The Zika Virus: Responses to Global Pandemics Post-Ebola
By Rebecca SuhPublished March 23, 2016On November 28, 2015, the medical journal, The Lancet, published a report conducted by an independent panel of the Harvard-London School of Hygiene & Tropical Medicine (LSHTM) that evaluated the global response to Ebola. The panel concluded that "[m]ajor reforms are both warranted and feasible." The judgment echoes earlier polemics on the slow to act W.H.O. that declared Ebola a global health emergency two months after Doctors Without Borders warned the disease was out of control and five months after being notified of outbreaks by the Guinean and Liberian governments. As a whole, the W.H.O's response to Ebola was underwhelming and undermines confidence in the organization's ability to handle global pandemics. As the first large-scale health threat since the 2015 Ebola outbreak, the Zika Virus is a testing ground to evaluate whether the W.H.O. has learned from its recent fumble.
Lauded by editorials and health groups for its rapid response, the W.H.O. declared the Zika Virus a global health emergency in a February 1st press release. An outbreak was first detected in Brazil, last May and has since spread to over 39 countries (especially concentrated in the Americas), and the W.H.O. predicts that as many as 4 million people could be infected by the virus by the end of the year. There are currently 52 cases of the virus in the U.S. — all associated with travel. Cases of the Zika Virus, however, have been documented since the 1940's, when it was first isolated in a rhesus macaque monkey in the Zika Forest of Uganda. Signs of infection manifest in only 1 out of 5 people and victims typically suffer from fever, rash, and aching joints for anywhere between a few days to weeks before making a full recovery.
The Zika Viruses' mild symptoms and fast recovery has protected it from international action until last year when the regions of Brazil affected by the Zika virus saw a sharp increase in babies born with microcephaly — 150 babies were born with the condition in 2014 compared with 2,700 babies in 2015. As a result, the CDC has warned pregnant women not to travel to places with Zika outbreaks. There is currently no treatment or vaccine for the Zika Virus. Although the virus spreads predominantely through mosquitoes, there are three recorded cases of sexual transmission, causing the CDC to suggest pregnant women to avoid the semen of men who recently traveled to outbreak areas and for men returning from such areas to consider using condoms.
On February 16th, the W.H.O. said it would need $56 million to develop vaccines, research its spread, and support its regional office. One week before the W.H.O., the Obama Administration announced that it would ask Congress for more than $1.8 billion in emergency funds to address the virus domestically and abroad. While the efforts to combat the Zika Virus are commendable, the uncertain link between the Zika Virus and Microcephaly calls to question the amount of hysteria and paranoia that is driving the actions of W.H.O. and governments.
Although areas of Brazil provide a convincing correlation between the Zika Virus and Microcephaly, there is no research that establishes a causal link between the two conditions. Because a wide range of factors can cause Microcephaly, even the W.H.O. cautions the link is not yet proven. A study on Brazilian women suggests that pregnant women can transmit the Zika virus to the fetus through the placenta, but the study cannot determine whether the Zika virus was the cause of microcephaly in their sample of women studied. A group of doctors in Brazil are claiming that the recent surge of microcephaly may be linked to a larvicide used in South America, further complicating the scientific discourse. In fact, many scientists are skeptical about the link between Zika and microcephaly.
Leslie Lobel, who worked with both the US military and the Uganda Virus Research Institute, believes "public panic over epidemics can cause more damage than the diseases themselves" and that there should be a greater focus on strengthening global research networks and that the money pledged to control Zika could be better used to deal with future, more severe challenges, considering Zika's only threat is a possible link to babies via pregnant woman.
It is impossible to divorce the almost hysterical response by the public, W.H.O., and governments from the missteps during the recent Ebola crisis. But as climate change contributes to the rise in mosquito-born diseases and international travel allows for these disease to be spread with relative ease, calm and educated responses to health threats become increasingly important. Zika is then a warning: as outbreaks become more common, we need to build a global health infrastructure that can provide more rapid and informed responses than that of the past.