Experts approve world health emergency warning over Zika

Health professionals have welcomed the declaration by the World Health Organisation (WHO) that the suspected link between the Zika virus and a congenital brain condition found in babies should be considered a "public health emergency of international concern".

Zika virus
WHO, which last declared a global emergency over the Ebola outbreak in West Africa, has predicted that as many as four million people could be infected with the virus this year, with babies believed to be at risk of shrunken brains when born to mothers infected with the Zika in the early stages of pregnancy.Both Brazil and Colombia have reported dramatic rises in the number of babies with underdeveloped brains and most of North, Central and South America now considered vulnerable to the virus.Dr Margaret Chan, WHO director general, said the causal relationship between infection during pregnancy and microcephaly in babies was "strongly suspected" although not yet scientifically proven. She said a co-ordinated international response was needed to investigate the relationship between Zika and the brain condition."After a review of the evidence the committee advised that the clusters of microcephaly and other neurological complications constitute an extraordinary event and a public health threat to other parts of the world," she said."In their view a co-ordinated international response is needed to minimise the threat in effected countries and reduce the risk of further international spread."Members of the committee agree that the situation meets the conditions for a public health emergency of international concern."I have accepted this advice. I am now declaring that the recent cluster of microcephaly and other neurological abnormalities reported in Latin America, following a similar cluster in French Polynesia in 2014, constitutes a public health emergency of international concern."Dr Chan added that no public health justification had been found for restrictions on travel or trade because of the threat from the virus.Reacting to the WHO declaration, Dr Ulrike Sucher, medical director at Allianz Worldwide Care, said, "Those most at risk of Zika are pregnant women and their babies, due to foetal abnormalities linked to the infection, which is transmitted by mosquito bite. It is only this group that should consider the virus dangerous."It is recommended that expectant mothers postpone travel to areas where the Zika infection is concentrated. If travel cannot be avoided, then the normal precautions such as mosquito repellents, mosquito nets and long-sleeved clothes should be used for prevention. Women living in affected areas may want to consider delaying pregnancy until the World Health Organisation declares the area free of Zika, or an approved vaccine against the virus is developed."We must, however, be cautious of responding to the hysteria in the media surrounding the virus. The risk of symptoms to those infected is relatively low with only 20 per cent of humans experiencing mild symptoms such as low grade fever and a rash, joint discomfort mainly in hands and feet or a conjunctivitis, between two and 12 days after the mosquito bite."Whilst the World Health Organisation has declared that the Zika outbreak is enough to constitute a global emergency, it is worth remembering that only a small proportion of the global population are at risk. Questions should centre on which specific demographics are most likely to be affected and ways to prevent infection."For now at least, all those travelling to the affected areas should make sure that they protect themselves against transmission of the virus by mosquitoes."Jonathan Ball, professor of molecular virology at the University of Nottingham, said, "Whilst a direct link between Zika virus infection in pregnancy and babies born with microcephaly needs to be established, the severity of the disease and the strong association with recent and ongoing Zika outbreaks is clearly sufficient cause for concern to declare an international health emergency."This makes sense as it will help mobilise international effort and collaboration.
Regarding the reluctance to impose travel or trade bans, the real difficulty is balancing the risk of further international spread with the needs of those countries experiencing the worst of the current outbreak."A knee-jerk response would be to ban travel and trade with countries affected, but the truth is that the potential problem is much wider. It wouldn't really be feasible to lock down the affected countries to try to stop the spread of a virus that is carried by the Aedes mosquito, especially when affected and unaffected countries border one another."Until populations can build up sufficient immunity, either through natural infection or through vaccination then the risk to pregnant women is real and therefore this group need to take extra care to avoid becoming exposed."Prof Trudie Lang, director of the Global Health Network at the University of Oxford, said, "It is excellent news that the WHO have taken this step to make this announcement today. There are many key research questions that must now be addressed in order to understand, manage and ultimately treat and prevent this apparent effect that the Zika virus is having on foetal development during pregnancy."This essential research needs to be co-ordinated, supported and prioritised and this will require rapid international collaboration and strong leadership from a neutral organisation, and this surely must be the WHO rather than any one country."

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