The number of people infected with the Zika virus in India has increased to 94 confirmed cases in the western state of Rajasthan, including 22 pregnant women, as of 17 October.
The first case was confirmed on September 23 and the number of people who have tested positive for the virus in the city of Jaipur has steadily grown since then.
Teams sent by the government of India are working on the ground, said Dr V.K. Mathur, director of Public Health for Rajasthan.
The state's health department has deployed 330 teams to affected areas in the Shastri Nagar area in Jaipur to monitor and stall the spread of the infection with intensive fogging of mosquito sites and rigorous surveillance to identify cases early.
People who have tested positive are being isolated in hospitals or in their homes and are being monitored closely by officials.
Special teams have also been formed to verify positive cases and isolate them.
The state's health department has split the infected areas into eight zones in which doctors, district officials, social welfare workers and health officers are mobilized to deal with the outbreak, according to a statement released by the state.
Around 434,515 people have been brought under surveillance and 86,903 houses have been checked, according to to India's Health Ministry.
All pregnant mothers in the area will be monitored. So far, at least 4 who have delivered already have had normal healthy babies, said Govind Parikh, spokesperson for Rajasthan Health Department.
Out of more than 200,000 breeding sites, 74,483 have tested positive for the virus, according to an official statement.
Executive meetings for doctors and a public awareness campaign were launched last week. Fogging -- intensive spraying of insecticides -- in mosquito sites is also underway.
To counter this outbreak, the government needs to develop better public health facilities, train more people and put in more money, said Dr. Dileep Mavalankar, director of the Indian Institute of Public Health in Gujarat.
The Indian government has allocated a little above $2,000, or 147,000 rupees, until now to counter the virus.
Mosquito control is poor in India and small puddles of water exist across both rural and urban India, providing perfect breeding grounds for mosquitoes, Mavalankar said.
"We need a massive awareness campaign like how we did with polio. This is a new disease and if it spreads then it will become permanent," he added.
Awareness involves informing people in affected areas on prevention measures, such as ensuring there is no stagnant water around their homes, keeping doors and windows closed to make sure mosquitoes do not enter homes and seeking help if they get any of the symptoms associated with Zika. Awareness campaigns have been conducted over the past few years for dengue and Chikungunya, which have seen continued outbreaks in India.
Zika in India
This is India's third outbreak of Zika since 2017, but is by far the biggest.
The first was reported in Ahmedabad in the western Gujarat state around January 2017 with three confirmed cases, according to the World Health Organization.
Months later in July, a second outbreak was reported in the southern state of Tamil Nadu. According to local media reports, one man tested positive for the virus. Both outbreaks were contained.
Risk to expectant mothers
Zika virus was first identified 70 years ago in the Zika forest of Uganda. Isolated, small-scale outbreaks have occurred in various parts of the world, including Africa, Southeast Asia and the Pacific islands, but no major complications had been linked to the virus until it arrived in Brazil, which has been reporting an extensive outbreak to the World Health Organization since March 2015, and soon spanned to Central and South America.
As of March 2018, the US Centers for Disease Control and Prevention estimated there were at least 90 countries and territories with active Zika virus transmissions.
The virus is primarily transmitted through the bite of an infected female Aedes aegypti mosquito. Most people infected with Zika virus won't have symptoms. If there are symptoms, they typically appear a few days to a week after exposure, although the precise incubation period is not known, according to the CDC. There is no vaccine to prevent Zika.
Fever, rash, joint pain and conjunctivitis (pink eye) are the most common symptoms of the virus. Some patients may also experience muscle pain or headaches.
The virus can be transmitted through sexual contact, blood transfusion, by needle or from a pregnant woman to her fetus.
The real concern is among pregnant women as the virus can cause microcephaly, a neurological disorder that results in babies being born with abnormally small heads, which in turn can cause severe developmental issues and sometimes death. A Zika infection may cause other birth defects, including eye problems, hearing loss and impaired growth. Miscarriage can also occur.
The World Health Organization announced in November 2016 that the Zika virus is no longer a public health emergency of international concern, but India's Health Ministry continues to monitor it.
If India does not clamp down on this outbreak, said Mavalankar, Zika may become another virus, like dengue, that the country will have to live with for the foreseeable future.