenue to develop their vocational skills with a Government Industrial Technical Institute (ITI) taking off at the Tiruchi Central Prison
Sunday, February 7, 2016
2nd International Epilepsy Day 2016 February 8: Epilepsy Is A Health Care Priority
2nd International Epilepsy Day February 8. " Epilepsy Is A Health Care Priority"
Misconceptions and Reality about Epilepsy
Epilepsy is a common brain disorder in the world afflicting about 50 million people worldwide. It responds to treatment about 70% of the time, yet about three fourths of affected people in developing countries do not get the treatment they need (WHO). It is also one of the oldest diseases known to mankind and is associated with a lot of stigma and shame.
In fact it is said that “The history of epilepsy can be summarized as 4000 years of ignorance, superstition and stigma, followed by 100 years of knowledge, superstition and stigma.”
Hence it is of paramount importance to dispel the common myths and misconceptions about epilepsy.
Epilepsy is a condition when a person suffers from repeated or recurrent seizures; which are a sudden and abnormal increase in the electrical activity of the brain. This can result in violent muscle spasms, strange behavior, emotions, sensations, convulsions or loss of consciousness.
One common belief; especially prevalent in the rural areas, is that a person with epilepsy believed to be possessed by an evil spirits during the attack. Epilepsy is a medical condition and such persons are to be taken to a qualified doctor and not to faith healers or sorcerers for treatment.
Another common belief is that epilepsy is contagious. But this is far from the truth, epilepsy is not contagious and there is no harm in touching a patient who is having a seizure to help him.
When a person is having a seizure there is no requirement of pressing an iron key or any object between his fingers or thrusting it between his teeth to stop the seizure. The only requirement is removing all dangerous, sharp objects in the vicinity which can injure the person. One must not try to restrain a person when he is having a seizure. This will not stop the seizure and may prove dangerous for the both the patient and the person restraining him by causing injury. Water/food should not be given to the person till the seizure passes off. After the seizure, the person is to be placed on one side so that the tongue does not fall back and obstruct breathing. A person will rarely die from having a seizure but may be injured by nearby objects, or falling or when something is forced into his mouth.
All seizures do not involve falling to the ground and having convulsions. Some may last for just a few seconds and involve a brief black out when the person just stares or blinks or has slight movements of mouth or hand.
A person who has epilepsy usually does not have any cognitive disability unless it is associated with a brain injury. In fact many famous people in history such as Leonardo da Vinci, Isaac Newton, Napoleon Bonaparte, Alexander the Great, Alfred Nobel, Michelangelo and Lewis Carol had epilepsy. But this did not deter them from achieving great heights.
Marriage is not a barrier when consent of prospective partner is taken without hiding the facts. Also with proper pre conception counseling it is possible for a woman to conceive and have children. The risk of the children having epilepsy because of one or both parents with epilepsy is very low and only for certain kind.
Finally regular medication with adequate sleep, food and avoiding anything that stimulates the brain is extremely important for persons with epilepsy. Any withdrawal/stoppage of medicines should be done only with the consent of the treating doctor even if the patient has been seizure-free for a certain period of time.
In short, proper education and awareness about the disease can dispel the myths and misconceptions surrounding epilepsy.
Once called the ‘falling disease’ and said to be caused by possession by a demon or ghost, epilepsy still remains a condition very often misunderstood. In the rural areas of our country, people still go to witch doctors and babas to drive the demon away from the body of the epileptic. On World Epilepsy day, we attempt to bust some of the myths about epilepsy:

Myth 1: People suffering from epilepsy are mentally deranged or challenged.
Fact 1: Epilepsy is a disorder of the brain in which certain clusters of nerve cells sometime signal abnormally causing strange sensations, emotions, behaviour, muscle spasms, in some case convulsions and loss of consciousness. The functioning of the other parts of the brain and body are perfectly normal. Some people with mental retardation might have epileptic attacks but people with epileptic attacks never progress to mental retardation or decrease in IQ. The fact that well-known names like Sir Alfred Nobel, Napoleon and Socrates were known cases of epilepsy is enough to dispel this myth.
Myth 2: All epileptic attacks occur with convulsions.
Fact 2: There are several kinds of epileptic attacks. Some people may just have altered sensations, some may exhibit repetitive movements, some may experience auras. Convulsions are common in certain types of epilepsy, but not in all forms.
Myth 3: Epilepsy is hereditary.
Fact 3: While there might be a genetic angle to epilepsy, it is not the only cause. Anything that disturbs the nerve cell activity ranging from abnormal brain development, illness or brain damage can cause epilepsy. Brain tumours, meningitis and other infections of the brain, fever, Alzheimer’s disease, head injuries and even alcoholism can also be responsible for attacks.
Myth 4: There are no triggers for epileptic attacks. They can occur anyplace, anytime without warning.
Fact 4: There are certain triggers like lack of sleep, flashing lights, stress, alcohol, hormonal changes during menstruation, smoking etc which can precipitate attacks.
Myth 5: Epilepsy makes people dependent on others.
Fact 5: People with epilepsy can lead a normal life with proper treatment and precautions. Their family and friends need to understand their condition and know how they can help in case of an emergency. Only when it comes to driving, attempting dangerous sports etc are they prohibited for the sake of their own safety.
Myth 6: When a person is having an epileptic attack, he/she should be restrained.
Fact 6: This is the worst thing you can do to help. It may end up making the seizure more severe. If the person is moving, remove dangerous objects near him/her. If they fall, turn them to one side so that saliva can drain from their mouth. Loosen their clothing, don’t let people crowd near them. If they are wearing glasses, remove them. Do not attempt to insert anything inside their mouth, even if it is soft. The tongue cannot be ‘swallowed’. Usually the attack lasts for less than five minutes. If it lasts for more than that, do call their doctor or the nearest hospital. Do not attempt to get them on their feet immediately after the attack.
Myth 7: Epilepsy makes people unfit for marriage.
Fact 7: This misconception is a big one in India, especially in the case of women. With proper treatment, one can lead a normal life and can even prevent them to a great extent with awareness and education.
Myth 8: Women suffering from epilepsy cannot have children.
Fact 8: Epilepsy or anti-epileptic drugs cannot affect fertility in anyway. Even during pregnancy, women can take their medicines under their doctor’s supervision.
Misconceptions and Reality about Epilepsy
Epilepsy is a common brain disorder in the world afflicting about 50 million people worldwide. It responds to treatment about 70% of the time, yet about three fourths of affected people in developing countries do not get the treatment they need (WHO). It is also one of the oldest diseases known to mankind and is associated with a lot of stigma and shame.
In fact it is said that “The history of epilepsy can be summarized as 4000 years of ignorance, superstition and stigma, followed by 100 years of knowledge, superstition and stigma.”
Hence it is of paramount importance to dispel the common myths and misconceptions about epilepsy.
Epilepsy is a condition when a person suffers from repeated or recurrent seizures; which are a sudden and abnormal increase in the electrical activity of the brain. This can result in violent muscle spasms, strange behavior, emotions, sensations, convulsions or loss of consciousness.
One common belief; especially prevalent in the rural areas, is that a person with epilepsy believed to be possessed by an evil spirits during the attack. Epilepsy is a medical condition and such persons are to be taken to a qualified doctor and not to faith healers or sorcerers for treatment.
Another common belief is that epilepsy is contagious. But this is far from the truth, epilepsy is not contagious and there is no harm in touching a patient who is having a seizure to help him.
When a person is having a seizure there is no requirement of pressing an iron key or any object between his fingers or thrusting it between his teeth to stop the seizure. The only requirement is removing all dangerous, sharp objects in the vicinity which can injure the person. One must not try to restrain a person when he is having a seizure. This will not stop the seizure and may prove dangerous for the both the patient and the person restraining him by causing injury. Water/food should not be given to the person till the seizure passes off. After the seizure, the person is to be placed on one side so that the tongue does not fall back and obstruct breathing. A person will rarely die from having a seizure but may be injured by nearby objects, or falling or when something is forced into his mouth.
All seizures do not involve falling to the ground and having convulsions. Some may last for just a few seconds and involve a brief black out when the person just stares or blinks or has slight movements of mouth or hand.
A person who has epilepsy usually does not have any cognitive disability unless it is associated with a brain injury. In fact many famous people in history such as Leonardo da Vinci, Isaac Newton, Napoleon Bonaparte, Alexander the Great, Alfred Nobel, Michelangelo and Lewis Carol had epilepsy. But this did not deter them from achieving great heights.
Marriage is not a barrier when consent of prospective partner is taken without hiding the facts. Also with proper pre conception counseling it is possible for a woman to conceive and have children. The risk of the children having epilepsy because of one or both parents with epilepsy is very low and only for certain kind.
Finally regular medication with adequate sleep, food and avoiding anything that stimulates the brain is extremely important for persons with epilepsy. Any withdrawal/stoppage of medicines should be done only with the consent of the treating doctor even if the patient has been seizure-free for a certain period of time.
In short, proper education and awareness about the disease can dispel the myths and misconceptions surrounding epilepsy.
Once called the ‘falling disease’ and said to be caused by possession by a demon or ghost, epilepsy still remains a condition very often misunderstood. In the rural areas of our country, people still go to witch doctors and babas to drive the demon away from the body of the epileptic. On World Epilepsy day, we attempt to bust some of the myths about epilepsy:

Myth 1: People suffering from epilepsy are mentally deranged or challenged.
Fact 1: Epilepsy is a disorder of the brain in which certain clusters of nerve cells sometime signal abnormally causing strange sensations, emotions, behaviour, muscle spasms, in some case convulsions and loss of consciousness. The functioning of the other parts of the brain and body are perfectly normal. Some people with mental retardation might have epileptic attacks but people with epileptic attacks never progress to mental retardation or decrease in IQ. The fact that well-known names like Sir Alfred Nobel, Napoleon and Socrates were known cases of epilepsy is enough to dispel this myth.
Myth 2: All epileptic attacks occur with convulsions.
Fact 2: There are several kinds of epileptic attacks. Some people may just have altered sensations, some may exhibit repetitive movements, some may experience auras. Convulsions are common in certain types of epilepsy, but not in all forms.
Myth 3: Epilepsy is hereditary.
Fact 3: While there might be a genetic angle to epilepsy, it is not the only cause. Anything that disturbs the nerve cell activity ranging from abnormal brain development, illness or brain damage can cause epilepsy. Brain tumours, meningitis and other infections of the brain, fever, Alzheimer’s disease, head injuries and even alcoholism can also be responsible for attacks.
Myth 4: There are no triggers for epileptic attacks. They can occur anyplace, anytime without warning.
Fact 4: There are certain triggers like lack of sleep, flashing lights, stress, alcohol, hormonal changes during menstruation, smoking etc which can precipitate attacks.
Myth 5: Epilepsy makes people dependent on others.
Fact 5: People with epilepsy can lead a normal life with proper treatment and precautions. Their family and friends need to understand their condition and know how they can help in case of an emergency. Only when it comes to driving, attempting dangerous sports etc are they prohibited for the sake of their own safety.
Myth 6: When a person is having an epileptic attack, he/she should be restrained.
Fact 6: This is the worst thing you can do to help. It may end up making the seizure more severe. If the person is moving, remove dangerous objects near him/her. If they fall, turn them to one side so that saliva can drain from their mouth. Loosen their clothing, don’t let people crowd near them. If they are wearing glasses, remove them. Do not attempt to insert anything inside their mouth, even if it is soft. The tongue cannot be ‘swallowed’. Usually the attack lasts for less than five minutes. If it lasts for more than that, do call their doctor or the nearest hospital. Do not attempt to get them on their feet immediately after the attack.
Myth 7: Epilepsy makes people unfit for marriage.
Fact 7: This misconception is a big one in India, especially in the case of women. With proper treatment, one can lead a normal life and can even prevent them to a great extent with awareness and education.
Myth 8: Women suffering from epilepsy cannot have children.
Fact 8: Epilepsy or anti-epileptic drugs cannot affect fertility in anyway. Even during pregnancy, women can take their medicines under their doctor’s supervision.
Escalator begins to roll in Tiruchi
Escalator begins to roll in Tiruchi: The newly established escalator at Tiruchi railway junction started rolling on Sunday.It was inaugurated by Railway Minister Suresh Prabhakar Prabhu through video conferencing at a function held at Ea
Saturday, February 6, 2016
இந்தியாவைத் தாக்குமா ஜிகா ஜுரம்?
இந்தியாவைத் தாக்குமா ஜிகா ஜுரம்?: கருத்தரிக்க நினைக்கும் தாய்மார்கள் மருத்துவர்களிடம் முதலில் விவாதிக்க வேண் டும். கொசு கடியைத் தவிர்ப்பதற்கான வழிமுறைகளைக்
Wednesday, February 3, 2016
‘No need to panic over Zika virus’
‘No need to panic over Zika virus’: Tamil Nadu is fully prepared to tackle the Zika virus and there is no cause for concern at present, said Health Secretary J. Radhakrishnan.A high-level review meeting was held on Wednesday to assess t
Tuesday, February 2, 2016
Zika viral Infection Will Become A Pandemic
Key facts About Zika Virus
Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
There is no specific treatment or vaccine currently available.
The best form of prevention is protection against mosquito bites.
The virus is known to circulate in Africa, the Americas, Asia and the Pacific.
Introduction
Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.
Genre: Flavivirus
Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
Reservoir: Unknown
Signs and Symptoms
The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days.
During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.
Transmission
Zika virus is transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.
Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013 (Yap and French Polynesia, respectively), and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). In addition, more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus.
Diagnosis
Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever.
Prevention
Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.
This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.
Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.
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.
Travellers should take the basic precautions described above to protect themselves from mosquito bites.
Treatment
Zika virus disease is usually relatively mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available.
Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
There is no specific treatment or vaccine currently available.
The best form of prevention is protection against mosquito bites.
The virus is known to circulate in Africa, the Americas, Asia and the Pacific.
Introduction
Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.
Genre: Flavivirus
Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
Reservoir: Unknown
Signs and Symptoms
The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days.
During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.
Transmission
Zika virus is transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.
Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013 (Yap and French Polynesia, respectively), and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). In addition, more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus.
Diagnosis
Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever.
Prevention
Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.
This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.
Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.
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.
Travellers should take the basic precautions described above to protect themselves from mosquito bites.
Treatment
Zika virus disease is usually relatively mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available.
Zika Viral Infection Will Become a Academic
Key facts About Zika Virus
Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
There is no specific treatment or vaccine currently available.
The best form of prevention is protection against mosquito bites.
The virus is known to circulate in Africa, the Americas, Asia and the Pacific.
Introduction
Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.
Genre: Flavivirus
Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
Reservoir: Unknown
Signs and Symptoms
The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days.
During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.
Transmission
Zika virus is transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.
Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013 (Yap and French Polynesia, respectively), and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). In addition, more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus.
Diagnosis
Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever.
Prevention
Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.
This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.
Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.
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.
Travellers should take the basic precautions described above to protect themselves from mosquito bites.
Treatment
Zika virus disease is usually relatively mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available.
Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
There is no specific treatment or vaccine currently available.
The best form of prevention is protection against mosquito bites.
The virus is known to circulate in Africa, the Americas, Asia and the Pacific.
Introduction
Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.
Genre: Flavivirus
Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
Reservoir: Unknown
Signs and Symptoms
The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days.
During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.
Transmission
Zika virus is transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.
Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013 (Yap and French Polynesia, respectively), and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). In addition, more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus.
Diagnosis
Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever.
Prevention
Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.
This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.
Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.
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.
Travellers should take the basic precautions described above to protect themselves from mosquito bites.
Treatment
Zika virus disease is usually relatively mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available.
Zika Viral Infection so far Till Date Not in India But Beware Mosquito Bites. And Prevent Mosquito Bites
Zika virus disease: Questions and answers
Where does Zika virus occur?
Zika virus occurs in tropical areas with large mosquito populations, and is known to circulate in Africa, the Americas, Southern Asia and Western Pacific.
Zika virus was discovered in 1947, but for many years only sporadic human cases were detected in Africa and Southern Asia. In 2007, the first documented outbreak of Zika virus disease occurred in the Pacific. Since 2013, cases and outbreaks of the disease have been reported from the Western Pacific, the Americas and Africa. Given the expansion of environments where mosquitoes can live and breed, facilitated by urbanisation and globalisation, there is potential for major urban epidemics of Zika virus disease to occur globally.
How do people catch Zika virus?
People catch Zika virus by being bitten by an infected Aedes mosquito – the same type of mosquito that spreads dengue, chikungunya and yellow fever.
How does Aedes mosquito reproduce?
Only female mosquitoes bite; they are intermittent feeders and prefer to bite more than one person. Once the female mosquito is fully fed, it needs to rest 3 days before it lays eggs. The eggs can survive up to 1 year without water. Once water is available, and small quantities of standing water are sufficient, the eggs develop into larvae and then adult mosquitoes. Mosquitoes get infected from people with the virus.
Where can the Aedes mosquito survive?
There are 2 types of Aedes mosquito capable of transmitting the Zika virus. In most cases, Zika spreads through the Aedes aegypti mosquito in tropical and subtropical regions. The Aedes aegypti mosquito does not survive in cooler climate temperatures. The Aedes albopictus mosquito can also transmit the virus. This mosquito can hibernate and survive cooler temperature regions.
Can the Aedes mosquito travel from country to country and region to region?
The Aedes mosquito is a weak flyer; it cannot fly more than 400 meters. But it may inadvertently be transported by humans from one place to another (e.g. in the back of the car, plants). If it can survive the temperature climate of the destination, it may theoretically be capable of reproducing itself there and introduce Zika virus to new areas.
What are the symptoms of Zika virus disease?
Zika virus usually causes mild illness; with symptoms appearing a few days after a person is bitten by an infected mosquito. Most people with Zika virus disease will get a slight fever and rash. Others may also get conjunctivitis, muscle and joint pain, and feel tired. The symptoms usually finish in 2 to 7 days.
What might be the potential complications of Zika virus?
Because no large outbreaks of Zika virus were recorded before 2007, little is currently known about the complications of the disease.
During the first outbreak of Zika from 2013 - 2014 in French Polynesia, which also coincided with an ongoing outbreak of dengue, national health authorities reported an unusual increase in Guillain-Barré syndrome. Retrospective investigations into this effect are ongoing, including the potential role of Zika virus and other possible factors. A similar observation of increased Guillain-Barré syndrome was also made in 2015 in the context of the first Zika virus outbreak in Brazil.
In 2015, local health authorities in Brazil also observed an increase in babies born with microcephaly at the same time of an outbreak of Zika virus. Health authorities and agencies are now investigating the potential connection between microcephaly and Zika virus, in addition to other possible causes. However more investigation and research is needed before we will be able to better understand any possible link.
Guillain-Barré syndrome is a condition in which the body’s immune system attacks part of the nervous system. It can be caused by a number of viruses and can affect people of any age. Exactly what triggers the syndrome is not known. The main symptoms include muscular weakness and tingling in the arms and legs. Severe complications can occur if the respiratory muscles are affected, requiring hospitalisation. Most people affected by Guillain-Barré syndrome will recover, although some may continue to experience effects such as weakness.
Should pregnant women be concerned about Zika?
Health authorities are currently investigating a potential link between Zika virus in pregnant women and microcephaly in their babies. Until more is known, women who are pregnant or planning to become pregnant should take extra care to protect themselves from mosquito bites.
If you are pregnant and suspect that you may have Zika virus disease, consult your doctor for close monitoring during your pregnancy.
What is microcephaly?
Microcephaly is a rare condition where a baby has an abnormally small head. This is due to abnormal brain development of the baby in the womb or during infancy. Babies and children with microcephaly often have challenges with their brain development as they grow older.
Microcephaly can be caused by a variety of environmental and genetic factors such as Downs syndrome; exposure to drugs, alcohol or other toxins in the womb; and rubella infection during pregnancy.
How is Zika virus disease treated?
The symptoms of Zika virus disease can be treated with common pain and fever medicines, rest and plenty of water. If symptoms worsen, people should seek medical advice. There is currently no cure or vaccine for the disease itself.
How is Zika virus disease diagnosed?
For most people diagnosed with Zika virus disease, diagnosis is based on their symptoms and recent history (e.g. mosquito bites, or travel to an area where Zika virus is known to be present). A laboratory can confirm the diagnosis by blood tests.
What can I do to protect myself?
The best protection from Zika virus is preventing mosquito bites. Preventing mosquito bites will protect people from Zika virus, as well as other diseases that are transmitted by mosquitoes such as dengue, chikungunya and yellow fever.
This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold even small amounts of water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.
Should I avoid travelling to areas where Zika virus is occurring?
Travellers should stay informed about Zika virus and other mosquito-borne diseases and consult their local health or travel authorities if they are concerned.
To protect against Zika virus and other mosquito-borne diseases, everyone should avoid being bitten by mosquitoes by taking the measures described above. Women who are pregnant or planning to become pregnant should follow this advice, and may also consult their local health authorities if travelling to an area with an ongoing Zika virus outbreak.
Based on available evidence, WHO is not recommending any travel or trade restrictions related to Zika virus disease. As a precautionary measure, some national governments have made public health and travel recommendations to their own populations, based on their assessments of the available evidence and local risk factors.
Can El Niňo have an effect on Zika?
The Aedes aegypti mosquito breeds in standing water. Severe drought, flooding, heavy rains and temperature rises are all known effects of El Niño—a warming of the central to eastern tropical Pacific Ocean. An increase in mosquitos can be expected due to expanding and favourable breeding sites. Steps can be taken to prevent and reduce the health effects of El Niño, in particular by reducing the mosquito populations that spread Zika virus. WHO and partners are working together to provide support to ministries of health to:
increase preparedness and response to El Niño;
strengthen any action that helps control mosquito populations such as source reduction measures targeting main mosquito breeding spots, distribution of larvicide (insecticide that is specifically targeted against the larval life stage of the Aedes mosquito) to treat standing water sites that cannot be treated in other ways (cleaning, emptying, covering), etc.;
strengthen vector surveillance (e.g. how many breeding sites in an area, percentage of sites reduced) and
monitor the impact of actions to control the mosquito populations.
Individual households can also help reduce mosquito populations. Containers that can hold even small amounts of clear water such as buckets, flower pots or used tyres should be emptied, cleaned or covered so that mosquitoes cannot use them to breed (including during severe drought).
What gaps do we have in our understanding of Zika virus?
Key issues to be addressed in our understanding of Zika virus disease include:
Epidemiological characteristics of the virus, e.g. its incubation period, the role mosquitoes play in transmitting the virus and its geographical spread.
Potential medical countermeasures (including treatments and vaccines) that can be developed.
How Zika virus interacts with other arboviruses (viruses that are transmitted by mosquitoes, ticks and other arthropods) such as dengue.
Development of more specific laboratory diagnostic tests for Zika virus that can reduce misdiagnosis that may occur due to the presence of dengue or other viruses in a test sample.
Where does Zika virus occur?
Zika virus occurs in tropical areas with large mosquito populations, and is known to circulate in Africa, the Americas, Southern Asia and Western Pacific.
Zika virus was discovered in 1947, but for many years only sporadic human cases were detected in Africa and Southern Asia. In 2007, the first documented outbreak of Zika virus disease occurred in the Pacific. Since 2013, cases and outbreaks of the disease have been reported from the Western Pacific, the Americas and Africa. Given the expansion of environments where mosquitoes can live and breed, facilitated by urbanisation and globalisation, there is potential for major urban epidemics of Zika virus disease to occur globally.
How do people catch Zika virus?
People catch Zika virus by being bitten by an infected Aedes mosquito – the same type of mosquito that spreads dengue, chikungunya and yellow fever.
How does Aedes mosquito reproduce?
Only female mosquitoes bite; they are intermittent feeders and prefer to bite more than one person. Once the female mosquito is fully fed, it needs to rest 3 days before it lays eggs. The eggs can survive up to 1 year without water. Once water is available, and small quantities of standing water are sufficient, the eggs develop into larvae and then adult mosquitoes. Mosquitoes get infected from people with the virus.
Where can the Aedes mosquito survive?
There are 2 types of Aedes mosquito capable of transmitting the Zika virus. In most cases, Zika spreads through the Aedes aegypti mosquito in tropical and subtropical regions. The Aedes aegypti mosquito does not survive in cooler climate temperatures. The Aedes albopictus mosquito can also transmit the virus. This mosquito can hibernate and survive cooler temperature regions.
Can the Aedes mosquito travel from country to country and region to region?
The Aedes mosquito is a weak flyer; it cannot fly more than 400 meters. But it may inadvertently be transported by humans from one place to another (e.g. in the back of the car, plants). If it can survive the temperature climate of the destination, it may theoretically be capable of reproducing itself there and introduce Zika virus to new areas.
What are the symptoms of Zika virus disease?
Zika virus usually causes mild illness; with symptoms appearing a few days after a person is bitten by an infected mosquito. Most people with Zika virus disease will get a slight fever and rash. Others may also get conjunctivitis, muscle and joint pain, and feel tired. The symptoms usually finish in 2 to 7 days.
What might be the potential complications of Zika virus?
Because no large outbreaks of Zika virus were recorded before 2007, little is currently known about the complications of the disease.
During the first outbreak of Zika from 2013 - 2014 in French Polynesia, which also coincided with an ongoing outbreak of dengue, national health authorities reported an unusual increase in Guillain-Barré syndrome. Retrospective investigations into this effect are ongoing, including the potential role of Zika virus and other possible factors. A similar observation of increased Guillain-Barré syndrome was also made in 2015 in the context of the first Zika virus outbreak in Brazil.
In 2015, local health authorities in Brazil also observed an increase in babies born with microcephaly at the same time of an outbreak of Zika virus. Health authorities and agencies are now investigating the potential connection between microcephaly and Zika virus, in addition to other possible causes. However more investigation and research is needed before we will be able to better understand any possible link.
Guillain-Barré syndrome is a condition in which the body’s immune system attacks part of the nervous system. It can be caused by a number of viruses and can affect people of any age. Exactly what triggers the syndrome is not known. The main symptoms include muscular weakness and tingling in the arms and legs. Severe complications can occur if the respiratory muscles are affected, requiring hospitalisation. Most people affected by Guillain-Barré syndrome will recover, although some may continue to experience effects such as weakness.
Should pregnant women be concerned about Zika?
Health authorities are currently investigating a potential link between Zika virus in pregnant women and microcephaly in their babies. Until more is known, women who are pregnant or planning to become pregnant should take extra care to protect themselves from mosquito bites.
If you are pregnant and suspect that you may have Zika virus disease, consult your doctor for close monitoring during your pregnancy.
What is microcephaly?
Microcephaly is a rare condition where a baby has an abnormally small head. This is due to abnormal brain development of the baby in the womb or during infancy. Babies and children with microcephaly often have challenges with their brain development as they grow older.
Microcephaly can be caused by a variety of environmental and genetic factors such as Downs syndrome; exposure to drugs, alcohol or other toxins in the womb; and rubella infection during pregnancy.
How is Zika virus disease treated?
The symptoms of Zika virus disease can be treated with common pain and fever medicines, rest and plenty of water. If symptoms worsen, people should seek medical advice. There is currently no cure or vaccine for the disease itself.
How is Zika virus disease diagnosed?
For most people diagnosed with Zika virus disease, diagnosis is based on their symptoms and recent history (e.g. mosquito bites, or travel to an area where Zika virus is known to be present). A laboratory can confirm the diagnosis by blood tests.
What can I do to protect myself?
The best protection from Zika virus is preventing mosquito bites. Preventing mosquito bites will protect people from Zika virus, as well as other diseases that are transmitted by mosquitoes such as dengue, chikungunya and yellow fever.
This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold even small amounts of water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.
Should I avoid travelling to areas where Zika virus is occurring?
Travellers should stay informed about Zika virus and other mosquito-borne diseases and consult their local health or travel authorities if they are concerned.
To protect against Zika virus and other mosquito-borne diseases, everyone should avoid being bitten by mosquitoes by taking the measures described above. Women who are pregnant or planning to become pregnant should follow this advice, and may also consult their local health authorities if travelling to an area with an ongoing Zika virus outbreak.
Based on available evidence, WHO is not recommending any travel or trade restrictions related to Zika virus disease. As a precautionary measure, some national governments have made public health and travel recommendations to their own populations, based on their assessments of the available evidence and local risk factors.
Can El Niňo have an effect on Zika?
The Aedes aegypti mosquito breeds in standing water. Severe drought, flooding, heavy rains and temperature rises are all known effects of El Niño—a warming of the central to eastern tropical Pacific Ocean. An increase in mosquitos can be expected due to expanding and favourable breeding sites. Steps can be taken to prevent and reduce the health effects of El Niño, in particular by reducing the mosquito populations that spread Zika virus. WHO and partners are working together to provide support to ministries of health to:
increase preparedness and response to El Niño;
strengthen any action that helps control mosquito populations such as source reduction measures targeting main mosquito breeding spots, distribution of larvicide (insecticide that is specifically targeted against the larval life stage of the Aedes mosquito) to treat standing water sites that cannot be treated in other ways (cleaning, emptying, covering), etc.;
strengthen vector surveillance (e.g. how many breeding sites in an area, percentage of sites reduced) and
monitor the impact of actions to control the mosquito populations.
Individual households can also help reduce mosquito populations. Containers that can hold even small amounts of clear water such as buckets, flower pots or used tyres should be emptied, cleaned or covered so that mosquitoes cannot use them to breed (including during severe drought).
What gaps do we have in our understanding of Zika virus?
Key issues to be addressed in our understanding of Zika virus disease include:
Epidemiological characteristics of the virus, e.g. its incubation period, the role mosquitoes play in transmitting the virus and its geographical spread.
Potential medical countermeasures (including treatments and vaccines) that can be developed.
How Zika virus interacts with other arboviruses (viruses that are transmitted by mosquitoes, ticks and other arthropods) such as dengue.
Development of more specific laboratory diagnostic tests for Zika virus that can reduce misdiagnosis that may occur due to the presence of dengue or other viruses in a test sample.
Zika Virus Infection will Become a Panenmic
Key facts About Zika Virus
Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
There is no specific treatment or vaccine currently available.
The best form of prevention is protection against mosquito bites.
The virus is known to circulate in Africa, the Americas, Asia and the Pacific.
Introduction
Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.
Genre: Flavivirus
Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
Reservoir: Unknown
Signs and Symptoms
The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days.
During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.
Transmission
Zika virus is transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.
Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013 (Yap and French Polynesia, respectively), and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). In addition, more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus.
Diagnosis
Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever.
Prevention
Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.
This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.
Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.
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.
Travellers should take the basic precautions described above to protect themselves from mosquito bites.
Treatment
Zika virus disease is usually relatively mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available.
Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
There is no specific treatment or vaccine currently available.
The best form of prevention is protection against mosquito bites.
The virus is known to circulate in Africa, the Americas, Asia and the Pacific.
Introduction
Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.
Genre: Flavivirus
Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
Reservoir: Unknown
Signs and Symptoms
The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days.
During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.
Transmission
Zika virus is transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.
Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013 (Yap and French Polynesia, respectively), and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). In addition, more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus.
Diagnosis
Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever.
Prevention
Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.
This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.
Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.
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.
Travellers should take the basic precautions described above to protect themselves from mosquito bites.
Treatment
Zika virus disease is usually relatively mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available.
Zika Virus Will become
Key facts About Zika Virus
Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
There is no specific treatment or vaccine currently available.
The best form of prevention is protection against mosquito bites.
The virus is known to circulate in Africa, the Americas, Asia and the Pacific.
Introduction
Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.
Genre: Flavivirus
Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
Reservoir: Unknown
Signs and Symptoms
The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days.
During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.
Transmission
Zika virus is transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.
Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013 (Yap and French Polynesia, respectively), and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). In addition, more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus.
Diagnosis
Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever.
Prevention
Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.
This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.
Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.
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.
Travellers should take the basic precautions described above to protect themselves from mosquito bites.
Treatment
Zika virus disease is usually relatively mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available.
Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
There is no specific treatment or vaccine currently available.
The best form of prevention is protection against mosquito bites.
The virus is known to circulate in Africa, the Americas, Asia and the Pacific.
Introduction
Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.
Genre: Flavivirus
Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
Reservoir: Unknown
Signs and Symptoms
The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days.
During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.
Transmission
Zika virus is transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.
Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013 (Yap and French Polynesia, respectively), and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). In addition, more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus.
Diagnosis
Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever.
Prevention
Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.
This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.
Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.
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.
Travellers should take the basic precautions described above to protect themselves from mosquito bites.
Treatment
Zika virus disease is usually relatively mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available.
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