An investigation of the first zika virus infection in pregnant woman of Bueng Kan Province, April 18, 2016

Abstract

Background: On April 15, 2016, the Bureau of Epidemiology has been notified that the first pregnant women with the Zika virus had been detected in Bueng Kan Province. We conducted an investigation during 18-22 April 2016. The objectives were to confirm the outbreak, describe the epidemiological characteristics of the disease and identify prevention and control measures.
Methods: Descriptive epidemiology was conducted by interviewing patients and household members, using Zika virus infection investigation. We identified for patients with the definition as follows: rash with at least 1 in 3 symptoms, including fever, joint pain, red eyes; or fever with at least 2 of 3 symptoms, including headache, joint pain, red eyes; or microcephaly babies; or patients with Guillain-Barre's syndrome, within a radius of 100 meters from the patient's home. We did surveillance at Phon Charoen Hospital in Bueng Kan Province, and collected blood samples, urine and Aedes aegypti to test for Zika virus by Reverse Transcriptase-Polymerase Chain Reaction. We surveyed the environment, mosquito larvae index, destroyed mosquito breeding sites and sprayed chemicals to control mosquitoes.
Results: There were 2 confirmed cases of Zika virus infection with onset on April 11, 2016. The first case was a 29- year-old woman who was 8 weeks pregnant with rash, red eyes, lymph nodes enlargement, and joint pain. Zika virus genetic was detected in plasma and urine. The second case was a 30-year-old husband, with rash and joint pain, and Zika virus detected in the plasma and urine also. According to the environmental survey, the House Index was 0.76% and the Container Index was 2.03%. After the larvae control, the House Index and Container Index were zero within 5 days. We sprayed 1% W/V of Deltamethrin. No new patients were found in two incubation periods.
Discussion and Conclusion: This was an outbreak of Zika virus infection that found the first infection in pregnant women, likely to be infected by a mosquito carrying a Zika virus. Therefore disease control should be proactive and follow the World Health Organization and International Health Regulations measures, focus on active patient search, getting rid of mosquitoes and destroying mosquito breeding sites.