On Thursday, the World Health Organization announced it will hold an emergency meeting on the Zika virus, which is “spreading explosively” and “strongly suspected” of causing a surge in birth defects across Brazil.
The meeting, scheduled for Monday, will convene an expert panel to determine whether Zika constitutes a “public health emergency of international concern.” Since 2009, the declaration has only been made for three previous health crises: the H1N1 pandemic, polio and Ebola.
The emergency committee will tackle a few key questions: what is the appropriate level of concern? What recommendations should be given to affected countries? And what are the priorities for research and outbreak response?
For some public health experts, these are urgent questions that should have been already addressed by the UN health agency — which is still stinging from harsh criticisms over its sluggish response to the Ebola outbreak.
“This is something we’ve been waiting for, for the World Health Organization to take a leadership role in global health governance,” said Oscar Cabrera, executive director of the O’Neill Institute for National and Global Health, where his colleagues recently urged the WHO to convene an emergency meeting.
“We really need to come up with a game plan.”
The Zika virus was first detected in Uganda in 1947, and for decades it was only thought to cause mild disease. Spread by mosquito bites, the virus is estimated to only cause symptoms in one in four people.
Today, the Zika situation is “dramatically different,” according to WHO director general Dr. Margaret Chan. Since Zika’s arrival in the Americas, Brazilian doctors have noticed an alarming spike in microcephaly cases, a condition where babies suffer from abnormally small heads and incomplete brain development. Some Zika-affected countries have also reported a surge in Guillain-Barré syndrome, a condition that can cause temporary paralysis.
There is no proof yet that Zika causes either of these neurological problems, although scientists are currently investigating the mounting evidence. Regardless, the sudden spike in both conditions is cause for alarm, especially since Zika — if proven as the cause — has no vaccine or specific treatment.
“The possible links, only recently suspected, have rapidly changed the risk profile of Zika from a mild threat to one of alarming proportions,” Chan told the WHO executive board on Thursday.
Since last spring, Zika has already spread to at least 23 countries and territories (it also caused an outbreak on Chile’s Easter Island in 2014). The Pan American Health Organization anticipates the virus will eventually reach every country with populations of Aedes aegypti, the day-biting mosquito currently thought to be spreading the virus. The WHO said Thursday that the virus could cause between 3 and 4 million cases over the next year, though this estimate is a crude projection based on data from previous outbreaks of dengue, another virus related to Zika.
There are also increasing reports of tourists getting infected and bringing the virus home — including to Canada, where three cases have been confirmed so far.
Two were diagnosed in B.C. and a third in Alberta, with travel histories to either Colombia or El Salvador. All three have since recovered.
While Zika’s threat to Canadians remains low, the Public Health Agency of Canada is recommending that pregnant women — and women who plan to become pregnant — avoid travel to Zika-affected countries.
Canadian Blood Services will also start turning away donors who have visited high-risk countries. The agency already prohibits blood donations from people who have recently travelled to malaria-endemic countries.
“We think that the chance of Zika virus showing up in the Canadian blood supply is very remote, but we don’t want to sit here and do nothing, knowing that Zika virus is spreading around in areas where Canadians are potentially going to be travelling,” chief medical and scientific officer Dr. Dana Devine told The Canadian Press.
Cabrera acknowledged that Zika is unique compared to global health threats like SARS or Ebola; the virus carries an extremely low risk of death, but its social and economic impacts are potentially staggering.
Several Latin American countries have already recommended that pregnancies be delayed, with El Salvador even calling for women to hold off until 2018. The suspected link to congenital deformities is also raising concerns that women could seek clandestine abortions in the Roman Catholic countries where the procedure is restricted or outlawed.
Zika is also causing anxiety around the upcoming Summer Olympics in Rio de Janeiro and the Canadian Olympic Committee’s chief medical officer is currently keeping an eye on Zika’s fast-moving developments.
If Zika virus is declared a global health emergency on Monday, it will dramatically escalate the level of urgency around the outbreak and rally the global community to contribute more money and resources.
But specific criteria have to be met for a global emergency to be called and a declaration is far from guaranteed. The WHO has held several such meetings to assess the Middle Eastern respiratory syndrome — which has already caused more than 1,600 laboratory-confirmed cases in 26 countries — but an emergency has yet to be declared.
Where Canadians could get Zika
Canada may not harbour the Aedes aegypti, the mosquito currently implicated in the Zika epidemic, but that doesn’t mean Canadians are immune to the threat — in 2014, Canadian residents made more than 4 million visits to the 24 countries and territories where Zika has now appeared. Here are Canada’s top ten destinations where the virus is currently spreading:
1. Mexico — 2,117,300 visits
Mexico confirmed its first locally acquired Zika infections in November, with 14 now reported in three states: Chiapas, Nuevo Leon and Jalisco. Another four cases have also been imported.
2. Dominican Republic — 563,700 visits
On Jan. 23, health authorities tested 27 samples and found 10 that were positive for Zika virus. Two more were imported from El Salvador.
3. U.S. Virgin Islands — 154,800 visits
A 42-year-old woman on the island of St. Croix, with no recent travel history, was confirmed last week as the first Zika case on the U.S. Virgin Islands.
4. Barbados — 146,900 visits
Health authorities confirmed three locally acquired cases of Zika on Jan. 14, and are now awaiting test results from 27 other samples.
5. Puerto Rico — 139,400 visits
On Dec. 31, health authorities reported Puerto Rico’s first Zika case. A further 18 cases have been confirmed, none of them pregnant women.
6. Honduras — 118,300 visits
Since mid-December, Honduras has registered 1,000 cases of Zika and hospitals have been reporting increases in Guillain-Barré syndrome.
7. Colombia — 106,800 visits
After Brazil, Colombia has been hardest hit by Zika, with more than 11,000 cases. The last few days have seen hundreds of reports of Guillain-Barré syndrome, according to the health minister.
8. Panama — 90,600 visits
Since early December, 42 cases of Zika have been detected in Guna Yala (formerly San Blas), an indigenous province in northeast Panama.
9. Brazil — 75,400 visits
Brazil has been hardest hit by Zika, with estimates of up to 1.5 million cases since May 2015. Officials have confirmed 270 microcephaly cases, with another 3,448 still under investigation.
10. Haiti — 69,900 visits
In mid-January, Haiti’s health ministry announced that the country had been hit by a Zika outbreak, with five cases confirmed.
*Costa Rica and the United States — both popular Canadian destinations with Aedes aegypti populations — have also seen imported Zika cases, although local spread has not been reported.
- With files from Toronto Star wire services