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EDITORIAL

Zika Virus Disease (ZVD): Another viral disease outbreak

Just when we emerged 
from the Ebola virus disease 
outbreak in West Africa, we 
are inundated by another viral 
disease outbreak with possible 
global spread. This time, it is 
not from Africa but from South 
America and specifically from 
two countries namely Brazil 
and Colombia. The Zika virus is 
a mosquito-borne virus disease 
first discovered in 1947 among 

rhesus monkeys from the Zika forest of Uganda, through a 
monitoring network of sylvatic yellow fever.1 

The first human cases were confirmed in 1952 from Uganda and 
Tanzania respectively. Since then, there have been outbreaks in 
various parts of Africa, the Americas, Asia and the Pacific that 
did not attract much attention as the current outbreak in South 
America. In 2013, there was a large outbreak of Zika in French 
Polynesia. In 2015, Brazil and Columbia (South America) and 
Cape Verde (West Africa) reported outbreaks. Then on 1 Feb 
2016, the World Health Organisation (WHO), declared Zika virus 
a public health emergency of international concern.2 Available 
data on 2 March, 2016, indicate that Brazil confirmed 641 cases 
of microcephaly and 139 babies with the birth defect have died 
since the Zika virus outbreak started in October 2015.3

What makes the current outbreak in South America unique has 
been the increase in Guillain-Barré syndrome, which coincided 
with the increase in Zika virus infections in the general population, 
as well as the increase in babies born with microcephaly in north 
east Brazil.1 It is still early days in terms of increasing body of 
evidence on the possible link between the Zika virus infection in 
pregnant mothers and babies born with microcephaly. However, 
it is known that the Aedes species mosquitoes (A. aegypti and 
A. albopictus) transmit the disease, which usually bite during 
the mornings and late afternoons. Researchers are still trying to 
determine the incubation period of the disease. It is postulated 
that the incubation period is probably a few days. The symptoms 
are similar to other arbovirus infections, such as dengue fever, 
chikungunya and yellow fever. It presents with mild fever, 
headaches, skin rashes, muscle/joint pains and conjunctivitis. It 
appears that the “conjunctivitis” may be a distinguishing feature 
of this disease when compared with other arbovirus infections. 
The symptoms are short-lived and last 2-7 days with patients 
fully recovering. 

Zika virus is transmitted from an infected mother to her foetus in 
utero and during birth. To date, there is no reported case of infants 
infected through breast-feeding. However, the virus spreads by 
unprotected heterosexual sexual contact from men who have 
Zika virus symptoms as the virus persists longer in semen than 
in blood. Between 1 Jan 2015 and 24 February 2016, the United 
States of America recorded 107 travel-related Zika virus diseases 
in twenty-six states. The three states with the highest cases were 
Florida (28), New York (17) and Texas (13).4 Obviously, the Zika 
virus outbreaks has introduced a new dimension to the spread 
of the disease beyond the mosquito bite, that is, via unprotected 
sexual intercourse with infected persons. On 20 February 2016, 
South Africa reported its first travel-related case of Zika virus 
disease in a Columbian businessman who visited the country.5

The disease is diagnosed in the serum of suspected infected 
patients through reverse transcriptase-polymerase chain 
reaction (RT-PCR).  The treatment is symptomatic comprising of 
bed rest, adequate fluid intake and analgesics. Currently, there 
is no vaccine against the disease. Prevention follows the same 
precautions against the mosquito bite including the use of 
repellents and insecticides. Should travel be restricted between 
South Africa and Brazil or Columbia? ZVD is a mild disease and 
no death has been reported. However, pregnant women are 
advised against travelling to these countries and men with flu-
like symptoms should be tested for malaria and Zika virus on 
return from these countries. If they test positive for ZVD, they 
should use condoms during sexual intercourse for a reasonable 
period to prevent the possible transmission of the disease. These 
are common sense approaches until we are fully aware of the 
impact of this outbreak in Brazil and Columbia.

Prof. Gboyega A Ogunbanjo 

Editor: SAFPJ

References

1. World Health Organisation. Zika virus 03 March 2016. Available at http://www.who.
int/mediacentre/factsheets/zika/en

2. Centers for Disease Control and Prevention. About Zika Virus Disease. 03 March 
2016. Available at http://www.cdc.gov/zika/about/index.html 

3. The News International. Brazil confirms641 cases of microcephaly amid Zika out-
break. 04 March 2016. Available at http://thenews.com.pk/latest/102329-Brazil-
confirms-641-cases-of-microcephaly-amid-Zika-outbreak 

4. Centers for Disease Control and Prevention. Zika virus disease in the United States, 
2015-2016. 03 March 2016. Available at http://www.cdc.gov/zika/geo/united-states.
html 

5. The Citizen. Columbian man diagnosed with Zika virus in Joburg. 20 February 
2016. Available at http://www.citizen.co.za/1000448/columbian-man-diagnosed-
with-zika-virus-in-joburg/