Zika Virus: What you need to know

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Joanna Robertson

BRIDGETOWN, Barbados, Tuesday February 2, 2016 – An emergency World Health Organisation committee met on Monday to discuss the threat that Zika virus poses and advise on the response to the mosquito borne disease, which has been linked to surge in the number of babies born with microcephaly in Brazil.

Is the Caribbean and Latin America losing the battle against the mosquitos that carry the Zika virus? Well, Brazil’s health minister, Marcelo Castro certainly thinks his country is, and “badly ” too.

The WHO director general, Margaret Chan has said it was “deeply concerning” that the Zika virus had been detected in 23 countries in the Americas.

The Zika virus story is currently leading many news bulletins, featuring heavily in the papers and being discussed across social media. In Brazil, the government has said it’s sending in the army to try and halt the spread of the disease and issuing repellent to approximately 400,000 pregnant women.

So what is Zika virus and how concerned should we be?

Zika virus is a mosquito-borne infection, and while it isn’t harmful in most cases, it may be harmful in pregnancy, as it’s been linked to birth defects.


Risk of microcephaly

News coverage of an increase in the number of children born in Brazil in 2015 with serious birth defects such as microcephaly, a serious condition where babies are born with abnormally small heads, which can cause lifelong developmental problems, has put Zika at the top of the news agenda causing great concern and anxiety to expectant mothers and those planning to conceive.

The concern has arisen after Brazilian scientists reported Zika virus in placental tissue.  And speaking in Geneva at a specially convened meeting, Margaret Chan of WHO said a relationship between the virus and birth malformations had yet to be established but was “strongly suspected”.

However, the US Centers for Disease Control and Prevention has said there is no direct link yet between the virus and the birth defect. And eminent bacteriologist Hugh Pennington, an emeritus professor of bacteriology at the University of Aberdeen writing in a blog on the London Review of Books believes the connection between Zika and microcephaly is circumstantial:  “So far, the link between its {microcephaly’s} increase and Zika infections is only coincidence. Evidence demonstrating a definitive link in individual cases will be hard to get. Establishing whether a mother was infected during pregnancy will usually rely on antibody tests; the virus itself does not persist in the body after an acute infection. The close relationship between dengue virus and Zika makes it virtually impossible to know which virus could have stimulated an immune response.” (http://www.lrb.co.uk/blog/2016/01/27/hugh-pennington/zika-virus-the-story-so-far/)

Despite the lack of definitive causal evidence between Zika and microcephaly, many South American countries including Brazil and Colombia are asking women to avoid pregnancy and have called on women to consider the implications of the infection before getting pregnant. El Salvadorian authorities have gone a step further and asked women to not get pregnant until 2018. {How this is achievable in predominantly Catholic countries is questionable.}

Guillain-Barre and Zika link?

Earlier this month El Salvadorian authorities notified PAHO and WHO of an unusual increase of Guillain-Barré Syndrome, which can cause paralysis.  The annual average number of Guillain-Barré Syndrome cases reported in El Salvador is 169; however, from the start of December 2015 until 6 January 2016, 46 cases of Guillain-Barré Syndrome were recorded, resulting in 2 deaths. Which is why El Salvador is investigating if the unusual spike in Guillain-Barré syndrome may be linked to the recent surge of Zika virus infections.

Economic impact

The threat of Zika is not only to physical health, it also threatens the economies of many Latin America and the Caribbean countries where the virus has now been found.

Hundreds of thousands of visitors were expected to visit Rio de Janeiro this year for Brazil’s annual carnivals starting on February 5. The city then plays host to the Olympic Games in August and the Paralympics begin the following month.


Flickr / Creative Commons

Despite city workers fumigating the Sambadrome, the parade grounds where the carnival festivities occur, in recent days ahead of the annual extravaganza there could be a fall in numbers this year with governments such as the USA and the UK advising against travel to the country.

The outbreak also has serious implications for the tourism industry in other parts of Latin America and the Caribbean. Pregnant women have been urged not to travel to affected areas by American and European authorities and a number of airlines are offering customers the option to make alternative travel arrangements free of charge.

At a time when Barbados has reported that it’s economy has grown to an estimated 0.5 per cent in 2015 as a result of a burgeoning tourism sector the Zika virus threatens the stability of the industry to the region. With the long-term health effects not known, travel forums feature discussions of would be travellers contemplating cancelling their Caribbean holidays out of fear of the risk to fertility.

In recent years growing numbers of couples have travelled abroad for fertility treatment; the Barbados Fertility Centre offers specialist assistance to would be parents from all over the world, are they concerned that Zika could see a fall in the number of clients? An upbeat spokesperson from the Barbados Fertility Centre said that “Thankfully the incubation period from the initial bite to the symptoms developing and illness period for Zika is short. Each being between 2-7 days. After which the patient has life long immunity.  Given the timing of IVF – initially for stimulation and monitoring, then egg retrieval and subsequent Embryo Transfer if a patient was to be bitten during this time frame the impact, from what we know, to the foetus is limited due to the improbability of blood circulation between mother and foetus.


So what’s the latest travel advice?

In a statement British Airways said: “If a pregnant customer is due to travel up to and including February 29, but they no longer wish to travel, they can change their booking free of charge and delay their journey or amend to an alternative destination. ​This applies to flights to Brazil, Mexico, Barbados and Dominican Republic, and we will continue to review the situation.”

Virgin who offer packaged holidays and flights to numerous Caribbean destinations including St. Lucia and Tobago say that they “always endeavour to do the right thing by our customers and anyone currently booked to travel to regions affected by the Zika Virus should call our customer service teams for help and advice. We can look at options to rebook onto a later Virgin Atlantic flight or rebook onto a Virgin Atlantic flight to another destination. Alternatively we can issue a full refund to our pregnant customers who no longer wish to travel. We will continue to monitor the advice from the World Health Organisation and adapt our policy should there be a need to do so”.

And Thomson who fly to destinations such as Aruba and Jamaica said: “As the health and wellbeing of our customers is important to us, customers due to travel to Mexico, Barbados, Dominican Republic, Cape Verde, Panama, Colombia and Martinique who would like to amend to an alternative destination, and have a doctor’s note confirming their pregnancy, can do so without incurring an amendment fee.”

As a result of the suspected link between Zika and microcephaly, the risks that are presented by the virus are no longer considered to be mild by the WHO and the risk profile is now thought to be one of “alarming proportions”. If global health officials fail to act urgently then US scientists have warned that Zika could become an ‘explosive pandemic’. And Brazil’s health minister, Marcelo Castro might be proven to be right in his view about ‘losing the battle’ against mosquitoes.


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