Rare neurological complication due to Zika virus in Pune, 61-year-old patient stable

Dr Ameet Dravid, an infectious diseases consultant at Noble Hospital and Research Centre in Hadapsar, along with his team, treated a patient who had perhaps the first reported case of Zika meningoencephalitis in the country. Similar cases have been reported in Brazil and the USA.

“It was on July 9 that the patient sought OPD consultation for symptoms like fever, body ache, loose motion, and headache. He also had comorbid conditions like blood pressure and hyperthyroidism and was pre-diabetic,” Dr Dravid told The Indian Express.

Initially, with no confirmed report of the Zika virus infection, doctors provided symptomatic treatment. However, later, he complained of severe headaches and became unresponsive and comatose. This left the treating team puzzled as to the cause of the altered sensorium. A tropical fever panel test soon confirmed the plasma Zika virus infection, Dr Dravid said.

Tests were conducted to rule out brain infection, and the cerebrospinal fluid (CSF) test confirmed Zika virus infection after ruling out other common brain pathogens due to altered sensorium.

“The plasma and CSF samples were sent to ICMR-NIV for confirmation and the report, too, said positive for Zika virus infection on July 17. This is perhaps the first case Zika meningoencephalitis reported from India,” Dr Dravid said.

Dr. Dravid said meningoencephalitis is an extremely rare complication of Zika virus infection. Dr Zafer Khan, Balasaheb Bande, the ICU in charge, along with Dr Paras Borse, Dr Aparna Kodre, and Dr Dilip Mane, were involved in stabilising the patient.

“He has now recovered and fully regained his cognitive abilities, and has been moved from the intensive care unit to a regular ward for recovery. While severe neurological illness due to the Zika virus has been reported, there is no need to panic. The majority of cases are self-limiting and mild, and only a very small minority progress to develop complications,” Dr Dravid said.

Dr Suryakant Deokar, Assistant Chief Medical Officer at PMC, said they have intensified surveillance activities in areas reporting Zika virus cases, with a particular focus on pregnant women.