States Capacity to Conduct Testing and Sequencing of Viruses

Context:

Since the Zika outbreak began on June 20, when the first case was reported in Pune, confirmed cases have been gradually increasing. As of the first week of August, Maharashtra has reported 88 confirmed cases, with Pune city, the epicenter, accounting for 73 cases and six more from rural Pune. Of the total cases reported so far, 37 are pregnant women, making up half of the confirmed infections.

Relevance:

• GS- Health
• GS3- Scientific Innovations & Discoveries

Mains Question:

In the context of the recent rise in the number of reported zika cases, examine the states capacity to conduct testing and sequencing of viruses. Also suggest a way forward strategy to enhance the infrastructure further. (15 Marks, 250 Words).

About the Zika Virus:

• The Zika virus is a mosquito-borne flavivirus primarily transmitted by Aedes mosquitoes, especially Aedes aegypti.
• It can also be spread from mother to fetus during pregnancy, through sexual contact, and via blood transfusions.
• The virus has an RNA genome, giving it a high potential to accumulate mutations.
• Genomic research indicates that the Zika virus has two lineages: African and Asian.

History:

• The Zika virus was first discovered in 1947 in the Zika forest of Uganda in infected monkeys, with the first human cases recorded in 1952 in Uganda and Tanzania.
• Since 2007, outbreaks have been reported across Africa, the Americas, Asia, and the Pacific, with notable recent outbreaks in Indian states such as Kerala and Karnataka.

Symptoms:

Zika infection is often asymptomatic, but when symptoms do occur, they commonly include fever, joint pain, muscle pain, and headache, typically lasting 2-7 days.

Association with Other Conditions:

• Zika virus has been linked to Guillain-Barre syndrome, neuropathy, and myelitis in both adults and children.
• Its interaction with the dengue virus can significantly worsen disease severity, creating challenges in vaccine development and public health management.

Complications:

• Although rare, those infected with the Zika virus are at risk of developing Guillain-Barré syndrome, a neurological disorder where the immune system mistakenly attacks part of the peripheral nervous system.
• However, the more serious impact is on pregnant women, who risk giving birth to babies with microcephaly (a condition where the baby has a smaller than average head size) and other neurological impairments.
• A January 2023 paper in The Lancet Regional Health–Americas conducted a meta-analysis of babies born to 1,548 pregnant women infected with the Zika virus, based on 13 studies in Brazil from 2015 to 2017.
• The study found that the absolute risk of microcephaly was 6.6%, either at birth or during follow-up.
• Additionally, there was an 18.7% absolute risk of functional neurological abnormalities in these babies, along with a relatively smaller risk of neuroimaging, ophthalmic, and auditory abnormalities.
• The study also identified a significant risk of premature birth (10.5%), low birth weight, and being small for gestational age (16.2%).
• Less well-known is the risk of sexual transmission of the virus by infected men, as potentially infectious virus particles can be present in their semen for at least two months.
• It is therefore crucial for infected men, particularly those planning to start a family, to be informed of this risk and advised on preventive measures to avoid transmitting the virus to women for at least three months, in accordance with U.S. CDC guidelines.

Testing the Virus:

• Given the harmful effects of the virus, it is alarming that the Pune-based ICMR lab only increased testing efforts after news broke about the Pune Municipal Corporation’s plans to send samples to a government medical college to reduce testing delays.
• As Kerala recently showed during the Nipah virus outbreak, and as Gujarat experienced with the ongoing Chandipura virus outbreak and acute encephalitis syndrome cases, it is becoming increasingly crucial for states to develop the capacity for high-quality testing and sequencing of viruses that cause frequent and deadly outbreaks.
• Reducing the lead time to test results from the moment a suspected case is observed is key to implementing timely public health responses that can limit virus spread and prevent an outbreak.

Conclusion:

The COVID-19 pandemic highlighted the benefits of decentralized testing and sequencing, and this approach should be replicated for every pathogen that causes deadly outbreaks.