Zika virus is upon us

In late 2013, Chikun-gunya emerged in the Caribbean, where it quickly spread to almost every island. Now the threat of Zika, another mosquito borne disease is upon us.

Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania.{{more}} Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.

The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to that of dengue and chikungunya, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for two to seven days.

During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently, in Brazil, local health authorities have observed an increase in Guillain-Barré syndrome, which coincided with Zika virus infections in the general public, as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence of a possible link between Zika virus and microcephaly. However, more investigation is needed to better understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.

To date, no licensed treatments or vaccines exist; thus, treatment is supportive, using anti-inflammatory agents, adequate hydration and rest.

Public health efforts should continue to focus on identifying infected persons and interrupting the transmission cycle, using anti-vector methods, such as insect repellents, drainage of mosquito breeding sites and fogging, in order to significantly decrease or more ambitiously to eliminate the mosquito that transmits this disease.

However, with misconceptions in the mind of many, it is becoming increasingly difficult to control the mosquito population. Some people are not doing as much as they can to fight this disease, since they question the mode of transmission of the virus.

The St Vincent and the Grenadines Public Health Act of 1977 clearly provides legal protection for the Vincentian people against mosquito borne diseases. Albeit the laws are archaic and need possible revision, the act provides for a Public Health Department, with community public health officers, who are tasked with protecting the health of communities and the overall health of the nation from communicable diseases such as Chikungunya, Dengue, Zika and other diseases.

The Public Health Act addresses the need for vector control and in particular, mosquito control. The Mosquito Rules are clearly outlined in the laws of St Vincent and the Grenadines, Revised Edition of 1990, Volume 5, Chapter 232, Booklet 20. According to Section 113 of the Public Health Act, any environment that supports the breeding of mosquitoes is considered as a nuisance and requires a public health response. In other words, the public health authorities have the legal power to inspect and destroy any drums, containers, or receptacles that may be contributing to the breeding of mosquitoes.

The Public Health Act also gives the Minister of Health the power to make rules to decrease conditions that encourage the breeding of mosquitoes and for the prevention of mosquito borne diseases such as Chikungunya, Dengue and Zika.

Section 114 of the Act states that an occupier or owner of premises who encourages conditions around his/her home that encourages the breeding of mosquitoes is guilty of an offence and is liable to a fine of twenty-five dollars (EC $25).

Although these public health laws exist and provide protection from communicable diseases, two things are important to note: these laws are old and they require revision. Revision of these laws should not only provide protection from communicable diseases, but should also be extended to address issues such as non-communicable disease risk factors, such as smoking and dietary regulations. Secondly, enforcement of the law remains a problem and so we must begin to put them into practice. As is evident, the fines are also very small and so these may need to be increased in order to seriously discourage people and strengthen the public health response against these diseases.

With all that said, it is very important to remember that every individual should play an active role in the fight against Zika. Laws alone cannot protect us. Individual, community and national efforts are needed to adequately respond to the threat from these emerging and Dr Rosmond Adams is a medical doctor and a public health specialist. He may be emailed at adamsrosmond@gmail.com