The yellow fever mosquito, <cite>Aedes aegypti</cite>, is Zika's most important vector.

The yellow fever mosquito, Aedes aegypti, is Zika's most important vector.

Marcos Teixeira de Freitas, Creative Commons

WHO director calls for emergency Zika meeting

An emergency panel convened by the World Health Organization (WHO) will discuss on Monday what steps should be taken to slow the spread of Zika, the mosquito-borne virus spreading quickly through Latin America. WHO director-general Margaret Chan announced the panel today at a meeting of WHO's Executive Board in Geneva, saying that "[t]he level of alarm is extremely high." The Zika virus is suspected of causing severe birth defects and occasional but serious neurological complications in adults. The virus has spread to 23 countries in the Western Hemisphere, after emerging in Brazil in May 2015.

The committee will decide whether the epidemic deserves to be designated a “Public Health Emergency of International Concern.” That would allow WHO to issue travel restrictions and would also be a strong signal that more resources should be devoted to studying and fighting the virus. The last such emergency was declared in August 2014 in response to the Ebola epidemic in West Africa; it is still in place today. WHO was widely criticized for taking that step many months too late.

Chan’s announcement today is an important first step in the fight against Zika, says Lawrence Gostin, an expert in global health law at Georgetown University in Washington, D.C. He was an author on a commentary published yesterday in the Journal of the American Medical Association that criticized WHO for acting too slowly in its response to the epidemic. “WHO is finally recognizing the urgency of Zika,” he says. “It is a promising start. Now we need to follow words with actions.” The agency should provide technical assistance to affected countries to help with mosquito control—currently the only defense against the disease—and should coordinate research on key questions about how the disease is spreading, how it might be affecting fetal development, and on vaccine development, Gostin says.

All of those questions are on the agenda for Monday, Chan said today. She called the epidemic and the increase in a birth defect called microcephaly “a heartbreaking burden on families and communities.” Babies with microcephaly have heads smaller than normal, usually indicating that the brain has failed to develop properly. The condition can be caused by drug use, genetic mutations, or in utero infections.

Brazil has seen a spike in microcephaly cases after Zika started spreading there. Since October, Brazilian health authorities have recorded more than 4000 cases. But a health ministry spokeswoman said yesterday that those initial numbers may be too high. When officials looked more closely at more than 700 cases, they found that 462 of them could be ruled out—either the babies did not have microcephaly or the condition could be attributed to causes such as drug abuse by the mother. The authorities were able to confirm 270 cases as due to infections, but so far only six have been confirmed as positive for Zika.

The number of open questions about Zika is another reason for WHO to encourage more research and to attempt to coordinate efforts so that answers can come more quickly, Gostin says. “They dropped the ball on Ebola. There’s a genuine worry that WHO doesn’t have the capacity to lead. This will give them the chance to demonstrate they can do that.” 

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