2019, Number 1
Response to comment on article “Zika, afebrile disease?”
del Carpio-Orantesa L
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Language: Spanish
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Page: 7-8
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ABSTRACT
The almost immediate release, both in Asia and in Latin America, of clinical observations on patients infected by Zika virus has allowed a transmission of timely and useful information in health care. Since the spread of the virus in Mexico so it has happened: the experience published by scholars of South Asia has prompted us to add to the study of the virus in the interest of providing better healthcare services.Dear Beuy Joob and Viroj Wiwanitkit, we always appreciate your interest in our research work and documentary research. This time we have the opportunity to offer a reply to the recently published letter,1 about the work we have been developing since 2016, the year Zika colonized Mexico and we started to have the first experiences and scientific involvements with the evolution of this virus. Initially, we documented the cases of Guillain-Barré syndrome associated with the Latin American Zika pandemic.
As you said, in your environment Zika virus is endemic and you know well its clinical picture, ranging from asymptomatic cases carrying the virus, patients with febrile and afebrile pictures (as mentioned in the article upon which we are giving this answer), and complicated cases with neurological pictures that establish Zika virus neurotropism as undeniable.
Three years after the colonization that we suffered from Zika virus, we still have many unknowns that we try to decipher. When we had the first contact, we declared ourselves ignorant on the subject; then, when symptoms that went beyond the classical definition of arbovirus or viral infections transmitted by vector were objectified, it was a watershed for those of us who studied these cases for the first time, trying to learn from Asian experiences (such as those of your study group) and the South American ones (the recipients of the virus upon their arrival in the new continent). The asymptomatic or afebrile character of this arboviral disease resulted in a subject of debate that invited us to write the document that you commented, in an attempt to disclose such characteristics.
Your description of Zika virus experience in Southeast Asia (whose forests and jungles are very similar to those of Latin America) is of great value in the observation of the atypical or unknown manifestations that drew our attention strongly. To you is something common, something that now in our own experience, and after three years of study, we have already assimilated and applied in daily clinical practice. This also makes us look forward in the face of new cases of these arboviruses that tend to become endemic, with the passage of time, throughout the Americas.
Zika virus still generates surprises, such as the cases associated with the Guillain-Barré syndrome and microcephaly (today known as Congenital Zika Syndrom), or its different avenues of transmission, including that of person to person without mediating a known vector or, speaking of vectors, its ability to use different vectors from those of the genus Aedes, which gives it a greater virulence and pathogenicity that forces us to be always alert.
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