Zika.
That name and its association with a virus were a relative unknown just before the 2016 New Year. Today, Zika virus has been on the lips of most everyone sometime this week.
Some people may remember the fear that Rubella once carried with pregnant women until a vaccine was developed to rid society of miscarriages and stillbirths. There was also Congenital Rubella Syndrome, which inflicted as many as 20,000 unvaccinated mothers’ babies with blindness and deafness as well as brain and heart damage (Wolfson, 2016).
Monday, 1 February 2016, the World Health Organization (WHO) will have met to convene an International Health Regulations Emergency Committee on Zika virus to determine if current conditions warrant “a Public Health Emergency of International Concern ” (WHO to convene, 2016). The Director-General of the WHO decided to increase global attention to Zika virus partly in response to Centers for Disease Control and Prevention (CDC) travel alerts and declarations that the virus had become a globally distributed concern in a matter of days (Zika Virus Travel Alert, 2016). The other part, Director-General Margaret Chan considered was due to factors that make for a “perfect storm.”
In short, transmission is dependent on just two things: direct contact with the Aedes aegypti mosquito and indirect contact with a person who has been infected with Zika virus.
The CDC and the news media, like NBC’s “What is The Zika Virus?” (Fox, 2016) and NPR’s “Big Zika Virus Outbreak Unlikely In The U.S., Officials Say” (Stein, 2016) have discounted most concern for the virus by reminding people that they are enjoying wintertime conditions when the Aedes aegypti mosquito is dormant.
After all, Dengue Virus, which has a similar mode of transmission, does not seem to inflict the people of North America with the same intensity as Caribbean and Central and South American regions. Thus, transmission is not of any concern.
And, after two week’s clearance returning from a Caribbean or South American vacation without symptoms, all should be well.
Does this allay all your fears? Should it?
Ours is a society that prefers to make informed decisions based on available and unmodified fact. So, this review will avoid the use of any “conspiracy theory” jargon to feed fear or political innuendo to soothe a false sense of security. With that in mind, let’s investigate Zika further.
First, a quick review of Zika and the virus is in order.
Zika is one of two, not one virus types. The original virus was named after the Zika forest in Uganda where the first monkey was discovered to carry the virus (WHO Director-General, 2016). That was 1947.
Zika virus was, until 2007, just a monkey virus. In the forests of Africa. 2007 marked the time when Zika left Africa and entered one island of Micronesia in the Pacific Islands area. Over the course of 2013 to 2014, four more islands had Zika virus (WHO Director-General, 2016). And, there were neurological problems (complicated by coexisting Dengue virus), which may or may not have been the paralysis known as the Guillain-Barré syndrome.
The variant that has started in the Western Hemisphere is a different Zika “flavivirus” (Zika Virus Travel Alert, 2016). At the time of this post 23 countries and territories have already reported cases since late 2015 (WHO Director-General, 2016).
There have been rates of microcephaly (small brain size at birth) that are ten times normal in Brazil and a pronounced increase in cases of the Guillain-Barré syndrome. Still, there remains NO established, causal or biological relationship between Zika virus infection and birth malformations and neurological syndromes.
The medical community is using an epidemiological construct to isolate the direct cause, but as of yet the official link is: “strongly suspected” after two autopsies of Brazilian babies who had microcephaly (WHO Director-General, 2016; WHO to convene, 2016; Zika Virus Travel Alert, 2016).
Why is the WHO concerned? Why is the North America news media focused on quieting this topic?
The answer to the first is four things: First, there is an absence of acquired immunity in any of the affected areas of the Western Hemisphere. Second, there exist NO vaccines to combat this sudden epidemic. Third, there are no treatments that respond to the Zika virus. Fourth, there are no rapid diagnostic tests available to confirm Zika virus; all samples must be confirmed currently at the CDC.
The answer to the second (why the news media seems to be quieting this topic under a winter blanket of calm) may be politically motivated by an impending presidential election that requires more attention. Additionally, it could be that the efforts of the CDC to calm and soothe demonstrate sound epidemiological wisdom using only the evidence available at this moment (Zika Virus Travel Alert, 2016).
Meanwhile, the WHO will seek to activate global priority to develop “vaccines and new tools to control mosquito populations, as well as improving diagnostic tests” (WHO to convene, 2016). Let’s see why the WHO is so interested in making this “a Public Health Emergency of International Concern” (WHO to convene, 2016). After all, the WHO has the option to permit this virus outbreak to become part of the background noise with Dengue virus.
First, the WHO is not limited by epidemiological principle that uses only the evidence presented. Instead, the WHO is forecasting.
WHO recognizes that North American winter season does not last all year long. The WHO Director-General sites “conditions associated with this year’s El Nino weather pattern are expected to increase mosquito populations greatly in many areas.”
Zika virus can freely transfer from an infected person to nearby individuals once warm season returns and the Aedes aegypti mosquito is no longer dormant. Aedes includes the entire Aedes genus such as Aedes albopictus.
One news media resource has already identified this trend and discounted the CDC theory that “everyone in North America lives in air conditioning” (Sun & Dennis, 2016). It should be noted that the conclusion of the article retains the central theme in all U.S. news sources that North America is “unlikely” to see widespread local outbreaks.
Second, the two-week clearance after return from a Caribbean or South American vacation is not considered “safe.” It has been reported by the CDC the mild symptoms of fever, rash, joint pain, and red eyes or conjunctivitis are typically associated with only one in five who test positive for Zika virus (Zika Virus Travel Alert, 2016).
Still, Zika virus can be transmitted sexually, and not just from the bite of the Aedes aegypti mosquito. According to Dr. Schuchat of the CDC, live Zika virus has been found in semen after two weeks (Zika Virus Travel Alert, 2016).
What about the solutions?
Suerie Moon of Harvard University’s Kennedy School has stated in a The New York Times “Room for Debate” that the WHO must assume leadership of the Zika virus matter (Moon, 2016). Peter Hotez of the National School of Tropical Medicine, Baylor College of Medicine emphasized at the same debate that mosquitoes must be eradicated until such a time as a vaccine becomes available (Hotez, 2016). And, Amy Vittor of University of Florida’s Emerging Pathogens Institute implicated urban poverty as “facilitating the transmission of mosquito-borne viruses” (Vittor, 2016).
So, what is the WHO doing or trying to do as it develops “vaccines and new tools to control mosquito populations, as well as improving diagnostic tests” (WHO to convene, 2016)?
For its part, the CDC has stated that vaccines will be at least a few more years or more away. The CDC plans to use existing grant money for the “flavivirus class” that includes Zika to launch two experiments. One is a vaccine designed similar to a West Nile virus DNA structured because it is considered “safe and immunogenic” (Zika Virus Travel Alert, 2016). The second is a live vaccine that is structured similarly to the Dengue virus.
Vaccines are going to be useless resources for several years. That leaves tools to control mosquito populations and improving diagnostic tests.
The WHO has been working with Oxitec, from the UK, which has genetically altered the Aedes aegypti mosquito. These wild male mosquitoes mate with local female Aedes aegypti mosquitos, and their offspring become larvae that never mature into mosquitos. In field tested areas of Brazil, Oxitec has reduced the Aedes aegypti mosquito population 90 percent (Allen, 2016).
So far improvements for rapid diagnostic testing have not been announced. The CDC, in the interim, has mandated that each U.S. state report all Zika virus cases (Muir, 2016; Pelley, 2016). Reporting was before voluntary.
Now, given the WHO concerns and known solutions, what is the bright side to this story?
Prevention of mosquito bites and infected semen is one thing. There are barrier protections available for these. And, on the grander scale, there are fancy, genetically altered males to reduce the mosquito population.
But, there’s not going to be a vaccine for several years. And, the progression of infection has advanced rapidly with over 4 million expected to have the Zika virus by the end of 2016 (Pelley, 2016). That means there will be no acquired immunity in any of these communities.
Is this a bright side to the story?
Yes! (Well, maybe…)
You can bolster your existing immune system to combat the effects of viruses like Zika before they hit. You do that all the time by eating and exercising correctly. Or at least, you should!
But, more recently, clinical researchers have taken the mammalian mother’s colostrum, that special milk available only during the first three days after birth, and extracted its active ingredients for certain immune deficiency and hyperactive disorders. The “research” on Transfer Factors has been in the literature for almost 60 years, but most of it is protected from peer-review by proprietary privilege.
The sole-proprietor of Transfer Factors paid to get its product listed in the Physician’s Desk Reference (PDR) for non-prescription drugs, which has been an advertising inducement to both conventional and alternative medicine physicians around the world in over 53 countries.
Unfortunately, it is only a nutraceutical, which means that it is, for all intents and purposes, a placebo. A placebo (sugar pill) has beneficial success, statistically, over 40 percent of the time because of the hope that it will work. Thus, it stands to reason that claims of monumental success by one-third of the users would amount to a treatment failure in the real medical and statistical professions. And, yet, the organization, 4Life Research prints in its “Guide to Supplements and Good Health” recommendations to use its product in massive amounts for anything from eczema to Human Immunodeficiency Virus (HIV) to various forms of cancer.
Is Transfer Factors the bright side of the story for Zika Virus? Probably not. Preventive measures are your best protection. The soon release of the early trials of the Dengue Virus Vaccine (with the Zika Virus Vaccine, included) is most likely going to be the true bright side to the story.
REFERENCES:
Allen, G. (2016). Genetically Modified Mosquitoes Join The Fight To Stop Zika Virus. Goats and Soda. National Public Radio, 29 January 2016. Retrieved 30 January 2016 from http://www.npr.org/sections/goatsandsoda/2016/01/26/464464459/genetically-modified-mosquitoes-join-the-fight-to-stop-zika-virus
Fox, M. (2016). “What Is the Zika Virus? Your Questions Answered.” NBC News. Retrieved 30 January 2016 from http://www.nbcnews.com/storyline/zika-virus-outbreak/what-zika-virus-your-questions-answered-n506126?cid=eml_nmn_20160129
Hotez, P. (2016). A Campaign to Eliminate Mosquitoes Is Needed Until a Vaccine Is Developed. The Opinion Pages, Room for Debate, 29 January 2016. The New York Times. Retrieved 30 January 2016 from http://www.nytimes.com/roomfordebate/2016/01/29/how-to-stop-the-spread-of-zika/a-campaign-to-eliminate-mosquitoes-is-needed-until-a-vaccine-is-developed
Moon, S. (2016). The World Health Organization Needs to Be in Charge of Zika. The Opinion Pages, Room for Debate, 29 January 2016. The New York Times. Retrieved 30 January 2016 from http://www.nytimes.com/roomfordebate/2016/01/29/how-to-stop-the-spread-of-zika/the-world-health-organization-needs-to-be-in-charge-of-zika
Muir. (2016). ABC World News, story 5, 2:50, January 28, 2016.
Pelley. (2016). CBS Evening News, lead story, 2:35, January 28, 2016.
Stein, R. (2016). Big Zika Virus Outbreak Unlikely In The U.S., Officials Say. Shots: Health News from the NPR. National Public Radio, 29 January 2016. Retrieved 30 January 2016 from http://www.npr.org/sections/health-shots/2016/01/26/464459350/big-zika-virus-outbreak-unlikely-in-the-u-s-officials-say
Sun, L. & Dennis, B. (2016). Why the United States is so vulnerable to the alarming spread of Zika virus. Health & Science, 28 January 2016. The Washington Post. Retrieved 30 January 2016 from https://www.washingtonpost.com/national/health-science/why-the-united-states-is-vulnerable-to-spread-of-zika-virus/2016/01/26/a8c6a9b4-c440-11e5-8965-0607e0e265ce_story.html?tid=a_inl
Vittor, A. (2016). To Tackle the Zika Virus, Alleviate Urban Poverty. The Opinion Pages, Room for Debate, 29 January 2016. The New York Times. Retrieved 30 January 2016 from http://www.nytimes.com/roomfordebate/2016/01/29/how-to-stop-the-spread-of-zika/to-tackle-the-zika-virus-alleviate-urban-poverty
WHO Director-General briefs Executive Board on Zika situation. (2016). Briefing to the Executive Board on the Zika situation, Geneva, Switzerland, 28 January 2016. Retrieved 30 January 2016 from http://www.who.int/dg/speeches/2016/zika-situation/en/
WHO to convene an International Health Regulations Emergency Committee on Zika virus and observed increase in neurological disorders and neonatal malformations. (2016). WHO statement, 28 January 2016. Retrieved 30 January 2016 from http://www.who.int/mediacentre/news/statements/2016/emergency-committee-zika/en/
Wolfson, W. (2016). Before Zika Virus, Rubella Was A Pregnant Woman’s Nightmare. Shots: Health News from NPR. National Public Radio, 30 January 2016. Retrieved 30 January 2016 from http://www.npr.org/sections/health-shots/2016/01/30/464899067/before-zika-virus-rubella-was-a-pregnant-womans-nightmare
Zika Virus Travel Alert. (2016). Transcript for CDC Telebriefing: Zika Virus Travel Alert, Thursday, January 28, 2016. Retrieved 30 January 2016 from http://www.cdc.gov/media/releases/2016/t0128-zika-virus-101.html
To complete this introductory story, WHO officially declared Zika Virus, today’s version of what rubella measles was to society in the 1960-70’s, “a global public health emergency:” http://www.bbc.com/news/health-35459797 Today’s action by WHO contradicts the downplay promoted by the U.S. news media. Meanwhile, Brazil equips its babies with mosquito-repellent clothing: https://www.washingtonpost.com/news/worldviews/wp/2016/01/25/as-zika-fear-spreads-brazilian-mothers-opt-for-mosquito-resistant-baby-clothing/ and Panama upgrades its 3-person count of last week to 50 Zika virus cases (according to TVN, Panama, today), all in the eastern Kuna Yala province, which is nationally isolated, but its San Blas Islands are a highly popular international tourist destination.
WHO found NO public health justification for restrictions on travel or trade to prevent spread of Zika Virus: https://twitter.com/WHO/status/694225358388903936
Still, many public health voices in the U.S. maintain the position that the current level of knowledge about Zika Virus does not justify a WHO declaration of “global public health emergency.” According to The Boston Globe, yesterday, Boston University Public Health professors, George Annas, Sandro Galea & Donald Thea believe such a declaration diverts resources away from the work that needs to be done to better understand Zika Virus while undermining the public’s confidence in global health authorities to discern the difference between true and unwarranted emergencies ( https://www.bostonglobe.com/opinion/2016/02/01/zika-virus-not-ebola/gbBZA18ILkLcLK2VNM7XfM/story.html ).
Meanwhile, Zika virus has managed to find its way through sexual contact as was predicted. Texas reported, two hours ago, the first case in the U.S., today ( http://www.bloomberg.com/news/articles/2016-02-02/zika-transmitted-for-first-time-in-continental-u-s-through-sex ).
And, today, work at Paris-based, Sanofi, gets underway to start developing a Zika virus vaccine and will need up to “two decades” before it is available ( http://www.bloomberg.com/news/articles/2016-02-02/sanofi-to-work-on-vaccine-against-zika-using-dengue-experience ). Sanofi has knowledge accumulated from recent development and license (December 2015) of a Dengue vaccine for limited use in Brazil and Mexico.
Individuals are wise to use appropriate mosquito and sexual barrier precautions, in the interim.
Social effects of associations to Zika virus are beginning to take a toll.
Sexual transmission has been added to the mosquito, which is now being compared to the 1980’s AIDS fears triggered by undeveloped medical knowledge. Wilson Savino, director of the Oswaldo Cruz Institute in Rio de Janeiro opines, ““Back then, the scientific and medical community did not know what was going on until many people had died and considerable research had been undertaken. Then it turned out to be a global health issue.” http://www.theguardian.com/world/2016/feb/02/zika-virus-scientific-research-lacking-latin-america
Fears of microcephaly, currently without a research-supported, biological link to Zika Virus, leave families across the globe asking medical professionals for direction: http://www.cdc.gov/mmwr/volumes/65/wr/mm6503e3.htm
Comfort and direction is provided from some who have lived with microcephaly: http://www.thehartleyhooligans.com/
Highlighted against the hyperbolic backdrop of fear is the reality that Zika virus currently has no proven biological links.
Thus far, there exist only associations with microcephaly and the life-threatening, paralyzing, Guillain-Barré syndrome. The Brazilian Health Ministry reminds the international community that of the 4800 (approximately) recent cases of Brazilian microcephaly, only 17 have tested positive for Zika virus: http://www.jwatch.org/fw111146/2016/02/05/zika-news-microcephaly-potentially-over-reported-1st?query=pfwTOC&jwd=000005105967&jspc=P
In that same report, blood transfusions have been added as yet another form of transmission. And, sexual transmission recommendations are now released by the CDC: http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e1er.htm and updated recommendations for pregnant women: http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e2er.htm
Still, Zika Virus has been discovered in all body fluids, including saliva and urine, according to the Brazilian Health Ministry: http://in.reuters.com/article/us-health-zika-brazil-idINKCN0VE1QQ prompting some to advocate total cessation of kissing. Transmission via these body fluids has yet to be validated.
Meanwhile, Zika virus conspiracy theories are complicating policy as Brazilian lawmakers are now delaying the UK firm, Oxitec, which has genetically altered the Aedes aegypti male mosquito and made it infertile: http://www.theguardian.com/world/2016/feb/04/alert-theres-a-dangerous-new-viral-outbreak-zika-conspiracy-theories Oxitec reduced the mosquito population 90 percent in field tested areas of Brazil (Allen, 2016).
Unknowns continue to dominate the theme that is Zika virus. An empowered immune system is the most useful defense while society awaits the decades of vaccine research.
REFERENCES:
Allen, G. (2016). Genetically Modified Mosquitoes Join The Fight To Stop Zika Virus. Goats and Soda. National Public Radio, 29 January 2016. Retrieved 30 January 2016 from http://www.npr.org/sections/goatsandsoda/2016/01/26/464464459/genetically-modified-mosquitoes-join-the-fight-to-stop-zika-virus
Real Zika virus fear advocates have now added their voice.
Initially, it was only the conspiracy theory advocates who still feed on the Russia Today (RT), politically-motivated story lines that twist details without comparing facts. One was a terrorist plot involving manipulation of UK firm, Oxitec, which offers society genetically altered and infertile Aedes aegypti male mosquitoes. Another is the goodwill Rockefeller Foundation that is held responsible for developing this latest (human) variant of Zika virus: http://www.theguardian.com/world/2016/feb/04/alert-theres-a-dangerous-new-viral-outbreak-zika-conspiracy-theories
Zika fear now feeds on regional cultures to influence behavior. The South American and Caribbean countries of Brazil, Colombia, Ecuador, El Salvador, and Jamaica have opted to issue degrees to its fertile women to delay getting pregnant rather than invest in education and intervention to promote positive change. The United Nations’ Geneva Office of the High Commissioner responded, 5 February 2016, by imploring those countries affected by Zika virus to provide all its women with “comprehensive sexual and reproductive health services to the full extent of the law.” http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=17014&LangID=E
Brazilian health officials contribute to the Zika fear by telling its pregnant women to restrict kissing and sharing dinnerware, given the latest findings that Zika is found in saliva and urine, not just semen and mosquito bites. http://news.yahoo.com/un-zika-virus-spark-review-birth-control-access-133435465.html
The Colombian Health Minister, in the wake of three Zika virus-related deaths, gave an errant announcement that “biological causation” has already been established between microcephaly and the life-threatening, paralyzing, Guillain-Barré syndrome. This, of course, has NOT yet been found true and remains a working theory, only. Alejandro Gaviria continues to hold to this statement as recent as today http://www.reuters.com/article/health-zika-colombia-idUSL8N15O3CY
Locally, U.S. Kika virus fear advocates promote quarantining all international travelers similar to attempts during the Ebola virus event. The practice of quarantining suspected virus carriers has been ineffective in all events, prior, but seems to gain traction for politically-motivated individuals. http://www.vox.com/2016/2/8/10938076/travel-quarantines-zika-virus
A carefully researched editorial describing the origins of human-variant, Zika virus was recently released, 6 February 2016, by The New York Times: http://www.nytimes.com/2016/02/07/health/zika-virus-brazil-how-it-spread-explained.html?_r=0
Finger-pointing at the originator of human-variant, Zika virus appears unproductive, especially when it happened following the principles of statistical chance in the roulette of life. The U.S., currently best suited to promote initiatives in support of the World Health Organization’s public health emergency declaration, is now working to fund a $1.8 billion national Zika response. This $1.8 billion is planned for “mosquito control programs, vaccine research, education and improving health care for low-income pregnant women…(to include) $355 million in foreign aid to South America, Central America, the Caribbean, where the Zika virus is spreading most rapidly,” according to the White House. http://www.usatoday.com/story/news/politics/2016/02/08/obama-asks-emergency-zika-funding/80002570/#
Despite the CDC (now at Level 1 alert for only the fourth time in its history) channeling much of this funding initiative, the response will be slow and cumbersome. Individuals desire to do something about their personal protection, now. Mosquito repellent products, condoms, and other barrier products are not entirely effective.
Personal immune system education appears the best, current intervention option. Vaccines will be decades in the future. Transfer Factor, the active ingredient in mammalian mother’s colostrum, has been proven by clinical research for almost 60 years to rapidly educate one’s individual immune response against unknown infection. Adding transfer factor products to one’s personal protection program should be strongly considered to decrease known, and unknown risk factors.
Evidence is now beginning to emerge suggesting, but not confirming, a biological link between some of the conditions associated with Zika Virus.
We now have our first peer-reviewed, published article using a case series research design that contrasts cases of positive physical finding and those without the condition against positive and negative Zika Virus individuals (De Paula Freitas, 2016).
The positive physical finding for this case series was microcephaly. Microcephaly was found in 29 Brazilian-located cases evaluated through the month of December 2015. Of the 29 positive cases, 23 mothers displayed “suspected Zika Virus infection signs.”
The JAMA Ophthalmology (formerly Archives of Ophthalmology) article reports the researchers discovered that the infection at birth creates a vision-threatening, optic nerve abnormality due to presumed Zika Virus exposure.
The vision-threatening findings include bilateral macular and perimacular lesions on the infant’s retina. The researchers confirmed by serology testing that all the other known ocular viruses were ruled-out: toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus, syphilis, and human immunodeficiency virus.
Specific bilateral ocular findings seen in 2/3rds of the positive cases included “focal pigment mottling of the retina” and retinal atrophy. Half of the positive cases had the optic nerve abnormality. Additionally, there was one case with a bulge on the iris and another case with an inverted lens, each a contributor to threatened vision.
Ongoing research is needed to achieve a “biological causation” link of Zika Virus with microcephaly and the life-threatening, paralyzing, Guillain-Barré syndrome. Only cohort studies, evaluating populations forward over time can establish such a link. Barrier protections are the best personal protection available, currently, and vaccines will take a decade or longer to participate as a therapeutic intervention.
REFERENCES:
De Paula Freitas, B., et al. (2016). Ocular Findings in Infants With Microcephaly Associated With Presumed Zika Virus Congenital Infection in Salvador, Brazil. JAMA Ophthalmol. Published online February 09, 2016. doi:10.1001/jamaophthalmol.2016.0267