Zika virus outbreak (2015present)

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Zika virus outbreak (2015present)
Zik-world-map active 03-18-2016 web.jpeg
Countries and territories with active transmission of the Zika virus
as of 18 March 2016[1]
Date April 2015 present
Type Outbreak
As of early 2016, a widespread outbreak of Zika fever, caused by the Zika
virus, is ongoing, primarily in Latin America and the Pacific Islands. The
outbreak began in April 2015 in Brazil, and has spread to other countries in
South America, Central America, Mexico, and the Caribbean. In January 2016,
the World Health Organization (WHO) said the virus was likely to spread
throughout most of the Americas by the end of the year;[2] and in February
2016, the WHO declared the cluster of microcephaly and GuillainBarr
syndrome (GBS) cases reported in Brazilstrongly suspected to be
associated with the Zika virus outbreaka Public Health Emergency of
International Concern.[3][4][5][6]

The virus is spread mainly by the Aedes aegypti mosquito, which is

commonly found throughout the tropical and subtropical Americas. It can also
be spread by the Aedes albopictus ("Asian tiger") mosquito, which has
become widespread as far north as the Great Lakes region in North America.
[7] Sexual transmission of the Zika virus is also possible.[6][8][9][10] Most
Zika virus infections are asymptomatic, rendering precise estimates of the
number of cases difficult to determine.[11] In approximately one in five
cases, Zika virus infections result in Zika fever, a minor illness that causes
symptoms such as fever and a rash. Critically, Zika virus infections of
pregnant women have a suspected link with newborn microcephaly by
mother-to-child transmission.[12][13] In addition, Zika is suspected of being
associated with a cluster of cases of GuillainBarr syndrome.[3]

A number of countries have issued travel warnings, and the outbreak is

expected to affect the tourism industry significantly.[6][14] Several countries

have taken the unusual step of advising their citizens to delay pregnancy
until more is known about the virus and its impact on fetal development.[15]

Contents [hide]
1

Epidemiology

1.1

Transmission

1.2

Microcephaly and other infant disorders

1.3

GuillainBarr syndrome

Containment and control

2.1

Diagnosis

2.2

Americas

2.3

International

2.4

Responses

2.5

Controversies

See also

References

External links

Epidemiology[edit]
Cases in the Americas[16]
[show]Country
as of 31 March 2016

Autochthonous cases

Cases in Africa, Asia and Oceania[23]

[show]Country
see ref. for latest update Autochthonous cases
Imported cases
[show]Country
see ref. for latest update

Deaths

As early as August 2014, physicians in Natal in northeastern Brazil began to

investigate an outbreak of illness characterized by a flat pinkish rash,
bloodshot eyes, fever, joint pain and headaches. While the symptoms
resembled dengue fever, testing ruled out this and several other potential
causes. By March 2015, the illness had spread to Salvador, Bahia and had
appeared in three different states.[61] Then, in May 2015, researchers from
the Federal University of Bahia and the Evandro Chagas Institute determined,
using the RT-PCR technique, that the illness was an outbreak of Zika virus.
[62][63]

The Zika virus was first isolated in 1947, in a rhesus monkey in a forest near
Entebbe, Uganda.[64] Although serologic evidence indicated additional
human exposure during subsequent decades in parts of Africa and Asia,[65]
before the 2007 Yap Islands Zika virus outbreak, only 14 cases of human Zika
virus disease had been documented.[64]

Researchers generally believe the virus was brought to Brazil by an infected

traveler who had been exposed to the virus in French Polynesia, who was
then bitten by a mosquito that then infected others.[66][67][68] Phylogenetic
analysis of the first Brazilian infections have strongly indicated that the
circulating virus is the Asian, rather than African, strain of the virus, and was
genetically similar to the virus found in the outbreak in French Polynesia.[67]
[68] It appears Zika's route from Africa and Asia to Oceania and then the
Americas may mirror that of chikungunya and dengue, both of which are
endemic in a large portion of the Americas.[69]

The specific event that brought the virus to Brazil was uncertain until March
2016. Brazilian researchers have suggested that the Zika virus arrived during
the 2014 FIFA World Cup tournament.[66] French researchers speculated the
virus arrived shortly afterwards, in August 2014, when canoeing teams from
French Polynesia, New Caledonia, Easter Island, and the Cook Islands, which
had been or were experiencing Zika outbreaks, attended the Va'a World
Sprint Championships in Rio de Janeiro.[61][67] However, the outbreak in
French Polynesia is known to have peaked and declined precipitously by
February 2014, lending doubt to the suggestion the virus arrived later that
year in Brazil with spectators and competitors.[70] A study published in
Science, which developed a "molecular clock" based on the count of virus
mutations in a relatively small sample, suggested Zika virus arrived in the
Americas (most likely in Brazil) from French Polynesia between May and
December 2013, well before the World Cup and Va'a Championships.[70] In

the Science article, Faria and colleagues managed to trace the origins of the
virus strain that is circulating in Brazil and found out that this strain has few
genetic variability when compared to the strain of French Polynesia; after
relating the number of travellers arriving in Brazil from French Polynesia with
the cases reported and the events happening in that year, the team was able
to prove that the virus arrived in Brazil on 2014 during the Confederation
Cup, when Tahiti's team played against other teams in a few brazilians cities,
which attracted a lot of tourists from both places.[71] Zika virus usually has
very mild, or no symptoms, so it took almost a year for Brazil to confirm the
first case of the disease. By then the outbreak was already widespread..
Factors associated with the rapid spread of Zika virus in Brazil include the
non-immune population, high population density, tropical climate and
inadequate control of Aedes mosquitoes in the country.[72]

Confirmed cases have now been reported in most of South and Central
America, and the Caribbean.[73] Cases have also been reported that were
imported from South America into Europe,[74] Canada,[75] United States,[76]
China,[77] and Australia.[78]

Transmission[edit]
See also: Zika virus Transmission

Adult Aedes aegypti mosquito, a vector or carrier of the Zika virus

Zika is a mosquito-borne disease and possibly a sexually transmitted
infection.[8] The resurgence of Aedes aegypti's worldwide distribution over
the past 23 decades makes it one of the most widely distributed mosquito
species.[79] In 2015, Aedes albopictus was present in tropical, subtropical,
and temperate regions of the Americas, reaching as far north as the Great
Lakes of North America and, internationally, living alongside Aedes aegypti in
some tropical and subtropical regions.[7]

The Aedes aegypti mosquito usually bites in the morning and afternoon
hours, and can be identified by the white stripes on its legs.[80] The mosquito
species (Aedes aegypti, mainly, and Aedes albopictus) that can spread Zika
virus can also spread dengue, chikungunya, and yellow fever.[81]

There have been two reports of possible Zika virus transmission via sexual
intercourse from infected males to their partners.[6][8][82] On 23 February
2016, the CDC announced that it is investigating 14 additional cases of
possible sexual transmission.[9][10]

Researchers also suspected that Zika virus could be transmitted by pregnant

woman to their babies ("vertical transmission"). None was proven until
February 2016, when a paper by Calvet et al. was published, showing that not
only Zika virus genome was found in the amniotic fluid but also IgM
antibodies to those virus.[83] This means that not only can the virus cross the
placental barrier, but also the antibodies produced by the mother can reach
the fetus, which suggests that vertical transmission is plausible in these
cases. One other study published in March 2016 by Mlakar and colleagues
analysed autopsy tissues from a fetus with microcephaly that was probably
related to Zika virus; researchers found ZIKV on the brain tissue and
suggested that the brain injuries were probably associated with the virus,
which also shed a light on the vertical transmission theory.[84]

Microcephaly and other infant disorders[edit]

A baby with microcephaly (left) compared to a baby with a typical head size
As of March 2016, public health officials strongly suspect that Zika infection
during pregnancy can cause a number of grave outcomes, including
microcephaly and loss of pregnancy.[6][85] Following the initial Zika outbreak
in Northeastern Brazil, physicians observed a very large surge of reports of
infants born with microcephaly, with 20 times the number of expected cases.
[86][87] Many of these cases have since been confirmed, leading WHO
officials to project that approximately 2,500 infants will be found to have born
in Brazil with Zika-related microcephaly.[88][89] On 10 March 2016, a
research group from the Faculty of Medicine, University of Ljubljana
(Slovenia), led by young researcher Jernej Mlakar, M.D., published an article
in The New England Journal of Medicine, connecting the Zika virus to
microcephaly.[84]

Proving that Zika causes these effects is difficult and complex for several
reasons.[90][91] For example, the effects on an infant might not be seen until
months after the mother's initial infection, long after the time when Zika is
easily detected in the body.[90] In addition, research is also needed to

determine the mechanism by which Zika produces these effects.[92]

Since the initial outbreak, studies that use several different methods have
found evidence of a link, leading public health officials to conclude that it
appears increasingly likely the virus is linked to microcephaly and
miscarriage.[92][93] On 1 February 2016, the World Health Organization
declared recently reported clusters of microcephaly and other neurological
disorders a Public Health Emergency of International Concern (PHEIC).[85] On
8 March 2016, the WHO Committee reconfirmed that the association between
Zika and neurological disorders is of global concern.[92]

The Zika virus was first linked with newborn microcephaly during the Brazil
Zika virus outbreak. In 2015, there were 2,782 suspected cases of
microcephaly compared with 147 in 2014 and 167 in 2013.[86] Confirmation
of many of the recent cases is pending,[94] and it is difficult to estimate how
many cases went unreported before the recent awareness of the risk of virus
infections.[95]

Brazilian President Dilma Rousseff in a videoconference about the Zika virus

at the National Center for Disaster Management.
In March 2016, researchers published a prospective cohort study that found
profound impacts in 29 percent of infants of mothers infected with Zika, some
of whom were infected late in pregnancy.[96] This study did not suffer from
some of the difficulties of studying Zika: the study followed women who
presented to a Rio de Janeiro clinic with fever and rash within the last five
days. The women were then tested for Zika using PCR, then the progess of
the pregnancies were followed using ultrasound.[96][97]

In November 2015, the Zika virus was isolated in a newborn baby from the
northeastern state of Cear, Brazil, with microcephaly and other congenital
disorders. The Lancet medical journal reported in January 2016 that the
Brazilian Ministry of Health had confirmed 134 cases of microcephaly
"believed to be associated with Zika virus infection" with an additional 2,165
cases in 549 counties in 20 states remaining under investigation.[6][98] An
analysis of 574 cases of microcephaly in Brazil during 2015 and the first week
of 2016, reported in March 2016, found an association with maternal illness

involving rash and fever during the first trimester of pregnancy.[99] During
this period, 12 Brazilian states reported increases of at least 3 standard
deviations (SDs) in cases of microcephaly compared with 200014, with the
northeastern states of Bahia, Paraba and Pernambuco reporting increases of
more than 20 SDs.[99]

In January 2016, a baby in Oahu, Hawaii, was born with microcephaly, the
first case in the United States of brain damage linked to the virus. The baby
and mother tested positive for a past Zika virus infection. The mother, who
had probably acquired the virus while traveling in Brazil in May 2015 during
the early stages of her pregnancy, had reported her bout of Zika. She
recovered before relocating to Hawaii. Her pregnancy had progressed
normally, and the baby's condition was not known until birth.[100]

In March 2016, first solid evidence was reported on how the virus affects the
development of the brain. It appears to preferentially kill developing brain
cells.[101] The first cases of birth defects linked to Zika in Colombia[102] and
in Panama were reported in March 2016.[103]

Ocular disorders in newborns have also been linked to Zika virus infection.
[104] In one study in Pernambuco state in Brazil, about 40 percent of babies
with Zika-related microcephaly also had scarring of the retina with spots, or
pigment alteration.[105]

On 20 February 2016, Brazilian scientists announced that they had

successfully sequenced the Zika virus genome, and expressed hope that this
would help in both developing a vaccine and in determining the nature of any
link to birth defects.[106]

In February 2016, rumors that microcephaly is caused by the use of the

larvicide pyriproxyfen in drinking water were refuted by scientists.[107][108]
[109] "It's important to state that some localities that do not use pyriproxyfen
also had reported cases of microcephaly", read a Brazilian government
statement.[110] The Brazilian government also refuted conspiracy theories
that chickenpox and rubella vaccinations or genetically modified mosquitoes
were causing increases in microcephaly.[109]

GuillainBarr syndrome[edit]
A high incidence of the autoimmune disease GuillainBarr syndrome (GBS),
noted in the French Polynesia outbreak, has also been found in the outbreak
that began in Brazil.[98] Laboratory analysis found Zika infections in some
patients with GBS in Brazil, El Salvador, Suriname and Venezuela,[111] and
the WHO declared on 22 March 2016 that Zika appeared to be "implicated" in
GBS infection, and that if the pattern was confirmed it would represent a
global public health crisis.[112]

Containment and control[edit]

Diagnosis[edit]
Main article: Zika fever
Symptoms of Zika virus
Symptoms of Zika virus[113]
Symptoms are similar to other flaviviruses such as dengue fever or the
alphavirus that causes chikungunya,[114] but are milder in form and usually
last two to seven days.[6] It is estimated that 80% of cases are
asymptomatic.[8] The main clinical symptoms in symptomatic patients are
low-grade fever, conjunctivitis, transient joint pain (mainly in the smaller
joints of the hands and feet) and maculopapular rash that often starts on the
face and then spreads throughout the body.[114]

It is difficult to diagnose Zika virus infection based on clinical signs and

symptoms alone due to overlaps with other arboviruses that are endemic to
similar areas.[115] The methods currently available to test for Zika antibodies
cross-react with dengue antibodies. An IgM-positive result in a dengue or Zika
ELISA test can only be considered indicative of a recent flavivirus infection.
Plaque-reduction neutralization tests can be performed and may be specific.
[116] The Zika virus can be identified by RT-PCR in acutely ill patients.[6]

Americas[edit]
Several countries, including Colombia, Ecuador, El Salvador, and Jamaica,
advised women to postpone getting pregnant until more was known about

the risks.[15][117] Plans were announced by the authorities in Rio de Janeiro,

Brazil, to try to prevent the spread of the Zika virus during the 2016 Summer
Olympics in Rio.[118] The health ministry of Peru installed more than 20,000
ovitraps during the 2015 dengue outbreak. The same ovitraps will be used to
monitor a potential Zika outbreak in tropical regions of Peru.[119]

symptoms of microcephaly
Symptoms of microcephaly, linked to mothers infected by Zika virus.[113]
Because of the "growing evidence of a link between Zika and microcephaly"
the CDC issued a travel warning on 15 January 2016 advising pregnant
women to consider postponing travel to Brazil as well as the following
countries and territories where Zika fever had been reported: Colombia, El
Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico,
Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto
Rico.[120] On 20 January, the Ministry of Health of Chile published a health
notice.[121] On 22 January, eight more countries and territories were added
to the list of those affected: Barbados, Bolivia, Ecuador, Guadeloupe, Saint
Martin, Guyana, Cape Verde, and Samoa.[122] On 1 February, Costa Rica and
Nicaragua were added to the list, bringing the number of countries and
territories affected to 28.[123]

The agency issued additional guidelines and suggested that women thinking
about becoming pregnant consult with their physicians before traveling.[124]
Canada issued a similar travel advisory.[118][125]

On 5 February 2016, after the laboratory confirmation of a Zika virus infection

in the U.S. in a non-traveler, which was linked to sexual contact with an
infected partner, the CDC issued interim guidelines for prevention of sexual
transmission of Zika virus for the United States.[8] These guidelines
recommend that men who reside in or have traveled to an area of active Zika
virus transmission who have a pregnant partner should abstain from sexual
activity or consistently and correctly use condoms during sex for the duration
of the pregnancy.[8] The guidelines recommend that pregnant women discuss
any possible Zika exposure with their male partners.[8] The guidelines
recommend that non-pregnant women and their partners consider taking
similar measures.[8] On 8 February 2016, CDC elevated its response efforts
to a Level 1 activation, the highest response level at the agency. On 23
February 2016, the CDC issued a statem2016. Retrieved 1 February 2016.

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the Americas raises alarm". Science News (Society for Science and the Public)
189 (4): 16. Retrieved 16 February 2016.
Jump up ^ Kiernan, Paul; Jelmayer, Rogerio (3 February 2016). "Zika Fears
Imperil Brazil's Tourism Push". The Wall Street Journal (Dow Jones &
Company). Retrieved 27 February 2016.
^ Jump up to: a b "Zika virus triggers pregnancy delay calls". BBC News
Online. 23 January 2016.
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countries and territories in the Americas, 20152016". Pan American Health
Organization. 31 March 2016.
Jump up ^ Arias, L. (27 March 2016). "No new cases of Zika in Costa Rica".
The Tico Times.
^ Jump up to: a b c d "Communicable Disease Threats Report, Week 13, 27
March2 April"(PDF). Publications. European Centre for Disease Prevention
and Control. 1 April 2016. p. 5.
Jump up ^ Serju, Christopher (19 March 2016). "Three More Zika Cases
Confirmed". The Gleaner (Kingston, Jamaica).
Jump up ^ Quirs, Jorge E. (21 March 2016). "Aumentan a 149 casos por virus
del zika" [Zika cases increase to 149]. TVN Noticias (in Spanish) (Panama).
Jump up ^ Nowakowski, Kelsey (15 March 2016). "Weekly Update: Four More
Zika Cases, No New Dengue Cases Confirmed". St. Thomas Source. Retrieved
16 March 2016.
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[Protocol for surveillance and response to the occurrence of microcephaly]
(PDF). Emergncia de Sade Pblica de Importncia Nacional (in Portuguese).
Ministrio da Sade, Secretaria de Vigilncia em Sade. 22 January 2016. p.
17.
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February 2016). "Zika: the origin and spread of a mosquito-borne virus"
(PDF). Bulletin of the World Health Organization. doi:10.2471/BLT.16.171082.
ISSN 0042-9686.
Jump up ^ Costa, Denise (11 March 2016). "Zika em Cabo Verde levanta
suspeitas de "estirpe africana" do vrus" [Zika in Cape Verde is suspected to

be "African strain" of the virus]. United Nations Radio (in Portuguese) (United
Nations).
Jump up ^ "Zika: Local transmission reported in Laos". Outbreak News Today.
5 March 2016.
Jump up ^ "Zika virus infection Maldives". Disease Outbreak News. World
Health Organization. 8 February 2016. Retrieved 11 February 2016.
Jump up ^ Valente, Catherine S. (7 March 2016). "Palace: No Zika outbreak".
The Manila Times Online.
Jump up ^ "Countries with local Zika transmission". European Centre for
Disease Prevention and Control (Stockholm). 5 February 2016. Retrieved 8
February 2016.
Jump up ^ Lefevre, Amy Sawitta; Birsel, Robert (2 February 2016). "Thai
health ministry says don't panic over Zika virus". Reuters. Retrieved 12
February 2016.
Jump up ^ "Epidemiological situation". Zika virus. European Centre for
Disease Prevention and Control. 24 March 2016.
Jump up ^ "400 suspected Zika cases in American Samoa". Marianas Variety.
29 March 2016.
Jump up ^ "Epidemiological situation". Zika outbreak in the Americas and the
Pacific. European Centre for Disease Prevention and Control. 1 April 2016.
Jump up ^ "10 cases of Zika virus confirmed in Fiji". Radio New Zealand. 2
April 2016.
Jump up ^ "Communicable Disease Threats Report, Week 7, 1420 February
2016"(PDF). Publications. Stockholm: European Centre for Disease Prevention
and Control. 18 February 2016. p. 2. Retrieved 25 February 2016.
^ Jump up to: a b c "Zika virus infection outbreak, Brazil and the Pacific
region" (PDF). Stockholm: European Centre for Disease Prevention and
Control. 25 May 2015. p. 4. Retrieved 12 February 2016.
^ Jump up to: a b "Epidemiological situation" (PDF). European Centre for
Disease Prevention and Control. Stockholm. 7 March 2016.
Jump up ^ "Samoa records 10 Zika cases". Xinhua. 21 March 2016.
Jump up ^ "Tonga says Zika clean-up working". Radio New Zealand. 5 March
2016.
Jump up ^ Herriman, Robert (28 April 2015). "Zika virus reported on Vanuatu

for the first time". Outbreak News Today.

Jump up ^ "pidmie Madagascar vulnrable au virus Zika" [Epidemic Madagascar vulnerable to Zika]. L'Express de Madagascar (in French). 12
March 2016.
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Africa's First Zika Case". Breitbart News Network. Retrieved 26 February
2016.
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Zika without leaving the country". Reuters.
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March 2016.
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Transmitted Zika Case". Medical Daily.
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March 2016.
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Disease Control and Prevention. 30 March 2016.
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Outbreak News Today. 1 April 2016.
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Zika, Say Health Officials". Haaretz Newspaper.
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March 2016.
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Express. Indo-Asian News Service. 16 February 2016. Retrieved 26 February
2016.ent further encouraging adherence to this guidance after 14 reports of
possible sexual transmission of the virus were under investigation.[9][10]

On 18 March 2016, Centers for Disease Prevention and Control cautioned

men who have been infected with Zika from attempting to conceive children
due to probability of virus transfer from man to woman during sexual activity
which in turn can affect the fetus, under this caution, men are advised not to
try conception until six months after the infection.[126]

International[edit]

Agent for endemic diseases of the city of Votuporanga, So Paulo, Brazil

Governments or health agencies such as those of the United Kingdom,[127]
Ireland,[117] Japan,[128] South Korea,[129] New Zealand,[130] Malaysia,
[131] Philippines[132] and the European Union[118] issued travel warnings.
The warnings are predicted to have an effect on the tourism industry in
affected countries.[133][134][135]

To prevent the transmission of the Zika virus, WHO recommends using insect
repellent, wearing long-sleeved clothes to cover the body, and using screens
and mosquito nets to exclude flying insects from dwellings or sleeping areas.
It is also vital to eliminate any standing water near homes to minimize
breeding areas for mosquitoes. Authorities can treat larger water containers
with recommended larvicides.[80][136] Furthermore, the Centers for Disease
Control and Prevention (CDC) recommends that containers holding water
near homes either be sealed or scrubbed once per week, because mosquito
eggs can stick to them.[81]

On 1 February 2016, WHO declared the cluster of microcephaly cases and

other neurological disorders a Public Health Emergency of International
Concern,[3] which may reduce the number of visitors to the Rio Olympics in
2016.[137] The designation has been applied in the past to the Ebola
outbreak in 2014, the outbreak of polio in Syria in 2013, and the 2009 flu
pandemic.[138] South Korea held an emergency meeting in response to the
WHO declaration in 2 February 2016.[129] A second meeting of the WHOconvened emergency committee, held on 8 March 2016, reaffirmed the
situation's status as a Public Health Emergency of International Concern. The
committee reported that evidence was increasing for a causal relationship
between Zika virus and microcephaly and other neurological conditions, and
called for continued research, aggressive mosquito control, and improved
surveillance and communication of risks to the public. The report stated that
pregnant women should be advised not to travel to affected areas, and
should use safe sex practices if their partners lived in or travelled to affected
areas throughout their pregnancy.[139] On 9 March 2016, WHO announced
that research should prioritise prevention and diagnosis, not treatment, and
in particular non-live vaccines suitable for pregnant women and those of
childbearing age, novel mosquito control measures, and diagnostic tests that
can detect dengue and chikungunya as well as Zika.[140]

Responses[edit]
See also: Mosquito control

The Brazilian Army has sent more than 200,000 troops to go "house to house"
in the campaign against Zika-carrying mosquitoes.

Brazilian Army soldier analyzes the water from a cistern

In January 2016, it was announced that, in response to the Zika virus
outbreak, Brazil's National Biosafety Committee approved the releases of
more genetically modified Aedes aegypti mosquitoes throughout their
country.[141] Previously, in July 2015, Oxitec had published results of a test in
the Juazeiro region of Brazil, of so-called "self-limiting" mosquitoes, to fight
dengue, chikungunya, and Zika viruses. They concluded that mosquito
populations were reduced by over 90% in the test region.[141][142][143]
Male genetically modified mosquitoes mate with females in the wild and
transmit a self-limiting gene that causes the resulting offspring to die before
reaching adulthood and thus diminishes the local mosquito population.[141]
[143]

On 1 February 2016, the WHO declared the current Zika virus outbreak an
international public health emergency,[5][144] and the Brazilian President
released a decree that increased local and federal pest control agents' access
to private property required by mobilization actions for the prevention and
elimination of Aedes mosquito outbreaks in the country.[145]

Some experts have proposed combatting the spread of the Zika virus by
breeding and releasing mosquitoes that have either been genetically
modified to prevent them from transmitting pathogens or that have been
infected with the Wolbachia bacterium, thought to inhibit the spread of
viruses.[146][147] Another proposed technique consists of using radiation to
sterilize male larvae so that when they mate, they produce no progeny.[148]
Male mosquitoes do not bite or spread disease.[149]

In February, the Brazilian federal government mobilized 60% of the country's

Armed Forces, or about 220,000 soldiers, to warn and educate the

populations of 350 municipalities on how to reduce mosquitoes breeding
grounds.[150]

A joint statement on the sharing of data and results on the Zika outbreak in
the Americas and future public health emergencies was issued on 10
February 2016 by a group of more than 30 global health bodies.[151] The
statement reinforces a similar consensus statement issued by WHO in
September 2015.[152] The statement calls for free access to all data as
rapidly and widely as possible.[153]

In February 2016, Google announced that they were donating $1 million via
UNICEF to fight the spread of the Zika virus and offering professional
personnel to help to determine where it will hit next.[154]

Controversies[edit]
Some efforts to contain the spread of Zika virus have been controversial.
Oxitec, the company behind the "self-limiting" mosquitoes released in Brazil,
has faced criticism from environmental groups, who fear that releasing a new
mosquito strain into the wild will damage the ecosystem. In the short term,
the concern is that a drop in the mosquito population could affect the
populations of other species. Supporters claim that the environmental impact
of the "self-limiting" mosquitoes will be minimal, since only one species of
mosquito is being targeted and the genetically-modified mosquitoes are still
safe for predators to eat. Oxitec Product Development Manager Derric Nimmo
likened the process to "going in with a scalpel and taking away Aedes
aegypti, leaving everything untouched."[155] Since Aedes aegypti is an
imported invasive species in Brazil, some experts expect that its eradication
will have little impact on the environment. However, other environmentalists
emphasize that the long-term consequences of eliminating an entire species
cannot be predicted.[156]

Government recommendations that women delay pregnancy have also

proven to be controversial. Human and reproductive rights groups have
deemed the recommendations irresponsible and difficult to follow, since
women alone are tasked with avoiding pregnancy despite having little control
to do so.[157] Evidence suggests that over half of the pregnancies in Latin
America and the Caribbean are unplanned.[158] Access to contraceptives is

limited in the predominantly Roman-Catholic region,[159] and widespread

sexual violence results in many women getting pregnant against their will.
Anti-abortion laws in much of the region leave women with no recourse once
they become pregnant. Aside from three countries where abortion is widely
available (French Guiana, Guyana, and Uruguay) and three countries where
abortion is allowed in cases of fetal malformation (Colombia, Mexico, and
Panama), most of the region only permits abortion in the cases of rape,
incest, or danger to the mother's health. In El Salvador, abortion is illegal
under all circumstances.[157]

On 5 February 2016, the UN High Commissioner for Human Rights urged Latin
American governments to consider repealing their policies regarding
contraception and abortion, emphasizing that "upholding human rights is
essential to an effective public health response."[160] On 16 February 2016,
the Vatican condemned the UN for its call to action, deeming it "an
illegitimate response" to the Zika crisis and emphasizing that "a diagnosis of
microcephaly in a child should not warrant a death sentence."[161]

On 18 February 2016, after a trip to Latin America, Pope Francis stated that
"avoiding pregnancy is not an absolute evil" in cases such as the Zika virus
outbreak. His comments sparked speculation that the use of contraception
may be morally permissible in the fight against the Zika virus.[162]

See also[edit]
Portal icon

Viruses portal

Zika virus outbreak timeline

Health crisis
References[edit]
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