About Zika Virus Disease

Zika virus disease

Zika virus disease (Zika) is a disease caused by Zika virus that is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. For this reason, many people might not realize they have been infected. Once a person has been infected, he or she is likely to be protected from future infections.

Zika virus was first discovered in 1947 and is named after the Zika forest in Uganda. In 1952, the first human cases of Zika were detected and since then, outbreaks of Zika have been reported in tropical Africa, Southeast Asia, and the Pacific Islands. Zika outbreaks have probably occurred in many locations. Before 2007, at least 14 cases of Zika had been documented, although other cases were likely to have occurred and were not reported. Because the symptoms of Zika are similar to those of many other diseases, many cases may not have been recognized.

In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infection in Brazil and on Feb 1, 2016, the World Health Organization (WHO) declared Zika virus a public health emergency of international concern (PHEIC). Local transmission has been reported in many other countries and territories. Zika virus likely will continue to spread to new areas.

Transmission

Zika virus is transmitted to people primarily through the bite of an infected Aedes species mosquito (A. aegypti and A. albopictus). These are the same mosquitoes that spread dengue and chikungunya viruses.

A mother already infected with Zika virus near the time of delivery can pass on the virus to her newborn around the time of birth.

A pregnant woman can pass Zika virus to her fetus during pregnancy. We are studying the adverse pregnancy and infant outcomes associated with Zika virus infection during pregnancy. To date, there are no reports of infants getting Zika virus through breastfeeding. Because of the benefits of breastfeeding, mothers are encouraged to breastfeed even in areas where Zika virus is found.

Zika virus can be spread by a man to his sex partners. In known cases of likely sexual transmission, the men had Zika symptoms, but the virus can be transmitted before, during, and after symptoms develop. In one case, the virus was spread a few days before symptoms developed.The virus is present in semen longer than in blood.

As of February, 1, 2016, there have not been any confirmed blood transfusion transmission cases in the United States. There have been multiple reports of blood transfusion transmission cases in Brazil. These reports are currently being investigated. During the French Polynesian outbreak, 2.8% of blood donors tested positive for Zika and in previous outbreaks, the virus has been found in blood donors.

Symptoms

• Most people infected with Zika virus won’t even know they have the disease because they won’t have symptoms. The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache. The incubation period (the time from exposure to symptoms) for Zika virus disease is not known, but is likely to be a few days to a week.
• • See your healthcare provider if you are pregnant and develop a fever, rash, joint pain, or red eyes within 2 weeks after traveling to a place where Zika has been reported. Be sure to tell your health care provider where you traveled.
• The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito.
• People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. For this reason, many people might not realize they have been infected.
• Zika virus usually remains in the blood of an infected person for about a week but it can be found longer in some people.
• Once a person has been infected, he or she is likely to be protected from future infections.

Diagnosis

• The symptoms of Zika are similar to those of dengue and chikungunya, diseases spread through the same mosquitoes that transmit Zika.
• See your healthcare provider if you develop the symptoms described above and have visited an area where Zika is found.
• If you have recently traveled, tell your healthcare provider when and where you traveled.
• Your healthcare provider may order blood tests to look for Zika or other similar viruses like dengue or chikungunya.

Treatment

• There is no vaccine to prevent or medicine to treat Zika infections.
• Treat the symptoms:
  • Get plenty of rest.
  • Drink fluids to prevent dehydration.
  • Take medicine such as acetaminophen (Tylenol®) or paracetamol to relieve fever and pain.
  • Do not take aspirin and other non-steroidal anti-inflammatory drugs.
  • If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication.
• If you have Zika, prevent mosquito bites for the first week of your illness.
  • During the first week of infection, Zika virus can be found in the blood and passed from an infected person to a mosquito through mosquito bites.
  • An infected mosquito can then spread the virus to other people.

Ebola

Ebola virus disease

Ebola hemorrhagic fever (Ebola HF) is a severe, often-fatal disease in humans and nonhuman primates (monkeys and chimpanzees) that has appeared sporadically since its initial recognition in 1976.

Ebola first appeared in 1976 in 2 simultaneous outbreaks, in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.

Genus Ebolavirus is 1 of 3 members of the Filoviridae family (filovirus), along with genus Marburgvirus and genus Cuevavirus. 

Marburgvirus and genus Cuevavirus. Genus Ebolavirus comprises 5 distinct species:

• 1.      Bundibugyo ebolavirus (BDBV)
• 2.      Zaire ebolavirus (EBOV)
• 3.      Reston ebolavirus (RESTV)
• 4.      Sudan ebolavirus (SUDV)
• 5.      Taï Forest ebolavirus (TAFV).

BDBV, EBOV, and SUDV have been associated with large EVD outbreaks in Africa, whereas RESTV and TAFV have not. The RESTV species, found in Philippines and the People’s Republic of China, can infect humans, but no illness or death in humans from this species has been reported to date.

Transmission

Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

Among workers in contact with monkeys or pigs infected with Reston ebolavirus, several infections have been documented in people who were clinically asymptomatic. Thus, RESTV appears less capable of causing disease in humans than other Ebola species.

However, the only available evidence available comes from healthy adult males. It would be premature to extrapolate the health effects of the virus to all population groups, such as immuno-compromised persons, persons with underlying medical conditions, pregnant women and children. More studies of RESTV are needed before definitive conclusions can be drawn about the pathogenicity and virulence of this virus in humans.

Signs and symptoms

EVD is a severe acute viral illness often characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

People are infectious as long as their blood and secretions contain the virus. Ebola virus was isolated from semen 61 days after onset of illness in a man who was infected in a laboratory.

The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days.

Diagnosis

Other diseases that should be ruled out before a diagnosis of EVD can be made include: malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis, hepatitis and other viral haemorrhagic fevers.

Ebola virus infections can be diagnosed definitively in a laboratory through several types of tests:

•          antibody-capture enzyme-linked immunosorbent assay (ELISA)
•          antigen detection tests
•          serum neutralization test
•          reverse transcriptase polymerase chain reaction (RT-PCR) assay
•          electron microscopy
•       virus isolation by cell culture.

Samples from patients are an extreme biohazard risk; testing should be conducted under maximum biological containment conditions.

Vaccine and treatment

No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use.

Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes or intravenous fluids.

No specific treatment is available. New drug therapies are being evaluated.

Favipiravir looks like it may be useful in a mouse model of the disease. Estrogen receptor drugs used to treat infertility and breast cancer (clomiphene and toremifene) inhibit the progress of Ebola virus in infected mice. Ninety percent of the mice treated with clomiphene and fifty percent of those treated with toremifene survived the tests. Given their oral availability and history of human use, these drugs would be candidates for treating Ebola virus infection in remote geographical locations, either on their own or together with other antiviral drugs.

Prevention and control

Controlling Reston ebolavirus in domestic animals

No animal vaccine against RESTV is available. Routine cleaning and disinfection of pig or monkey farms (with sodium hypochlorite or other detergents) should be effective in inactivating the virus.

If an outbreak is suspected, the premises should be quarantined immediately. Culling of infected animals, with close supervision of burial or incineration of carcasses, may be necessary to reduce the risk of animal-to-human transmission. Restricting or banning the movement of animals from infected farms to other areas can reduce the spread of the disease.

As RESTV outbreaks in pigs and monkeys have preceded human infections, the establishment of an active animal health surveillance system to detect new cases is essential in providing early warning for veterinary and human public health authorities.

Reducing the risk of Ebola infection in people

In the absence of effective treatment and a human vaccine, raising awareness of the risk factors for Ebola infection and the protective measures individuals can take is the only way to reduce human infection and death.

In Africa, during EVD outbreaks, educational public health messages for risk reduction should focus on several factors:

·         Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.

·         Reducing the risk of human-to-human transmission in the community arising from direct or close contact with infected patients, particularly with their bodily fluids. Close physical contact with Ebola patients should be avoided. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.

·         Communities affected by Ebola should inform the population about the nature of the disease and about outbreak containment measures, including burial of the dead. People who have died from Ebola should be promptly and safely buried.

Pig farms in Africa can play a role in the amplification of infection because of the presence of fruit bats on these farms. Appropriate biosecurity measures should be in place to limit transmission. For RESTV, educational public health messages should focus on reducing the risk of pig-to-human transmission as a result of unsafe animal husbandry and slaughtering practices, and unsafe consumption of fresh blood, raw milk or animal tissue. Gloves and other appropriate protective clothing should be worn when handling sick animals or their tissues and when slaughtering animals. In regions where RESTV has been reported in pigs, all animal products (blood, meat and milk) should be thoroughly cooked before eating.

Controlling infection in health-care settings

Human-to-human transmission of the Ebola virus is primarily associated with direct or indirect contact with blood and body fluids. Transmission to health-care workers has been reported when appropriate infection control measures have not been observed.

It is not always possible to identify patients with EBV early because initial symptoms may be non-specific. For this reason, it is important that health-care workers apply standard precautions consistently with all patients – regardless of their diagnosis – in all work practices at all times. These include basic hand hygiene, respiratory hygiene, the use of personal protective equipment (according to the risk of splashes or other contact with infected materials), safe injection practices and safe burial practices.

Health-care workers caring for patients with suspected or confirmed Ebola virus should apply, in addition to standard precautions, other infection control measures to avoid any exposure to the patient’s blood and body fluids and direct unprotected contact with the possibly contaminated environment. When in close contact (within 1 metre) of patients with EBV, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

Laboratory workers are also at risk. Samples taken from suspected human and animal Ebola cases for diagnosis should be handled by trained staff and processed in suitably equipped laboratories.

Bee venom kills HIV cells (NaturalNews) An ancient Chinese medicine protocol known as "apitherapy" appears to be making a resurgence in modern times, as scientists continue to uncover the many amazing healing powers of bees and the substances they produce. And a new study recently published in the journal Antiviral Therapy affirms this, having found that bee venom, which is released during a bee sting, may hold the key to targeting and destroying HIV. As reported by U.S. News & World Report, scientists from the Washington University (WU) School of Medicine in St. Louis, Missouri, identified the presence of a compound known as melittin that they say exhibits powerful anti-HIV effects. The bee venom toxin was visibly observed to destroy the viral components of HIV while leaving healthy cells unharmed. For their research, Joshua Hood and his colleagues from WU attached melittin to nanoparticles that are smaller than HIV. They then applied the resulting substance to HIV itself, where it was clearly observed to "rip holes" in the outer layer of the virus, effectively destroying it. But because of the particles' size, they did not harm healthy cells in the body. According to ScienceNews.org, the team also applied the solution to healthy human cells obtained from vaginal walls. They observed that the substance did not visibly affect these healthy cells at all, illustrating the unique nature of the bee venom in differentiating between the cells it is supposed to attack, and the cells it is supposed to leave unharmed. "Based on this finding, we propose that melittin-loaded nanoparticles are well-suited for use as topical vaginal HIV virucidal agents," wrote the authors in their paper. "Out hope is that in places where HIV is running rampant, people could use this as a preventative measure to stop the initial infections." As far as HIV potentially growing resistance to the treatment later on down the road, researchers believe such a scenario will never materialize due to the nature of the mechanistic action. Because bee venom specifically destroys the outer layer of the virus, which results in the virus itself dying, there is little or no chance of resistance ever developing. "Theoretically, melittin nanoparticles are not susceptible to HIV mutational resistance seen with standard HIV therapies," added the research team. "By disintegrating the [virus'] lipid envelope, [it's] less likely to develop resistance to the melittin nanoparticles." Propolis, royal jelly, bee pollen, and raw honey may also target HIV However, the use of nanoparticles, which have never been proven safe, is not actually necessary for bee venom to do its work. A patent issued to Vespa Laboratories, Inc. back in 1989 reveals that the use of melittin as a natural antiretroviral treatment was known long before nanoparticles were even invented (or discovered), which means the substance itself, without modification, possesses anti-HIV properties. And besides bee venom, many other bee products may also target HIV naturally without the need for deadly antiretroviral drugs and therapies. Numerous scientific studies have shown that bee propolis, for instance, is loaded with biologically-active substances that stimulate immunity and prevent HIV replication. And royal jelly, which is considered by many to be a "perfect food," contains all sorts of beneficial hormones, vitamins, and other nutrients that naturally promote strong immunity and the proliferation of healthy cells. "Five bee products are involved in apitherapy protocol for the treatment of HIV/AIDS," explains an article posted on ProNutrition.org. "These are honey, pollen, royal jelly, propolis, and bee venom. The first four can be used as food supplements and [medications], while bee venom is only applicable as medicine for HIV/AIDS and other disease conditions." Learn more: http://www.naturalnews.com/039595_bee_venom_HIV_apitherapy.html#ixzz2ONKiiZsf

Multidrug-resistant TB on the rise

Cases of tuberculosis (TB) resistant to a multitude of drug treatments are rising “at an alarming rate” across Europe, with an estimated 81,000 new cases every year, the World Health Organisation (WHO) said in a report published Wednesday.

Fifteen of the 27 countries with the highest incidence of multidrug-resistant TB are in eastern Europe, but Asia has also been hit hard by the disease.

The report

Almost 12 per cent of newly diagnosed patients with TB have the multidrug-resistant form, as do 37 per cent of those who have previously been treated for TB, the report said.

While countries in eastern Europe and central Asia were hardest-hit by drug-resistant TB, their treatment success rate of 65 per cent was greater than that in western Europe.

“In western Europe TB is widely perceived as a problem of the past, but the disease remains active, mainly in cities,” said the WHO report, presented in London.

9,000 cases annually

It said 3,500 new cases were reported in London every year — more than anywhere else in western Europe. Across Britain, there were around 9,000 cases annually.

Almost 50 per cent of patients affected by the multidrug-resistant form of TB will die because no drugs are strong enough to treat them, said the WHO.

The organization has launched a multi-billion-dollar action plan aimed at saving 120,000 lives in the period up to 2015.

Keywords: tuberculosis, World Health Organisation