The Zika virus can only be explained in terms of what happened between the years of 2007 up to the panic that ensued in 2016. This history of Zika is extremely important to understanding the disease and its impact. What made Zika important was the epidemic that ensued after the initial outbreak in Micronesia in 2007. It then jumped to French Polynesia in 2013 (CDC 2018). The first outbreak caused 5,000 people to be effected. This may sound insignificant, yet that number represents over 70% of the small island’s population. The second outbreak caused a more serious effect, of more than 30,000 victims infected. This is what gave Zika it’s strong foothold in the Pacific. The natives suspected an outbreak of Guillain-Barré syndrome, which is an incredibly rare neurological order. The disease causes the immune system to attack nerves and this can result in difficulty and extreme pain in doing simple tasks such as walking and eating. (WHO, 2016) However, the more disturbing part of the syndrome is that the actual causes are not known at this time. It is only known that there is a strong linked connection to Zika.
After the ravenging the Pacific, the Zika virus spread to Brazil in 2014. From there the virus spread easily to North and South America, Latin America and the Caribbean following suit as well (CDC 2018). Supposedly, this is due to the flight paths that were taken globally from the World Cup or the World Sprint Championship. Rio de Janeiro is a highly populated location which meant the advancement of Zika was unable to be contained. Within three hundred days days the virus was in every country that hosted a certain type of mosquito, known scientifically as the Aedes aegypti mosquito. This specific type of mosquito is known for being a prominent carrier of Zika, dengue, and other devastating illnesses. Consequently it is also one of the most common mosquito species in many countries. Scientists who studied the Zika noted the two paths that led determined the path of transmission. The first was the behavior of the mosquito species itself and the second was the population immunity in the geological area (CDC 2018).
In the United States during this period, there were strong pesticides that were commonly used. The use of these strong chemicals almost eradicated yellow fever in the 1940s-1950s! After this eradication, the funding for anti-mosquito campaigns dropping significantly. However, the species of Aedes aegypti is strong and built up a tolerance. This was just one more reason for the residents of the United States to fear the Zika virus. At this point, the cases of the “rare” GBS (Guillain-Barré syndrome) was increasing exponentially in terms of epidemiological statistics. Most scientists recognized the syndrome’s link to Zika and subsequent neurological testing for those with either disease were measured. Volume 22, Number 6 of a Center for Disease Control article published in June 2016 quoted that “In November, the Brazilian Ministry of Health declared a relationship between the microcephaly epidemic and Zika virus infection during pregnancy on the basis of accumulating evidence. A distinct pattern of other birth defects, called congenital Zika syndrome, has been found. Congenital Zika syndrome is unique to fetuses and infants infected with Zika virus before birth”. (CDC 2016) Zika was declared a public health emergency.
Background
Understanding the history of Zika is important. The reasons for the public health concern were abounding. The first reason for concern was the effects. As Zika became more prevalent, people began to notice the severity of the subsequent birth defects. The congenital virus is only unique to infants and the fetus. The fetus is infected before birth and can be found to have one or all of the five descriptions: Severe microcephaly (skull may be partially collapsed), decreased brain function because of a noticed pattern of brain damage, damage to the rear of the eye which may result in scarring of retinal mottling, congenital contractures, which is the hardening of tissue or tendons which may result in clubfoot, or deformity and/or shortening of limbs. Congenital Zika virus in infants is also characterized by the rigidity or spastic movements that are caused by damage to the immune system also known as the condition called hypertonia (CDC 2016). Microcephaly is the most notorious side effect. Although the child may recover fully and have no other lasting effect, there are cases reported where the infant goes on to have epilepsy, learning disabilities, hearing and sight issues as well as cerebral palsy, missing developmental milestones such as walking, difficulty with movement and other issues. The condition is defined as a condition where the head shape or size is smaller than average. (WHO 2016) This means that the brain has not fully developed. Obviously this can cause an onslaught of issues.
Another reason for the public health concern is because America was not prepared for the transmission of Zika through mosquitoes. The virus scared many pregnant women, who were easily the most susceptible. Moreover Zika could be transmitted through sexual contact. There were insufficient resources to control the prevalence of mosquitoes, less than adequate care and surveillance for the disease, and there were also no real legislative powers that could enforce interventions. Congress did not fund any investigations, despite the Obama administration’s pushes. Outside of the United States, the issues in third world and developing countries made the panic worsen. In counties such as Liberia, Uganda, and Rwanda, the availability of birth control and family planning services are close to non-existent. Therefore Zika often went undetected, and left pregnant women with little resources. Carrying and birthing a baby with defects as serious as microcephaly is extremely costly and often the mothers do not have stable income.
What kind of research has been published?
As mentioned previously, the causes for the Zika virus is the transmittal of the virus from of an infected mosquito, specifically the Aedes species. The mosquito is found almost everywhere on the globe, which is a main concern. The tiny insect picks up Zika from an infected person, and transmits that virus into the bloodstream of the next host, causing a chain of infection. It less common for Zika to be transmitted through sex, and even more uncommon to be spread through blood transfusion. The symptoms have a large range. There can be an infection in a host that causes no signs at all.. They occur usually in the first week after being bitten. The symptoms usually resolve in a week. The risk factors include traveling (or habitating) in locations that are known to host outbreaks of Zika. These areas can be tropical or subtropical, islands in the Pacific, islands in West Africa, or certain designated countries in middle and south America. The southern region of the United States is also a risk location. Due to the commonality of the specific of Aedes, it is likely that there will and can be new regions affected constantly. The CDC advises against having unprotected sex to avoid transmittal through sexual intercourse, especially if that person has traveled to an active Zika risk zone (Mayo Clinic 2018). The disease has a negative psychological effect on individuals. Pregnant mothers may stress about going outside especially if they live in areas prone to outbreaks.
Undo stress can have many negative effects on both mother and baby. The idea or reality of birthing a child with birth defects is stressful on the entire family, and possibly can spread community-wide. Zika disproportionally affects the most poor regions of the globe, and these communities already have an uphill battle in life. Walter Cotte, IFRC Regional Director for the Americas says, “The Zika virus has highlighted, once again, the critical role that communities and local health workers play during health emergencies putting resources towards community engagement to the Zika response can lead to stronger local partnerships, boost resilience, build leadership and help reduce stigma” (United Nations Programme Development 2018). In the same article, Jessica Faieta, UN Assistant Secretary-General and UNDP Director for Latin America and the Caribbean is quoted, “Aside from tangible losses to GDP and to economies heavily dependent on tourism, and the stresses on health care systems, the long-term consequences of the Zika virus can undermine decades of social development, hard-earned health gains and slow down progress towards the Sustainable Development Goals”. In 2017, the CDC reported 452 symptomatic Zika virus disease cases reported. There 96% of them contracted the disease in an affected area and brought to the US. Two US states had cases that were infected through local mosquito transmission, 2 in Florida and 5in Texas. 7 other cases were acquired through sexual transmission. These numbers were close to zero in 2018 so far. However, these statistics drastically differ from the 2017 reported numbers. There were 5,168 symptomatic disease cases in 2016 (CDC 2018).
The Zika Foundation, as well as larger organizations such as WHO and the CDC partner with local state governments to test and educate the population about the disease. Save The Children is also another group who supports younger people who are affected by Zika. There is not many organizations to support those affected when compared to other diseases such as breast cancer, or AIDS.
Discussion
Often when trying to detect the presence of Zika in a pregnant person, the physician will ask a series of questions about travel plans. If there has been recent visits to Zika prone areas, or if a partner has recently been. He or she may also inquire about the severity of symptoms. After determining that there may be a possibility of contracting the virus, the doctor will most likely do ultrasounds on the fetus to ensure that microcephaly is not developing. This type of testing is available 2 to 13 weeks following possible infection. Screening for Zika could also be done by amniocentesis (Mayo Clinic 2018). This procedure is done by testing the amniotic fluid of the fetus. Presently there is no set medicine to treat or vaccine for Zika. The best advice a doctor will give is to avoid the Zika prone areas. To do this one should consult the CDC website. The information will be uber a section entitled, “Travel Recommendations”. Other tips to prevent Zika spread is to utiliza tools to protect yourself from mosquito bites. This could be the use of bug spray, citronella, and most importantly, nets that cover the bed while sleeping. It is also important to protect during intercourse using condoms and other possible forms of birth control. According to the CDC, in the summer of 2018 Zika was declared by the World Health Organization as a Public Health Emergency of International Concern. This spurred global research and development to find a treatment. Currently there are 45 possible candidates that are being tested and gone into human trials. There has been “promising progress” seen despite all the challenges of of finding a real treatment (World Health Organizations 2016).
Zika remains a bewildering disease. The wide range of clinical complications it can cause as well as its virology and epidemiological status means that Zika is not understood by any scientist. Many reports have indicated that to have a comprehensive prevention effort, we as a nation must focus efforts on adapting protection programs and systems. It is our duty to strengthen those who are more susceptible, such as women, the disable, the elderly, and infants. Furthermore sexual health and education on reproductive health would increase the feasibility of successful in implementing the programs. Comparatively, the United States has a better grasp on gender equality than other developing countries. Our health plans are more comprehensive as well. The response to the infectious threat was not, as many assume, a prevention program built from basic public health infrastructure. The first response to Zika in the United States was surveillance. The CDC was attempting to detect the early signals of an outbreak and then figure out the appropriate emergency preparedness response subsequently.
