Making sense of the virus Zika
Paula Benn (pseudonymn used to protect identity), like most Barbadians, has been trying to make sense of the Zika virus as she watched television reports on the latest mosquito-borne threat now making its trek across the globe.
It never even crossed her mind she would be a victim.
“I never actually felt sick, really. I woke up one day, seemingly perfectly fine, but around midday that day, my arms started to itch. I saw this rash and I started thinking, ‘What did I eat that I might be getting an allergic reaction to?’
“I was rubbing and scratching, and then realized my back and stomach also had this rash. I was just rubbing and rubbing and scratching. It covered my chest, arms, and stomach. I sat back down, and soon after my face started itching too.
“I went and looked in the mirror again and the rash in that short space of time had covered my entire face. I was stunned, and by then started to get worried.”
Benn made the trip to her doctor who told her “the rash was most likely Zika”.
“I asked him if he was sure, because I didn’t feel sick at all; I just had the rash. He explained that the virus is very mild and some people actually never get symptoms at all, and the rash would disappear in three to seven days, and may or may not be accompanied by fever and/or pains –– which, to be honest, was information I had read myself and knew. But I guess actually experiencing it was a different story.”
During the night, Benn developed a fever, which she successfully treated with paracetemol. It however returned the next day; but again she used the fever reducer and it disappeared.
By Day 3 of the infection, the rash had started to fade.
Benn who has also suffered a bout of dengue fever, which is transmitted by the same Aedes aegypti mosquito, described the disease as mild.
“Had it not been for the rash, I don’t think I would have realized something was wrong. Dengue, on the other hand, was painful. My joints hurt a lot and I had horrible pain behind my eyes.”
Benn told Health Today she still had no idea when or where she was bitten, though she suspected it was not at home.
“There are three of us in the house and I was the only one infected. At home, my husband and I make sure we don’t have any stagnant water around at all. We are particularly careful, because we have a two-year-old son.”
Benn’s encounter with Zika is likely to be repeated multiple times in Barbados and other Caribbean countries in the months ahead, health experts warned this week.
The World Health Organization has predicted that over four million people could be infected.
At home in the region, executive director of the Caribbean Public Health Agency, Dr James Hospedales, cautioned, that while it was difficult to predict how Zika would manifest itself in the region, the conditions were ripe for infections to rise.
“As with chikungunya, we have good conditions for spread; nothing to be proud of. We have mosquitos abundantly; we have a lot of travel in and out of the region; and we have people who are susceptible.”
Dr Hospedales described the advent of the Zika disease in the Caribbean as historic, saying it “was only rarely in our lives that a new disease emerge and spread throughout the population”.
“Looking ahead, it is difficult to predict what this disease will do –– whether it will pass through in a few months like chikungunya did, or whether it will spread out over a number of years. It’s certainly another significant change in the health and disease landscape in the Caribbean.”
Zika, though once unheard of in our region, was first detected in Uganda, and for decades caused only mild outbreaks across Africa and Asia.
According to doctors, most people with the virus do not actually have symptoms, but some will experience a rash, muscle aches and pains, fever and headache.
Dr Hospedales explained there were two major concerns about the disease: first, microcephaly –– where babies are born with small heads.
“In Brazil, there’s been a big increase: 3,500 cases last year. If that rate was applied to the Caribbean region –– CARPHA member states –– there might be something like 300 cases.
“The second is an increase in a neurological disease called Guillain-Barre syndrome where limbs get weaker and in severe cases the patient may need life support.”
There is no cure or vaccine for Zika, and scientists at the University of Texas’ medical branch, who are leading the search for a vaccine, warn it could be decade before one is publicly available.
Dr Hospedales maintains the only way to keep the virus away is to eradicate the Aedes aegypti mosquito, dismissing suggestions for screening to be introduce at airports.
“A high percentage of people with Zika have no symptoms; so there is no place for screening at airports; it just doesn’t make sense.”
It’s also the strong view of Dr Joy St John, director of surveillance, disease prevention and control at CARPHA, who lamented that the Aedes aegypti mosquito had become like a good family friend in the region.
“The way to control the spread of zika is to make sure they are so few mosquitoes that they aren’t mosquitoes to bite an infected person to spread it to someone who is not infected.”
She also advised regional health authorities to issue clear guidelines to practitioners in both the public and private health sectors and to step up their public education campaigns.
“Health authorities need to make sure that in a hospital setting, if there are suspected cases of Zika, that these samples are taken and sent to us; because we need to characterize how Zika is going to look in the Caribbean. It may look like Brazil or it may not; it may be completely different.
“There were things about H1N1 in the Caribbean that were completely different than elsewhere. So it is important for health authorities to give us information that we can work with it to help characterize what is happening,” she said.