"I am confused now, more than ever, on whether or not there should be increased or decreased concern surrounding Zika."
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zika
"Following these few easy tips will help your thanksgiving or winter break be a happy and healthy one."
"However, the community at the epicenter for proposed trials – Key Haven, Florida – is strongly protesting the idea of releasing genetically modified (GM) mosquitoes in their neighborhood."
"it is clear that the United States needs a change in the status quo when it comes to basic research."
The Centers for Disease Control and Prevention (CDC) has placed strict guidelines on who can be tested for Zika virus. Labs all over the country are backed up with the increased demand for Zika testing because the test is a lengthy three-step procedure (Rabin). While these tests may not be very invasive, and may not require multiple samples, the process is dependent on many different factors (travel history, date of onset, immunization record) (Memorandum). First, a test is done for active virus in the blood or urine; however, this is only effective within the first two weeks after contraction (Rabin). Next, a test for antibodies is done. Since many people don’t show symptoms, these two tests are effectively useless because negatives results do not conclusively show that the patient was never exposed to the virus (Rabin). Lastly, a Plaque Reduction Neutralization Test (PRNT) is conducted, which is a test used for many different types of mosquito born illnesses, including Chikungunya and Dengue (Alvarez, Memorandum, Rabin). At the moment though, this last test is only being conducted by a small number of labs, including the CDC itself (Rabin).
The problem many women are now facing is the lack of preemptive testing. Women will not be tested unless they are pregnant, but women don’t want to get pregnant until they are tested. With over 70 cases reported in Florida, it seems reasonable that women trying to conceive would be apprehensive about fetal health because they could have been exposed to the virus, yet remain unaware of their status (Alvarez). Florida in particular has been backlogged with tests (Alvarez). In response, the CDC has sent down technicians to help move the testing along, as testing is time sensitive (Alvarez). However, the tests take 4-5 weeks to analyze, so speed may be difficult to come by (Rabin). As a result of their efforts, over 2,500 pregnant women have received free testing thanks to the CDC, but they are running out of funds quickly (Alvarez).
References:
Alvarez, Lizette. "Florida Gets Help to Deal With Backlog of Zika Tests." The New York Times. The New York Times, 14 Sept. 2016. Web.
"Memorandum." Linguistics 9.66 (2016): n. pag. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 7 Feb. 2016. Web.
Rabin, Roni Caryn. "Want a Zika Test? It’s Not Easy." The New York Times. The New York Times, 19 Sept. 2016. Web.
A new study jointly funded by the CDC and the Canadian Institutes of Health Research identified eight African and Asian nations that are at the greatest risk for experiencing outbreaks of the Zika virus in coming months. Using three different modeled scenarios, including one mirroring the spread of the comparable Dengue virus, researchers labeled India, China, the Philippines, Indonesia, Nigeria, Vietnam, Pakistan and Bangladesh as the countries most at risk (Sun 2016). The combined population of the affected areas is over 2.6 billion, and nearly 400,000 travellers visit the identified risk areas annually (Bogoch et al. 2016). The identified nations have warm, humid climates and are considered resource-limited and the populations immunologically naive, presenting a vulnerable breeding-ground for the Aedes aegypti mosquito and the Zika virus that it can carry. Some scientists hope that prior exposure to Zika in African and Asian nations, where outbreaks of the virus have previously occurred, will confer immunity to some members of the population.
References:
Sun, Lena H. "Zika Outbreaks Most Likely to Hit Eight Countries in Asia, Africa." Washington Post. September 2, 2016. Accessed September 10, 2016. https://www.washingtonpost.com/news/to-your-health/wp/2016/09/01/zika-outbreaks-most-likely-to-hit-these-countries-in-asia-africa/.
Bogoch, Isaac I., Oliver J. Brady, Moritz U G Kraemer, Matthew German, Maria I. Creatore, Shannon Brent, Alexander G. Watts, Simon I. Hay, Manisha A. Kulkarni, John S. Brownstein, and Kamran Khan. "Potential for Zika Virus Introduction and Transmission in Resource-limited Countries in Africa and the Asia-Pacific Region: A Modelling Study." The Lancet Infectious Diseases, September 1, 2016. doi:10.1016/s1473-3099(16)30270-5.
The zika virus is currently of paramount concern to many health care officials in the United States, as there have been 29 cases of zika originating in the U.S. in the past several months (CDC). One area that has been particularly afflicted with the virus is southern Florida. As new cases emerge in Miami Beach, biotechnology companies have begun to propose that surrounding areas adopt a novel, yet preventative approach to fighting the zika virus. These companies argue that current methods to tackle zika are ineffective, but there are uncertainties regarding this new proposed method.
Zika can be transmitted multiple ways, but the most common is by mosquito bites. Other ways the virus can infect people are through intercourse, blood transfusions, and from a mother to fetus. The primary demographic that should be concerned about zika is pregnant women. Many adults rarely get sick enough from zika to go to the hospital and almost never die from the disease. However, the pathogen does pose a real threat to pregnant women because of the birth defects that it can cause. The main birth defect associated with zika is microcephaly, a condition in which a newborn’s head is smaller than normal. This abnormal shape is due to the brain’s insufficient growth either during pregnancy or after birth (CDC). The severity of microcephaly varies case by case, where the more severe instances of the condition can lead to many different learning disabilities and health conditions. Some of these include propensity to have seizures, intellectual disability, hearing loss, and vision loss. These negative effects of the virus are so pressing that public service workers in the Miami area are working overtime to ensure that all mosquitoes have been eradicated from the city streets.
Last Thursday there were reports that two new cases of zika had been diagnosed in Miami Beach. Public works crews are working around the clock to ensure that the tourism capital of southern Florida is completely without zika-carrying mosquitoes. They are using two different strategies to eradicate the disease, and are encouraging all residents of the Miami Beach area to do the same: drain and cover. Sanitation workers are working with pressure washers at temperatures of 250 degrees Fahrenheit to force all stagnant water into the sewer system while simultaneously killing any bacteria living in the water. Additionally, public health officials are urging residents drain any standing irrigation or rain water that can collect in trash cans, pool covers, gutters, etc. (Flechas). Mosquitoes need standing water to lay their eggs, but not a lot of it; mosquito larvae can hatch in as little as a teaspoon of water. This fact is the reason that eliminating all standing water in the area is of the utmost importance. The other approach that Miami workers are using to combat Zika is to cover any isolated areas where the virus may be. Workers are vacuuming up debris where mosquitoes may lay their eggs are throwing larvicide pellets into storm-water drains. They also are requiring homeowners to cover up their doors, windows, porches, and patios with screens. People are also encouraged to wear clothing that does not expose their skin to potential mosquito bites. These are the current measures the Florida Department of Health is taking to protect its people from zika. There are certain biotechnology companies that are proposing more innovative measures to prevent this virus from spreading to other adjacent areas of the state.
Oxitec is a company that has genetically engineered mosquitoes designed to kill other ones carrying the zika virus. These synthetic mosquitos would mate with wild female ones and their offspring would die before adulthood. On August 5th, the Federal Drug Administration approved test trials of this new technology in the Florida Keys as a preventative measure. No cases of the zika virus have been reported in the Florida Keys at this time. Hadyn Perry, the CEO of Oxitec, advocates for the use of this technology to combat zika and cites its previous success. This same technology was employed in 2010 when there was a dengue outbreak in the Florida Keys, and it killed about 40% more mosquitos than the methods previously described. However, there had been opposition from local residents to use this technology, primarily because there is no current problem with zika in the Florida Keys and that there may be unpredictable side effects of this new technology (Allen). As such, this technology has not been used to date in the fight against zika, but its potential life-saving effects are very promising.
The zika virus is garnering all the attention among major healthcare officials in the United States, and for good reason. Its harmful effects on infant babies are very concerning, and must be dealt with. As such, Miami health officials have adopted a multi-faceted approach to battle the virus. However, more radical measures to fight this pathogen are on the horizon.
References:
Allen, Greg. “Florida Keys Opposition Stalls Tests of Genetically Altered Mosquitos”.
NPR Shots: Health News from NPR. August 17, 2016. Accessed August 26, 2016.
< http://www.npr.org/sections/health-shots/2016/08/17/490313999/opposition-in-
florida-puts-tests-of-genetically-altered-mosquitoes-on-hold>.
CDC. “Overview: How Zika Spreads”. Center for Disease Control and Prevention.
Accessed August 26, 2016. < http://www.cdc.gov/zika/about/overview.html>.
Flechas, Joey. “Miami Beach workers Sweep City for Zika Breeding Grounds”.
Miami Herald: Healthcare. August 19, 2016. Accessed August 26, 2016.
< http://www.miamiherald.com/news/health-care/article96637632.html>.
"In cases such as Zika the shared fundamental belief of the right to access healthcare and prevent citizens from harm must take priority over a minority’s beliefs."
"...it is clear that wholly ineffective, sweeping methods of disease prevention . . . are both unwarranted and unethical in combating the spread of Zika."
With less than two months until the start of the Olympic Games in Rio de Janeiro, the World Health Organization (WHO) has announced that the games should not be cancelled due to the recent Zika virus outbreak in the region (Mcneil and Tavernise). The WHO does not anticipate any increased consequences from travel to Brazil – the Zika virus is expected to spread to the southern United States regardless (Mcneil). With the recent impeachment of Brazilian President Rousseff, the severe recession, and the large spike in police killings, postponing or moving the 2016 Olympics would only send Brazil into further political and economic turmoil (Waldron).
The Zika virus can be transmitted through mosquitos, sex, blood transfusions, and from mother-to-child during pregnancy, but can be avoided with simple precautionary measures. Only 1 in 4 people present symptoms, which can last for up to a week. Symptoms are mild enough that most people do not require hospitalization, and many never realize that they contracted the virus (Symptoms, Diagnosis, & Treatment). Though it is still advised that pregnant women should not attend the games due to the heightened risk of fetal microcephaly, other travellers, at risk for mild and short-lived symptoms, can protect themselves from the virus with measures that would be taken for any other mosquito transmitted diseases (Symptoms, Diagnosis, & Treatment). The Center for Disease Control and Prevention (CDC) has issued an Alert for the Summer Olympics (2016 Summer Olympics). They advise travellers to take preventative measures against mosquito bites by using insect repellent, covering exposed skin and staying in air-conditioned or screened rooms (Avoid Bug Bites).
The Zika virus is not the only threat posed to outsiders during the 2016 Summer Olympics. Travellers must also take precautionary measures against crime, foodborne illnesses, and other mosquito-borne illnesses, including dengue fever and malaria (2016 Summer Olympics). The CDC recommends seeking medical attention for any health concerns that may arise following the games.
References
"2016 Summer Olympics (Rio 2016)." – Alert Level 2. N.p., 2 June 2016.
"Avoid Bug Bites." Centers for Disease Control and Prevention. CDC, 22 Apr. 2016.
Mcneil, Donald G., and Sabrina Tavernise. "W.H.O. Says Olympics Should Go Ahead in Brazil Despite Zika Virus." The New York Times. The New York Times, 14 June 2016.
"Symptoms, Diagnosis, & Treatment." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 26 Apr. 2016.
Waldron, Travis. "Everything Is Going Wrong in Brazil Ahead of the Olympics." Huffington Post. Huffington Post, 23 Mar. 2016.
With cases of Zika virus in pregnant mothers being linked to microcephaly and fatal birth defects, many Brazilians are taking a closer look at the restrictive abortion laws in the country. Currently, getting an abortion is illegal in Brazil unless a mother’s life is put at risk through the continuation of the pregnancy, the mother was raped and this is a resultant pregnancy, or if the fetus is found to be brain-dead prior to birth. Being found guilty of an illegal abortion under these laws can result in one to three years of prison time. One exception to the brain-death allowance for abortion has already been made with anencephaly being considered an acceptable justification for abortion.
Some Catholic leaders are seeking stricter abortion laws. They are proposing measures that would increase prison sentences to a maximum of 15 years, make it illegal to encourage or assist a pregnant woman to have an abortion, or require both a forensic medical exam and a formal police report for all rape-related exceptions to the anti-abortion law. The push for more restrictive laws seems to stem from religious beliefs. Pope Francis has been more accepting of birth control measures but is adamant about the unacceptable nature of abortion. The Pope is quoted as calling abortion, “a crime, an absolute evil.” Members of the Brazilian government have also been quoted as claiming aborting microcephalitic fetuses would constitute an act of eugenics.
It is important to note that microcephaly is not universally fatal and not always diagnosed prior to abortion. There is an increasing consideration of abortion in Brazil, attributed to the fear cause by the rise of Zika in Latin America. This fear is compounded by the fact that Zika is often hard to diagnose due to its occasionally asymptomatic prognosis.
Other movements in Brazil are seeking greater freedom for abortion in possible Zika cases. These movements cite the lack of adequate access to sexual education and contraceptives as a barrier to following the government’s recommended process for dealing with Zika-related birth defects. Brazil’s government has pushed a message of waiting to get pregnant until the virus has been controlled. At least one judge has said he recognizes this movement and will rule abortion due to confirmed microcephaly of the fetus to be acceptable under the same exception made for anencephaly, despite the difference in life expectancies. Anencephaly is almost universally fatal at the fetal stage whereas up to 90% of microcephaly cases result in no mental deficits.
Future shifts in Zika infection rates may encourage change in Brazilian abortion policy. It is not yet clear whether that change will result in more relaxed or tighter control over abortions in Brazil.
Works Cited
Collucci, Claudia. "Pregnant Women with Zika Virus Have Abortions Before Microcephaly Is Confirmed." Folha. Folha De S. Paulo, 1 Feb. 2016. Web. 18 May 2016.
Johnson, Reed, and Luciana Magalhaes. "In Brazil, Zika Fuels Abortion Debate." WSJ. The Wall Street Journal, 8 Mar. 2016. Web. 18 May 2016.
Mcdonald, Brent. "Brazil’s Abortion Restrictions Compound Challenge of Zika Virus." The New York Times. The New York Times, 18 May 2016. Web. 18 May 2016.
Román, Valeria. "Zika Awakens Debate over Legal and Safe Abortion in Latin America." Scientific American. Scientific American, 23 Feb. 2016. Web. 19 May 2016.
Romero, Simon. "Surge of Zika Virus Has Brazilians Re-examining Strict Abortion Laws." The New York Times. The New York Times, 03 Feb. 2016. Web. 18 May 2016.
Sandy, Matt. "Brazilian Legislators Look to Increase Abortion Penalties in the Wake of Zika Outbreak." Time. Time, 22 Feb. 2016. Web. 18 May 2016