WHO Flags Zika Virus Outbreak in India as a Growing Concern
The World Health Organisation has raised alarms regarding the Zika outbreak in India, highlighting it as an escalating issue that demands attention.
In a recent update, health authorities have reported a cumulative total of 151 cases of Zika virus disease (ZVD) across three states in India during the year 2024. The states affected include Gujarat, Karnataka, and Maharashtra. Maharashtra State has recorded the highest incidence of ZVD cases, totalling 140, as reported by the Integrated Disease Surveillance Program (IDSP). In recent developments, health authorities have reported a total of 125 cases from Pune district. Additionally, Ahmednagar district has identified 11 cases, while Kolhapur, Sangli, and Solapur districts, along with the Mumbai suburban area, have recorded one case each. In a recent update, Karnataka state has confirmed a total of ten cases. The Bengaluru urban district reports seven of these cases, while Shivamogga district reports three. In a recent development, Gujarat state has confirmed a case of Zika virus in the Gandhinagar Corporation area. Health officials are monitoring the situation closely.
The World Health Organisation (WHO) has reported that the number of ZVD cases in Maharashtra in 2024 has reached its highest level since 2021. "In a significant development, Karnataka state has recorded the highest number of cases in 2024 since the initial case was reported in 2022."
As of December 31, 2024, there have been no reported cases of microcephaly or Guillain-Barre syndrome (GBS) linked to this outbreak. Humans primarily contract the Zika virus, also known as ZIKV, through the bite of an infected Aedes mosquito. The transmission of this condition can occur in several ways, including from mother to foetus during pregnancy, through sexual contact, via the transfusion of blood and blood products, and potentially through organ transplantation. Currently, there is no designated treatment for Zika virus infection or the associated disease.
The Zika virus poses a significant threat, especially when it enters populations lacking immunity. This can lead to widespread outbreaks, which in turn places considerable strain on public health resources. It is crucial to conduct surveillance, case management, and differential laboratory diagnostic testing to distinguish ZVD from other mosquito-borne viruses such as dengue and chikungunya. About 60 to 80% of people who get the Zika virus don't have any symptoms or only have mild ones. However, it is important to know that getting the Zika virus can cause serious problems like Guillain-Barré syndrome (GBS), microcephaly, and congenital Zika syndrome (CZS) in pregnant women.
In a significant health development, India confirmed its inaugural case of Zika virus in the state of Gujarat back in 2016. In recent developments, a number of states have reported cases, including Tamil Nadu, Madhya Pradesh, Rajasthan, Kerala, Maharashtra, Uttar Pradesh, Delhi, and Karnataka. Despite ongoing monitoring, there have been no reports of microcephaly associated with ZIKV. In Maharashtra state, the presence of the Zika virus is not surprising due to the widespread distribution of its vectors, Aedes aegypti and Aedes albopictus, throughout India. However, the number of Zika virus disease cases reported in Maharashtra in 2024 has significantly increased compared to previous years, marking a notable and unusual trend.
To prevent ZIKV infection, it is crucial to take protective measures against mosquito bites, particularly during the day and early evening hours. It is crucial to focus on measures that prevent mosquito bites, particularly for pregnant women, women of reproductive age, and young children. Aedes mosquitoes are known to reproduce in small bodies of water found in and around residential areas, educational institutions, and places of employment. To combat the spread of mosquitoes, it is crucial to take proactive measures in eliminating their breeding sites. This can be achieved by covering water storage containers, removing standing water from items like vases and flowerpots, and ensuring that trash, unused containers, and old tires are properly cleaned up. Local community initiatives play a crucial role in helping healthcare authorities and national public health programs minimise mosquito breeding sites. In a proactive approach to public health, authorities are considering the implementation of larvicides and insecticides as measures to diminish mosquito populations and curb the transmission of diseases.
We advise travellers heading to high-risk areas, especially pregnant women, to take essential precautions to protect themselves from mosquito bites. Recommendations for protection against mosquito bites include the use of light-colored, long-sleeved shirts and trousers; the installation of screens in rooms to keep mosquitoes out; and the application of insect repellents containing N-Diethyl-meta-toluamide (DEET), IR3535, or Icaridin, following the instructions on the product label.
In areas where Zika virus transmission is ongoing, it is crucial for individuals suspected of having a Zika virus infection, along with their sexual partners—especially those who are pregnant—to be informed about the potential risks associated with sexual transmission of the virus. The World Health Organisation has issued important recommendations regarding Zika virus infections in sexually active individuals. It emphasises the necessity of proper counselling for both men and women about the implications of a ZIKV infection. The organisation advocates the provision of a comprehensive range of contraceptive methods, enabling couples to make informed decisions regarding pregnancy timing to mitigate the risks of congenital Zika syndrome and other potential adverse outcomes.
In light of the health concerns surrounding the ZIKV infection, it is crucial for women who have engaged in unprotected sexual activity and wish to avoid pregnancy to have immediate access to emergency contraceptive services and counselling. This access is essential for ensuring informed choices and safeguarding reproductive health. It is advised that pregnant women engage in safer sexual practices that include the correct and consistent use of condoms or consider abstaining from sexual activity throughout their pregnancy. Urging pregnant women to participate in their scheduled appointments and engage in improved antenatal care and follow-up is essential. This includes using ultrasound to find microcephaly and other birth defects connected to ZIKV infection during pregnancy, in line with the state and national response plan.
The World Health Organisation has issued guidelines for regions where Zika virus transmission is not currently active. These recommendations emphasise the importance of practicing safe sexual behaviour to mitigate potential risks. Key suggestions include delaying sexual debut, engaging in nonpenetrative sexual activities, ensuring the correct and consistent use of male or female condoms, and limiting the number of sexual partners. Additionally, men returning from areas with active Zika transmission are advised It is advised that sexual partners of pregnant women, particularly those residing in or returning from regions with local transmissions of the Zika virus, engage in safer sex practices or consider abstaining from sexual activity for the duration of the pregnancy.
The World Health Organisation has stated that, based on the currently available information, it does not advise any travel or trade restrictions concerning India.