Another WHO-driven epidemic

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According to the World Health Organization (WHO), a total of 8,098 people worldwide became sick with SARS during the 2003 outbreak. Of these, 774 died.

Yes, 774 in the entire world and the travel industry was hit so hard it is only just recovering. Thailand can kill more than that in two holiday weekends.

However, the WHO has uncovered another epidemic, which almost brought the Rio Olympics undone, and stopped many top athletes competing, as they were worried about the medical implications of this new WHO epidemic. Its name? Zika!

Zika fever (also known as Zika virus disease) is an illness caused by the Zika virus. Most cases have no symptoms, but when present they are usually mild and can resemble dengue fever. Symptoms may include fever, red eyes, joint pain, headache, and a rash. Symptoms generally last less than seven days. It has not caused any reported deaths during the initial infection.

So what is so fearful about Zika? According to WHO, infection during pregnancy causes microcephaly and other brain malformations in some babies.

You will be interested to know that the Zika virus (ZIKV) is not new and was first discovered in 1947, but has now emerged as a global public health threat over the last decade, with the accelerated geographic spread of the virus noted during the last 5 years.

The World Health Organization (WHO) predicts that millions of cases of ZIKV are likely to occur in the Americas during the next 12 months. These projections, in conjunction with suspected Zika-associated increase in newborn microcephaly cases, prompted WHO to declare public health emergency of international concern. ZIKV-associated illness is characterized by an incubation period of 3-12 days. Most patients remain asymptomatic (i.e., ~80%) after contracting the virus. When symptomatic, clinical presentation is usually mild and consists of a self-limiting febrile illness that lasts approximately 2-7 days.

Hospitalization and complication rates are low, with fatalities being extremely rare. Newborn microcephaly, the most devastating and insidious complication associated with the ZIKV, has been described in the offspring of women who became infected while pregnant. Much remains to be elucidated about the timing of ZIKV infection in the context of the progression of pregnancy, the corresponding in utero fetal development stage(s), and the risk of microcephaly.

Without further knowledge of the pathophysiology involved, the true risk of ZIKV to the unborn remains difficult to quantify or suggest remedies. Accurate, portable, and inexpensive point-of-care testing is required to better identify cases and manage the current and future outbreaks of ZIKV, including optimization of preventive approaches and the identification of more effective risk reduction strategies.

If we use other viral problems in the womb as examples, the first three months are the ‘danger’ times, and to be quite honest, I would be very surprised if ZIKV were any different.

Another complicating factor for the WHO statisticians is the fact that microcephaly can arise without ZIKV infection.

Helping the WHO case is the global distribution of the most cited carrier of ZIKV which is A. aegypti (yes the same one as Dengue), and is expanding due to global trade and travel. A. aegypti distribution is now the most extensive ever recorded – across all continents including North America and even the European periphery (Madeira, the Netherlands, and the northeastern Black Sea coast). A mosquito population capable of carrying Zika has been found in a Capitol Hill neighborhood of Washington, D. C., and genetic evidence suggests they survived at least four consecutive winters in the region. The study authors conclude that mosquitos are adapting for persistence in a northern climate.

If one accepts the fact that there is a potential ‘risk’ for pregnant ladies who pick up ZIKV, the WHO has more bad news. It’s in the bedroom! In March 2016, the CDC updated its recommendations about length of precautions for couples, and advised that heterosexual couples with men who have confirmed Zika fever or symptoms of Zika should consider using condoms for at least 6 months after symptoms begin. Couples with men who live in an area with Zika, but have not developed symptoms, might consider using condoms or not having sex while there is active Zika transmission in the area, they are saying.

Scare tactics over an unproven threat!