Zika virus outbreaks spreading rapidly through the Americas are getting some high-level attention, with federal officials briefing President Barack Obama on the developments yesterday and the World Health Organization's (WHO's) executive board to discuss the situation tomorrow.
Brazil today reported more than 200 more suspected cases microcephaly, a devastating birth defect thought to be linked to maternal Zika infections, and airlines starting to offer rebooking and refunds to pregnant women who opt out of visiting destinations where the virus is circulating.
US officials brief Obama
In Washington yesterday, leaders of health and national security departments met with Obama to discuss the spread of Zika and other mosquito-borne viruses, and what steps are under way to protect the American public, according to a White House press release. Senior health officials at the meeting included Health and Human Services Secretary Sylvia Burwell, Centers for Disease Control and Prevention (CDC) Director Tom Frieden, MD, MPH, and National Institutes of Allergy and Infectious Diseases (NIAID) Director Tony Fauci, MD.
Fauci discussed factors that could affect the spread of the virus in the United States and covered recent travel and clinical guidance issued by the CDC. Other officials laid out the possible economic and development threats posed by Zika virus transmission in the Western Hemisphere.
Obama emphasized the need to speed up research efforts to deliver diagnostic tests, vaccines, and drugs, as well as the importance of making sure Americans have the information they need to protect themselves from the virus.
National Institutes of Health (NIH) Director Francis Collins, MD, PhD, addressed the Zika threat in a blog post, saying there's a critical need to confirm through epidemiologic and animal studies a link between Zika virus infection in pregnant women and microcephaly in newborns, a condition that causes abnormally small heads and underdeveloped brains. He also said much more research is needed to clarify how Zika virus interacts with mosquito, human, and non-human primate hosts and how easily Asian tiger mosquitoes, which can tolerate relatively cold temperatures, spread the virus.
Collins said the science community needs to step up efforts to develop tools to battle the virus, and that NIAID-led studies are under way to better understand Zika virus effects during human infections, rapid diagnostic tests, and test possible drug candidates. "Importantly, NIAID researchers already are working on vaccine candidates to prevent Zika virus from infecting people," he wrote.
Also yesterday, the American Society of Tropical Medicine and Hygiene (ASTMH) issued a statement on Zika virus. Stephen Higgs, PhD, the group's president said, "Many of us in the research community are very concerned that Zika has the potential to spread further and become permanently established in the Americas."
He also pointed out that research investments are always a good bet in the battle against global disease spread. "Yellow fever, for example, is relatively rare today because we have an effective vaccine to prevent it."
WHO executive board to address Zika
Meanwhile, country representatives gathered in Geneva this week for the WHO executive board meeting have asked the group for an informational session on Zika virus developments, which is slated for tomorrow at 1:00 pm Geneva time. The executive board proceeding are being webcast this week on the WHO's Web site.
Health officials scheduled to address the group include WHO Director-General Margaret Chan, MD, MPH; officials from the WHO's Pan American Health Organization (PAHO); Claudio Maierovitch, MD, director of communicable diseases surveillance with Brazil's health ministry; and a representative from the CDC.
Some experts have called for the WHO to convene an emergency committee under the International Health Regulations (IHR) to assess the rapidly evolving situation, especially since the agency came under widespread criticism for how long it took to convene a similar group for Ebola, one of several factors many reviewers thought delayed the global response to that outbreak.
Two experts from Georgetown University writing today in the Journal of the American Medical Association (JAMA) said the WHO should convene an IHR emergency committee immediately to advise Chan on whether the developments warrant declaring a public health emergency of international concern (PHEIC). The commentary authors are Daniel Lucey, MD, MPH, with Georgetown's school of medicine, and Lawrence Gostin, JD, with the university's O'Neill Institute for National and Global Health Law.
Calling together a Zika virus emergency committee would yield benefits, even if conditions don't meet the PHEIC threshold, the two wrote. They noted that no PHEIC has been declared for MERS-CoV (Middle East respiratory syndrome coronavirus), but the establishment of an emergency panel for that disease helped draw attention to the threat, and the group's recommendations have been useful for to other countries, the two wrote.
Lucey and Gostin also called on countries to help nations that haven't met the core health system capacities spelled out in the IHRs to shore up their preparedness for Zika virus, particularly with regard to vector control, risk communications, enhanced Zika virus surveillance, travel advisories, clinical management, and research and development.
More microcephaly in Brazil
In related news, Brazil's health ministry today adjusted its microcephaly totals to reflect new suspected, confirmed, and ruled-out cases, according to a statement translated and posted by Avian Flu Diary, an infectious disease news blog.
The country now has 4,180 cumulative cases, 270 of them now confirmed, 287 new suspected ones since last week, and 462 ruled-out cases.
Airlines scramble to help travelers
In other developments, some US airlines are allowing some people traveling to Zika-affected areas to cancel or rebook their flights without a fee, ABC News reported today.
One is United Airlines, while other carriers, including American Airlines, LAN Airlines, and TAM Airlines, have signaled that, with a doctor's note, pregnant passengers can change their flights or get a refund.
Southwest Airlines already allows fliers to make changes minus the fee. Carnival Cruise Lines and its sister companies are allowing pregnant women and their spouses to switch to routes that don't include Zika-hit countries or to rebook for later travel.
See also:
Jan 26 White House press release
Jan 26 Francis Collins blog post
Jan 26 ASTMH Zika virus statement
Jan 27 JAMA commentary
Jan 27 Avian Flu Diary post
Jan 27 ABC News story
