06272017What's Hot:

India Acknowledges Three Cases of Zika Virus

The Zika virus attracted global attention in late 2015 when a surge in the number of babies born with microcephaly — abnormally small heads and brain damage — was seen in northeastern Brazil several months after an epidemic of the mosquito-borne disease in the region. The W.H.O. declared a global health emergency in February 2016. But no cases were reported in India at that time.

Even so, the cases found in Gujarat are almost undoubtedly not India’s first, Zika experts said. The virus, which was first discovered in Uganda in 1947, was found in India in 1952, according to a study published in Clinical Microbiology Review last year, which noted that antibodies to Zika were found in 17 percent of 196 Indian subjects who were tested then.

Dr. Scott C. Weaver, a virologist at the University of Texas Medical Branch in Galveston who predicted in 2009 that Zika was likely to strike the Americas someday, said it was unlikely that there would be a huge surge in brain damage among Indian babies, because the population probably already has a certain level of immunity from past exposure.

But experts in India said that the country has not done the kind of testing necessary to know whether millions of Indians may have already had the disease, and therefore are immune.

Duane J. Gubler, an expert in mosquito-borne diseases at the Duke-NUS Medical School in Singapore, one of the authors of the 2016 study, said that India “needs to be concerned,” because the virus may have picked up genetic changes that could make it more dangerous than in the past.

The environment in India is ripe for Zika, because of factors like the preponderance of the Aedes aegypti mosquito, the type that carries the virus. The post-monsoon months when mosquitoes swarm, particularly in slum areas where there is standing water and accumulating trash, could produce many more infections.

Two of the three people who tested positive in Ahmedabad were women, and both gave birth to healthy babies, the government said. But those were just two out of about 26 million births in India annually. Experts said testing needed to be stepped up.

The British government has advised pregnant women against traveling to India on account of the risk of the Zika virus.

Indian experts and residents of Ahmedabad were taken aback by the news of the Zika cases in the city. Dr. G. Arunkumar, the head of the Manipal Center of Virus Research at Manipal University, the site of one of the 30 government laboratories that can test for Zika, said he learned of all three of them only after the W.H.O. announcement, months after they were confirmed.

“That is not the standard practice,” he said, adding that the government officially reported its first cases of another worrisome virus, H1N1, almost immediately after detection. That virus caused a large number of deaths in Mexico in 2009.

“It would have been better if it were released earlier,” Doctor Arunkumar said of the news about Zika. “That would have given an opportunity for press attention, and that could have been used for a positive response to control measures.”

The Ahmedabad Municipal Corporation started a major drive against mosquitoes in four areas of the city at the request of the Gujarat state government, according to Bhavin Joshi, a city health official. But at the time, he said, no one knew why.

“We didn’t find out until the state government recently declared a few days back,” he said.

The first case was mentioned by the national government in March in response to a question in Parliament, but it attracted little attention and was not a formal report.

Doctor Swaminathan said that across the country, some 40,000 samples have been tested for Zika since July of last year, and aside from the three reported cases in Ahmedabad, none had come up positive. Those tests, though, if they are for the virus itself, would detect recent active infections, not past exposure that could convey immunity.

In addition, 18,000 mosquitoes have been tested, including 500 from the Bapunagar area in Ahmedabad, where two of the Zika cases were reported, Doctor Swaminathan said; those, too, were negative, and officials had not detected any upsurge in microcephaly cases.

If large numbers of people hear reports of Zika and rush to be tested, they could overwhelm the country’s testing laboratories, she said. .

“In general, keeping the public informed is a good principle to follow in public health — that’s what I believe,” Doctor Swaminathan said. “But every situation demands a decision that needs to be made. We have to strike a balance between what is practical and feasible, and what is a risk or danger to society.”

Experts say that until recently, the government did not appear to be testing widely for the disease. Dr. Arunkumar said that many medical colleges had the required facilities, but were not part of the current network of testing labs; it would be up to the health ministry to train their staff, distribute necessary supplies and integrate the colleges into the disease detection system.

“I personally feel we need more stringent surveillance,” he said, in part because many patients infected with Zika have no visible symptoms. “If you don’t have good lab surveillance, you’re not going to detect until it reaches the brim.”

The government is planning to add more laboratories in the coming months, Dr. Swaminathan said.

Residents of the Bapunagar area of Ahmedabad who had heard about the Zika cases in their neighborhood expressed concern and complained that they were not getting information from the government.

“I’m still not exactly sure what it is — I had never heard of its name before,” said a 28-year-old business owner, Ashish Patel, who said his wife is three months pregnant. “I wanted to know more about it immediately, but I still don’t. I don’t understand how it’s spread. I’m scared of getting it, and the thought has worried me all week.”

Source: NYT > World

comments powered by HyperComments

More on the topic