Zika: Then, now, and tomorrow
Where do we stand one year after WHO announced Zika as a public health emergency? International spread has continued, while surveillance has improved. In line with WHO advice, innovative approaches to mosquito control are being piloted in countries and WHO will provide sustained guidance for effective interventions and support for families, communities, and countries experiencing Zika virus.
In 2015, the Brazil Ministry of Health notified PAHO/WHO about the circulation of a disease with symptoms that included rash and which later was confirmed as Zika. Soon after, PAHO/WHO released an alert for the Americas. Although the response to the virus was fast and timely, it happened in a context of relative calm given the fact that it was a mild disease, with no known severe consequences except for Guillain-Barre syndrome.
"We have been working very closely with governments and research institutions, gathering experts from all over Brazil and the world to exchange knowledge and produce guidance for health professionals, policy-makers and the general public."
Enrique Vazquez, Coordinator for Communicable Diseases and Health Analysis
This scenario changed when we were informed, on 22 October 2015, about an unusual rise of newborns with microcephaly in the Northeast of the country. Four days later, we met with national and local health authorities in the most affected state, Pernambuco. We agreed that it was important to provide care to the children, to describe the symptoms – tiny heads, seizures, inability to flex arms and legs, irritability – and to urgently set in motion a study which compares newborns with microcephaly with newborns without the condition.
We have been working very closely with governments and research institutions, gathering experts from all over Brazil and the world to exchange knowledge and produce guidance for health professionals, policy-makers and the general public. The Brazilian authorities have taken crucial measures in a transparent and timely manner in line with the International Health Regulations, a legal instrument that is binding for all WHO Member States. To assist the country in these tasks, the PAHO country office in Brazil quickly purchased essential materials such as laboratory reagents, insecticides and diagnostic kits. We also helped to develop the methodology and criteria for defining cases of microcephaly and laboratory techniques for diagnosing the condition, to detect new cases and to strengthen integrated surveillance of chikungunya, dengue and Zika. Our strong partnership with the Ministry of Health makes it possible for us to share our experiences in Brazil with the world.
To find new ways to respond to Zika and its consequences, we continue to support Brazil. For example, we are helping to develop strategies to control the spread of Zika virus and offer quality care to families and their babies with congenital Zika virus syndrome. One example is a partnership with Fiocruz Amazônia to strengthen the integrated management of disease-carrying organisms in public health. This includes scaling up the use of larvicides, which are picked up by female Aedes mosquitoes and carried to breeding sites. When the larvicide enters the water, it becomes deadly for the mosquito larvae. PAHO/WHO is also helping Fiocruz Bahia to bring a project called Zibra (Zika in Brazil Real Time Analysis) to other Member States in the Amazon region, which will investigate the evolution of Zika virus strains. In the next few months, we will also support the training of health professionals in providing psychosocial care for pregnant women, families and caregivers of children with congenital Zika virus syndrome. We will continue to work with Brazil to strengthen laboratory capacity, data analysis and public health surveillance.