2019/04/25 by Michael S. Rolph, Suresh Mahalingam · 1 citation
Mathematics · Medicine · #Biology #COVID-19 epidemiological studies #China #Demography #Geography #MEDLINE #Medicine #Mosquito-borne diseases and control #Observational study #Outbreak #Pathology #Scopus #Transmission (telecommunications) #Viral Infections and Vectors #Virology #Virus #Zika virus
paper · pdf · doi:10.1016/s1473-3099(19)30169-0
openalex publication_date 2019/04/25 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
Kriangsak Ruchusatsawat and colleagues1Ruchusatsawat K Wongjaroen P Posanacharoen A et al.Long-term circulation of Zika virus in Thailand: an observational study.Lancet Infect Dis. 2019; (published online Feb 27.)https://doi.org/10.1016/S1473-3099(18)30718-7Summary Full Text Full Text PDF PubMed Scopus (68) Google Scholar reported an observational study of individuals with suspected Zika virus infection in Thailand between January, 2016, and December, 2017. Phylogenetic analysis suggested persistent circulation of Zika virus in Thailand since at least 2002. This finding is important because it suggests that Zika virus has the potential for endemic transmission. Although comparable data for other Asian countries are not available, concern exists about possible epidemic transmission elsewhere in Asia, particularly in India.2Watts AG Huber C Bogoch II Brady OJ Kraemer MUG Khan K Potential Zika virus spread within and beyond India.J Travel Med. 2018; 26: tay132Google Scholar Four Zika cases were reported in India in 2016–17, which were probably due to local transmission because the individuals did not report any travel history in the past several months.3Khaiboullina S Uppal T Martynova E Rizvanov A Baranwal M Verma SC History of ZIKV infections in India and management of disease outbreaks.Front Microbiol. 2018; 9: 2126Crossref PubMed Scopus (10) Google Scholar But travellers are also a potential source of Zika virus in India, particularly individuals from Malaysia and Singapore, where Zika cases have been reported in the past 3 years.4Lim SK Lim JK Yoon IK An update on Zika virus in Asia.Infect Chemother. 2017; 49: 91-100Crossref PubMed Scopus (58) Google Scholar The more recent outbreaks of Zika virus in India are a major cause for concern. In late 2018, 159 cases of Zika virus infection were reported in Rajasthan5Yadav PD Malhotra B Sapkal G et al.Zika virus outbreak in Rajasthan, India in 2018 was caused by a virus endemic to Asia.Infect Genet Evol. 2019; 69: 199-202Crossref PubMed Scopus (37) Google Scholar and 127 in Madhya Pradesh.6Saxena SK Kumar S Sharma R Maurya VK Dandu HR Bhatt MLB Zika virus disease in India—update October 2018.Travel Med Infect Dis. 2019; 27: 121-122Crossref PubMed Scopus (15) Google Scholar Since most Zika virus infections are mild or asymptomatic, the extent of these outbreaks is probably underestimated, and the consequences could be severe if the pattern continues into 2019. As many as 465·7 million people in India could become infected if a major Zika virus outbreak was to occur.7Siraj AS Perkins TA Assessing the population at risk of Zika virus in Asia—is the emergency really over?.BMJ Glob Health. 2017; 2: e000309Crossref PubMed Scopus (18) Google Scholar On Dec 13, 2018, the US Centre for Disease Control and Prevention issued a level 2 alert for travellers to India, recommending enhanced precautions against Zika virus infection and advising pregnant women not to travel to affected areas. Numerous parallels exist between India, Thailand, and the most affected countries in South America, particularly the similar climates, distribution of mosquito species, and prevalence of other arboviruses such as chikungunya and dengue. The widespread poverty and large population in India make uncontrolled spread of Zika virus likely.8Vijaykumar S Raamkumar AS Zika reveals India's risk communication challenges and needs.Indian J Med Ethics. 2018; 3: 240-244PubMed Google Scholar Ruchusatsawat and colleagues1Ruchusatsawat K Wongjaroen P Posanacharoen A et al.Long-term circulation of Zika virus in Thailand: an observational study.Lancet Infect Dis. 2019; (published online Feb 27.)https://doi.org/10.1016/S1473-3099(18)30718-7Summary Full Text Full Text PDF PubMed Scopus (68) Google Scholar suggested that Zika virus in Thailand has found a so-called middle ground, with transmission levels high enough to maintain the virus but not high enough for widespread immunity to develop; perhaps a similar dynamic has been established in India. 130 pregnant women in Thailand had Zika virus infection between January, 2016, and August, 2018, of whom 119 gave birth, with four babies having microcephaly.1Ruchusatsawat K Wongjaroen P Posanacharoen A et al.Long-term circulation of Zika virus in Thailand: an observational study.Lancet Infect Dis. 2019; (published online Feb 27.)https://doi.org/10.1016/S1473-3099(18)30718-7Summary Full Text Full Text PDF PubMed Scopus (68) Google Scholar, 9Wongsurawat T Athipanyasilp N Jenjaroenpun P et al.Case of microcephaly after congenital infection with Asian lineage Zika virus, Thailand.Emerg Infect Dis. 2018; 24: 1758-1761Crossref Scopus (54) Google Scholar During this period, 285 cases of microcephaly were reported in Thailand with no maternal history of Zika virus infection. Three of these cases were identified as congenital Zika virus syndrome. No similar data exist for India, but mechanisms need to be put in place to identify Zika congenital syndrome or other serious disease manifestations in the country. We note with some concern the advisory note of the Indian Ministry of Health and Family Welfare titled Zika virus strain that causes microcephaly not found in Rajasthan, the content and title of which seem to imply the Zika virus strains in India do not cause microcephaly. This conclusion is based on the absence in Zika viruses isolated in Rajasthan of a single mutation5Yadav PD Malhotra B Sapkal G et al.Zika virus outbreak in Rajasthan, India in 2018 was caused by a virus endemic to Asia.Infect Genet Evol. 2019; 69: 199-202Crossref PubMed Scopus (37) Google Scholar that has been associated with neurovirulence in vitro and in mice.10Yuan L Huang XY Liu ZY et al.A single mutation in the prM protein of Zika virus contributes to fetal microcephaly.Science. 2017; 358: 933-936Crossref PubMed Scopus (299) Google Scholar No genetic or epidemiological data exist to support this claim, which we consider to be dangerously simplistic. We believe that data for India similar to that reported by Ruchusatsawat and colleagues for Thailand are urgently needed, allowing Indian authorities to adopt the most appropriate public health strategies to deal with the risk of a major Zika outbreak. We declare no competing interests. Long-term circulation of Zika virus in Thailand: an observational studyOur evidence shows that Zika virus has circulated at a low but sustained level for at least 16 years, suggesting that Zika virus can adapt to persistent endemic transmission. Health systems need to adapt to cope with regular occurrences of the severe complications associated with infection. Full-Text PDF