As Zika virus cases rise, ICMR urges states to increase testing, check negative dengue and chikungunya cases too

The warning comes after states, including Maharashtra, reported rising number of patients infected with the Zika virus.

“States governments and agencies should focus on enhanced surveillance… States should test dengue and chikungunya negative cases for zika virus,” an ICMR scientist aware of the matter, requesting not to be named, told Mint.

In 2016, the World Health Organisation (WHO) had declared Zika virus as a ‘public health emergency of international concern’ after the outbreak was reported in some South American and Caribbean countries.

“Zika virus was first detected in India in 2016. During covid pandemic, we found the virus in 16 states. Since there is a prevalence of viruses in the country, Zika virus outbreak will also occur like dengue outbreak… In the past, we have seen sporadic cases in Uttar Pradesh, Rajasthan, Kerala,” the ICMR scientist added.

Following WHO’s classification of Zika virus infection as a public health emergency, India had initiated sentinel surveillance of the virus in March 2016 and since then, sporadic cases have been reported in Gujarat (2016) and Tamil Nadu (2017), among other places.

Queries sent to the health ministry spokesperson remained unanswered.

Limited testing, a challenge

This time, Asian strains of Zika—a vector-borne virus spread by Flavivirus, transmitted through the bite of infected Aedes dengue mosquitoes—have been found circulating in the country.

“In the past, both the strains—Brazilian and Asian—were found in India. However, this year, it is the Asian lineage of the virus,” said another ICMR scientist that Mint spoke to.

The research body is concerned about limited testing, which could result in underreporting of Zika virus cases in the country. “Zika virus is a raising concern in India. Hence, continuous and strengthened surveillance is required throughout the year to enhance detection and implementation of control measures with an increased pace of testing,” the scientist explained.

This year, Maharashtra has reported eight cases from Pune (6), Kolhapur (1) and Sangamner (1).

The scientist further explained that the government is constantly monitoring patients reporting febrile (caused by fever) illness and pregnant mothers residing in affected states.

“There is an upsurge in mosquito-borne diseases so the cases might go up. This time, it is the Asian lineage of Zika in circulation which was (prevalent) during covid 2021,” the scientist added.

Testing in antenatal care

The need for widespread testing is more acute as there are no vaccines for the virus yet. Although vaccine development for the virus has been fast-tracked throughout the world due to the implications of ZIKV (Zika virus) infection for pregnant women and their newborns.

With the virus linked to congenital malformations, a major hurdle to overcome in developing a vaccine for it, is the need to ensure that it’s safe for pregnant women and their children.

As Zika is associated with microcephaly and other neurological consequences in the foetus of an affected pregnant lady, the central government has also asked doctors to closely monitor pregnant women for Zika virus infection.

“Around 70-80% of people remain asymptomatic and mildly symptomatic people recover gradually. The concern is for pregnant women. If they get infected by Zika virus, in 1 in 15,000 cases, we may find the baby having abnormality due to microcephaly—a condition in which baby’s brain has not developed properly during pregnancy or stopped growing after birth,” said Dr Sujeet Singh, former head of National Centre for Disease Control (NCDC).

“Rather than going for mass testing of pregnant mothers—like it is being done in Pune and creating panic in the society—the government should make Zika testing mandatory in the antenatal screening. The need is for the first-three months because termination is possible during this time. However, beyond this time frame—it is difficult to do so,” Singh added.