What Do You Know About the Zika Virus

Dr. Sampson Ampofo Koranteng – Consultant Obstetrician / Gynaecologist
March 20, 2014
Our IVF Team
February 2, 2016

You probably have heard about a Zika virus making rounds in certain parts of our world and its possible effect on unborn babies. What do you know about the virus and how can it possibly affect you? Let’s get some answers from our health advisers.

What is it and where is it coming from?

Zika Virus is a mosquito-borne flavivirus.

It was first isolated from the rhesus monkey in the Zika forest of Uganda in 1947; in mosquitoes (Aedes Africans) in the same forest in 1948. In 1968, it was isolated from human host in Nigeria.

It has been circulating in Africa and Asia until 2015 when Zika virus first appeared in Brazil, where it caused a minor outbreak after the 2014 FIFA World Cup.

Zika Virus is closely related to other mosquito-borne flavivirus such as the Yellow Fever Virus, the Dengue Virus and the Japanese Encephalitis Virus.

What is its make-up?

Zika Virus is a positive sense single stranded RNA virus (ssRNA) of the family flaviviridae and genus flavivirus.

The virion attaches to the host cell membrane receptors via the envelope protein, which induces endocytosis. Then the virus membrane fuses with the endosomal membranes and the single stranded genome of the virus is released into the cytoplasm of the host cell. It is then translated into polyproteins that is subsequently cleaved to form all structural and non-structural proteins.

It is then replicated at the intracellular compartments known as cytoplasmic viral factories in the endoplasmic reticulum, resulting in double stranded RNA genomes (dSRNA).

The dSRNA genome is then transcribed to produce additional ssRNA genomes. The genomes are then assembled within the endoplasmic reticulum and the new virions are transported into the Golgi apparatus and then excreted into the intracellular space. These new virions are now ready to infect new host cells.

How can I contract it?

It is transmitted primarily to humans through bites from Aedes mosquitoes commonly Aedes aegypti, A. albopictus and A. africanus.

Recent studies have also shown that it can be transmitted through blood transfusion, perinatal transmission and sexual transmission.

It has an incubation period of 2-10 days. It has a 2 weeks life cycle in the mosquito. Since Zika Virus is closely related to Yellow Fever virus and having the same vector (Aedes mosquitoes), it can cause epidemics in all yellow fever at- risk countries including Ghana.

Zika Virus first caused an epidemic in Yap Islands in 2007 and French Polynesia in 2013. Minor epidemic in Brazil in 2015 until recent epidemic in Southern America which is about forming a Pandemic.

Countries/Territories with active Zika Virus transmission are;

Americas: Barbados, Bolivia, Brazil, Colombia, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, and Venezuela.

Oceania: Samoa

Africa: Cape Verde

However, transported cases have been recorded in the UK and USA.

How will the virus affect my system?

 Zika Fever

Zika virus infection can lead to Zika Fever in one out of five infected individuals. Symptoms include; headaches, fever, back pains, maculopapular rashes, general malaise, joint pains and conjunctivitis. The condition is self-limiting in approximately one week. Symptoms are mild and generally do not require hospital admission in healthy individuals. Management is conservative, but aspirin and NSAIDS are to be avoided since they increase the risk of developing hemorrhagic syndrome which has been reported in other flaviviruses as well as the risk of Reye’s syndrome after viral infection in children and teenagers.

 Zika Virus in pregnancy and childbirth

Irrespective of the fact that Zika Fever caused by Zika Virus infection is generally a mild illness, it has been associated with a severe birth defect, Microcephaly.

Studies are underway to determine if Zika virus infection is the cause of the rise of incidence rate of Microcephaly in Brazil where 4000 cases have so far been recorded. This association also lends credence to the first case of microcephalic child in a previously diagnosed Zika fever mother.

What happens if my baby is born with MICROCEPHALY

This includes intellectual disability, developmental delay, craniofacial abnormalities, muscle spasticity, epilepsy, cerebral palsy, hyperactivity, etc.

It is still not clear which trimester it is likely to develop microcephaly from Zika Virus, hence, all pregnant women and those planning to get pregnant should take steps to prevent Zika Virus infection.

Another neurodevelopmental condition of concern is Guillain-Barre’ Syndrome. Again, more study is needed to establish a good link to Zika virus.

How can I prevent the Zika virus

Pregnant women and women trying to be pregnant should discuss their travel plans with their health care provider.

They should at best postpone travel to Zika Virus at- risk countries.

If travel cannot be postponed, then strict mosquito bite prevention measures should be employed.

Port Health Surveillance should be strengthened to prevent imported cases of Zika Virus into Zika Virus-free countries.

Brazil is trying to develop a vaccine against Zika Virus.

You also asked us a few questions about the virus too. These are what our experts’ advice:

Should we give attention to this Zika Virus phenomenon here in Ghana?

Yes. This is because, Aedes mosquitoes are present in Ghana so any imported case(s )of Zika Virus is of epidemic potential capable of causing microcephaly among Ghanaian newborns. Hence, port health surveillance should be well tightened and also social communication strategies should be adapted to reduce the presence of the mosquito vectors.

How does it affect the unborn baby? 

There is a wide knowledge gap between Zika Virus infection and its effect on the unborn baby. However, there is an association between the Zika Virus infection and Microcephaly. Brazil has recorded about 4000 new cases of microcephaly in this Zika Virus epidemic. Also, an imported case of a mother who suffered Zika Virus infection in South America had delivered a baby with microcephaly in USA, so the association is strong. Nonetheless, studies are ongoing to clearly define the effects of Zika Virus on the unborn baby.

What is your advice to pregnant women in Ghana currently?

My advice to pregnant women in Ghana currently is that, no case of Zika Virus has been recorded in Ghana and so they should not panic but should at best avoid or postpone travel to the at-risk countries listed. They should also take measures to avoid mosquito bites such as using insecticide repellents, drainage of water collections, clearing of bushes around their environment, etc. They should note that, the mosquito that transmits Zika Virus can bite both at night and during the day time. So measures should at all times be adapted. They should avoid sex with their counterparts that arrive in the country from any of the listed at-risk countries since sexual transmission is possible.

Do women in Ghana have good reasons to postpone getting pregnant in Ghana?

No. There is no need to postpone getting pregnant in Ghana. No case has been recorded in Ghana. Ghanaians should be vigilant to avoid importing the virus into the country and also prevent the bite of mosquitoes.