Felicitas Asuncion C.

Elago
2012-32861

Zoo 117 CD-2L

February 17, 2016

A Review of Literature on the History and Epidemiology of the Zika Virus

The Zika virus, a single stranded RNA virus from the genus Flavivirus of family
Flaviviridae, which is accordingly closely related to Dengue, Yellow fever, Japanese encephalitis
and the West Nile viruses (Rabe, 2016), has been gaining worldwide popularity after its 2007
outbreak. Its birth traces back to 1947 in the Zika (Luganda for overgrown) forest near the East
African Virus Research Institute in Entebbe, Uganda, where scientists originally researching
about yellow fever first isolated it from a rhesus macaque that developed a fever (Zika Virus
Net, 2016). It has since been transmitted to humans from the sylvatic cycle via aggressive
daytime household mosquitoes of genus Aedes (Stegomyia), particularly Ae. aegypti and Ae.
Albopictus that lay eggs in domestic water-holding containers (Rabe, 2016) and caused
sporadic human infections with usually mild symptoms of fever, rash, and arthralgia in some
African and Asian countries ( The Lancet, 2015).
From Uganda, the virus spread abroad to the Yap Island in the Federated States of
Micronesia, as well as Oceania, where the epidemic potential was first perceived in 2007. Five
years later in French Polynesia, scientists concluded that the viral pattern has changed with
even higher rates of attack, estimating the occurrence in 11% of the entire population. Cases in
Central and South America, particularly Colombia, El Salvador, Guatemala, Mexico, Paraguay,
Puerto Rico, and Venezuela, followed, leading to a speculation that it traveled via the Easter
islands (The Lancet, 2015). The Zika virus was confirmed to be active in northeast Brazil by
infectologist Kleber Luz in April 2015 when he performed PCR on eight of the 25 blood samples
from suspected cases in Bahia, and subsequently in eight of the 21 cases in Rio Grande do
Norte. The symptoms recorded were early onset exanthema, with no or little fever, accompanied
by arthralgia, articular edema and conjunctivitis (Brito, 2015). Contemporarily, the Zika virus
epidemic is considered a global challenge.
The rapid international spread of Zika virus has been attributed to several factors, all of
which can be considered anthropogenic. In Brazil or South America in general, climate change
and drought brought about by global warming has been blamed given that elevated temperature
can expand the geographic vector range, decrease the extrinsic incubation period of the
pathogen, and increase the female mosquito biting rate. Droughts (El Nio), on the other hand,
can indirectly expand the vectors range. The range expansion of the Aedes aegypti may be
expected since the amount of water being stored or saved in containers by different households
also increase (Paz & Semenza, 2016). Aside from mosquito bites, another mode of transmission
recently suggested would be through sexual activities. This was discovered in Texas, USA, after
CDC (Centers for Disease Control and Prevention) reported one case of Zika virus wherein the
virus was found being present in a man's semen after it disappeared from his blood (Sheridan,
2016). With current outbreaks in the Americas, cases among U.S. travelers will most likely
increase. In fact, the infection rate has gone up to 73% (95% CI 6877) whereas the attack rate
among infected is 18% (95% CI 1027). It is also noteworthy that this virus can affect all agegroups (Rabe, 2016).

The level of alarm towards the Zika virus is not only in terms of the speed and scope of
this viral outbreak, but also because of its correlation to neurological development and
disorders. In the state of Pernambuco in Brazil, seven patients were found positive for Zika, as
determined by PCR-TR and viral isolation. Of which, six had the virus in their serum samples
while one had it in liquor. In these seven cases, four were diagnosed with the Guillain-Barr
syndrome, two with acute disseminated encephalomyelitis (ADEM) and one with
meningoencephalitis. Seventy other cases are under investigation aiming the detailing of this
outbreak (Brito, 2015). The most controversial of these neurological abnormalities is the
Microcephaly exhibited by children gestated by infected mothers, hence another proposed
modes of transmissionthe Maternal-Fetal Transmission or Perinatal transmission. The latter
was first suggested in 2013 when day-old infants given birth by symptoms-showing mothers
tested positive for the virus when it was highly unlikely that the child was bitten by a mosquito
(Rabe, 2016).
Microcephaly is characterized mainly by newborns with unusually smaller heads caused
by abnormal brain development. As a result, the child experiences a range of consequences
from mild developmental delays to severe motor and intellectual deficits, like cerebral palsy.
Unfortunately, this is currently malignant in Brazil. Congenital infections, chromosomal
abnormalities, exposure to drugs, alcohol, and other environmental toxins are the possible
reasons for the premature fusion of the bones of the skull (craniosynostosis) as well as certain
metabolic disorders coupled to this phenomenon. The sudden increase in the number of infants
born with microcephaly associated with cerebral damage characteristically seen in congenital
infections in a region where an outbreak of a newly circulating virus has recently occurred is
suggestive of a possible relationship (Schuler-Faccini, et.al. 2016). However, more recent
studies tell us otherwise. According to Navarro (2016), we must remain skeptical and
comprehend the statistics after it was reported that in the 732 cases out of 4,180 Zika-related
microcephaly, more than half were not related to Zika at all. Only 270 cases were confirmed as
Zika-linked microcephaly. Additionally, a report from researchers in Paraiba, an area with one of
the most number of cases, claims that it had been recording microcephaly cases since 2012,
with the condition more common two years ago than in 2015, which is when Zika virus was first
recorded in Brazil (Bowater, 2016). Instead of Zika, the proposed cause of the multitude of
microcephaly cases is a larvicide, pyroproxifen, used in drinking water to combat diseasecarrying mosquitoes. While both hypotheses on the two possible causes of microcephaly is
being heavily studied and disputed on, everyone agrees that it is only a matter of time before a
conclusion is made.
Another area concerning the Zika virus being researched on is its vaccine. French
pharmaceutical giant Sanofi announced last February 2 that it would begin developing a vaccine
against the mosquito-borne disease. This has become especially relevant given the virus
possible link to some neurological disorders and the WHO warning that the American region
could see up to four million Zika cases this year alone (Agence France-Presse, 2016).

Literature Cited

Agence France-Presse. (2016, February 2). France's Sanofi launches Zika virus vaccine
research. Retrieved February 17, 2016, from http://www.rappler.com/science-nature/lifehealth/121133-france-sanofi-zika-virus-vaccine-research

Bowater, D. (2016, February 15). Zika virus: Brazil dismisses link between larvicide and
microcephaly
Telegraph.
Retrieved February 17,
2016,
from
http://www.telegraph.co.uk/news/worldnews/zika/12157747/Zika-virus-Brazil-dismisseslink-between-larvicide-and-microcephaly.html

Brito, C. (2015). Zika virus: a new chapter in the history of medicine. Revista Cientfica da
Ordem
dos
Mdicos,
28(6),
679-680.
Retrieved
from
www.actamedicaportuguesa.com/revista/index.php/amp/article/.../4565

Paz, S., & Semenza, J. C. (2016). El Nio and climate changecontributing factors in the
dispersal of Zika virus in the Americas? The Lancet, 6736(7). doi:10.1016/s01406736(16)00256-7

Rabe, I. (2016, January 26). Zika Virus The latest emerging arbovirus in the Americas [PDF].
Retrieved from emergency.cdc.gov/coca/ppt/2016/01_26_16_zika.pdf

Schuler-Faccini, L., Ribeiro, E. M., Feitosa, I. M., Horovitz, D. D., Cavalcanti, D. P., Pessoa, A.,
Sanseverino, M. T. (2016). Possible Association Between Zika Virus Infection and
Microcephaly Brazil, 2015. MMWR. Morbidity and Mortality Weekly Report, 65(3),
59-62. doi:10.15585/mmwr.mm6503e2

Sheridan, K. (2016, February 3). Zika virus: US reports sexually transmitted case.
Retrieved February 17,
2016,
from
http://www.rappler.com/science-nature/lifehealth/121174-zika-virus-us-reports-sexually-transmitted-case

The Lancet. (2016). Zika virus: a new global threat for 2016. The Lancet, 387(10014), 96.
doi:10.1016/s0140-6736(16)00014-3