Zika Virus Outbreak: How Do We Respond to the Unknown?

Sunnie Yi Ning ’18
Contributing Writer

This week, the World Health Organization (WHO) declared the Zika virus an international public health emergency. Officials at the Centers for Disease Control and Prevention have urged pregnant women to not travel to about two dozen countries. It is predicted that as many as four million people could be infected by the end of the year. Outbreaks continue, mostly in Central and Southern America, to spread across the borders up North.

Zika is a virus spread by mosquitoes. Although Zika has been long present in Africa and Asia, the Western Hemisphere had remained untouched until May 2015. There is difficulty in diagnosing Zika as most infected people do not show symptoms or only show mild symptoms such as fever, headaches and muscle pain. At this time, there is no cure for Zika.

Zika was not known to cause any severe diseases or maladies until it was discovered last October to cause microcephaly – unusually small heads and often damaged brains – in infants born to mothers with the virus.

In response to the widespread infection, the WHO has declared a global public health emergency, prompted by growing concern that Zika could cause birth defects. The WHO faces heavy criticism for waiting too long to declare the outbreak a public emergency. Brazil’s cases of microcephaly surged last October and the WHO did not declare it an emergency until this month. The leadership of the WHO has been challenged globally after its weak and slow response to the recent Ebola outbreak in parts of West Africa that caused the death of more than 11,000 people. The WHO is under pressure to act quickly in the fight against Zika.

However, the many uncertainties of the Zika infection complicate the necessary response actions. Difficulties in diagnosis make it hard to estimate the infected population, ineffective mosquito control in infected countries pose a severe challenge and lack of vaccine and treatment methods weakens the medical response.

The most severe challenge, though, is that little is known about Zika. Experts don’t have definitive proof that Zika causes microcephaly, although the evidence is highly suggestive. Nor do they know what mechanism causes the condition. Much also remains unknown about how the Zika virus is transmitted. Body fluid and sexual transmission are suspected to lead to infection, but this has not been proven.

Testing of the Zika infection remains difficult. Due to the mild symptoms and similarity to other diseases transmitted by mosquitoes, it is hard to diagnose. Until now, specialized blood tests have been the only method of diagnosis, rendering it a slow process. The maddening fact is that we just don’t know enough about Zika, and until we do, it will be hard to predict or control the situation.

The outbreak also brings reproductive rights to the table. An increasing number of pregnant women in Central and South America may seek abortions, which are illegal or inaccessible in many of these countries. In El Salvador, which has one of the highest rates of Zika infections, abortion is strictly banned under all circumstances and contraceptive access is limited. Therefore, pregnant women in those countries will likely seek unsafe abortions, which is another serious public health concern.

Women’s unfair burden of Zika infection doesn’t end there. Health authorities in five affected countries have advised women against getting pregnant, with Colombia telling women to delay pregnancy for six to eight months and El Salvador suggesting a delay of two years. These suggestions disregard the fact that most births in this region are unplanned and that women cannot be responsible for their pregnancies, as they lack access to birth control.

Even more absurd is that when researchers at the Oswaldo Cruz Foundation found that the live virus had been active in human saliva, Paulo Gadelha, the president of the foundation, suggested that pregnant women think twice about kissing anyone other than their partners, or sharing drinking glasses or cutlery with people, even though there is no proof of transmission through bodily fluid.

It is disappointing to see governments passing off their responsibilities to control the outbreak to pregnant women, while limiting their agency’s ability to do so. In response, the debate of abortion rights has resurfaced. The United Nations high commissioner for human rights has called on Latin American countries hit by the Zika epidemic to allow women access to abortion and birth control. In Brazil, judges and legal scholars are pushing authorities to re-examine the strict abortion law. Hopefully these measures will result in increased reproductive rights for Latin American women.

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