On 10 July, India reported the diagnosis of its fourth case of the Zika virus, in Tamil Nadu’s Krishnagiri district. The patient first presented with symptoms—fever, headache, photophobia, among others—on 28 June. He visited a local primary healthcare centre, and was treated with paracetamol. When he returned to the health centre on the subsequent day with the same symptoms, the medical professionals sent his blood samples for further testing to the Manipal Centre for Virus Research in Karnataka. The test returned positive for the virus, and the result was then confirmed by two other medical institutes. Within 11 days of its detection, the state government released information of the case to the public.
The Tamil Nadu government’s response to the Zika virus in the state was significantly different from that of the central government as well as the government of Gujarat, where the first three Zika cases of the country were reported. Both the state and central government did not disclose the outbreak of the virus to the public. The ministry of health and family welfare informed the World Health Organisation about the cases on 15 May, more than five months after the first case was detected. It only became public knowledge after the WHO reported the case on its website, on 26 May. In the aftermath of its disclosure, there appeared to be a conspicuous silence on part of most national print media organisations about the government’s failure to intimate the public at the time of the Zika outbreak, and the circumstances surrounding the same.
Zika is a vector-borne virus transmitted through infected mosquitoes and sexual contact. The virus can lead to birth defects such as microcephaly, due to which a child is born with an abnormally small head and an underdeveloped brain. It has no vaccine or treatment, and because it is vector-borne, the virus is particularly dangerous in areas with high population density such as India. The recent Zika epidemic broke out in Brazil, in 2015—54 children were born with microcephaly between August and October that year. In February 2016, the WHO reported that Zika constituted a Public Health Emergency of International Concern (PHEIC) after the transmission of the infection had been reported from over 20 countries. The WHO’s International Health Regulations (IHR), which are binding on 194 countries including India, define a PHEIC as an “extraordinary event” that is a “public health risk to other States through the international spread of the disease” and “potentially require a coordinated international response.” On 18 November, the WHO declared the end of Zika as a PHEIC.
According to the WHO report on India’s Zika cases, the first patient to carry the Zika virus in India was a 34-year-old woman, who showed symptoms just after the delivery of her child, on 9 November 2016. The Zika diagnosis was confirmed at the National Institute of Virology in Pune, on 3 January 2017. The second case was of a 22-year-old pregnant woman, who tested positive for Zika during an antenatal clinic surveillance conducted from 6–12 January, and the third case was that of a 64-year-old man who was confirmed to be infected with the virus during an acute fever surveillance from 10–16 February.
Six days after the WHO disclosed the cases—and over four months after the first case was confirmed—the health ministry issued a press release confirming the three cases in the country. In an apparent defense of the government’s delay in releasing the information, the ministry stated that news of the virus was reported earlier, on 17 March, “as part of an answer to a Parliament question raised by Smt. Vanaroja R, MP [member of parliament] Loksabha.” It also stated that because Zika was no longer a PHEIC, “the case was handled as per our existing protocol.”