Early diagnosis and containment are key to controlling Zika

Containment efforts over the next week will determine how the outbreak shapes up across the country

How quickly India contains its biggest ever zika virus outbreak, which has so far infected 80 people in Jaipur, is a test for the country’s newly established outbreak-response preparedness that screens humans and animals for viruses such as Avian influenza, H1N1, zika and Nipah. Following the H1N1 pandemic that spread to 74 countries across five continents within three months of the virus being identified in central Mexico in April 2009, India set out to decentralise its diagnostic capabilities from two overburdened labs to every region. Four years ago, all outbreaks of unknown aetiology were tested at the National Institute of Virology in Pune and the National Centre for Disease Control in New Delhi, resulting in backlogs and delays. Realising the imperative of rapid diagnosis of outbreaks and continuous monitoring of existing and new virus strains, the Centre gave its nod to setting up a chain of Virus Research & Diagnostic Laboratories (VRDL) across India in June, 2013. The 86 labs that have been set up since include ones at Kasturba Medical College, Manipal, which identified the Nipah outbreak in Kerala this year, and at Jaipur’s Sawai Man Singh Hospital (inaugurated on May 1), which confirmed this year’s first zika case.

A man leaves with garbage cans from a guarded by the police as it has been quarantined in view of Zika cases, Jaipur. Zika, which has been reported in 86 countries, was first reported in India with three cases in Ahmedabad in February, 2017, which was followed by one case in Krishnagiri in Tamil Nadu in July(Himanshu Vyas/Hindustan Times)

Diagnosis, however, can go just that far. Quarantining patients to ensure mosquitoes that feed on their infected blood do not spread the disease and tracking people for fever in a 3-km radius of patient zero are the first steps in rapid containment. The giant leap is sanitising the neighbourhood of both adult mosquitoes and their larvae to break the cycle of mosquito breeding for one week to break the incubation period of the virus.

Zika, which has been reported in 86 countries, was first reported in India with three cases in Ahmedabad in February, 2017, followed by one case in Krishnagiri in Tamil Nadu in July. The infection causes flu-like symptoms in healthy people, but it is deadly for pregnant women as it puts their unborn children at risk of microcephaly, a birth defect in which the baby’s head is smaller than normal. Each year, 26 million babies are born in India, of which one in five (21.1%) are not born in a clinic or hospital, according to National Family Health Survey (NFHS-4). If zika becomes endemic in underserved areas where pregnant women miss regular antenatal screenings, thousands of babies will be at risk of subnormal brain development. Containment efforts over the next week will determine how the outbreak shapes up, not just in Jaipur, but in all of India.