ZIKA VIRUS INFECTION

emerging public health concern

Dr.T.V.Rao MD

01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

HISTORY OF ZIKA VIRUS

The virus was first isolated in April 1947 from a rhesus
macaque monkey that had been placed in a cage in
the Zika Forest of Uganda, near Lake Victoria, by the
scientists of the Yellow Fever Research Institute. A
second isolation from the mosquito A. africanus
followed at the same site in January 1948. When the
monkey developed a fever, researchers isolated from
its serum a transmissible agent that was first
described as Zika virus in 1952
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

ZIKA VIRAL INFECTION IS ARBOVIRUS

INFECTION
Zika virus (ZIKV) is a
member of the
Flaviviridae virus
family and the
Flavivirus genus,
transmitted by
daytime-active Aedes
mosquitoes, such as A.
aegypti
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

ZIKA VIRUS IS A RNA VIRUS

ZIKV is an RNA virus containing
10,794 nucleotides encoding 3,419
amino acids. It is closely related to
Spondweni virus; the 2 viruses are
the only members of their clade
within the mosquito-borne cluster
of flaviviruses .
Studies in the Zika Forest suggested
that ZIKV infection blunted the
viremia caused by yellow fever
virus in monkeys but did not block
transmission of yellow fever virus .
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

Zika Virus Have Two Lineages

There are two lineages of Zika
virus, the African lineage and the
Asian lineage. Complete genome
sequences of Zika viruses have
been published. Recent
preliminary findings from
sequences in the public domain
uncovered a possible change in
non-structural protein 1 codon
usage that may increase the viral
replication rate in humans
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

ZIKA FEVER KNOWN AS ZIKA DIESEASE

In humans, the virus causes a mild illness known as
Zika fever, Zika, or Zika disease, which since the 1950s
has been known to occur within a narrow equatorial
belt from Africa to Asia. In 2014, the virus spread
eastward across the Pacific Ocean to French Polynesia,
then to Easter Island and in 2015 to Mexico, Central
America, the Caribbean, and South America, where
the Zika outbreak has reached pandemic levels
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

Transmission of ZIKA Virus

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.
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

WHY HUMANS NOW INFECTED WITH ZIKA ?

The virus was identified almost
70 years ago, and so why did it
suddenly begin to affect so many
humans and why has it spread
so fast? Well, scientists believe
that these types of viruses can
evolve very fast, and so Zika
presumably evolved so that it
could be transmitted by the
mosquito
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

10

Transmission rarely from mother to

child
A mother already infected with Zika virus near the time of
delivery can pass on the virus to her new-born around the
time of birth, but this is rare.
It is possible that Zika virus could be passed from mother to
fetus during pregnancy. This mode of transmission is being
investigated.
To date, there are no reports of infants getting Zika virus
through breastfeeding. Because of the benefits of
breastfeeding, mothers are encouraged to breastfeed even
in areas where Zika virus is found
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

11

Through infected blood or sexual contact

Spread of the virus
through blood
transfusion and
sexual contact
have been
reported.
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

12

Many Types of Mosquitos spread Zika viral

infections
Zika virus is transmitted by
daytime-active mosquitoes and
has been isolated from a
number of species in the genus
Aedes, such as A. aegypti, and
arboreal mosquitoes such as A.
africanus, A. apicoargenteus, A.
furcifer, A. hensilli, A.
luteocephalus, and A. vitattus.
Studies show that the extrinsic
incubation period in mosquitoes
is about 10 days
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

13

Zika Virus reported in Many Countries

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.
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

14

ZIKA VIRUS CROSS PLACENTA

Zika virus can migrate
between humans through
sexual contact and it can
also cross the placenta,
affecting an unborn fetus. A
mother already infected
with Zika virus near the time
of delivery can pass on the
virus to her new-born
around the time of birth, but
this is rare.
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

15

Key facts to Know

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.
Studies show that the extrinsic incubation period in mosquitoes is
01-02-2016
Dr.T.V.Rao MD @ Rao's Microbiology on Facebook
16
about 10 days

Who gets Zika virus infection?

Zika virus affects people that have travelled to affected tropical areas
and have been bitten by a mosquito that carries the infection. It is
estimated that only about one in five people carrying the virus
actually develop symptoms from zika virus infection.
For current affected areas worldwide, see Zika-affected areas
information on the US Center for Disease Control (CDC) website. New
Zealand does not have the zika-virus carrying mosquitoes, and to
date, zika virus infection has only been reported in people that have
recently travelled to an affected area. During 20142016, these have
included the Pacific Islands, South East Asia, Central and South
American countries
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

17

What are the complications of zika virus?

Guillain-Barr syndrome
Guillain-Barr syndrome is a rare, rapid-onset form of paralysis. It is
an autoimmune sydrome, and is often triggered by an infection a few
days to weeks earlier. The first case of zika virus infection complicated
by Guillain-Barr syndrome was reported from French Polynesia in
March 2014, and others have occurred in Brazil. Death is rare.

For futher information about Guillain-Barr syndrome, see GuillainBarr Syndrome Fact Sheet, NIH National Institute of Neurolo
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

18

Risk of Zika Virus still under scientific lens

The risk of zika virus infection
damaging a fetus is unknown.
Brazil has reported an increase
in birth defects in babies born
during the recent zika virus
epidemic, specifically:
Foetal microcephaly (small
head)
Intracranial calcifications
(calcium deposits in the brain)
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

19

Testing for Zika Virus

Pregnant mothers with
suspected zika infection,
or that have recently
travelled to an infected
zone, should see their
doctor or midwife. They
should undergo testing
for zika virus . If infection
is confirmed,
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

20

CDC Recommends
CDC recommends serial
ultrasound examination to
monitor foetal growth and
anatomy and referral to a
maternal foetal medicine or
infectious disease specialist with
expertise in pregnancy
management. Amniocentesis
may be considered after 15
weeks of gestation.
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

21

MICROCEPHALY A GREAT CONCERN

01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

22

Raise of Zika Virus

01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

23

Zika Virus Testing Considerations and

Classification
The diagnosis of Zika virus infection is made through
molecular and serologic testing .
This includes reverse transcription-polymerase chain
reaction (RT-PCR) for viral RNA, and immunoglobulin
(Ig) M ELISA and plaque reduction neutralization test
(PRNT) for Zika virus antibodies. Because it is currently
not known which type of testing most reliably
establishes the diagnosis of congenital infection,
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

24

CDC Recommends
CDC recommends both molecular
and serologic testing of infants who
are being evaluated for evidence of a
congenital Zika virus infection . No
commercial tests for Zika virus are
available; Zika virus testing is
performed at CDC and some state
and territorial health departments.
Health care providers should contact
their state or territorial health
department to facilitate testing
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

25

Interim Guidelines for the Evaluation and Testing of Infants with

Possible Congenital Zika Virus Infection United States, 2016
Paediatric health care providers
should work closely with
obstetric providers to identify
infants whose mothers were
potentially infected with Zika
virus during pregnancy (based
on travel to or residence in an
area with Zika virus transmission
and review foetal ultrasounds
and maternal testing for Zika
virus infection .
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

26

Zika virus testing is recommended for

1Infants with microcephaly or intracranial calcifications born
to women who travelled to or resided in an area with Zika
virus transmission while pregnant; or
2) infants born to mothers with positive or inconclusive test
results for Zika virus infection. For infants with laboratory
evidence of a possible congenital Zika virus infection,
additional clinical evaluation and follow-up is recommended.
Health care providers should contact their state or territorial
health department to facilitate testing. As an arboviral
disease, Zika virus disease is a nationally notifiable condition.
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

27

Management and Prevention of Congenital

Zika Virus Infections
1No specific antiviral treatment is available for Zika
virus infections and no vaccine against Zika virus is
available
(2). Treatment of congenital Zika virus infection is
supportive and should address specific medical and
neurodevelopmental issues for the infants particular
needs; investigations are ongoing to better
understand what services will be most effective for
these children as they grow .
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

28

Encouraged to Breast Feed

Mothers are encouraged to
breastfeed infants even in
areas where Zika virus is
found, as available evidence
indicates the benefits of
breastfeeding outweigh any
theoretical risks associated
with Zika virus infection
transmission through breast
milk
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

29

Best way to prevent ZIKA VIRUS INFECTION

The only way to prevent congenital Zika virus infection is to
prevent maternal infection, either by avoiding areas where
Zika virus transmission is ongoing or strictly following steps
to avoid mosquito bites . Mosquito-bite prevention includes
using air conditioning or window and door screens when
indoors, wearing long sleeves and pants, using permethrintreated clothing and gear, and using insect repellents. When
used according to the product label, U.S. Environmental
Protection Agency-registered insect repellents are safe for
pregnant women
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

30

Zika Virus on Notice

In May 2015, the Pan American
Health Organization (PAHO)
issued an alert regarding the
first confirmed Zika virus
infection in Brazil. The outbreak
in Brazil led to reports of
Guillain-Barr syndrome and
pregnant women giving birth to
babies with birth defects and
poor pregnancy outcomes.
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

31

WHAT YOU SHOULD DO

Consequently, people should make
every effort to eradicate mosquitoes
from their living and working
environment, and to avoid being
bitten by mosquitoes. Emptying
standing water from containers
around your house that can become
breeding grounds for mosquitoes,
wearing mosquito repellents and
long-sleeved shirts, and condom use
for sexual intercourse are but some of
the many efforts that individuals can
undertake.
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

32

Is there a vaccine to prevent or

medicine to treat Zika?
No. There is no
vaccine to prevent
infection or
medicine to treat
Zika.
Prevention is the
only available option
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

33

Program Created with Many Resources and need to

refer the current developments
CDC Centre for Disease Control and Prevention Atlanta
NIH National Institute of Health USA
WHO World health organization resources
Derrick Aarons MD, PhD is a consultant
bioethicist/family physician, a specialist in ethical
issues in medicine, the life sciences and research, and
is the ethicist at the Caribbean Public Health Agency
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

34

Personal Information to Many Friends in

the World
I wish to state that I am parting with regular Undergraduate Teaching work
in Medical Colleges in future
I will be associated with Freelancer work with many health organizations in
the world how we perceive infection and Antibiotic Misuse
In future my contributions will be focused in Post graduate students as
freelancer in teaching dynamics of infection and methodology
I you wish my assistance in on matters regarding Medical Microbiology,
Infectious diseases, Hospital infections can be contacted
I am grateful to many in the world including professionals in USA and
Developing countries as my programs are viewed by many millions
Dr.T.V.Rao MD
Email doctortvrao@gmail.com
01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

35

 Program Created by Dr.T.V.Rao MD for Public and Medical

awareness on the Newly Emerging Infection ZIKA with
potential to infect many in the Developed as well as
Developing countries
Email
doctortvrao@gmail.com

01-02-2016

Dr.T.V.Rao MD @ Rao's Microbiology on Facebook

36