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Asian and African countries face Zika risk due to high volume of people travelling there

The World Health Organisation has declared the virus a global public health emergency.

Micaela Milagros Mendoza Ramirez sleeps in the arms of her mother Maria Fernanda Ramirez Bolivar who contracted the Zika virus when she traveled to her native Venezuela when she was three months pregnant.
Micaela Milagros Mendoza Ramirez sleeps in the arms of her mother Maria Fernanda Ramirez Bolivar who contracted the Zika virus when she traveled to her native Venezuela when she was three months pregnant.
Image: Alan Diaz/AP/Press Association Images

MANY COUNTRIES ACROSS Africa and Asia could be vulnerable to Zika virus outbreaks, researchers have warned.

According to a new study published in The Lancet Infectious Diseases, India, China, the Philippines, Indonesia, Nigeria, Vietnam, Pakistan and Bangladesh are at greatest risk of Zika virus transmission.

This is due to a combination of high travel volumes from Zika-affected areas in the Americas, local presence of mosquitos capable of transmitting Zika virus, suitable climatic conditions, large populations and limited health resources.

The World Health Organisation has declared the virus a global public health emergency. The first case of the virus in Malaysia was reported this week.

The authors of the report have said that identifying where and when populations would be most susceptible to local transmission of Zika virus “could help inform public health decisions about the use of finite resources”.

An estimated 2.6 billion people live in areas of Africa and Asia-Pacific where the local mosquito species and suitable climatic conditions mean that local Zika virus transmission is possible.

Deaths from Zika are rare and only one-in-five of those infected is thought to develop symptoms such as a mild fever, headache, joint pain, a rash and sore eyes.

‘Many unknowns’ 

Dr Kamran Khan of St Michael’s Hospital in Toronto noted there are “still many unknowns about the virus and how it spreads … and whether immunity exists in areas that have previously reported cases of Zika virus”.

Khan said the impact on populations will “also depend heavily on the country’s ability to diagnose and respond to a possible outbreak”.

“Warmer temperatures in the northern hemisphere (when mosquitos are more active) increase the risk of new outbreaks appearing outside of the Americas.

The potential for epidemics to occur in parts of Africa and the Asia-Pacific region is particularly concerning given that the vast numbers of people who could be exposed to Zika virus are living in environments where health and human resources to prevent, detect, and respond to epidemics are limited.

“Our findings could offer valuable information to support time-sensitive public health decision-making at local, national and international levels.”

The research was carried out by scientists from the London School of Hygiene & Tropical Medicine, Oxford University and the University of Toronto.

zika Indonesian Health Ministry officials operate a thermal scanner used to monitor ferry passengers arriving from Singapore at the arrival hall of Batam Center International Port in Batam, Indonesia yesterday. Source: M Urip/AP/Press Association Images

At the time of the analysis, local transmission of the Zika virus had been confirmed in 40 countries in Central and South America and the Caribbean. At that time, no cases of local transmission had been reported in the US.

Flights 

The researchers gathered data on airline ticket sales from all 689 cities with one or more airports in the region travelling to Africa or Asia-Pacific from December 2014 to November 2015.

The team mapped the monthly volume of travellers arriving into Africa and Asia-Pacific in order to identify countries at greatest risk of Zika virus importation across seasons. Health expenditure per capita was used as a proxy of a country’s capacity to detect and effectively respond to a possible Zika virus outbreak.

Countries with large volumes of travellers arriving from Zika virus-affected areas of the Americas and large populations at risk include:

  • India (67,422 travellers arriving per year; 1.2 billion residents in potential Zika transmission areas);
  • China (238,415 travellers; 242 million residents);
  • Indonesia (13,865 travellers; 197 million residents);
  • The Philippines (35,635 travellers; 70 million residents);
  • Thailand (29,241 travellers; 59 million residents).

While the analysis emphasises the potential for human infection via mosquitos, sexual transmission of Zika virus infection is now well documented. The authors have said travellers returning from affected areas would benefit from health education to prevent sexual transmission.

US and European cases

Earlier this month, five new cases of Zika were discovered in tourist hotspot Miami Beach in Florida.

In July, a woman infected with the Zika virus gave birth to a baby with the brain-damaging disorder microcephaly in a hospital in Barcelona.

At the time, researchers said that tens of thousands of babies may be born with debilitating Zika-related disorders in the course of the outbreak sweeping through Latin America and the Caribbean.

Mathematical projections suggest about 93.4 million people may catch the virus — including some 1.65 million pregnant women — before the epidemic fizzles out, a team reported in the journal Nature Microbiology.

- Contains reporting from © AFP 2016

Read: Zika: Five new cases in tourist hotspot Miami Beach

Read: First baby born in Europe with Zika-linked microcephaly born in Spain

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Órla Ryan

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