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Zika virus: 6 things to know about the growing outbreak

Since hitting Brazil last May, the Zika virus has spread to at least 21 other countries in the Americas

By Tiffany Bateman, for CBC News Posted: Jan 28, 2016 3:18 PM ETLast Updated: Jan 28, 2016 4:13 PM ET

A health ministry worker fumigates a house in Managua, Nicaragua on Jan. 26, 2016. Cases of the virus have been confirmed in 24 countries, 22 of which are in the Americas.

A health ministry worker fumigates a house in Managua, Nicaragua on Jan. 26, 2016. Cases of the virus have been confirmed in 24 countries, 22 of which are in the Americas. (Oswaldo Rivas/Reuters)

 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 
  
 
 

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The mosquito-borne Zika virus is drawing global attention due to its rapid spread and its possible connection to a rare neurological birth defect.

Earlier today, the head of the World Health Organization said Zika is "spreading explosively" and that an emergency meeting would take place Monday to decide if the virus outbreak should be declared an international health emergency.

 

Brazil has reported more than 4,000 cases of babies born recently with microcephaly, a brain condition characterized by an abnormally small head that can lead to developmental issues or even death. That number compares with fewer than 150 cases in the country for all of 2014.

 And with no vaccine or treatment for Zika, it is likely to keep spreading.

 Here's what you need to know about the virus that is putting health officials around the world on alert.

  • Dr. Margaret Chan, director-general of the World Health Organization, and Dr. Bruce Aylward, assistant director for emergencies, raised the alarm about the mosquito-borne Zika virus 'spreading explosively' in the Americas at a special meeting in Geneva on Jan. 28, 2016.
  • The WHO is concerned about Zika virus chiefly for its possible link to microcephaly and the potential for its spread given the wide range of its mosquito vector. Brazilian officials report a spike in cases of the birth defect and strongly suspect Zika virus is the cause.
  • In Brazil a major effort to eradicate the mosquito tied to Zika virus is underway. The virus has slumbered for decades but co-spreading with dengue fever in the mid-2000s, including an outbreak linked to neurological complications on some Pacific islands, were precursors to today's 'dramatically different' situation, according to the WHO.
  • Some 220,000 soldiers have been mobilized in Brazil to fight mosquitoes. These fumigators are part of a push to disinfect the Sambadrome on Jan. 26 ahead of Rio de Janeiro's famous Carnival parades. The venue will also host archery events during the Summer Olympics.
  • These Aedes aegypti mosquitoes, in a lab at the Fiocruz institute in Recife, are the vector for Zika virus and the target of mass eradication efforts in Brazil. According to the WHO, the Zika virus outbreak is likely to spread throughout nearly all the Americas.
  • Estafany Perreira holds her five-month-old nephew, who has microcephaly, in Recife on Jan. 25. Over 4,000 suspected cases of the rare birth defect have been recorded in Brazil in recent months. The WHO says investigators are still looking into a link between the virus and the defect.
  • Scenes of daily life in Recife, in Brazil's northeastern Pernambuco state, now include fumigators sent to areas where stagnant water make for prime mosquito-breeding territory.
  • Preventative efforts are underway in other South and Central American countries as well. This man sprays a smoke-like insecticide in Nicaragua's capital, Managua, on Jan. 26.
  • Venezuela, which recorded its first cases of Zika virus in December, continues its mosquito spraying operation in Caracas, and other cities, on Jan. 28.
  • These men are shrouded in clouds of insecticide in Nicaragua's capital on Jan. 26. Nicaragua reported its first cases of Zika, in two women in Managua, on Jan. 27.
  • The WHO has listed one case of Zika virus in Guatemala since mid-November. Here, a public health worker feeds sterile female Aedes aegypti mosquitoes at a lab in Guatemala City on Jan. 26 as part of a government-backed program to prevent the virus's spread.
  • The WHO lists three lab-confirmed cases of Zika virus in El Salvador. As part of preventative measures, health ministry workers are fumigating homes against mosquitoes.
  • Dr. Margaret Chan, director-general of the World Health Organization, and Dr. Bruce Aylward, assistant director for emergencies, raised the alarm about the mosquito-borne Zika virus 'spreading explosively' in the Americas at a special meeting in Geneva on Jan. 28, 2016. (Denis Balibouse/Reuters)
  • The WHO is concerned about Zika virus chiefly for its possible link to microcephaly and the potential for its spread given the wide range of its mosquito vector. Brazilian officials report a spike in cases of the birth defect and strongly suspect Zika virus is the cause. (Felipe Dana/AP)
  • In Brazil a major effort to eradicate the mosquito tied to Zika virus is underway. The virus has slumbered for decades but co-spreading with dengue fever in the mid-2000s, including an outbreak linked to neurological complications on some Pacific islands, were precursors to today's 'dramatically different' situation, according to the WHO. (Felipe Dana/AP)
  • Some 220,000 soldiers have been mobilized in Brazil to fight mosquitoes. These fumigators are part of a push to disinfect the Sambadrome on Jan. 26 ahead of Rio de Janeiro's famous Carnival parades. The venue will also host archery events during the Summer Olympics. (Leo Correa/AP)
  • These Aedes aegypti mosquitoes, in a lab at the Fiocruz institute in Recife, are the vector for Zika virus and the target of mass eradication efforts in Brazil. According to the WHO, the Zika virus outbreak is likely to spread throughout nearly all the Americas. (Mario Tama/Getty )
  • Estafany Perreira holds her five-month-old nephew, who has microcephaly, in Recife on Jan. 25. Over 4,000 suspected cases of the rare birth defect have been recorded in Brazil in recent months. The WHO says investigators are still looking into a link between the virus and the defect. (Mario Tama/Getty)
  • Scenes of daily life in Recife, in Brazil's northeastern Pernambuco state, now include fumigators sent to areas where stagnant water make for prime mosquito-breeding territory. (Ueslei Marcelino/Reuters)
  • Preventative efforts are underway in other South and Central American countries as well. This man sprays a smoke-like insecticide in Nicaragua's capital, Managua, on Jan. 26. (Oswaldo Rivas/Reuters)
  • Venezuela, which recorded its first cases of Zika virus in December, continues its mosquito spraying operation in Caracas, and other cities, on Jan. 28. (Marco Bello/Reuters)
  • These men are shrouded in clouds of insecticide in Nicaragua's capital on Jan. 26. Nicaragua reported its first cases of Zika, in two women in Managua, on Jan. 27. (Inti Ocon/AFP/Getty)
  • The WHO has listed one case of Zika virus in Guatemala since mid-November. Here, a public health worker feeds sterile female Aedes aegypti mosquitoes at a lab in Guatemala City on Jan. 26 as part of a government-backed program to prevent the virus's spread. (Josue Decavele/Reuters)
  • The WHO lists three lab-confirmed cases of Zika virus in El Salvador. As part of preventative measures, health ministry workers are fumigating homes against mosquitoes. (Marvin Recinos/AFP/Getty)
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 What is Zika?

 The Zika virus is a mosquito-borne illness first discovered in 1947 when it was isolated from a monkey found in Uganda's Zika Forest.

 The virus has been reported in humans in Asia and Africa since the 1950s, and was first found outside its usual geographic area in 2007, when there was an outbreak in Micronesia, a small cluster of islands in the western Pacific Ocean.

 The virus eventually made its way to the Americas and was reported on Easter Island, off the coast of Chile, in 2014. Brazil reported the first case of local Zika transmission in May 2015.

 Health officials are particularly concerned about Zika because as a relatively new disease, there has been little to no exposure to the virus by the general population, leading to low immunity.

 This helps the virus spread — and quickly.

 How is Zika transmitted?

 The virus is primarily transmitted through the Aedes aegypti mosquito, a particularly aggressive, white-speckled mosquito that bites during the day. (This is the same mosquito that spreads dengue and chikungunya viruses, making it a triple threat.)

HEALTH-ZIKA/PERU-MEASURES

Specimens of Aedes aegypti mosquito are exhibited during a campaign to raise awareness around the prevention of the Zika virus in Lima, Peru. This species of mosquito is troublesome as it bites during the day. (Mariana Bazo/Reuters)

 Transmission occurs when an Aedes mosquito feeds on a person infected with Zika, and then spreads the virus by biting an uninfected person.

 According to the U.S. Centers for Disease Control and Prevention (CDC), there has been one possible case of transmission through blood transfusion and one possible case of transmission through sexual activity.

The Pan American Health Organization (PAHO), a regional office of WHO, notes Zika can be transmitted through blood, "but this is an infrequent mechanism."

So far there is limited evidence on whether Zika can be transferred from mother to child during pregnancy or at the moment of childbirth. But because of the rash of microcephaly cases in Brazil, which spiked after the first confirmed case of Zika, this maternal link is "strongly suspected" and being closely studied.

 The Aedes mosquito is prevalent throughout the Americas, with the exception of Canada and Chile, which is another reason for the virus's rapid spread.

 What are the symptoms?

 Only one in five of those infected with Zika show symptoms, which develop up to one week after being bitten.

 Most symptoms are mild, and include fever, rash, headache, muscle and joint pain, and conjunctivitis (red eyes). They can last for two to seven days.

 Most symptoms can be easily treated with rest and plenty of fluids. If symptoms worsen, a doctor should be consulted.

There's no vaccine to prevent the Zika virus and no medication to treat it.

 There is some evidence of a Zika infection causing serious complications, including microcephaly, with the greatest risk appearing to be associated with the first trimester of pregnancy.

The CDC notes that severe cases of Zika requiring hospitalization are "uncommon" and death is "rare."

Brazil Zika Birth Defects

A Brazilian man holds his daughter, Luiza, at their house in Santa Cruz do Capibaribe. Luiza was born in October with a rare condition known as microcephaly. Researchers are still determining the condition's connection to the Zika virus. (Felipe Dana/Associated Press)

 There are also links between Zika and Guillain-Barre Syndrome (GBS), with a number of GBS patients in Brazil, French Polynesia and El Salvador also having symptoms consistent with Zika virus infection. GBS can start with tingling and weakness in the body and progress to muscle weakness and paralysis. Most people with GBS recover completely.

Neurological symptoms, such as meningitis, have also been reported in outbreaks of Zika. 

 Which areas are affected by Zika?

 Zika is currently present in 24 countries and territories, 22 of which are in the Americas.

Zika-map

Most of the countries affected by the virus are in Central and South America, according to the U.S.-based Centers for Disease Control and Prevention. (CBC)

 As a response, a number of countries around the world have issued Zika-related travel warnings.

 Earlier this month, the Public Health Agency of Canada issued a level-two travel notice, warning Canadian travellers to "practise special precautions" if heading to areas where the virus is circulating. In particular, PHAC warns pregnant women to visit their health-care provider before and after a planned trip to assess the risk.

 The CDC issued a similar notice, suggesting pregnant women postpone travel to affected regions.

Officials in some countries, including Brazil, Colombia and El Salvador, have gone so far as to warn women against getting pregnant.

 Will it come to Canada?

 There have already been travel-related cases of Zika reported in Canada in travellers returning from places where the virus is circulating. But there have been no reports of locally acquired cases, and it's very unlikely there ever will be.

 The transmitting vector — the Aedes aegypti and possibly the Aedes albopictus species of mosquito — does not live in Canada.

Climate largely determines where these mosquitoes live, with the species thriving in tropical and sub-tropical regions. Canada's colder conditions mean the species is unlikely to become established here.

And without this mosquito, Zika cannot be transmitted from person-to-person.

Because of the possibility of blood-based transmission, the Canadian Blood Services is going to stop accepting donations from people returning from Zika-hit countries. The U.S. FDA is said to be considering similar measures.

"We are carefully monitoring the Zika virus issue and are currently planning revisions to our travel-deferral policies in order to protect the Canadian blood supply from the threat of this virus. We are working with Health Canada and Héma-Québec to come up with the best strategy," Dr. Dana Devine, chief medical and scientific officer for Canadian Blood Services, said in an email statement.

 What's being done to prevent Zika?

 Since the primary transmitter of Zika is the Aedes mosquito, efforts are being made to prevent reproduction by eliminating their breeding grounds.

 The mosquitoes lay eggs near standing water, so officials are encouraging those in the affected areas to empty out containers where water can pool, such as buckets, flower pots, old tires or pets' water bowls, especially if they're close to a residence. Larvicide can also be added to standing water.

BRAZIL ZIKA VIRUS fumigators at Sambadrome ahead of Carnival Jan 26 2016

Workers disinfect the famous Sambadrome in Rio de Janeiro, Brazil, ahead of the beginning of Rio's Carnival parade next month. Brazilian officials have vowed to mobilize some 220,000 troops to help eradicate the Aedes mosquito. (Marcelo Sayao/EPA)

 Another way to prevent transmission is to avoid mosquito bites. The use of mosquito repellent, clothing that covers most of the body, mosquito nets at night and screens on windows and doors will all help prevent bites.  

 In Brazil, officials have vowed to soon mobilize some 220,000 troops to help eradicate the Aedes mosquito through door-to-door visits. Those efforts may be doubled again in August, when the country plays host to the Olympic Games.

Ahead of Monday's emergency WHO meeting, the agency also says it's ramping up its surveillance systems in the affected countries and will "prioritize the development of vaccines and new tools to control mosquito populations."


Tiffany Bateman 

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