As the Zika virus scare reaches the region, it appears apt to recall the Arabic proverb: “He places His secrets in His weakest creations.” The world struggles with one question: how to avoid the Aedes mosquito? The mosquito in question transmits the Zika virus, a disease that causes mild fever, skin rash and conjunctivitis. More importantly, it's feared to be the reason for a spike in infant microcephaly — a rare condition where a baby has an abnormally small head due to abnormal brain development in the womb or during infancy — which is passed on through infected pregnant mothers. While Aedes is the same mosquito that transmits dengue, chikungunya and yellow fever, and microcephaly could be caused by a variety of environmental and genetic factors, such as Downs syndrome, exposure to drugs, alcohol or other toxins in the womb, the Zika virus is now widely viewed as the reason for the recent outbreak of birth defects in Latin America, despite uncertainties among health organisations. Because it has no vaccine and so little is known about the Zika virus, the scare it is causing in the Americas, and now elsewhere, appears justified. The sight of crying, brain-damaged babies touches a nerve for virtually everyone, especially prospective parents. Already health ministers of five Latin American countries stricken by the virus have issued statements advising women to delay getting pregnant until a vaccine is procured — an unprecedented warning in modern medical history. But just how alarmed should the world be? Following an emergency meeting earlier this month, the director general of the World Health Organisation (WHO) announced the recent cluster of microcephaly and other neurologic disorders reported in Brazil — that has 4,000 cases alone — to be a “public health emergency of international concern”. The WHO's first situation report on the virus issued earlier this week concluded that a “causal” relationship between Zika infection during pregnancy and microcephaly is “strongly” suspected, though not yet scientifically proven. For now, the global prevention and control strategies launched by the WHO are based on surveillance, response activities and research. According to the WHO situation report, between January 2014 and 5 February 2016, a total of 33 countries reported autochthonous circulation of Zika virus. There is also indirect evidence of local transmission in six additional countries. Between the WHO's reserved statements and the flow of alarming stories, news and statements coming from the Americas where the virus is already manifested in a staggering four million infections, including three deaths in Columbia, conflicting reports in Egypt have left the public puzzled about the virus. While a Health Ministry spokesman was quoted in the press as saying Zika virus cases have been detected in Egypt, the ministry itself issued a counterstatement of denial. According to the WHO's Egypt representative, John Gabour, there are no reports of Zika infections in the country (or the Eastern Mediterranean region), but the Health Ministry's surveillance system is observing the situation rigorously. Citing what he described as a swift approach to a Dengue fever outbreak in parts of Upper Egypt last year, Gabour said it went down from 23 per cent to almost zero, evidence he said of the health authorities' ability to monitor and respond to similar outbreaks, like Zika should it occur. There are no reports of microcephaly cases in Egypt either, Gabour told Al-Ahram Weekly, adding that in the event of a case, it should not be interpreted as an outcome of the Zika virus, which is identified through “clusters” of cases. A national Zika virus awareness campaign targeting health clinics with a wide distribution of educational posters is currently in progress by the ministry, with WHO support, he said. The geographical distribution of Zika virus has been steadily increasing since it was first detected in the Americas in 2015. Further spread to countries within the geographical range of competent disease vectors — Aedes mosquitoes — is considered likely. Seven countries have reported an increase in the incidence of cases of microcephaly and/or Guillain-Barré syndrome (a rare condition in which the body's immune system attacks part of the nervous system) concomitantly with a Zika virus outbreak. Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013, and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). More than 13 countries in the Americas have reported sporadic Zika virus infections, indicating rapid geographic expansion. The virus has also prompted debate on abortion in largely Catholic Latin America and the Caribbean. Calls to ease laws that restrict abortions have gained momentum but are being resisted by conservative religious authorities, causing an increase in the rate of illegal abortions in Brazil. The Olympic Games 2016, due in Brazil's Rio de Janeiro in August, has also entered the debate. The United States Olympic Committee told US sports federations that athletes and staff concerned for their health over the Zika virus should consider not going. On Tuesday, Kenya said it would consider pulling out of the Olympics if the virus reaches “epidemic levels”.
