Fears and Facts About the Zika Virus

The mosquito that bears zika, which may be associated with birth defects including microcephaly, went extinct in Israel decades ago.

Baby Jose Wesley being bathed in a bucket, Poco Fundo, Brazil. His microcephalic condition was diagnosed a couple of days after his birth. Dec. 23, 2015.
AP

Israel has had only one case of Zika virus so far, the Health Ministry confirmed today, and adds: there is no danger of catching the disease here.

Zika is native to parts of Africa. It spread long ago to South-East Asia and made the leap to South America in 2015. There, its appearance – chiefly in Brazil – was associated with a spike in birth defects, including the rare condition called microcephaly, which involves an unusually small head and brain in newborns.

Since then, the world and Israelis too have been frightened and confused: Colombia, Ecuador, El Salvador and Jamaica have even counseled couples to put off pregnancy until more information is clear. Meanwhile, what is Zika and how is it caught? Is this seeming nonentity of a disease really dangerous after all?

1. What is Zika, anyway?

Zika is a species of flavivirus, a family that includes the likes of yellow fever, chikungunya, viral encephalitis  – and West Nile and dengue. It's named after the Zika Forest in Uganda.

2. How is Zika transmitted?

Zika is transmitted specifically by Aedes aegypti mosquitoes.  As aegypti's name suggests, it is an African insect but has been plaguing other parts of the world for centuries, apparently having been brought over by exploration, colonization and trading ships.

An Aedes aegypti mosquito, eating. Only the females suck blood, so this is a female. Photo (2006) provided to AP by the Centers for Disease Control and Prevention.
AP

3. Can Zika be caught in Israel?

No. The one case identified in Israel so far was a 2-year-old who caught it in Colombia, as reported last week and confirmed by the Health Ministry on Sunday.  The disease is not infectious in the sense that one sick person cannot infect another person, the ministry stresses in its directives to the general public regarding Zika. Infection requires the mosquito vector.

4. Does the mosquito that spreads Zika, Aedes aegypti, live in Israel?

Apparently not, though it once did. Aegypti went extinct in Israel, and Europe too, sometime in the mid-20th century, the Health Ministry told Haaretz.

In ministry argot, that means that none have been trapped in the country since then, so the prevailing belief is that it's not here. Therefore, Zika cannot be caught in Israel.

Analyzing samples for Zika virus in a laboratory at the Fiocruz institute in Rio de Janeiro, Brazil, Friday, Jan. 22, 2016.
AP

West Nile and dengue have been spreading around the world and do exist now in Israel because they are transmitted by the Asian tiger mosquito, Aedes albopictus, which was first noticed in Israel in 2002 and is now biting Israelis practically nationwide. Whether albopictus can spread Zika is not entirely clear – it might, but inefficiently.

It bears noting that experts caution: by the time albopictus was "noticed" in Israel, it had become quite widespread. One probably doesn't notice the very first new mosquito in town or even the first million.

5. Does Zika really cause birth defects, and how?

Nobody knows yet. The link is NOT confirmed. But the medical establishment began to suspect a link between Zika and birth defects after an outbreak of the virus in a specific area of Brazil coincided with a spike in a rare form of birth defect called microcephaly, which is a nervous system defect causing babies to be born with smaller than normal crania and brains. (Most microcephalics are mentally handicapped but some have normal mental capabilities.)

To date about 4,000 microcephalic babies have been born in that area of Brazil over some four months, which worked out to about 1% of all babies born in the worst-afflicted part. That is a huge proportion, compared with 150 microcephalic babies out of the 3 million born in all of Brazil in 2014.

Fumigating to kill mosquitoes and prevent dengue, chikunguya and Zika virus, at El Angel cemetery, in Lima, Peru, January 20, 2016.
AP

6. What are the symptoms of Zika?

In adults, this is usually a mild disease, a bit like the flu. Plenty of people catch it and feel nothing. All that said - doctors are starting to suspect correlation between Zika and another nervous condition entirely, in adults, which can leave them almost completely paralyzed for weeks.

7. Can it be dangerous?

So far, 49 of the microcephalic babies have died, Brazil's health ministry reported. There is also the new suspicion that Zika may be involved in nervous conditions in adults.

As for pregnant women, doctors suspect the "danger" time to avoid the mosquito is the first trimester. But they cannot be sure, especially as they cannot be sure the virus is even involved in the birth defect spike in Brazil. Nobody knows yet how the virus affects the fetus, if it does.

8. Treatment? Cure? Vaccine? Anything?

None exist at this time. Nor are there commercially available tests for the Zika virus; it can however be identified from blood, in the lab.

9. Any useful advice?

If one is pregnant or considering pregnancy, avoid traveling to areas where the virus is being actively transmitted, counsels the Israeli Health Ministry. Keep track carefully of Zika-related travel alerts: for instance, the virus has been located in Puerto Rico too, and much of Latin America.

The list of affected countries, according to the World Health Organization, as of January 2016, is, by alphabetic order: Barbados, Bolivia, Brazil, Colombia, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, and Venezuela.

If one must go, use every means available to repel mosquitoes, from swatters to lotions to nets over the bed.

10. And if I went to a zika-afflicted area when pregnant?

There is no commercial test for the virus. The only readily available recourse is to carefully monitor the pregnancy, advises the CDC in its 2016 paper, "Interim Guidelines for Pregnant Women During a Zika Virus Outbreak".

If a pregnant women who had been in the risk area develops zika-related symptoms such as acute fever, joint pain, rash, and/or conjunctivitis, she should rush to be tested – even though the tests are not entirely reliable.
Note however that a woman may be infected but asymptomatic - meaning, she doesn't feel or look sick. If a pregnant woman has been  to an area associated with zika outbreaks, even if she feels fine within the two weeks as of her trip - she should be tested in any case and should consider serial ultrasound monitoring for cranial abnormalities in the child, the CDC counsels.