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 The World Health Organization on Friday said the Zika outbreak is no
longer a public health emergency, putting the virus in the same
category as other mosquito-born illnesses like malaria and yellow
fever.
This ended an emergency declaration in place since February due to
clusters of brain damage and birth defects among babies born in
areas where the virus was spreading.
“I think the travel advisories still should hold,” said Dr. Davidson
Hamer, a global public health researcher at Boston University who
led the new study.
“While the epidemic has slowed down in the Americas, there remains a
threat of Zika there, and increased recognition (and local outbreaks
like in Singapore) in Southeast Asia and the South Pacific mean that
there is a continued risk in many parts of the world,” Hamer added
by email.
The current study uses data reported by the GeoSentinel Surveillance
Network to assess the extent and characteristics of Zika virus
infections caught by global travelers.
Zika virus has spread rapidly throughout Latin America and the
Caribbean since its initial identification in the Americas in Brazil
in 2015, researchers note in the Annals of Internal Medicine.
Although infections are asymptomatic or relatively mild in
approximately 80 percent of cases, serious complications have been
described including neurologic disorders such as Guillain-Barre
syndrome and inflammation in the spinal cord and brain. The virus is
also linked to miscarriages, premature deliveries, severe birth
defects and infant deaths.
Researchers examined data on 102 patient cases reported to the
surveillance network with a Zika diagnosis between January 2013 and
February 2016. This included 64 confirmed Zika cases, 13 probable
cases, and 16 clinically suspect cases.
Of the 93 patients with confirmed or possible Zika cases, 62 percent
were female and half were at least 41 years old.
Roughly half of these travelers were tourists, while 39 percent were
visiting friends or family and 8 percent were on business trips.
The top five countries where Zika virus was acquired include
Suriname (22 percent), Colombia (17 percent), Brazil (11 percent),
Martinique (11 percent) and Venezuela (8 percent).
Half of the travelers had spent at least 22 days in the country
where they contracted the virus.
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Among the 93 confirmed or suspected Zika cases, 72 people had tests
for the virus done on at least one bodily fluid and 57 of the tested
individuals were positive, the study found. The virus was detected
in blood alone in 30 patients, in urine alone in 10 patients, in
blood and urine in 12 patients, in urine and saliva in 2 patients,
in urine and semen in one patient, and in semen alone in 2 patients.
Researchers found nine cases when blood tests for Zika were negative
but the virus was detected in other fluids.
These test results highlight the need for a standardized diagnostic
screening for Zika virus that can be used worldwide, said Mark A.
Wainberg, a microbiologist at McGill University in Montreal who
wasn’t involved in the study.
“The use of (blood) testing is problematic and confuses Zika with
dengue and chikungunya,” two other viruses transmitted to people by
mosquitoes, Wainberg said.
While people may not necessarily need to cancel travel plans or
panic, they should still take precautions to avoid contracting the
virus, Wainberg said by email.
“Use of mosquito repellant and doing whatever can be done to prevent
mosquito bites is a good idea,” Wainberg said.
Recent evidence also suggests Zika can be transmitted through sexual
contact.
That means women who are pregnant or planning to conceive soon after
travel should defer trips to areas where the virus is spreading –
and so should their male partners, Hamer said. If they do visit
areas where Zika is a known problem, they should use condoms to
avoid pregnancy for at least two to six months after travel.
SOURCE: http://bit.ly/2fazTFW Annals of Internal Medicine, online
November 21, 2016.
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