The past few days have been significant ones for news about the Zika virus.
WHO Declares Public Health Emergency of International Concern
On Monday (Feb 1, 2016), the World Health Organization (WHO) declared “that the recent cluster of microcephaly cases and other neurological disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes a Public Health Emergency of International Concern.” (WHO Director-General Dr Margaret Chan’s statement) This decision was taken after the first meeting of the Emergency Committee which had been convened by the Director-General to look at these clusters in some areas now experiencing outbreaks of Zika virus. (WHO statement on 1st meeting of International Health Regulations Committee on Zika virus)
A Case of Sexually Transmitted Zika in Texas
Then yesterday came the headline-catching news from Dallas that the Centres for Disease Control (CDC) had confirmed a case of Zika virus infection which had been sexually transmitted. The Dallas County Health and Human Services (DCHHS) sent out a press release about the case. DCHHS Press Release re Sexually Transmitted Case of Zika Virus. A case of sexually transmitted Zika virus was recorded in 2008, but no cases during the current epidemic. (Listen to a 2011 CDC podcast about the 2008 case in Colorado.) Though the main mode of infection remains via the Aedes aegypti mosquito, this new case in Dallas does add another dimension to the current epidemic.
Two Briefings in the Wake of Jamaica’s First Confirmed Case of Zika Virus
Yesterday (Feb2, 2016) in Jamaica the Ministry of Health (MOH) held a press briefing, to update the country about the first confirmed case of Zika virus, which it had informed the public of last Saturday. Five Government Ministers addressed the briefing on aspects of the Government’s actions and plans regarding the Zika outbreak. Also in attendance were some Members of Parliament and Mayors, the MOH Permanent Secretary, the new Chief Medical Officer and a number of other government personnel.
The Ministers (from left to right) were: Minister of Local Government & Community Development, Noel Arscott; Minister of Youth & Culture, Lisa Hanna; Minister of Information, Sandrea Falconer; Minister of Health, Horace Dalley and Minister of Education, Ronald Thwaites.
The video of the press conference is posted online, with the Minister of Health’s comments about the first confirmed case and subsequent actions taken by his Ministry running from 10:37 – 16:46 of the video.
Among the things that Minister Dalley mentioned were that:
- the child who was the 1st confirmed case of Zika has recovered & no other member of the family is showing symptoms of the disease
- there is increased fever/rash surveillance in Portmore and the entire island
- that 1894 households in the particular area have been checked & interviews done with 1355 people
- that 15 blood samples were taken as a result of the interviews & were sent to the CARPHA lab in Trinidad for Zika testing
The presentations were followed by a question and answer session with journalists.
Last night, Prime Minister Simpson Miller made a national broadcast regarding the preparations to reduce the impact of the Zika virus (video).
At 5:30 that evening, the University of the West Indies (UWI) Faculty of Medical Sciences in collaboration with PAHO/WHO and the MOH held a Public Symposium entitled “Zika Virus Update”. It is a pity that this symposium wasn’t broadcast or recorded, as it was an excellent session, with very informative presentations and a robust question and answer session.
The focus of this symposium was obviously different from that of the MOH press briefing in the morning and a great deal of medical and scientific information was given and issues explored. It was particularly useful to have information given about the Jamaican context for the Zika outbreak and the issues arising out of that context. I found Professor Christie’s presentation of particular interest, raising as it did issues about the seriousness of the situation being faced regarding our ability to deal with an increase in cases of children born with possibly severe microcephaly.
A few other issues that came up during the symposium:
- the impact of the advice for women to postpone pregnancies, given the fact that 50-60% of pregnancies in Jamaica are unplanned
- whether in Jamaica women will have the option of an abortion in cases of Zika infection
- the complexities surrounding testing for Zika virus & Jamaica’s current and planned capability for doing such testing
- whether the current levels of fever/rash surveillance are adequate or should be greatly increased during the early stages of the outbreak
Repeatedly the point was made regarding how much is not yet known about the Zika virus and the possible complications associated with this generally mild to moderate disease. The need for further and ongoing research was stressed, but as Professor Figueroa said, in public health, you need to take the best of what you know and act on it; you can’t tell patients to wait on the results of a study.
There is a need for more opportunities for professionals to share information of this kind regarding Zika, and to be able to answer questions and engage in discussions with members of the public. These opportunities mustn’t be scripted and limited, but must allow for the open exchange of information and for frank discussion. A wide range of options exists for sharing such information and they must be used.