Dr. Supriya

Key facts

•  Zika virus disease is caused by a virus transmitted by aedes mosquitoes.
•  People with zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
•  There is no specific treatment or vaccine currently available.
•  The best form of prevention is protection against mosquito bites.
•  The virus is known to circulate in africa, the americas, asia and the pacific.

Introduction

Zika virus is an emerging mosquito-borne virus that was first identified in uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in uganda and the united republic of tanzania. Outbreaks of zika virus disease have been recorded in africa, the americas, asia and the pacific.

•  Genre: flavivirus
•  Vector: aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
•  Reservoir: unknown

Signs and symptoms

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 other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 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 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 about the link between zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the zika virus. Other potential causes are also being investigated.

Transmission

Zika virus is transmitted to people through the bite of an infected mosquito from the aedes genus, mainly aedes aegypti in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.

Zika virus disease outbreaks were reported for the first time from the pacific in 2007 and 2013 (yap and french polynesia, respectively), and in 2015 from the americas (brazil and colombia) and africa (cape verde). In addition, more than 13 countries in the americas have reported sporadic zika virus infections indicating rapid geographic expansion of zika virus.

Diagnosis

Zika virus is diagnosed through pcr (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, west nile and yellow fever.
Prevention

Mosquitoes and their breeding sites pose a significant risk factor for zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.

This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.

Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.

During outbreaks, health authorities may advise that spraying of insecticides be carried out. Insecticides recommended by the who pesticide evaluation scheme may also be used as larvicides to treat relatively large water containers.

Travellers should take the basic precautions described above to protect themselves from mosquito bites.

Treatment

Zika virus disease is usually relatively mild and requires no specific treatment. People sick with zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available.
Who response

Who is supporting countries to control zika virus disease through:

•  Define and prioritize research into zika virus disease by convening experts and partners.
•  Enhance surveillance of zika virus and potential complications.
•  Strengthen capacity in risk communication to help countries meet their commitments under the international health regulations.
•  Provide training on clinical management, diagnosis and vector control including through a number of who collaborating centres.
•  Strengthen the capacity of laboratories to detect the virus.
•  Support health authorities to implement vector control strategies aimed at reducing aedes mosquito populations such as providing larvicide to treat standing water sites that cannot be treated in other ways, such as cleaning, emptying, and covering them.
•  Prepare recommendations for clinical care and follow-up of people with zika virus, in collaboration with experts and other health agencies.

Candidiasis or yeast Infection of the female reproductive organ is a condition caused from the fungus known as ‘Candida’. A vaginal yeast infection is accompanied by severe itching, swelling or irritation in your vaginal region. 

Yeast is present in your vagina in a small proportion as part of the normal vaginal flora, an imbalance of which results in vaginal Yeast Infection. Frequent in its nature, these infections can be quite bothering due to the symptoms that such as persistent burning sensation in your genital area, excess vaginal discharge, painful sex, rashes followed by soreness around your vagina.

What are the causes of Vaginal Yeast Infection?

1. Antibiotics lowering good bacteria or ‘lactobacillus’ within your vagina
2. Unchecked and untreated diabetes
3. Pregnancy
4. A Fragile immune System
5. Uncontrolled eating habits, like consuming a lot of sugary food
6. Stress
7. Menstrual imbalance
8. Inadequate or no sleep

How to treat Vaginal Yeast Infection?

Treatment of the infection varies with the severity of the condition. For simple infections

1. One to three days of anti-fungal medications in the form of cream or ointment, for instance, Terazol, Lotrimin, Gynazle and Monistat.
2. One dosage of an oral medicine known as Fluconazole

For complicated Infections
There are particular types of Candida that does not respond to the normal treatment and hence requires a more aggressive approach. If you meet any one of the following criteria like uncontrolled diabetes, weak immune system due to HIV positive or medicinal side-effects, you are pregnant, excess build-up of the candida fungus, the infections recur more than four times a year or you are down with severe itching, swelling, redness, tears or sores in your vaginal area, your case is severe and complex.

Possible treatments in this situation can be:

1. A 14-day tablet course, cream or ointment for vaginal treatment.
2. 2 to 3 dosages or a long term usage of anti-fungal medication or  Fluconazole (not suggested for pregnant women).
3. Cure of your sexual partner who may be transmitting it to you (although these are rare) or use of condoms during intercourse.