Information on the Zika Virus

12 May 2016. Zika virus infections are usually mild. However, the Robert Koch-Institute shares the CDC’s (Centers for Disease Prevention) assessment that there is a link between the virus and babies born with brain malformations. In February, the World Health Organization (WHO) had declared the outbreak to be a Public Health Emergency of International Concern. The German Federal Foreign Office advises pregnant women to refrain from non-essential travel to affected areas. On 1 May 2016, Germany saw the entry into force of a regulation making arbovirus infections, which includes zika virus infections, notifiable. 

12 May 2016
Photo: Close-up of an Egyptian Tiger mosquito
Egyptian Tiger mosquito (Source: Rafaelgilo)

The new provision, which makes arbovirus infections notifiable, ensures better monitoring of isolated cases of Zika infections in Germany, for instance in travellers returning from overseas. This means that local health offices will get the valuable information they need to allow them to respond swiftly.

Federal Minister of Health Hermann Gröhe

The relevant Protection Against Infection Act Compulsory Notification (Adaptation) Ordinance (IfSG-Meldepflicht-Anpassungsverordnung) came into effect on 1 May 2016. In a separate development, the Federal Government is boosting research into diseases that can be transmitted from animals to humans. A research agreement on these diseases, also known as zoonoses, has just been renewed.

Situation in Germany

Before the notification requirement was introduced, exact numbers of infected people were not available. The Bernhard Nocht Institute for Tropical Medicine (BNITM) has diagnosed isolated cases of infected travellers returning to Germany, as well as one case of sexual transmission. There has been no known case of domestic transmission in Germany. Case numbers are likely to increase with compulsory notification and more precise examination of returning travellers.  The notification requirement will contribute to improving the monitoring of infections in Germany. The Robert Koch-Institute’s FAQ will keep you updated about the situation in Germany.

Zika virus infections are usually symptomless

Zika infections are usually rather mild. Only one in four infected persons experience symptoms at all (such as mild fever, a rash, headache, conjunctivitis). In most cases, the infection resolves without sequelae. A possible complication is the Guillain-Barré syndrome. This nervous system disorder is a very rare complication of various viral infections. Generally, it can be said that ZIKV cases are rarely serious. Zika virus infection is not known to be directly associated with fatalities. However, in the recent past, Zika virus infections (ZIKV) have been spreading rapidly in subtropical and tropical countries. Whereas, as late as 2013, outbreaks were mostly limited to the Pacific region, more and more countries in South and Central America are affected in the meantime. The Zika virus is transmitted primarily by the yellow fever mosquito (Aedes aegypti) and possibly also by the Asian tiger mosquito. Isolated cases of sexual transmission or mother-to-child transmission have been reported. There is no vaccine, nor is there any specific treatment.

Advice for pregnant women

The Robert Koch-Institute shares the CDC’s assessment that a link between a Zika infection during pregnancy and babies born with brain malformations can be regarded as certain – even though it remains unclear how high the individual risk might be. The Robert Koch-Institute’s FAQ provides more information about the hazards for unborn children, the known risk groups, symptoms, sequelae and transmission routes.

The Federal Foreign Office advises women who are pregnant or planning to get pregnant to postpone non-essential travel to high-risk areas. In addition, pregnant women or women who could get pregnant are advised to preventively use condoms for the duration of six months, should they have sexual contact with male returnees from outbreak areas. Depending on their personal risk profile for trips to outbreak regions, male returnees should also consider safer sex for the same duration, in order to protect their sexual partners. The Robert Koch-Institute provides an assessment of the situation on its website.

WHO declares Public Health Emergency

On 1 February 2016, the World Health Organization declared a public health emergency of international concern. In its follow-up meeting on 8 March 2016, the WHO Emergency Committee reaffirmed its assessment. This enables WHO to coordinate infection control and response efforts by issuing time-limited recommendations for action. Such a "coordinated international response" is triggered whenever a "serious, unusual or unexpected" situation arises that can have public health implications for other countries and requires immediate international action.

Despite taking this step, WHO underscored that there was no reason for panic.