Zika Virus: An Emerging Mosquito-Borne Disease Threat in Kerala

  • MS Sasi Assistant Director (Entomology), Directorate of Health Services, Thiruvananthapuram, Government of Kerala, India.
  • R Rajendran Consultant, National Centre for Disease Control, Calicut, Kerala, India.
  • V Meenakshy Director of Health Services (I/C) and SPO (NVBDCP), Directorate of Health Services, Thiruvananthapuram, Government of Kerala, India.
  • T Dilip Kumar Filaria Consultant, Regional Office for Health and Family Welfare, Thiruvananthapuram, Kerala, India.
  • Sherly Vardhanan District Vector Borne Disease Control Officer, District Medical Office (H), Thiruvananthapuram, Kerala, India.
  • T Suresh Former District Vector Borne Disease Control Officer, Health Services Department, Kerala, India.
  • K Regu Additional Director and Head, National Centre for Disease Control, Calicut, Kerala, India.
  • SN Sharma Consultant, National Centre for Disease Control, 22-Sham Nath Marg, Delhi, India.
Keywords: Zika Virus, Kerala, Aedes vittatus, Breeding Preference Ratio


First laboratory confirmed Zika case in Kerala was reported in Thiruvananthapuram, on 8th July 2021. Since then, 68 ZIKV positive cases have been reported from Kerala, with majority of cases from Thiruvananthapuram Corporation area. Based on the preliminary investigation, micro containment zones were identified and detailed investigation was carried out in these areas. Entomological surveillance indicated that all the three species of Aedes mosquitoes - Ae. aegypti, Ae. albopictus and Ae. vittatus were present in the survey areas. The Aedes larval indices were found above the critical level. The most preferred habitats of Aedes mosquitoes were water stagnated areas in cemented floor of the newly constructing buildings followed by cement tanks/ cement pits and discarded tires. ZIKV could be detected from all the three Aedes mosquitoes collected from the micro containment zones. Trasovarial transmission of ZIKV could be noted in this outbreak. Vector control was intensified with the active participation of local bodies and local health institutions. The epidemiological study showed most of the Zika positive cases has fever, rash and conjunctivitis and in majority of cases, the duration of the illness lasts only for 2-3 days. The females were more affected. The most affected age group was 21-30 followed by 31-40. Among the 68 ZIKV positive cases, 7 (10.29%) were pregnant women. No major anomaly was detected in ZIKV positive cases; however there is a need to scale up surveillance and vector control activities to prevent further outbreaks in Kerala and elsewhere.

How to cite this article:
Sasi MS, Rajendran R, Meenakshy V, Dilip Kumar T, Vardhanan S, Suresh T, Regu K, Sharma SN. Zika Virus: An Emerging Mosquito-Borne Disease Threat in Kerala. J Commun Dis. 2021;53(3):201-212.

DOI: https://doi.org/10.24321/0019.5138.202158


Dick GW. Zika virus. II. Pathogenicity and physical properties. Trans R Soc Trop Med Hyg. 1952

Sep;46(5):521-34. [PubMed] [Google Scholar]

Dick GW, Kitchen SF, Haddow AJ. Zika virus. I. Isolations and serological specificity. Trans R Soc Trop Med Hyg.

Sep;46(5):509-20. [PubMed] [Google Scholar]

Smithburn KC. Neutralizing antibodies against certain recently isolated viruses in the sera of human beings

residing in East Africa. J Immunol. 1952 Aug;69(2):223-34. [PubMed] [Google Scholar]

MacNamura 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 Mar;48(2):139-45. [PubMed] [Google Scholar]

Moore DL, Causey OR, Carey DE., Reddy S, Cooke AR, Akinkugbe FM, David-West TS, Kemp GE. Arthropodborne

viral infections of man in Nigeria, 1964-1970. Ann Trop Med Parasitol. 1975 Mar;69(1):49-64. [PubMed]

[Google Scholar]

Duffy MR, Chen TH., Hancock WT, Powers AM, Kool JL, Lanciotti RS, Pretrik M, Marfel M, Holzbauer S, Dubray

C, Guillaumot L, Griggs A, Bel M, Lambret AJ, Laven J, Kosoy O, Panella A, Biggerstaff BJ, Fischer M, Hayes EB.

Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med. 2009 Jun;360(24):2536-43.

[PubMed] [Google Scholar]

Patterson J, Sammon M, Garg M. Dengue, Zika and Chikunguniya: emerging arboviruses in the new world.

West J Emerg Med. 2016 Nov;17(6):671-9. [PubMed] [Google Scholar]

Lanciotti RS, Kosoy OL, Laven J J, Velez JO, Lambert AJ., Johnson AJ, Stanfield SM, Duffy MR. Genetic and

serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect

Dis. 2008 Aug;14(8):1232-9. [PubMed] [Google Scholar]

Campos GS, Banderia AC, Sardi SI. Zika virus outbreak, Bahia, Brazil. Emerg Infect Dis. 2015 Oct;21(10):1885-6.

[PubMed] [Google Scholar]

Cao-Lormeau VM, Roche C, Teissier A, Robin E, Berry AL, Mallet HP, Sall AA, Musso D. Zika virus, French

Polynesia, South pacific, 2013. Emerg Infect Dis. 2014 Jun;20(6):1085-6. [PubMed] [Google Scholar]

Musso D, Roche C, Robin E, Nhan T, Teissier A, Cao-Lormeau VM. Potential sexual transmission of

Zika virus. Emerg Infect Dis. 2015 Feb;21(2):359-61. [PubMed] [Google Scholar]

Heukelbach J, Alencar CH, Kelvin AA, de Oliveira WK, Pamplona de Goes Cavalcanti L. Zika virus outbreak

in Brazil. J Infect Dev Ctries. 2016 Feb;10(2):116-20. [PubMed] [Google Scholar]

Cardoso CW, Paploski IA, Kikuti M, Rodrigues MS, Silva MM, Campos GS, Sardi SI, Kitron U, Reis MG, Ribeiro

GS. Outbreak of Exanthematous illness associated with Zika, Chikungunya and dengue Viruses, Salvador, Brazil.

Emerg Infect Dis. 2015 Dec;21(12):2274-6. [PubMed] [Google Scholar]

Musso D. Zika virus transmission from French Polynesia to Brazil. Emerg Infect Dis. 2015 Oct;21(10):1887.

[PubMed] [Google Scholar]

Sapkal GN, Yadav PD, Vegad MM, Viswanathan R, Gupta N, Mourya DT. First laboratory confirmation on the

existence of Zika virus disease in India. J Infect. 2018 Mar;76(3):314-7. [PubMed] [Google Scholar]

Gupta N, Yadav PD, Patil DY, Sapkal G. Preparedness of public health-care system for Zika virus outbreak:

An Indian perspective. J Infect Public Health. 2020 Jul;13(7):949-55. [PubMed] [Google Scholar]

Cao-Lormeau VM, Musso D. Emerging arboviruses in the Pacific. Lancet 2014 Nov; 384(9954):1571-2.

[PubMed] [Google Scholar]

de Araújo TVB, Rodrigues LC, de Alencar Ximenes RA, de Barros Miranda-Filho D, Montarroyos UR, de Melo

APL, Valongueiro S, de Albuquerque MFPM, Souza WV, Braga C, Filho SPB, Cordeiro MT, Vazquez E, Di Cavalcanti

Souza Cruz D, Henriques CMP, Bezerra LCA, da Silva Castanha PM, Dhalia R, Marques-Júnior ETA, Martelli

CMT; investigators from the Microcephaly Epidemic Research Group; Brazilian Ministry of Health; Pan

American Health Organization; Instituto de Medicina Integral Professor Fernando Figueira; State Health

Department of Pernambuco. Association between Zika virus infection and microcephaly in Brazil, January to

May, 2016: Preliminary report of a case-control study.Lancet Infect Dis. 2016 Dec;16(12):1356-63. [PubMed]

[Google Scholar]

Bhardwaj S, Gokhale MD, Mourya DT. Zika virus: Current concerns in India. Indian J Med Res. 2017

Nov;146(5):572-5. [PubMed] [Google Scholar]

Gupta N, Kodan P, Baruah K, Soneja M, Biswas A. Zika virus in India : past present and future. QJM. 2019

Oct;hcz273. [PubMed] [Google Scholar]

Center for Disease Control (CDC). Traveler’s health. National Centre for Emergency and Zoonotic Infectious

Diseases (NCEZID), Division of Global migration and quarantine (DGMQ), May 24, 2021.

Muraduzzaman AKM, Sultana S, Shirin T, Khatun S, Islam MT, Rahman M. Introduction of Zika virus in

Bangladesh: An impending public health threat. Asian Pac J Trop Med. 2017 Sep;10(9):925-8. [PubMed]

[Google Scholar]

Streatfield PK, Karar ZA. Population changes for Bangladesh in the coming decades. J Health Popul

Nutr. 2008;26(3):261-72. [PubMed] [Google Scholar]

Ali MY. Zika virus in Bangladesh. Faridpur Med. Coll. J. 2016;11(1):01. [Google Scholar]

Singh RK, Singh S. Prevalence of Aedes mosquitoes during the first outbreak of Zika in Jaipir City, India. J

Commun Dis. 2019;51(3):33-9. [Google Scholar]

Malhotra B, Gupta V, Sharma P, Singh R, Sharma H, Vyas M, Mathur RP, Mathur VK, Meena D, Malhotra H,

Yadav PD, Sapkal G, Pt U, Rao Deshpande G, Gunjikar R, Shaman H, Mourya DT, Gupta N, Singh S, Ravindran

P, Tiwari J, Nyayanit DA, Kumar N, Phalke S, Chugani A, Bhandari S, Suravajhala P, Solanki PS, Salaria M.

Clinico-epidemiological and genomic profile of firsy Zika Virus outbreak in India at Jaipur city of Rajasthan

state. J Infect Public Health. 2020 Dec;13(12):1920-6. [PubMed] [Google Scholar]

Wood CS. ABO blood groups relation to selection of human hosts by yellow fever vector. Hum Biol. 1976

May;48(2):337-41. [PubMed] [Google Scholar]

Shirai Y, Funada H, Takizawa H, Seki T, Morohashi M, Kamimura K. Landing preference of Aedes albopictus

(Diptera: Culicidae) on human skin among ABO blood groups, secretors or non-secretors, and ABH antigens. J

Med Entomol. 2004 Jul;41(4):796-9. [PubMed] [Google Scholar]