Prince Harry and Meghan Markle

Most Zambians were elated by the news that Prince Harry, the Duke of Sussex would be visiting the country. The latest and hottest couple from the Royal family in the UK, who’s wedding early this year caught the eye of many people wide-world, soon caused the internet backlash from the Zambian media, facebookers and other citizens. This followed the report by the Sun online that the Duchess of Sussex, won’t be visiting Zambia alongside her Husband because of the threat of the Zika Virus. The caution came to light as the celebrity Princess is expecting her first child with the Duke. Both the government of the Republic of Zambia and the United Kingdom have not issued a statement though, the Zambian High Commission in London have asked for a formal apology from the UK-based online tabloid.

What is Zika Virus?

Zika Virus is part of the group of viruses called Flaviviridea, the same family as the virus which causes yellow fever, Dengue and West Nile. It was discovered in Africa in the Zika forest in Uganda in 1947. The first human case was recorded in 1952 and only 14 human infections were recorded by 2007. It is a re-emerging infectious disease because a new wave of infections have emerged in South America and South East Asia at a rate never seen before!

How is it spread?

Like other Flaviviridae viruses, such as yellow fever, Zika is spread by a mosquito bite which bite during the day and night. Zika is also spread through blood transfusion, sexual intercourse and from pregnant mother to a foetus- the real threat for the Princes!
How does one know they have Zika infection?
On most instances, one cannot even know they have been infected by Zika Virus because the infection usually go unnoticed. On some occasions, a person can develop symptoms like fever, headache, a skin rash, joint pains and muscle pains and red eyes. These symptoms are indistinguishable from most viral infections. Zika infections are usually mild and self-limiting and does not result in death!

Why the fuss about Zika?

The real problem Zika poses is for a foetus where babies infected during pregnancy are born with a small brain called microcephaly! The other complication from Zika infection is a condition called Guillain-Barre’ Syndrome (GBS). This condition is characterised by weakness which starts in the legs and ascends till the person fails to breath at which point it becomes fatal. GBS has been associated to a number of viral infections and not just Zika!

It Zika treatable?

There is no specific treatment for Zika and neither is there a vaccine. Treatment is supportive with such as pain killers (analgesics), antipyretics to bring down the fever and plenty fluids. However, people who have been infected before develops life-long immunity.

How do you prevent Zika?

Zika like most mosquito borne infections are preventable by different simple interventions like vector control-preventing breeding of mosquitoes! Putting on long sleeves when outdoor and use of mosquito repellents and use of insecticide treated mosquito nets.

Do we have Zika in Zambia?

The official communications from the Zambian government came in 2016, when the late Honourable Minister of Health, Hon. Dr Joseph Kasonde assured the nation amidst the height of the Zika epidemic in South America, that there was no Zika in Zambia. Check here; https://www.lusakatimes.com/2016/02/11/112940/). Two years earlier to that statement, South Africa, had indicated that Zambia was a high risk for yellow fever when WHO had declared it no risk in 2010. In Response, during the routine surveillance, WHO and Ministry of Health sponsored a study to evaluate the reclassification of no risk by WHO. During the same study done in Western and North-Western provinces of Zambia, the sero-prevalence [presence of antibodies] of Zika virus and other Flaviviruses were evaluated. It was found that the prevalence of Yellow fever (YF) was 0.6% and Zika was 6% [10 times higher than YF]. Sero-prevalence of both infections were strongly associated with travel to Congo DR and Angola. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338443/ )

So the multi-million question; do we have Zika in Zambia? Probably yes! Caution to this data is that we are yet to report cases of microcephaly associated with Zika infection in Zambia or other African countries as seen in the Americas. Whether this is the same or different strain is yet to be established.

Should we make a fuss about the Princess not visiting us? Probably not! In the Western world, travel medical advice is take seriously and the attending physicians to the Duchess are well read to have advised her not to travel to Zambia based on the fact that the prevalence of Zika in Western and Northwestern Zambia stands at 6%. The only problem is that, the doctors did not look at the schedule of the royal couple which didn’t include visiting these two regions. Lusaka is likely a NO RISK based on the low prevalence of other Flaviviridea viruses. Based on that, the media team should have handled the information better. But one knows that allowing the Duke to travel ultimately puts the duchess at risk should he have travelled to these high risk places as explained above. Secondly, there has been cases of Zika infections in the US, the native country of the Duchess.
Should you be concern about travelling to any parts of the country or other countries, for health reasons, kindly visit the Travel Medical Clinic at the University Teaching Hospital.

Dr Francis Mupeta

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