The Zika virus

February 24th, 2016

A public health emergency

At the beginning of February, the World Health Organization (WHO) designated the Zika virus, as well as the complications that it’s suspected to cause in newborns, a public health emergency of international concern. This is only the fourth time such a designation has been made. Previous designations were made for the H1N1 flu epidemic of 2009, the re-emergence of polio in Pakistan and Syria in 2014, and the Ebola crisis in West Africa in 2014.

While scientists have been aware of the Zika virus for more than 50 years, it’s recently become a grave concern because it could be associated with the sudden appearance of thousands of cases of a rare brain defect called microcephaly in Brazil. While scientists haven’t yet been able to confirm or deny that the Zika virus is causing microcephaly, the WHO “strongly suspected” a link and felt that the risk of waiting to declare an emergency was too great. The declaration allows the WHO to coordinate the monitoring of both Zika cases and microcephaly and will encourage more funding and direct assistance for fighting the virus.

Zika and microcephaly

The Zika virus was first identified in monkeys in Uganda in 1947, with the first human case appearing in Nigeria in 1954. Before the current outbreak in the Americas, there were periodic outbreaks in Africa, Southeast Asia and the Pacific Islands. The current outbreak of Zika has primarily been spread by Aedes mosquitoes, which are the same insects that spread dengue, a potentially lethal virus. Global campaigns to prevent malaria infections through insecticide-treated bed nets are of limited benefit to those at risk of Zika because Aedes mosquitoes are primarily active during the daytime. There have also been a number of cases reported of the virus being spread through sexual contact.

Only about one out of five people who contract Zika is expected to exhibit symptoms. These include fever, rash, conjunctivitis (red, sore eyes), headache and joint pain. There is no vaccine for Zika, nor is drug treatment available. Death from the Zika virus is rare. There are indications, however, that the Zika virus can sometimes have long-lasting neurological effects on infected adults.

The primary reason the virus is of so much concern to health officials is because of its potential impact on babies in the womb. A rapid rise in microcephaly has occurred in regions where Zika has also spiked. One of the challenges to knowing for certain whether a link exists between Zika and microcephaly is that it’s often difficult to know if a pregnant woman actually had the Zika virus.

Microcephaly is a condition in which a baby is born with an abnormally small head, often because the brain hasn’t developed correctly. The effects of microcephaly vary greatly. About 15 percent of people with the condition don’t experience any intellectual disabilities. Officials in Brazil, where there were more than 4,000 reports of microcephaly as of early February, say the cases they’re seeing are on the severe end of the spectrum. Many infants are likely to live with serious speech and motor problems and will require continual care. In some cases, the brain is so underdeveloped that the children won’t survive. For those who do survive, there’s no one particular treatment for the condition. Treatments are generally limited to the symptoms, such as providing speech therapy or medication to prevent seizures.

Efforts to stop the spread

Dr. Rafael Franza, an immunologist in Recife, Brazil, says the greatest challenge to stopping Zika is the inability to “test with certainty if someone had Zika or some other infection, like dengue, which is very similar.” Dr. Franza has a team working to develop a rapid test, because right now the only option is to take a blood test within five days of infection. Since many patients don’t exhibit symptoms, it’s difficult to know whom to test. There’s also a lack of the needed equipment for testing in many laboratories in Brazil.

The Latin American countries experiencing Zika outbreaks often have underfunded health ministries. Many also have a higher percentage of young people in their population, which means there are more women of childbearing age who are at risk. Between limited resources and the lack of a vaccine, most efforts to stop the spread of the disease focus on mosquito control and protection. Health officials are advising people to use insect repellent, cover themselves in long-sleeved clothes, and keep their windows and doors closed. Perhaps the most controversial advice from some health officials about Zika prevention has been a warning to women in affected countries to delay pregnancy.

UNICEF has launched an appeal for close to $9 million in an attempt to limit the spread of Zika. UNICEF is working with the WHO to control the spread of the Aedes mosquito, which carries the Zika virus. A leading component of their efforts is providing education to communities, especially women and pregnant mothers, about how to protect themselves from the mosquitoes. The global Christian health and relief organization MAP International is currently responding to immediate requests from affected communities for strong insecticides, pain relievers and antibiotics.

Some scientists are experimenting with releasing genetically modified mosquitoes into the environment that pass on a lethal gene to their offspring. Small-scale studies suggest that doing this can reduce mosquito populations by 80 percent or more. However, other scientists have raised concerns about this idea as a way to control dengue. Dr. Helen Wallace of GeneWatch UK wrote in a 2015 editorial on the topic, suggesting that “releasing genetically engineered mosquitoes could even make the dengue situation worse, perhaps by reducing immunity to the more serious form of the disease.” Another obstacle to this approach is that it would likely take years to scale such a mosquito release effort up to a level where it could have an impact on Zika infections.

A ministry of healing

As we hear of the rapid spread of Zika and the devastating effects of microcephaly on babies, it’s easy to imagine a young mother crying out words like those of Psalm 13: “How long will you forget me, Lord? Forever? How long will you hide your face from me?” (verse 1). The speed with which the virus is multiplying, the alarming rise of microcephaly in newborns, and the limited resources of the affected countries can take us to a place of hopelessness.

Yet the combined efforts of many different governments, organizations, and individuals from both rich and poor countries could likely do much to slow down the spread of the virus. As people of faith, we can remind our nation and our world that God asks us to pay attention to the needs of the most vulnerable, those whose voices are likely to be ignored. Just as the laws of the Hebrew Scriptures and the voices of the Prophets continually pointed their people to look after the poor, the widows and the orphans, we can magnify the cries of parents and babies affected by this disease.

We can engage in ministries of healing by supporting short-term relief and education efforts around the disease. As individuals and as a church, we can also strive for long-term solutions that provide robust health care for all people and that protect the rights of women and children. We can remind our world that God doesn’t intend for so many to suffer alone when there are so many resources in our world that can be shared. We can live toward God’s vision of a new world, where “there will be no mourning, crying, or pain anymore, for the former things have passed away” (Revelation 21:4).

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