India’s Zika Virus Testing: Challenges and Developments

August 25, 2024
Posted by: OptimizeIAS Team
Category: DPN Topics

India’s Zika Virus Testing: Challenges and Developments

Sub: Sci

Sec: Health

Why This Is in the News

The lack of indigenously developed and approved Zika virus test kits in India remains a pressing issue, with national labs and government medical colleges relying on imported kits from the U.S. CDC.

Main Issue

Reliance on U.S. CDC Kits

NIV’s Dependence: The National Institute of Virology (NIV), Pune, has relied on the CDC’s Trioplex RT-PCR test kits since the first Zika case in India in 2016.
Regulatory Gaps: As of February 2023, no Zika virus test kit has been approved by India’s Central Drugs Standard Control Organisation (CDSCO), limiting the availability of validated testing tools.

Impact on National Labs

Limited Testing Capability: Most national labs and government medical colleges in India face challenges in Zika virus testing due to the unavailability of accurate test kits.
Turnaround Time Issues: Delays in testing and confirmation of Zika cases could impede timely detection and outbreak control.

What Is a Test Kit and How It Works

A test kit for viruses like Zika typically includes reagents and tools for detecting viral RNA in samples. The CDC’s Trioplex RT-PCR test can simultaneously detect Zika, dengue, and chikungunya viruses, addressing the challenge of cross-reactivity among these viruses.

Main Crux: India’s Zika Virus Testing Challenges

Dependence on Imported Kits: India relies on the U.S. CDC’s Trioplex RT-PCR test kits for Zika virus detection due to the lack of approved indigenous kits.
NIV’s Role: The National Institute of Virology (NIV) in Pune uses these imported kits to confirm Zika, dengue, and chikungunya cases across India.
Regulatory Gaps: The Indian drug regulator (CDSCO) has not approved any domestic test kits for Zika, limiting testing capabilities in national labs and government medical colleges.
IAV’s Efforts: The Institute of Advanced Virology (IAV) in Thiruvananthapuram has developed an in-house assay for Zika testing, but widespread approval is still pending.
Impact on Outbreak Control: The absence of widely available, approved test kits hinders timely detection and management of Zika outbreaks in India.

Zika Virus Overview

Cause: Zika virus is caused by the Zika virus, which is transmitted primarily through the bite of infected Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus.

First Detected: The Zika virus was first identified in Uganda in 1947 in rhesus monkeys and later in humans in 1952.

First Detected in India: The first cases of Zika virus infection in India were reported in Ahmedabad in November 2016.

Symptoms: Common symptoms include fever, rash, joint pain, and conjunctivitis. Many infections are asymptomatic.

Complications: The virus is associated with neurological complications, including microcephaly (a birth defect where a baby’s head is smaller than normal) and Guillain-Barré syndrome.

Transmission: Besides mosquito bites, Zika can be transmitted from mother to baby during pregnancy, through sexual contact, and potentially through blood transfusion.

Prevention: Preventive measures include avoiding mosquito bites using repellents, wearing protective clothing, and eliminating mosquito breeding sites.

Vaccination: As of now, there is no commercially available vaccine for Zika virus.

Microcephaly:

Definition:	A condition where a baby’s head is smaller than normal due to abnormal brain development.
Causes:	Genetic Mutations. Infections During Pregnancy (e.g., Zika virus). Maternal Malnutrition.
Symptoms:	Small Head Size. Developmental Delays. Seizures.
Diagnosis:	Prenatal Ultrasound. Postnatal Head Measurement.
Complications:	Intellectual Disability. Physical and Developmental Challenges.
Treatment:	No Cure; focus on symptom management. Therapies: Physical, occupational, and speech therapy to improve abilities.

Trioplex RT-PCR Test by CDC

Development: Created by the U.S. CDC, this test kit was granted emergency use authorization by the U.S. FDA.
Detection Capability: It can identify Zika, dengue, and chikungunya viruses.
Cross-Reactivity Issue: These viruses can cross-react, making diagnosis challenging; the Trioplex RT-PCR test addresses this challenge by distinguishing between them.

Relevant Institutions: NIV and IAV

National Institute of Virology (NIV), Pune

Establishment: Founded in 1952 as a premier institute for virus research in India.

Function: Focuses on research, diagnosis, and control of viral infections.

Affiliation: Operates under the Indian Council of Medical Research (ICMR).

Key Role: Plays a crucial role in identifying and confirming outbreaks of viral diseases, including Zika, dengue, and chikungunya.

Facilities: Equipped with high-level biosafety labs for handling dangerous pathogens.

Contributions: Developed diagnostics and research for several significant outbreaks, including H1N1, Ebola, and COVID-19.

Collaborations: Works with international organizations like the CDC and WHO for research and diagnostics.

Institute of Advanced Virology (IAV), Thiruvananthapuram

Establishment: Established in 2018 as a specialized institute for advanced virology research and diagnostics.

Function: Focuses on the research, detection, and management of viral infections.

Affiliation: Operates under the Kerala State Government and the Rajiv Gandhi Centre for Biotechnology (RGCB).

Key Role: Develops diagnostic assays and conducts research on emerging and re-emerging viral diseases, including Zika virus.

Achievements: Developed an in-house assay for Zika virus testing and validated it using local outbreak samples.

Facilities: Equipped with advanced laboratories for virology research and diagnostic testing.

Collaborations: Partners with national and international institutions for research and outbreak management.

Virus Detection and Surveillance

Importance of Genome Sequencing

Mutation Impact: Mutations in viruses can affect the efficacy of tests, as seen with COVID-19 variants and mpox clade mutations.
Need for Public Data: Rapid sharing of genome sequences is essential for developing effective diagnostic assays.

Cost-Effective Testing

IAV’s Assay: The in-house test developed by IAV is more affordable, facilitating broader surveillance and testing in both humans and mosquitoes.

Dengue, Chikungunya, and Zika:

Dengue: Caused by the dengue virus; transmitted by Aedes mosquitoes; symptoms include fever, rash, and joint pain.
Chikungunya: Also transmitted by Aedes mosquitoes; symptoms include severe joint pain, fever, and rash; often confused with dengue due to similar symptoms.
Zika: Transmitted by Aedes mosquitoes; associated with birth defects like microcephaly in newborns when pregnant women are infected.