Zika threat in Kerala can undo COVID-19 containment efforts, fear health experts

Zika infections in Thiruvanathapuram have created shock waves in cities that have a perennial mosquito problem

By K A Shaji
Published: Tuesday 13 July 2021
Zika threat in Kerala can undo pandemic gains, say experts

Zika virus infection is turning into a significant public health concern in Kerala although the 15 patients in the state capital Thiruvananthapuram have already recovered and no new cases have been reported anywhere else.

Kerala was the only Indian state to have reported cases of Zika infection recently. This was at a time when the state was unable to tackle the rising novel coronavirus disease (COVID-19) cases.

The prevailing Zika virus threat is likely to undo state's early achievements to contain the COVID-19 pandemic, according to health experts.

Two months ago, Kerala's northern city, Kozhikode, suffered from the Shigella virus.

Areas of Kozhikode districts like Perambra and Nadapuram witnessed a large-scale outbreak of the Nipah virus before Kerala reported India's first cases of the COVID-19.

The state is treating the Zika virus threat seriously, according to TS Anish, a member of Kerala's expert committee on pandemics.

Thiruvananthapuram has better wastewater and garbage treatment facilities. So, the mosquito population in the region remained low.

Zika infections in Thiruvanathapuram have created shock waves in Kochi and Alappuzha, which are infamous for mosquito menace.

Mosquitoes have been a perennial problem in these two cities surrounded by still backwaters and canals. Heaps of waste on roadsides despite government awareness campaigns also provides for a breeding ground for the disease-spreading insects.

Efforts are already on to prevent transmission of Zika infection to pregnant women, said Thiruvananthapuram district collector Navjot Khosa. “Also, steps have been taken to spoil mosquito breeding indoors and peridomestic areas.”

Fever clinics have been started across the state and existing facilities against mosquito menace have been strengthened, said Kerala's Health Minister Veena George. A massive Zika awareness campaign is also underway in the state, she added.

Dr SS Lal, a leading public health expert, said:

It is a shame for Kerala that it is still facing the mosquito threat despite its achievements over the years in setting standards in public health. In recent years, there have been numerous efforts to eliminate mosquitoes but with little or no effect. We have to prevent the appearance of the virus in Kochi and Alappuzha by any means as they are more vulnerable.

Three days after the virus infection was reported in Thiruvananthapuram, shops have started selling mosquito nets in different shapes, sizes and colours and people have indulged in panic buying. Rich and poor, young and old, people have queued up to buy nets and mosquito repellants.

"Kerala has a long history of mosquito-borne diseases but Thiruvananathapuram is a new entrant into the list of affected areas,” said Amar S Fette, Kerala’s nodal health officer.

There are possibilities of infective vectors reaching new areas as climate change becomes the new reality, he added.

The first case in Kerala was detected in a pregnant woman from the border town of Parassala. Experts from Kerala's vector control unit and the state's entomology and disease surveillance units visited the area where the 24-year-old resided.

The patient didn’t have a travel history but her home is not far from the Kerala-Tamil Nadu border. Alerts have been sent to all district administrations to keep a close eye on cases of mosquito bites and conduct necessary fumigation drives.

Subsequent cases have been reported mainly among health workers.

Deaths from Zika are sporadic and less dangerous compared to measles and Ebola.

Warming temperatures associated with climate change are expected to expand the range of Aedes mosquitos, putting tens of millions more people at risk for Zika and other mosquito-borne diseases.

"The 15 cases detected in humans in Kerala were mild," said Palakkad-based health expert Dr NM Arun. Brazil had experienced a severe Zika outbreak in 2015-16, with over 321,000 suspected and confirmed cases, followed by Colombia and Venezuela, he said.

Global studies have confirmed that women infected with the Zika virus during their early pregnancy stages are 17 times more likely to have a child with microcephaly.

They also confirmed that one-third of children aged three years or younger exposed to the Zika virus experienced below-average neurodevelopment and eye abnormality or hearing assessments during their mother's pregnancy.

"There are possibilities of future endemics when the virus, perhaps after some evolution, jumps back into the human population. An enormous amount of research needs to be done across the country," said Lal.

“Eradicating these mosquitoes will also bring several other diseases under control, including dengue,” he said.

Around 87 countries and territories had evidence of current or previous mosquito-borne Zika transmission, according to WHO. "People living in or travelling under the risk of transmission should protect themselves from mosquito bites. Government must evolve measures to prevent people's exposure to mosquito-borne diseases," said Arun.

As many as 118 species of mosquitoes under 15 genera have been recorded from Kerala so far by experts. “There is no place in Kerala that is exempted from mosquito menace, according to the health minister.

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