Zika Virus – How Worried Should we be, Anyway?

Zika is a virus that spreads via mosquito rather than person-to-person. Historically it has been confined to a narrow area around the equator in Africa and Asia. It almost never leads to death, and its symptoms are usually mild or nonexistent, so it hasn’t been seen as a high-priority disease.

Why is Zika in the news right now?

Zika has spread out of its traditional habitat into the US – cases have been seen in Florida, Illinois, Texas, and Hawaii; and Brazil. The US cases seem to have been among individuals who recently traveled to Latin America. But the Brazilian cases were definitely locally infected in Brazil. The prevalence of the virus in areas with excellent public health surveillance, as in Brazil, has showed a link to severe birth defects in babies born to mothers infected with Zika. The infants were born with microcephaly, a condition where the head is very small. Some children with microcephaly are able to lead normal lives, but others face serious disabilities or even death.

It is likely that this new spread of Zika is the result of air travel. The speed of air travel allows sick people to travel and infect others around the world.  The mosquitoes that spread Zika were already present in Brazil and the US. Once a person infected with Zika arrived, the existing mosquitoes spread the virus.

Zika PAHO

How is it treated?

There is no cure or treatment for Zika, although getting plenty of rest and fluids helps. It’s difficult to even diagnose, as its symptoms are similar to many other viruses. That’s how health officials missed the connection to microcephaly for so long; Zika wasn’t being identified or reported so it wasn’t recognized as a factor in the birth defects.

How is it avoided?

Zika, like so many other diseases, reminds us of the stark inequalities of global health. The CDC has recommended that women who are or may become pregnant avoid traveling to areas which are reporting Zika. That’s fine for some people, but what about the women living in those areas already?

Jamaica’s Minister of Health has recommended that women not get pregnant for the next 6-12 months. Brazilian health workers have issued similar recommendations unofficially. This seems more like panic than sound public health policy. Women don’t always get pregnant on purpose! Also, those who are seeking to get pregnant may have a whole range of reasons that they can’t delay conception.

The best way to avoid Zika is to avoid being bitten by the mosquitoes that spread it. Mosquito bednets, when used, are highly effective. Authorities also recommend staying indoors, wearing long sleeves and long pants, and wearing mosquito repellant. Communities can work to reduce the transmission of all mosquito borne-disease by eliminating mosquito habitats, mostly by removing the stagnant water where mosquitoes breed.

Over time, efforts to combat Zika will most likely look like the efforts to combat malaria and dengue. They will focus on accurate diagnosis and surveillance, bednet distribution, and reducing mosquito exposure via indoor residual spraying.

One-sentence takeaway

Zika is scary for both people who live in affected areas and for the rest of us because it’s a symptom of the effects of climate change and globalization of public health.