We’re hearing more about Zika now that it threatens the US. I asked Rachel Perkins, one of our pre-medical students, to update us about the virus and it’s likely effect on Haiti.
As of January 2016, the CDC has issued a level 2 travel alert for people traveling to the countries where Zika virus transmission is ongoing. The Zika Virus is transmitted by daytime active mosquitoes, and in humans’ results in a mild illness known as Zika fever. Zika fever is a dengue-like virus that is sometimes accompanied by mild symptoms such as: headache, a skin rash, fever, light sensitivity and joint pains. Only about one in five people who are infected with the Zika virus even show symptoms. As of January 2016, no vaccine is available so Zika fever is generally treated with bed rest, and non-steroidal anti-inflammatory drugs such as acetaminophen (Tylenol). Symptoms usually only persist for a few days.
Many of Americans are hearing about Zika fever for the first time because of the travel warning that the CDC issued, even though it has been around since 1947. Zika fever was first isolated in monkeys in the Zika Forrest in Uganda, then three years later was seen in humans in parts of Africa and Asia. Zika fever has not received much media attention in the past, as it is not known to lead to hospitalization or death. At this point, you might be wondering why the CDC would issue a travel warning for such a mild illness. However, doctors in Brazil have noticed a 20-fold increase in babies born with microcephaly, which is characterized by abnormally small heads and underdeveloped brains. This increase of microcephaly has been correlated with the Zika epidemic that appeared in May 2015. Although this link has not been proven, in 2015 Zika virus RNA was detected in the amniotic fluid of two fetuses, which indicates that it crossed the placenta and that fetal infection is possible.
The Zika virus has reached French Polynesia, Easter Island, South America, Central America, and the Caribbean and is now considered a pandemic. Besides avoiding travel to areas with the Zika virus while pregnant, the best preventative measures against Zika virus are: air conditioning, house screens, and the removal of debris and containers that provide easy mosquito breeding sites. Prevention of this virus seems easy, if you live in an air-conditioned brick house, with screens on the windows. These luxuries are often unavailable to impoverished areas where the epidemics seem to hit the hardest. For example, there are already 5 confirmed cases of Zika fever in the Port-au-Prince area of Haiti. Many Haitians live in shacks with very little protection from mosquitoes, and are therefore at a heightened risk of catching Zika fever. In addition to the heightened risk, mothers in places such as Haiti have less access to resources that would help them care for a child with microcephaly.
Caring for a child with microcephaly is quite the undertaking even for middle class families in America, as it is often accompanied by some level of mental disability. The earliest microcephaly can be detected is typically the third trimester, with a prenatal ultrasound. While families in middle class America would likely find out during the third trimester and have a little bit of time to prepare, many Haitians don’t seek much prenatal care, and traditionally babies are born at home with the help of a midwife. Depending of the severity, the life expectancy of a baby born with microcephaly is only around 10 years. A child born with microcephaly would require frequent medical examinations and diagnostic testing to help them lead a more comfortable life. Many Haitians do not have access to this kind of medical treatment, making it more difficult to properly care for the child. The lack of protection from such diseases, as well as the lack of resources to treat the disease create a vicious cycle that occurs in many impoverished areas.