Zika virus: Centre issues guidelines; warns against travel to affected areas

A day after WHO declared emergency over the "explosive" spread of the mosquito-borne Zika virus, the Centre today issued detailed guidelines for combating the disease, including a travel advisory that asks pregnant women to either defer or cancel their travel to the affected areas.

The health ministry said that all international airports and ports will display signage with information on the disease. Travellers will be asked to report to customs if they are returning from affected countries and suffering from febrile illness, it added.

Zika virus, which is carried by mosquito and suspected to cause serious birth defects, has affected countries in the Americas.

In its guidelines, the ministry said that while the disease has not been reported in India, the mosquito which transmits Zika virus, namely Aedes aegypti, also transmits dengue virus, which is widely prevalent in the country.

Union Health Minister JP Nadda said he has asked for steps to be taken to prevent entry and transmission in India of the virus.

The health ministry said the overall situation would be monitored by a 'joint monitoring group' under Director General of Health Services (DGHS) while the Indian Council of Medical Research (ICMR) would identify the research priorities and take appropriate action.

Rapid Response Teams (RRTs) shall be activated at central and state surveillance units with each team comprising an epidemiologist or public health specialist, a microbiologist and a medical specialist, the ministry added.

The National Centre for Disease Control in Delhi would be the nodal agency for investigation of any outbreaks in India, it said.

"Non-essential travel to the affected countries to be deferred/cancelled. Pregnant women or women who are trying to become pregnant should defer/cancel their travel to the affected areas. All travellers to the affected countries/areas should strictly follow individual protective measures, especially during day time, to prevent mosquito bites.

"Persons with co-morbid conditions like diabetes, hypertension, etc. should seek advice from the nearest health facility, prior to travel to an affected country. Travellers having febrile illness within two weeks of return from an affected country should report to the nearest health facility," the guidelines said.

"I have instructed all concerned to take steps for preventing entry and transmission of the virus in India. Sufficient diagnostic capacity and risk communication are also key elements of strategy on Zika virus.

"My ministry is fully geared to deal with Zika virus. No case reported in India. No need to panic," Nadda said in a series of tweets.

A majority of those infected with Zika virus disease either remain asymptomatic (up to 80 per cent) or show mild symptoms of fever, rash, conjunctivitis, body ache, joint pains, the ministry said.

Based on information on previous outbreaks, severe forms of the disease requiring hospitalisation is uncommon and fatalities are rare, it said, adding there is no vaccine or drug available at present to prevent or treat Zika virus disease.

Airports or ports would have quarantine or isolation facilities while Directorate General of Civil Aviation will be asked to instruct all international airlines to follow the recommended aircraft disinsection guidelines, the ministry said.

Spraying of insecticide on board aircraft is known as disinsection.
Health Ministry said that NCDC in Delhi and National Institute of Virology (NIV) in Pune would be the apex laboratories to support the outbreak investigation while 10 additional laboratories would be strengthened by ICMR to expand the scope of laboratory diagnosis.

The guidelines said that states in India like Kerala and Tamil Nadu, where dengue transmission is prevalent aided by weather conditions, should ensure "extra vigil".
WHO has listed 22 countries and territories in Americas from where local transmission of Zika virus has been reported.

Health Ministry said that Integrated Disease Surveillance Programme (IDSP) through its community and hospital-based data gathering mechanism would track clustering of acute febrile illness and seek primary information from those who travelled to the affected areas.

"IDSP would also advise its state and district-level units to look for clustering of cases of microcephaly among newborns and reporting of Gullian Barre Syndrome.

"The states and UTs would create increased awareness... about Zika virus disease and its possible link with adverse pregnancy outcomes (foetal loss, microcephaly, etc.)," it said.

Noting that the public needs to be reassured that there is "no cause for undue concern", the ministry said the central and state governments will take the necessary steps to deal with the virus.

"There would be enhanced integrated vector management. The measures undertaken for control of dengue or dengue haemorrhagic fever will be further augmented," it said.
In the travel advisory, the ministry said travellers with febrile illness within two weeks of return from an affected country should report to the nearest health facility.

The guidelines said that the ministry and state health departments would work closely with NGOs and professional bodies to sensitise clinicians in the government as well as the private sector about the Zika virus disease.