Massive Outbreak of Zika feared across the Americas. What you need to know

UPDATE, FEB 4, 2016 
Spain has confirmed that a pregnant woman from Catalonia is infected with Zika virus. The woman in her second trimester of pregnancy is the first of such cases in Europe; she is believed to have been infected while on a recent trip to Colombia. 7 others cases of Zika have also been identified in Spain.

OVERVIEW
– Texas Department of State Health Services has confirmed 6 cases of Zika virus as of Friday January 29th.

– National Health Institute, Colombia has reported 20,297 recorded cases of Zika virus infections; 63.6% of them are women; at least 2,000 of the women are pregnant (January 30th).

– Brazil: Brazil is the worst affected country. The WHO estimates 500,000 – 1.5 million cases of Zika virus infections. The country has confirmed 270 cases of microcephaly, and 3,448 suspected cases (January 23rd).

Zika virus
Ana Beatriz is held by her father Alipio Martin during a medical appointment at the Altino Ventura Foundation in Recife, Brazil, 29 January 2016. In Brazil, authorities are trying to shed light on the link between Zika virus and babies born with microcephaly. (Photo: Percio Campos, EPA)

WHO to hold emergency meeting Monday on Zika virus
USA TODAY
LIZ SZABO
January 31, 2016

The World Health Organization will hold an emergency meeting Monday to find ways to battle the Zika virus, which is linked to birth defects and “spreading explosively” through the Americas.

The WHO could classify the Zika outbreak now in 25 countries and territories as a “public health emergency of international concern,” deserving of a coordinated global response.

An emergency declaration is “similar to a global Amber Alert for public health,” Susan Kim, deputy director of Georgetown University’s O’Neill Institute for National and Global Health Law in Washington, said Sunday. “An emergency declaration by WHO is a spotlight on the issue, telling the world that this is something the world needs to pay attention to.”

Zika is “a novel, emerging infection that we know very little about,” said Lawrence Gostin, director of Georgetown’s O’Neill Institute, who urged the WHO to act in aJAMA editorial last week. “The people in these countries deserve the protection of the international community and the World Health Organization.”

Zika, which first appeared in the Western Hemisphere in May, is worrisome because “you have populations who have never been exposed and have no immunity,” Gostin said Sunday. “You have a huge moral and public health concern about the well-being of pregnant women and their babies.”

Brazilian authorities have linked the Zika virus to a surge in cases of microcephaly, a birth defect in which babies are born with abnormally small heads and incomplete brain development.

The virus is spread through mosquitoes, like malaria or West Nile Virus. It does not spread directly from person to person. Four out of five people with Zika virus have no symptoms, according to the WHO. Those who do become ill typically have mild symptoms, such as a low fever, rash, joint pain, pink eye and headaches.

An emergency declaration would direct more money to combat the problem, said Amesh Adalja, a senior associate at the Center for Health Security at the University of Pittsburgh Medical Center. If an emergency is declared, “there is a legal duty to respond promptly to contain the outbreak.”

The WHO has declared a public health emergency only three times: the H1N1 swine flu pandemic in 2009; the Ebola outbreak in West Africa in 2014; and a resurgence of polio in Syria and other countries in 2014.

But the WHO never declared a public health emergency with other viruses, such as MERS, or Middle East Respiratory Syndrome, Adalja said.

WHO officials want to make sure that nations don’t take inappropriate steps to limit travel or trade because of the virus, said Bruce Aylward, assistant director-general of the WHO. During the Ebola outbreak, many countries closed their borders, which harmed the fragile economies of West Africa.

The Americas could see 3 million to 4 million Zika infections a year, Sylvain Aldighieri of the Pan American Health Organization said last week.

The WHO should “wage war” against the Aedes mosquito, which spreads Zika virus and other infections, said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. He said the WHO should appoint a “field marshal” to lead this fight.

Hotez said officials should test pools of mosquitoes as well as local residents for the Zika virus.

The WHO needs to spray insecticides and reduce standing water, where mosquitoes breed, Hotez added. Plus the agency should launch pilot studies of both genetically engineering mosquitoes and bacteria designed to reduce the mosquito population.

The WHO should also study giving everyone in a community a deworming medication called ivermectin, which kills any mosquitoes that bite the person taking the drug, Hotez said. Researchers are already testing some of these strategies against other deadly mosquito-borne diseases.

The Centers for Disease Control and Prevention has already warned pregnant women to avoid traveling to countries with Zika outbreaks. El Salvador and other countries have gone further and urged women to postpone pregnancy because of the virus.

 

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