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Friday, 15 November 2019

The Zika paradox

Finding answers to why the Zika epidemic has struck at this particular moment in Brazil is the basis of any reactive health protection, while the implications of these answers could be hard to contain

Gamal Nkrumah , Tuesday 16 Feb 2016
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Zika, one of the world's oddest viruses, is causing a commotion in the Western Hemisphere and sapping productivity in Brazil, one of the most dynamic economic powerhouses in South America and the world.

The genetically modified mosquito-borne Zika virus is the emblematic cause of fear in contemporary South, Central America and the Caribbean. Zika has deep roots.

Genetically modified mosquitoes in Brazil are linked to the current Zika epidemic. Curiously, the genetically engineered Oxitec mosquito, commonly known as "Friendly Aedes aegypti," appears to have its origins in Egypt, and hence the scientific appellation "aegypti."

People in Brazil, pregnant women in particular, are petrified. So how did Zika spread to the Americas from Egypt?

Well, Zika was first detected in 1947 in Uganda and it is not normally considered life-threatening. This is a puzzling fact. Indeed, most people suffering from Zika have no symptoms. Why has it now become such a menace? 

First, it is widely believed that Zika virus is causing brain damage and birth defects in infants. The World Health Organisation (WHO) expects infection rates of up to four million people in Brazil and the Western Hemisphere.

Second, as research is progressing swiftly, new and more menacing symptoms are cropping up. A remarkable amount has been discovered in the past few months, yet much is concealed from the public, or seems to be covered up. Why are people kept in the dark?

Mothers are becoming less misty-eyed and more furious about the status quo. El Salvador's government suggests avoiding pregnancy until 2018. A number of other Latin American countries are discouraging women from becoming pregnant. Meanwhile, most of the continent's population are Roman Catholic, at least nominally, so contraception in certain countries is rejected on religious grounds.

What Zika did was to send a signal that something horrifically sinister is going on in the laboratories that produce genetically modified mosquitoes.

Many Latin Americans suspect foul play. Is Zika an excuse to halt population growth? They wonder. In Colombia, which has the second-highest Zika infection rate after Brazil, there is strong suspicion of a baser motivation.

Capitalist Colombia screeches about the possibility of the privatisation of the country's healthcare system, as in certain neighbouring and leftist countries, such as communist Cuba and socialist-leaning Venezuela.

There is no specific treatment or vaccine for Zika, which is related to Dengue. Many Brazilians are questioning whether vaccines are the real cause behind the microcephaly brain deformity.

Brazil launched a mandatory vaccine campaign for pregnant women in 2014, so without wanting to sound like a conspiracy theorist, studies indicate that most of the Brazilian babies with brain defects and head deformations actually did not suffer such deformities because of Zika.

Brazil, with a population of 210 million people, is the largest country in South America in area and population. The sprawling country has been the hardest hit, documenting more than 3,500 cases of Zika between October 2015 and January 2016. Brazil, which borders all South American countries except Ecuador and Chile, has deployed 220,000 troops to help in battle against the Zika virus.

Zika emerged at a particularly precarious moment in the country's history. Hundreds of thousands of tourists from all over the world are scheduled to converge on Brazil for the 2016 Olympics games. There are predictions that many tourists will stay away for fear of contracting Zika.

Medical practitioners have scare-mongered about Zika, and yet the record shows no signs of past epidemics. Malaria is a far more serious plague in Africa south of the Sahara.

From 1951 through 1981, evidence of human infection was reported from other African countries, such as the Central African Republic, Egypt, Gabon, Sierra Leone, Tanzania, and Uganda, as well as in parts of Asia, including India, Indonesia, Malaysia, the Philippines, Thailand, and Vietnam. However, it rarely reached epidemic proportions.

"Zika is generally mild and only causes symptoms in one in five people," notes a WHO study. They include joint pains, feverishness, headaches and conjunctivitis, or redness of the eyes. In other words, symptoms are far less severe than patients of malaria, Dengue fever, or other similar ailments.

So how did Zika metamorphose, according to WHO director general Margaret Chan, "from a mild threat to one of alarming proportions?" A reality check appears long overdue.

The possible association of Zika virus with congenital microcephaly may not be valid. "The link with Zika has not been confirmed. But some babies who died had the virus in their brain and it has been detected in placenta and amniotic fluid too," noted a recently released WHO report.

In Brazil, there are growing fears that vaccines are to blame. Expectant women in Brazil are routinely given the DPT (diphtheria, pertussis and tetanus) vaccine, or its modern version, the TDAP.

Brazilian authorities are systematically scouring cities for mosquito breeding grounds, fumigating, and educating residents on the dangers of still and stagnant water where female insects lay their eggs.

Last week, the United States warned pregnant women to avoid travelling to 14 countries in the Caribbean and Latin America. Washington and the countries south of the Rio Grande are at loggerheads over this issue, in particular because Brazil is hosting the Olympics. The American ban is bound to ruin the Brazilian economy which is already is a state of recession since 2011.

Here perhaps is the core Ziko paradox: finding answers to why the epidemic has struck at this particular moment in Brazil is the very basis of reactive health protection, while the implications of these answers could be hard to contain.

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Sam Enslow
14-02-2016 11:38am
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Ebola?
Ebola has the same history. It appears and disappears. New diseases and antibiotic bacteria show up suddenly. The fast appearing nature of new epidemics (new strains of flu, for example) catch the world unprepared. New diseases are frightening. The fear and ignorance causes panic and conspiracy theories. Scientific knowledge must be found and cures discovered. This takes time in a world wanting instant solution. Snake oil salesman often fill in the gaps. Often scientific work leads to dead ends or incorrect solutions. But science, unlike dogma, will correct itself. Honorable governments will take steps to protect, perhaps over protect, their citizens. Travel advisories will adversely affect some countries, but they must be issued. Some countries will fight such advisories out of economic interests (remember the mayor in Jaws who wanted to protect the big weekend). Epidemics and natural disasters happen. We are not prepared for every unexpected event.
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