Tuesday October 23 2018

Posted by Tomas on October 16, 2018
  • The tiger strips on the abdomen of the Aedes aegypti identifies them as the threat
    The tiger strips on the abdomen of the Aedes aegypti identifies them as the threat
  • The Zika Virus under a  scanning electron microscope
    The Zika Virus under a scanning electron microscope
  • The varying effects of microcephaly severity
    The varying effects of microcephaly severity
  • The iconic image of the Brazilian microcephaly affected baby that puts chills into the hearts of would-be parents.
    The iconic image of the Brazilian microcephaly affected baby that puts chills into the hearts of would-be parents.
  • Spraying for Mosquitos began in Los Cabos and La Paz in mid September 2018
    Spraying for Mosquitos began in Los Cabos and La Paz in mid September 2018

Updated October 16, 2018, The number of new cases testing positive for the Zika virus rose by only 29 persons nationwide and two new cases were reported on the Baja peninsula by the Mexican Secretary of Health in the last week.  The unfortunate by-product of our late summer rains is an abundant crop of Mosquitoes, particularly of the species that carries not only the Zika Virus, but Chikungunya Virus and the Dengue virus as well. In adventuring outdoors it is advisable to protect yourself with a mosquito repellant, particularly in the sunset hours. There are increasing reports of both Dengue and Chikungunya and we are seeking additional statistics on the outbreaks in this 2018 fall season. The largest increase in new cases was in the state of Sonora which was hit with flooding rains in September. 

15-Oct 2015-17 8-Oct This Week Change Total
In All Mexico 11,917 300 329 29.0 12,246
Aguascalientes  1 0.0 0.0 0.0 1
Baja California 3 0.0 0.0 0.0 3
Baja California Sur 51 18.0 20.0 2.0 71
Campeche 94 0.0 0.0 0.0 94
Coahuila 336 0.0 0.0 0.0 336
Colima 297 0.0 0.0 0.0 297
Chiapas 821 0.0 0.0 0.0 821
Durango 2 2.0 2.0 0.0 4
Guanajuato 5.0 5.0 0.0 5
Guerrero 885 2.0 2.0 0.0 887
Hildalgo 277 8.0 8.0 0.0 285
Jalisco 432 115.0 117.0 2.0 549
Mexico 27 20.0 20.0 0.0 47
Michoacán 67 2.0 2.0 0.0 69
Morelos 499 6.0 6.0 0.0 505
Nayarit 678 17.0 18.0 1.0 696
Nuevo León 949 1.0 1.0 0.0 950
Oaxxaca 514 2.0 2.0 0.0 516
Puebla 225 0.0 0.0 0.0 225
Querétaro 17 0.0 0.0 0.0 17
Quintana Roo 388 1.0 2.0 1.0 390
San Luis Potosi 524 7.0 7.0 0.0 531
Sinaloa  177 30.0 33.0 3.0 210
Sonora 84 45.0 65.0 20.0 149
Tabasco  367 8.0 8.0 0.0 375
Tamaulipas 802 0.0 0.0 0.0 802
Veracruz 2,100 2.0 2.0 0.0 2,102
Yucatán  1,299 9.0 9.0 0.0 1,308
Zacatecas 1 0.0 0.0 0.0 1
Pregnant Women 7,001 57.0 62.0 5.0 7,063

It is important to note that the statistics do not indicate whether the cases were contracted locally or on travel to other regions of Mexico or the world. 

The epidemic that authorities projected in 2015 has yet to materialize with the notable exception of some Caribbean locations. Every US state currently has cases of Zika under treatment, but only Florida has 273 locally acquired cases, a total of more than 5000 cases were contracted during travel to infected regions. Unfortunately, the Mexican Secretary of Health statistics we quote here in this article do not differentiate between locally acquired and travel contracted cases of the disease. Puerto Rico is the hemispheric hotspot with more than 37,000 cases of Zika reported. 

The disease has not proved as disastrous to the unborn as previously anticipated. With more than more than 7000 pregnant women testing positive for the virus in Mexico since January 1, 2016, only 5 babies have been born with symptoms of microcephaly. This number should rise as we move into the next 9 month period as more babies are born that were conceived since the beginning of the outbreak. The first week of February 2017 saw the first death from microcephaly as the baby was born with unsustainable brain deficiencies. 

Much of Mexico is now entering the mosquito season and undoubtedly the statistics will rise. But 2018 has brought a dramatic decrease in the number of reported cases testing positive nationwide.

Also remember that there are a number of small biting insects that leave a welt, while only the Aedes aegypti mosquito is a carrier of Zika. Keep you panic to a minimum. 

Do the Statistics Tell the Whole Story?

Absolutely not.

Previous statistics on the virus in Mexico appeared that testing was focused only on pregnant women. In several of the last few weeks of statistics the math shows non-childbearing women and men are being tested as well. Many people may have or have had Zika and not know it or even sought medical treatment for it. So the number of total cases is likely much higher. Since Zika can appear with limited symptoms, this is likely true everywhere.

Second, the Mexican statistics don't indicate if the cases of Zika were contracted locally or in travel. As of August 2016, the US had more than 5200 cases and less than 200 were contracted locally (Florida). 

Third several other diagnoses were presented for what seems to be clearly one of the three (as they present similar symptoms) before tests we insisted on proved it to be Chikungunya. Numbers have been revised my the Sec of Health on the chart to the right several times over the course of this article. 

Background on the Zika Epidemic

The Zika virus was first discovered in 1947 in a Sentinel Rhesus monkey in Uganda.  It was later shown to reside in mosquitoes in 1948, with the first human infections documented in 1952.  Zika belongs to a class of viruses known as Arboviruses, which are essentially any virus transmitted from blood-sucking arthropods, like mosquitoes and ticks, to vertebrates like humans. Technically a Flaviviridae virus, Zika is also in a family of viruses that include West Nile, Yellow fever, and mosquito transmitted Dengue Virus.

The World Health Organization declared the Zika Virus a Global Health Emergency on February 1, 2016. The Zika Virus, when contracted by pregnant women or women trying to become pregnant appears to have a direct correlation to an increase in the birth defect microcephaly, or underdeveloped brains. By this declaration, it allows for the immediate release of special funding for research and containment. Since Late February 2016, a number of additional health problems have been linked to a Zika infection, including paralysis in adults. However, these problems are extremely rare, the major threat remains to pregnant women and their unborn child.

On April 10, 2016 the Center for Disease Control (CDC) announced that they believe the Zika virus poses a greater threat than originally thought and that contracting the virus during any phase of pregnancy can be harmful to the fetus. Direct links have been made to the virus and birth defects and it is believed that mutation in the virus from its origins in Africa have made it not only more virulent but is what has resulted in the connection to birth defects and temporary paralysis syndrome in a rare number of patients. Birth defects remain the main concern in the contraction of the virus while the general risk of other side effects remains relatively low.

We had our first two reported cases of Zika Virus in Baja California Sur as of 10/24/16. 

The number of infected persons is likely much higher and tested numbers really just represent a relative assessment of risk, as the vast majority of people (particular males) contracting Zika are unaware they have had it, writing it off to a bad cold, case of the flu or travel sickness.

Zika poses a potential threat to the unborn of mothers who are pregnant or who may become pregnant in the near future. In researching the Health Ministries of several countries the definition of 'near future' appears to be about 6 months. There have also been some links to a neuro-paralysis disorder affecting both men and women.

Should I cancel my trip to Baja?

The last week of October 2016 has produced the first two reported cases of Zika Virus in Baja California Sur and the first case of Zika was reported in the northern state of Baja California the first week of February 2017. I checked all the local news outlets and finding any information on the Zika virus locally was virtually impossible. The major newspaper Sudcaliforniano had no mention. This year's extended dry period of the normally rainy late summer has kept the spread of the mosquitos to a minimum. The number of Dengue cases in the southern peninsula has been near record lows this year as well in Baja California Sur.

An interesting side note here is the Aedes aegypti mosquito is not found in locations higher than one mile in altitude. (Mexico City and Nairobi Kenya for example) 

The Zika virus is transmitted by the same Aedes aegypti mosquito that carries Dengue. The mosquito contagion season in Baja California Sur usually runs from late July until early November. Zika may pose a greater threat to the peninsula at that time. As of this date, the city of La Paz has authorized an early start to the 2016 mosquito eradication programs in a city that were plagued by a heavier than usual outbreak of Dengue in 2014. 

Prevention of Contraction

The Center for Disease recommends the use of a DEET-containing mosquito repellent applied over your sunscreen when traveling to areas where the Aedes aegypti, the carrier of this virus, is located. DEET (N, N-Diethyl-meta-toluamide) however is also a toxin and previously not recommended for children under 9 years of age. Some organic and less toxic mosquito repellents are available, but these are generally considered to be less effective. The effectiveness of DEET is also limited to about 4hrs between applications. The mosquito is most prevalent in tropical areas in the morning and evening hours, during rainy periods. However, I have also found the Aedes aegypti active during full moon periods in the nighttime hours and 24hrs per day in moist bathrooms. All it takes is one bite from an infected mosquito to be at risk of infection. (see other means of contraction below. 

Please recall that two decades ago it was recommended that mosquito repellent products containing DEET should not be used on children under the age of 9. 

What is the Zika Virus?

The Zika virus is caused by the bite of a mosquito and is classified as an arbovirus belonging to the genus flavivirus, which are those invertebrate animals such as mosquitoes and ticks that transmit the disease to humans. The Zika is similar to dengue, yellow fever, West Nile virus and Japanese encephalitis. It is transmitted by the bite of a mosquito of the genus Aedes, as the Aedes aegypti mosquito that causes dengue, Current evidence indicates human to human transmission is unlikely. 

Where is Zika From?

The virus was identified in 1947 for the first time in Uganda, specifically in the forests of Zika. It was discovered in a Rhesus monkey when a study of the transmission of yellow fever in the jungle was performed. The serological analysis confirmed infection in humans in Uganda and Tanzania in 1952, but it was in 1968 that the virus was isolated in samples from people in Nigeria. Genetic analyses have shown that there are two major lineages of the virus: the African and the Asian. The disease mutated somewhere in its travels to South America where this outbreak was discovered in Brazil and has become not only more virulent but caused the side effect of causing the birth defect of microcephaly.

How do you get the Zika Virus?

The #1 answer to that is almost always from the bite of the Aedes aegypti mosquito that has been infected with the virus.

On rare occasion from mother to child during the birth process

Through the transmission of blood and on rare occasion may be transmitted through sexual contact and bodily fluids.

The Zika Virus is not available in stores. 

What are the Symptoms of Zika?

Zika usually last four to seven days and may be confused with dengue.

In most cases the apparent symptoms are mild, the person may have a fever of less than 39 °C/102.2°F a headache, weakness, muscle, and joint pain, inflammation usually concentrated in the hands and feet, conjunctivitis nonpurulent, lower limb edema and rash, which tends to begin in the face and then spreads throughout the body. Less often vomiting, diarrhea, abdominal pain and loss of appetite occur.

Although further study is required to determine the links to birth defects and some of these birth defects can result in premature mortality, there are no deaths directly attributed to the disease. The detrimental results appear to be limited to the unborn of mothers infected during pregnancy.

What is the Treatment for Zika?

There is no vaccine or specific treatment for Zika, only symptomatic management consisting of rest and take acetaminophen or paracetamol to control fever. 

The use of aspirin is not recommended because of the risk of bleeding that entails for many patients. It is also advised drinking plenty of fluids to alleviate the fluid loss and dehydration. To deal with the itch caused by the eruption can be used antihistamines.

Pregnant women or women trying to become pregnant should stay away from the patient at least during the first week of the disease to avoid contagion, although there have been no known incidents at this time of human to human transmission. There is the question as to whether the Zika virus can be transmitted through seminal fluids during sexual intercourse

Why the Concern?

The Aedes aegypti mosquito ranges of much of the western hemisphere from the temperate lower altitude regions of Central and South America too much of the United States. (Editor's Note: High-altitude locations near 1 mile from Denver, Nairobi, and Mexico City are not threatened by mosquitoes, although in recent years some species seem to be adapting) It is likely to eventually spread to most of these areas, particularly those that confront the tropical mosquito-borne illnesses like Dengue. The affected regions cover the homes of more than half a billion people, even a fractional statistical rise in birth defects could result in tens of thousands of children that will need lifetime care.

Center for Disease Control Recommendations

The CDC notice follows reports in Brazil of microcephaly and birth defect outcomes in babies of mothers who were infected with Zika virus while pregnant. Additional studies since the first posting of this article in January indicate a very strong correlation between the Zika virus and birth defects. 

Reference:

The Center for Disease Control Website
The Mexican Secretary of Health
Secretaría de Salud Mexico, Dept de Epidemiologia
The World Health Organization Website
BBC News

 


All content and images
©2003-2018 BajaInsider.com
The Original Online Magazine fore Traveling & Living in Baja

About the BajaInsider