The 2021 Zika outbreak in Uttar Pradesh state of India: Tackling the emerging public health threat

Abstract

Zika virus is an RNA virus belonging to the Flavivirus family that is chiefly transmitted by the female Aedes mosquito. The Zika virus first infected humans in Uganda and Tanzania in 1952. Since, it has spread to several parts of the world causing outbreaks of variable extent. In India, these outbreaks have been reported from Gujarat, Tamil Nadu, Madhya Pradesh, Rajasthan, Kerala, and Maharashtra. The most recent outbreak is from the most populous state of India, Uttar Pradesh, where the climate is conducive to the breeding and transmission of other arboviral infections such as Dengue, Chikungunya, and Malaria. These infections also happen to share similar incubation periods and overlapping clinical manifestations with Zika virus (ZIKV) infection, leading to misdiagnoses or delayed diagnosis. We aim to provide an account of the outbreak, its repercussions, errors made in attempting to contain the spread of the disease, and, measures to be taken in the future.

Genetic diversity and phylogenetic analyses of Asian lineage Zika virus whole genome sequences derived from Culex quinquefasciatus mosquitoes and urine of patients during the 2020 epidemic in Thailand

“…Zika virus infection has historically been a neglected viral infection in Africa, the Americas, Asia, and the Pacific, likely due to the prevalence of silent infections and relatively mild clinical manifestations 26 , 27 . Southeast Asian countries such as Thailand 28 , Cambodia 29 , 30 , Indonesia 31 , the Philippines 32 , India 33 , Singapore 34 , Japan 35 , and Vietnam 36 , 37 have experienced continuous circulation of ZIKV. Thailand, a geographically diverse country and popular tourist destination, has seen cases of ZIKV infection among travelers to various regions, including Japan 38 , Europe 39 , Israel 40 , and Canada 41 .…”

Continuing development of vaccines and monoclonal antibodies against Zika virus

“…Pan American Health Organization (PAHO) continues to actively collate and report ZIKV disease cases (https://www3.paho.org/data/index.php/en/ mnu-topics/zika.html), but outside of the Americas, little new data are being reported, which may indicate low transmission or a lack of testing. Sporadic cases have been reported in the European Union and the Western Pacific, and India has reported several small outbreaks since 2016, with most recently 150 cases in Utter Pradesh state in October 2021 9,10 . In Brazil, the real burden of ZIKV disease remains unknown and is likely underreported, despite strong surveillance and diagnostic testing infrastructure.…”

Predicting Efficacy of a Purified Inactivated Zika Virus Vaccine in Flavivirus-Naïve Humans Using an Immunological Correlate of Protection in Non-Human Primates

“…It is estimated that half of the global population lives in regions that have reported Zika virus (ZIKV) cases [ 1 ]. After the large outbreak in the Americas in 2015–2016 [ 2 ], ZIKV has continued to circulate at low and sustained levels in the Americas [ 3 ] and Southeast Asia [ 4 , 5 , 6 ], together with locally acquired ZIKV cases in the United States [ 7 ] and France [ 8 ] and ZIKV outbreaks in India [ 9 , 10 ]. Given the significant threat to public health due to complications associated with ZIKV, especially to children born to women infected with ZIKV during pregnancy, the development of a vaccine is crucial to protect susceptible populations, including travelers [ 11 ] visiting Zika-endemic countries [ 1 , 12 ].…”