The Zika Virus

Zika, meaning “overgrowth,” earned its name not by its recent South American epidemic, but instead from the name of the forest in Uganda where it was first isolated in 1947. An arbovirus of the flavivirus family, Zika is related to other South American viruses like dengue, chikingunya, and yellow fever which spread via mosquitos. And while mosquitos remain the principle vector for transmission, reports of lateral transmission via sexual contact and other forms have surfaced in the literature. In our latest BrainWaves episode, Dr. Ana Cristancho (a pediatric neurology resident) interviews an infectious disease specialist, Dr. Jennifer McGuire, on this hot topic.

There is entirely too much to summarize here regarding Zika, and there are hundreds of manuscripts in circulation discussing the various aspects of the disease. In this episode, Dr. Cristancho leads an impressive interview and was able to cover most of the critical points in only 20 minutes.

While only 1 in 5 patients with Zika develop any symptoms at all, the concerns shared by health officials pertain to the type of symptoms that 1 patient will experience. For the most part, patients develop a rash, some fever, malaise, and the virus courses through the human body like any run-of-the-mill cold virus. In rare cases, patients have developed guillain barre syndrome, meningoencephalitis, and a number of fetal complications among pregnant women–including microcephaly.

zikamap

Map of Zika activity (as of July 26, 2016). From http://www.cdc.gov/zika/geo/active-countries.html.

At the end of the interview, one of the questions we are left with is, “How will this outbreak affect the USA?” Because the virus is largely spread via Aedes mosquito species (except for cases with reported spread by semen and saliva), we should only anticipate Zika to affect areas of the continental US where Aedes species are endemic (see map below). Finally, on July 29, 2016, government officials confirmed the first 4 cases of transmission of Zika in the United States–Miami, Florida.

aedes_map

Map of Aedes mosquitos in the USA, indicating possible sites for Zika propagation. From http://www.cdc.gov/zika/vector/index.html.

Due to ease of international travel, and the upcoming Olympic Games, health organizations are expecting additional spread of the virus beyond Central and South America. It is imperative that public health officials and healthcare providers continue to encourage their patients to implement safe practices–such as avoiding travel in the 6 month period prior to attempted pregnancy (as well as during pregnancy!), stifling the propagation of mosquito species in your area (e.g., eliminating any reservoirs of stagnant water), and using effective mosquito repellents. Olympic patrons are encouraged to continue supporting this international celebration, but they should do so safely!

 

[Jim Siegler]


This episode was vetted and approved by Jennifer McGuire.

REFERENCES

Bogoch, II, Brady OJ, Kraemer MU, German M, Creatore MI, Kulkarni MA, Brownstein JS, Mekaru SR, Hay SI, Groot E, Watts A and Khan K. Anticipating the international spread of Zika virus from Brazil. Lancet. 2016;387:335-6.

Campos GS, Bandeira AC and Sardi SI. Zika Virus Outbreak, Bahia, Brazil. Emerg Infect Dis. 2015;21:1885-6.

Duffy MR, Chen TH, Hancock WT, Powers AM, Kool JL, Lanciotti RS, Pretrick M, Marfel M, Holzbauer S, Dubray C, Guillaumot L, Griggs A, Bel M, Lambert AJ, Laven J, Kosoy O, Panella A, Biggerstaff BJ, Fischer M and Hayes EB. Zika virus outbreak on Yap Island, Federated States of Micronesia. The New England journal of medicine. 2009;360:2536-43.

Hayes EB. Zika virus outside Africa. Emerg Infect Dis. 2009;15:1347-50.

Mlakar J, Korva M, Tul N, Popovic M, Poljsak-Prijatelj M, Mraz J, Kolenc M, Resman Rus K, Vesnaver Vipotnik T, Fabjan Vodusek V, Vizjak A, Pizem J, Petrovec M and Avsic Zupanc T. Zika Virus Associated with Microcephaly. The New England journal of medicine. 2016;374:951-8.

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