The infamous Zika virus is a single stranded virus that has become one of the most severe epidemics the world has faced. Originally contracted from a sentinel rhesus monkey in a forest in Uganda, Zika has spread worldwide; the most serious cases being in Brazil. According to Science, in 2013 Zika spread from Uganda to several Pacific Islands, including French Polynesia, New Caledonia, Cook Islands, Tahiti, and Easter Island. By May 2015 Brazil was hit with astonishing numbers of people who contracted the deadly virus. By 2016, just 3 years from the original outbreak, nearly 30,000 cases of Zika infection had been reported in Brazil. (Brasil, Amaral Calvet, Machado Siqueira, Wakimoto, & Carvalho de Sequeira, 2016) An epidemic was peak was determined by July 2016 by the Notifiable Diseases Information System (SINAN). Today, SINAN monitors cases of widespread Zika in Brazil and helps keep the deadly disease under control. This paper will discuss the progress of Zika in Brazil and the effects on its population.
As stated above, Zika was originated in the Ziika forests of Uganda (hence the name) in 1947 where it was first observed in a Rhesus monkey. Transfered from monkey to mosquito, the virus quickly spread. Related to Dengue, Yellow Fever and West Nile viruses, all viruses infect about 75 percent of the Ugandan population as of reported in 2007. (World Health Organization, 2018) Vectors of Zika solely consist of the mosquito species. Specifically in Brazil, cases have skyrocketed when compared to neighboring countries. As of 2016 Brazil reported 1271 cases verus the second highest infected region, French Polynesia with a total of 8 cases; the lowest reported cases were 2 in Martinique and 3 in Cape Verde. (Brasil, Amaral Calvet, Machado Siqueira, Wakimoto, & Carvalho de Sequeira, 2016) Public health researchers believe the reasoning for Brazil’s high-infected numbers are due to the climate and ideal breeding grounds for mosquitos in general.
Economic factors have been linked to the rising numbers of infected individuals, as well as the population Zika seems to focus on. “Zika infection outbreaks are constrained to specific areas due to lack of resources and coordination with neighboring countries as well as the sheer enormity of the insect populations, especially along the Amazon basin.” (World Health Organization, 2018) Zika being deemed as a public health emergency is now a huge factor in economic disparities widening. Historically, health emergencies can have extreme long-term consequences that demolish decades of social development and prevention methods that were set in place to avoid the very disease contracted. Health emergencies also weaken health systems by hindering the progress towards sustainable development goals like free healthcare for all due to the sheer cost of medical resources used to help the infected populations. (WHO, 2010) Health crises can expose weaknesses, particularly in the health sector and broader social support infrastructure, and can deepen pre-existing inequities.
Zika is a health crisis and, as such, is predicted to exacerbate poverty, widen gender inequities, including through addi- tional caregiving responsibilities on women and girls and the reduction in workforce participation of women, and impact the psychological wellbeing of those affected
Zika is the first mosquito-borne pathogen with known effects that cause developmental malformations in fetuses. Scientists and public health officials are being forced to rethink previously held assumptions about mosquito-borne viruses and the ways to prevent, control and mitigate their impacts vectors of the virus include mosquito species A. aegypti, A. albopictus, and A. africanus. Most of those who contract Zika experience extreme fevers, accompanied by maculopapular rash, headache, conjunctivitis and myalgia. Originally in Africa, where the virus was first acknowledged, there were only reported cases of Zika displaying mild symptoms such as fever and mild diarrhea. As time went on and the virus spread, the effects grew more severe. (World Health Organization, 2018). Zika is an extremely detrimental virus that is most threatening to pregnant women. Recent and current trends in the Zika virus, according to the WHO, have shown to be the most threatening to pregnant women in the early stages of contraction. The virus is transmitted from mom to baby and is deadly to the fetus infecting “neural progenitor cells” which cause severe abnormalities. In addition to birth defects, there has been a proven link between Guillain-Barre syndrome and Zika. It has been said that the vectors of Zika are being enhanced from the effects of global warming.
The Brazilian Ministry of Health declared Zika a “public health emergency” in February 2016 due to the association of incomplete brain development observed in mothers who contracted the disease. The WHO concluded that around the time of prenatal side effects were determined, there were no deadly relationships to the virus and the side effects; however now, Zika is proven to have direct relationships to death, especially among infants. Although all strands of the Zika virus are proven to be detrimental to individual’s health, little research has been conducted on the details of how and why various stands affect populations differently. Labeled the “Brazilian epidemic,” Zika in Brazil specifically attacks the nervous system affecting approximately 32,000 people. (World Health Organization, 2018) Neonatologists and Obstetricians in the community were the first to observe how serious the malformations the virus had on newborns. Specifically, a medical condition called Microcephaly, where the brain does not develop properly, resulting in a smaller than normal head was the direct result of Zika contraction. Upon the discovery of the relationship to Zika and Microcephaly, epidemiologists were shortly alerted on the discoveries and worked together to further explore causes and cures. (Brasil MD, Pereira JR MD, Moreira MD, Riberio Nogueira MD, Damasceno PHD, & Wakimoto PHD, 2016)
In addition to neurological damage, recent studies have shown that the virus is expanding its attack to ocular, audio and skeletal disorders. Because the disease causes such severe abnormalities, the cost of medical care for children who are diagnosed with microcephaly, average from $800,000 to $1 million in medical costs over their lifetime. (WHO, 2010) Costs for individuals with Guillain-Barre syndrome range from $200-270,000 in medical costs over their lifetime. Inadvertently, because the care of sick babies in general can be pricey; women in Brazil have been reluctant to get pregnant due to the physical and financial burdens Zika has plagued the country with. It has been said that because of the interruption of fetal development, women’s reproductive rights have been up for debate causing a major gap in gender inequality. The country has reported a boom in unsafe abortions among low -income communities and an even higher infant mortality rate in which a survey revealed in 2010 where 95% of the 4.4 million abortions were among the poor. (WHO, 2010)
Socioeconomic factors play a large role in the seriousness Zika effects has on populations. This is another reason why it needs to be further studied. Previous evidence has based social determinants of health, such as poverty and social or geographic marginalization, to infectious diseases (e.g. malaria, tuberculosis and Ebola). Like other mosquito- borne diseases, Zika is a disease that is not of equal opportunity among all populations, leaving everyone at risk. It’s often referred to as a ‘poor man’s’ disease or a ‘disease of poverty’ because it targets poorer regions due to lack of resources (e.g clean water, bug repellant and preventative medicines.) Because of the lack of resources, it is hard for public health infrastructures to contain the spread of illnesses. “Extreme poverty often coincides with a lack of essential water resources and poor sanitation for example, leading to greater negative effects of diseases on already vulnerable populations.” (Alessandra Mendelski Pereira, 2018) As a region, Latin America and the Caribbean have made enormous progress towards increasing water access. Two-thirds of the Brazils poor live in urban communities where poverty partnered with poor sanitation serves as an ideal breeding ground for mosquito-borne disease increases. Zika is affecting low-income groups and women disproportionately when compared to neighboring “better off” communities in regards to better resources and clean water. Several long-term social impacts were raised by individuals, frontline health workers and families affected by microcephaly on how they cam into contact with the endemic and how it could’ve been prevented. It was concluded that if governments were to close the gap in access and uptake of health services for these low-income and vulnerable groups, addressing the wider issues of social inequity, the disease could’ve been prevented (among other vector borne diseases). This will include social welfare and proper fiscal planning for impact mitigation of Zika, enhanced social protection programs, the promotion of sexual and reproductive health and rights and more effective health spending. (Rawal, Yadav, & Kumar, 2016)
Ways we can reduce the risk of exposure to the Zika virus are by limiting travels to places that are surrounding wooded and heavily forested areas. Mosquitoes thrive in areas that are humid and are plentiful in greenery, which is believed to be why Brazil has such high contraction numbers. Scientists conquer that Brazil’s close to the equator, tropical weather serve as a perfect place for insects to flourish. To avoid the possibility of coming into contact with Zika, health professionals advise no travel to humid, tropical places; especially while pregnant. Zika has produced long term consequences on social effects and has exacerbated poverty, widening class gaps. “Interviews with professionals and Zika affected families revealed that microcephaly cases were perceived to be more common among families of low socio-economic status. This is consistent with findings from recent studies of microcephaly in north-eastern Brazil which found that most reported cases occurred in low-income families, suggesting that the epidemic could contribute to widening socioeconomic inequities. For instance, the majority of women in Brazil who have given birth to babies with microcephaly or other disorders associated with congenital Zika syndrome tend to be young, single, Afro-descendant, poor and live in small cities or periurban areas.” (Brasil MD, Pereira JR MD, Moreira MD, Riberio Nogueira MD, Damasceno PHD, & Wakimoto PHD, 2016)
Prevention methods, especially among lower income neighborhoods are crucial in avoiding risk of exposure to Zika. Vector management is also a serious issue being that Brazil is so ideal for mosquitoes. An effort named #ZikaZero has been a large part of prevention by using local armed forces to inspect buildings and surrounding areas for stagnant water and proceed with methods to eliminate potential breeding grounds for mosquitoes to transmit Zika to the nearby populations. (UNICEF, WHO, PAHO, IFRC, 2016) We know now that Zika can be sexually transmitted from partner to partner, so another way to prevent contraction is by using protection when being sexually active as well as the government providing health services to areas where there is an extreme lack in resources.
In order to sustain prevention efforts long term, the Brazilian government will need to set aside a budget, specifically used only for prevention efforts across the country, and especially in poor neighborhoods. The WHO called for long term planning in prevention methods, which can be impactful on public spending with the magnitude of the planning needed. Because of this, brazil has stuck to short term planning as of now. (World Health Organization, 2018) Zika has been an eye opener showing us that people in all countries are susceptible to unknown infectious diseases. Zika also has proven to Brazil how a disease may primarily affect poorer populations, which leads to social and economic disparities to entire communities, regions and nations. With all the negative implications Zika has brought upon the world, it also allows us insight on how to better prepare for, and respond to growing infectious disease challenges and instead to attain health and development goals. “If we neglect protection of the rights of people with disabilities and fall short of improving daily conditions for families in poverty, ignore gender inequality, and fail to take climate change and the impact that environmental degradation has on disease vectors seriously, public health will increasingly be at risk and social and economic progress for all will remain precarious.” (UNICEF, WHO, PAHO, IFRC, 2016) If serious measures are taken into account, together we can eliminate the severity the effects of Zika has had on our world and create an environment where women do not have to fear the birth of their unborn children.
