ZIKA ALERT

a new face of an old

disease

ANILAWATI MAT
JELANI
INFECTIOUS
DISEASE
 Zika : History
Worldwide Malaysia
First isolated in 1969 Zika virus
Uganda in 1947 found in mosquitoes
(Zika forest) in Bentong
rhesus monkey Sept 2014
German visitor
First human case diagnosed with zika
detected in 1952 virus infection upon
return to Germany
after visiting Sabah
 Zika Outbreak Timeline
2007 - 1st large outbreak reported from
the Island of Yap (Federated States of
Micronesia)
May 2015 first case confirmed in Brazil
July - Sept 2015 association with
Gullain Barre Syndrome & microcephaly
Nov 2015 WHO declared public health
emergency in Brazil
1 Feb 2016, WHO declared Zika virus a
public health emergency of international
concern (PHEIC)
27th August 2016
2nd Sept 2016
 1st 3rd
September September
2016 2016
 Zika Virus
Single stranded RNA virus
Flavivirus
Dengue, Japanese Encephalitis, West
Nile and yellow fever
Transmitted to human primarily by
aedes mosquitoes
ZikaV : Transmission
 Human to human
transmission
ZikaV can be
detected :
Semen : up to 6
months
Serum : few days up
to 12 weeks
Saliva : up to 91 days
Female genital tract
(cervical mucus) up
to 2 weeks after
onset of illness
 Clinical course
Incubation period
unknown (3-14 days)
Mild disease
Fever (50%) , Rash (80-
90%)
Symptoms last few days
to a week
Severe disease
requiring hospitalisation
uncommon
Fatalities are rare
ZIKA rash

Distribution :ash
Trunk and
limbs
Rash typically recede
within 2-3 days of
appearance
Strong association between GBS and ZIKA
Van-Mai Cao-Lormean et al, Lancet Feb 29
2016
 Zika virus and pregnancy
Evidence of maternal-fetal transmission
ZikaV infection confirmed in infant with
microcephaly in Brazil
ZikaV identified in specimen of fetal loss
ZikaV identified prenatally in amniotic fluid
2 women at 30 wks POA with sx consistent with
Zika Infection
Fetal microcephaly & intracranial clacification
detected on usg
Amniotic fluid +ve for ZikaV by rt-PCR
Zika Virus and
Microcephaly
 Lab diagnosis
FBC WBC normal/low with
lymphopenia +/- thrombocytopenia
Detection of viral nucleic acid by RT-
PCR
Blood
Urine
 ZIKA : Treatment and
Prevention
Symptomatic
No vaccine available
Avoid mosquitoes bites - repellant
Avoid unnecessary travel to areas
with ongoing ZIKV transmission
Avoid unprotected sexual contact
with partners who are at risk
Controlling mosquito vector
 Not the right time to
conceive ?
Women infected with ZikaV should
wait 8 weeks after symptoms onset
before trying to conceive
Infected men should wait 6 months
Patients who are exposed but
asymptomatic should wait at least 8
weeks
NO AEDES NO DENGUE
NO ZIKA