Prepare for ZIKV

I do not believe in New Year’s resolutions. I figure that if there is a bad habit that you need to dispense of, or a good one that ought to be embraced, there is no better time than the present. But now I am urging all Jamaicans, for 2016, to resolve to do all that we can to fight the Zika virus (ZIKV) and increase public awareness about it. Armed with our knowledge of ZIKV, and being amply warned, we must play our part in preparing our country for what appears to be the inevitable.

The virus is named after the Zika forest in Uganda, where it was first isolated from a rhesus monkey. It was not noted in humans until 1968 in Nigeria. The first outbreak outside of Africa and Asia was in 2007, and now it is in the Caribbean and Latin America, with the most recent country reporting a case being Puerto Rico. It is transmitted by mosquitoes belonging to the genus Aedes, including Aedes aegypti, which is found in Jamaica and also transmits dengue and chikungunya (CHIKV). The virus belongs to the same family as the dengue virus, but having had dengue, or CHIKV, does not protect one from being infected with the Zika virus, and there are no vaccines for it either. As a matter of fact, co-infection with these viruses can occur.

Rumours have been circulating about ZIKV already being in Jamaica. A colleague of mine claimed to not only have treated cases of the viral infection, but to have contracted it herself. However, no tests were performed to confirm it. I was also informed by a senior colleague that another physician obtained a positive ZIKV test result for a patient of his. I eventually contacted the doctor who obtained the positive result. It was not a hoax. The patient was hospitalised, and the requested test did in fact come back positive. The Ministry of Health (MOH) was informed about the case, and the specimen was sent to the Caribbean Public Health Agency (CARPHA), which is the confirmatory laboratory for Jamaica and the rest of the Caribbean, for further testing.

However, I was informed that the confirmatory test was negative.

We have been informed that the illness produces symptoms such as a rash, fever and pain, and is mild, lasting for only a few days. Sounds familiar doesn’t it? We were told the same thing about chikungunya, but people died after being infected, and more than one year later, some of us are still experiencing pain, and have not been the same after being afflicted. Brazil reported its first case of ZIKV in May 2015, and by November 30, 2015, 1,248 cases of microcephaly, including seven deaths, were reported, a 20-fold increase compared with preceding years.

Microcephaly is a neurodevelopmental disorder in which the head is abnormally small. The condition is associated with diminished brain function and reduced life expectancy, and the skyrocketing rate in Brazil has been attributed to ZIKV. The situation is so serious there that authorities have advised women to avoid getting pregnant, at least for now. In addition to this, three deaths directly related to ZIKV, two adults and a newborn, have been reported in the South American country.

So we have to ensure that ZIKV does not catch us off guard the way CHIKV did. It appears that it is not a matter of if, but of when the virus will reach our shores. The Aedes aegypti mosquito breeds in any container where water is allowed to settle, and we must exercise vigilance regarding the identification, and monitoring or elimination, of existing and potential mosquito breeding sites such as drums, tyres, flower pots and their overflow saucers, vases and pets’ water containers. We should bore holes in tins and other containers that we discard, dispose of our garbage properly in closed bags and refrain from littering. It is also a good idea to stock up on mosquito repellents, zappers and nets, and to use screens for windows and doors if possible.

Our MOH has apparently learnt from the mistakes made regarding the deadly CHIKV epidemic that literally crippled us. There have been public service announcements in the media, and the Minister of Health himself has been very vocal about us being prepared, and announced the planned training and hiring of 1,000 young people as vector-control workers to go into communities and identify and destroy mosquito-breeding sites. The Ministry also has a fact sheet on its website answering frequently asked questions. See ZIKV Fact Sheet here

We must play our part in preparing our country for what appears to be the inevitable. Many of us utilize social media to air grouses, complain and criticize, often with good reason. In this case, I invite my fellow Jamaicans to join me and use it to protect ourselves. Please tweet, post, share, text, message and email the link for the MOH document and other information concerning ZIKV to as many people as you can. Let us start our own social media campaign, and inspect our environments daily for mosquito breeding sites. We must work together to avoid a repetition of the CHIKV catastrophe.

- Dr Michael Abrahams is a gynaecologist and obstetrician, comedian and poet. Email feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or tweet @mikeyabrahams.