SM Virology

Letter to the Editor

Zika and Its Preparedness in Nepalese Scenario

Bishnu Prasad Upadhya1, Rajani Malla1, Krishna Das Manandhar1, Birendra Prasad Gupta2*, Anurag Adhikari2, Ramanuj Rauniyar3, Chirik Shova Tamarkar4, Bimlesh Kumar Jha5 and Roshan Kurmi6

Letter to the Editor

Case Detail

Zika virus came to known to public in 1947, when it was first isolated from a Rhesus monkey from Uganda [1-3]. Due to its unremitting spread in past decade, zika virus created havoc and gained its recognition as one of the prominent threat in public health across the globe [4-7]. In the March of 2015, Brazil confirmed its first zika infection. Following the zika cases, country had to face erupted increment in microcephaly cases [8]. In next nine month span, the cases of microcephaly increased from 150 cases to 400. After observing this trend, PAHO (Pan American Health Organization) issued an epidemiological alert on December 1st 2015, warning a suspected link between Zika and microcephaly [9].

After the discovery of Zika from Uganda in 1947, some initial infections in 50s and 60s were reported in South Asian plains, as in India [10], Malaysia [10,11], Thailand, Vietnam [11], and the Philippines [12], but not any notable outbreaks were reported during the period. However, sporadic cases with specified acute illness had been reported in South East Asia, as in Cambodia [5] and Thailand [4]. The etiological agent was closely related to ZIKV Asian lineage with Micronesia [4,6,13,14]. Indian subcontinent has no case report of Zika virus till date; however the chances of getting one can’t be dismissed [15]. Whenever new infections in Indian plains occur, the probability of their way in to Nepal remains very high. Indo-Nepal boarder is porous because of socio-economic and mutual cultural relationship in between two countries, providing relatively easy condition for disease transfer either by human or by any other means. Nepal already has reported some big localized flavivirus epidemic as well sporadic outbreak due to open border to India at South [16-20]. Dengue virus outbreak being the recent one in 2013 [18].

The government of Nepal has its state of art national public health laboratory with the facility of BSL 3, which was recently initiated to work on highly infectious agents of risk group III. The preparedness for Zika and its allies has been already initiated since early of 2015. The specialized team from the National Public Health Laboratory has optimized the routine diagnosis along with the rapid response team in standby for the epidemics, if happens. The laboratory is equipped with RT PCR, virus isolation, antigenic characterization and nucleic acid sequencing facility to be conducted in WHO guided protocol, thus easing the molecular diagnosis of Zika in suspected patients. The dengue cases from the 2013 outbreak have also been processed in this laboratory thus making it competent enough to study another flavivirus.


  1. Dick Gw. Zika virus. II. Pathogenicity and physical properties. Trans R Soc Trop Med Hyg. 1952; 46: 521-534.
  2. Dick Gw, Kitchen Sf, Haddow Aj. Zika virus. I. Isolations and serological specificity. Trans R Soc Trop Med Hyg. 1952; 46: 509-520.
  3. Macnamara Fn. Zika virus: a report on three cases of human infection during an epidemic of jaundice in Nigeria. Trans R Soc Trop Med Hyg. 1954; 48: 139-145.
  4. Buathong R, Hermann L, Thaisomboonsuk B, Rutvisuttinunt W, Klungthong C. Detection of Zika Virus Infection in Thailand, 2012-2014. Am J Trop Med Hyg. 2015; 93: 380-383.
  5. Heang V, Yasuda CY, Sovann L, Haddow AD, Travassos da Rosa AP. Zika virus infection, Cambodia, 2010. Emerg Infect Dis. 2012; 18: 349-351.
  6. Lanciotti RS, Kosoy OL, Laven JJ, Velez JO, Lambert AJ. Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis. 2008; 14: 1232-1239.
  7. McCarthy M. Zika virus outbreak prompts US to issue travel alert to pregnant women. BMJ. 2016; 352: i306.
  8. Barreto ML, Barral-Netto M, Stabeli R, Almeida-Filho N, Vasconcelos PF. Zika virus and microcephaly in Brazil: a scientific agenda. Lancet. 2016; 387: 919-921.
  9. Neurological syndrome, congenital malformations, and Zika virus infection. Implications for public health in the Americas-epidemiological alert. Pan American Health Organization. 1 Dec 2015.
  10. smithburn Kc. Neutralizing antibodies against arthropod-borne viruses in the sera of long-time residents of Malaya and Borneo. Am J Hyg. 1954; 59: 157-163.
  11. Pond WL. Arthropod-Borne Virus Antibodies In Sera From Residents Of South-East Asia. Trans R Soc Trop Med Hyg. 1963; 57: 364-371.
  12. Hammon Wm, Schrack Wd Jr, Sather Ge. Serological survey for a arthropodborne virus infections in the Philippines. Am J Trop Med Hyg. 1958; 7: 323-328.
  13. Haddow AD, Schuh AJ, Yasuda CY, Kasper MR, Heang V. Genetic characterization of Zika virus strains: geographic expansion of the Asian lineage. PLoS Negl Trop Dis. 2012; 6: e1477.
  14. Duffy MR, Chen TH, Hancock WT, Powers AM, Kool JL. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med. 2009; 360: 2536-2543.
  15. Zika-virus-case-reported-in-india-union-health-minister-jp-nadda-1276042. Accessed 1st April 2016.
  16. Gupta BP, Adhikari A, Rauniyar R, Kurmi R, Upadhya BP. Dengue virus infection in a French traveller to the hilly region of Nepal in 2015: a case report. J Med Case Rep. 2016; 10: 65.
  17. Pun SB, Shah Y. Critical phase among patients with dengue fever during the 2010 outbreak in Nepal. Trans R Soc Trop Med Hyg. 2013; 107: 598-600.
  18. Gupta BP, Singh S, Kurmi R, Malla R, Sreekumar E. Re-emergence of dengue virus serotype 2 strains in the 2013 outbreak in Nepal. Indian J Med Res. 2015; 142: S1-6.
  19. Singh S, Gupta BP, Manakkadan A, Das Manandhar K, Sreekumar E. Phylogenetic study reveals co-circulation of Asian II and Cosmopolitan genotypes of Dengue virus serotype 2 in Nepal during 2013. Infect Genet Evol. 2015; 34: 402-409.
  20. Takasaki T, Kotaki A, Nishimura K, Sato Y, Tokuda A. Dengue virus type 2 isolated from an imported dengue patient in Japan: first isolation of dengue virus from Nepal. J Travel Med. 2008; 15: 46-49.

Citation: Upadhya BP, Malla R, Manandhar KD, Gupta BP, Adhikari A, Rauniyar R, et al. Zika and Its Preparedness in Nepalese Scenario. SM Virol. 2016; 1(2): 1008.

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