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Writer's pictureSanjay Trivedi

India continues to maintain high vigilance about Zika Virus


Cases of vector borne disease (VBD), mainly Dengue and Chikungunya were noticed in the State of Gujarat during post monsoon period last year. The State Government had accordingly planned fever surveillance, vector surveillance and intense vector control activity. One of the blood samples collected during laboratory surveillance during this period from Ahmedabad Municipal Corporation limits tested positive for Zika virus. This sample was retested at National Institute of Virology, Pune and was further confirmed through positive RT-PCR test and virus sequencing at National Institute of Virology, Pune on 3rd January, 2017. This sample was from a 34-year-old female patient admitted to hospital with complaints of fever following delivery of a healthy baby. She had no travel history to any Zika affected country. Following the first case, the surveillance was further strengthened and thousands of blood samples were tested as only a thorough investigation can detect cases, given that 80 % of the cases are asymptomatic. Acute Febrile Illness (AFI) surveillance and testing of antenatal cases were undertaken by the State Government and ICMR in Ahmedabad. This surveillance in total yielded 2 more cases of laboratory confirmed Zika virus disease (samples collected during January and February 2017). The other two cases include a 22-year-old pregnant woman in her 37th week of pregnancy and a 64-year-old male with 8 days history of fever. The Zika virus disease case was reported as part of an answer to a Parliament question raised by Smt. Vanaroja R, MP Loksabha on 17th March, 2017. After due process of investigation and verification of the Zika virus disease cases, WHO was notified of all the three Zika virus disease cases on 15th May, 2017. On 18th November, 2016 WHO had declared that Zika disease infection no longer constituted a Public Health Emergency of International Concern (PHEIC). Since WHO had already withdrawn the notification of Zika virus disease as a PHEIC the case was handled as per our existing protocol. As a matter of abundant caution, measures to contain local transmission were carried out in the affected area. No further samples taken during antenatal screening and acute febrile illness surveillance have tested positive for Zika virus disease. The ongoing country-wide Zika laboratory based surveillance in India has so far tested 36613 human samples and 16571 mosquito samples for the presence of Zika virus. No other sample has been tested positive apart from the three laboratory confirmed cases reported from Ahmedabad. India’s response to Zika Virus Disease outbreak • Following the Declaration of Zika virus disease as a Public Health emergency of International Concern (PHEIC) in February,2016, Government has been taking adequate steps to prevent, detect and respond to the situation. The notification for Zika being a PHEIC was withdrawn by WHO on 18th November, 2016. However, India continues to maintain high vigilance and surveillance on the issue. • National Guidelines and Action Plan (with scenario based approach) on Zika virus disease have been prepared and shared with the States to prevent outbreak of Zika virus disease and containment of spread in case of any outbreak. • An Inter – Ministerial Task Force has been set up under Chairmanship of Secretary (Health & FW) with Secretary (Bio – Technology), Secretary (Department of Health Research) as members. • The Joint Monitoring Group, a Technical group under DGHS, tasked to monitor emerging and re-emerging diseases is regularly reviewing the situation on Zika virus disease. • All the International Airports / Ports have displayed signage providing information for travelers on Zika virus disease and to report if they are returning from any of the affected countries and suffering from febrile illness. • Integrated Disease Surveillance Programme (IDSP) is tracking for clustering of acute febrile illness in the community. It has also sensitized its State and District Rapid Response Teams. • In addition to National Institute of Virology, Pune, and NCDC, Delhi, 25 laboratories have been strengthened by Indian Council of Medical Research for laboratory diagnosis. • In addition, 3 entomological laboratories are conducting Zika virus testing on mosquito samples. 6 more Laboratories staff have been trained for vector surveillance for Zika virus. • The ICMR has tested 36613 human samples and 16571 mosquito samples for the presence of Zika virus. No positive case has been detected after the above three cases were found. • The Rashtriya Bal Swasthya Karyakram (RBSK) is monitoring microcephaly from 55 sentinel sites. As of now, no increase in number of cases / clustering of microcephaly has been reported from these centers. • A 24x7 control room (011-23061469) is functioning from Directorate General of Health Services. The situation is being monitored closely.

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