Based on a recommendation from its emergency committee today, the World Health Organization (WHO) said Zika virus infections and related microcephaly cases no longer constitute a public health emergency of international concern (PHEIC), and efforts to battle and research the disease will now be folded into the WHO's regular work, where it will receive high-level attention and more sustained funding.
Today's meeting was the committee's fifth since recommending a PHEIC in February, not for the disease itself, which is typically mild in the roughly 30% of infected people who show symptoms, but for the unusual clusters of microcephaly cases in Brazil that emerged as the outbreak unfolded, which had never been seen before.
Focus on long-term response
At a media briefing today, Peter Salama, MBBS, executive director of the WHO's new Health Emergencies Program, emphasized that experts aren't downgrading the importance of Zika virus or its complications. He said the move is rather an acknowledgement that the virus will be an endemic threat in many countries.
"Zika is here to stay," he said, adding that WHO Director-General Margaret Chan, MD, MPH, has accepted the group's recommendation.
David Heymann, MD, who led the Zika emergency committee, said a key factor in today's PHEIC step-down was that researchers have now demonstrated an association between the virus and microcephaly with its constellation of neurologic defects. He said the initial declaration helped galvanize an intensive response, especially research into the disease and related birth defects. Heymann is an infectious disease epidemiologist at the London School of Hygiene and Tropical Medicine.
He said the emergency committee worried that calling off the PHEIC might signal an urgency downgrade to the public, but he said today's action escalates the importance of Zika response within the WHO's programs.
Heymann said the emergency committee's recommendations, addressing several long-range issues such as reproductive health and public health surveillance, are still in place and will be internalized into the WHO's main programs.
Microcephaly link established, but questions remain
Salama said now that the link between Zika and microcephaly syndrome is well established, health officials know that they can expect to see the disease in more countries, with more microcephaly cases. He added that there are still many unknowns that require more research.
"There's lots of work still to be done on Zika. That's the message we want to leave you with today," Salama said.
Heymann said the committee heard detailed reports today from outbreak countries, including Brazil, where a probe into unusually high microcephaly levels in the northeastern part of the country has still not revealed any related cofactors, such as infection with other flaviviruses or environmental factors. However, he said those investigations take a long time and will continue.
In a related development, Brazil today released a statement maintaining its Zika health emergency, a move Heymann said is appropriate. He added that the WHO's ending of the PHEIC doesn't preempt other countries from keeping or declaring national emergencies, a step that typically triggers more resources and efforts to battle a disease.
Florida cases, vaccine funding, Cambodia case
- The Florida Department of Health today added four locally acquired Zika cases to its total and one to its "undetermined" category, meaning the exposure location is unknown. Three of the local cases are in Miami-Dade County resident, and one involves a traveler from outside the state. All were exposed in Miami-Dade County. The undetermined case involves a Florida resident. The state now has 234 locally acquired cases and 15 undetermined cases.
- The United Kingdom's Department of Health announced today that six Zika vaccine projects are among 26 vaccine efforts that will receive $150,700,000 in funding. Other diseases targeted by the funding group include Ebola, Q fever, Crimean Congo hemorrhagic fever, Middle East respiratory syndrome coronavirus (MERS-CoV), plague, and chikungunya.
- Cambodia today announced its first Zika case in 6 years, involving a 44-year-old man from Kampong Cham province, Xinhua, China's state news agency, reported. Findings were confirmed by the Pasteur Institute office in Cambodia, and the health ministry urged people, especially pregnant women, to avoid mosquito bites. Other Asian countries have also reported recent Zika spread, such as Thailand, Vietnam, Myanmar, and Singapore.
See also:
Nov 18 WHO statement
