WHO, in contrast to slow Ebola response, quick to categorize Zika as a global emergency


The World Health Organization declared an international emergency on Monday over the explosive spread of the mosquito-borne Zika virus, which is linked to birth defects in the Americas, saying it is an “extraordinary event.”

The U.N. health agency convened an emergency meeting of independent experts in Geneva to assess the outbreak after noting a suspicious link between Zika’s arrival in Brazil last year and a surge in the number of babies born with abnormally small heads.

“After a review of the evidence, the committee advised that the clusters of microcephaly and other neurological complications constitute an extraordinary event and public health threat to other parts of the world,” WHO Director-General Margaret Chan said.

WHO estimates there could be up to 4 million cases of Zika in the Americas in the next year, but no recommendations were made to restrict travel or trade.

“It is important to understand, there are several measures pregnant women can take,” Chan said. “If you can delay travel and it does not affect your other family commitments, it is something they can consider.

“If they need to travel, they can get advice from their physician and take personal protective measures, like wearing long sleeves and shirts and pants and use mosquito repellent.”

The last such public health emergency was declared for the devastating 2014 Ebola outbreak in West Africa, which killed more than 11,000 people. A similar declaration was made for polio the year before.

Such emergency declarations are meant as an international SOS signal and usually trigger increased money and efforts to stop the outbreak, as well as prompting research into possible treatments and vaccines.

WHO officials say it could be six to nine months before science proves or disproves any connection between Zika and the spike in the number of babies born in Brazil with abnormally small heads.

WHO, which was widely criticized for its slow response to the 2014 Ebola crisis in West Africa, has been eager to show its responsiveness this time. Despite dire warnings that Ebola was out of control in mid-2014, WHO didn’t declare an emergency until August, when nearly 1,000 people had died.

Its officials say that up to 4 million cases of Zika could turn up in the Americas within the next year. Zika was first identified in 1947 in a Ugandan forest but until last year, it wasn’t believed to cause any serious effects; about 80 percent of infected people never experience symptoms. The virus has also been linked to Guillain-Barre syndrome, which causes muscle weakness and nerve problems.

“Of course, the world and the World Health Organization have all learned from the Ebola crisis,” WHO spokesman Christian Lindmeier said earlier Monday before the emergency was declared. “That’s why we are trying to bring in the best experts we can gather for this event, to try to establish what steps to take and what the way forward should be.”

Lindmeier credited authorities in Brazil for being “extremely transparent” since the Zika outbreak turned up there in May. He said WHO first raised the possible connection between the virus and abnormally small heads back in October — a prospect that has sown fear among many would-be mothers and pregnant women.

Brazilian officials shared lab samples with foreign experts and brought in scientists from abroad, he said.

“What we know so far is that the only microcephaly cases we see currently are from Brazil,” Lindmeier said, noting that abnormally small heads in newborns can have many causes — such as the effects of herbicides, alcohol use, or drugs and toxins. “This is exactly what is the concerning question: why do we see this in Brazil?”

Jimmy Whitworth, an infectious diseases expert at the London School of Hygiene and Tropical Medicine, said we might soon see other babies born with malformed heads as the virus becomes entrenched in other countries.

“It could be that we’re getting the strongest signal in Brazil,” he said before WHO’s announcement. “But having these cases occurring and pinning it to Zika is tough.”

Whitworth said it was important for WHO to act quickly, despite definitive evidence that Zika is responsible for the surge in microcephaly cases.

“For situations like this, you have to essentially have a ‘no regrets’ policy,” he said. “Maybe this will be a false alarm when more information is available months later, but it’s serious enough on the evidence we have right now that we have to act.”

Brazil’s top health official said on Monday that the Zika virus outbreak is proving to be worse than believed because most cases show no symptoms, but improved testing should allow the country to get a better grip on the epidemic.

Health Minister Marcelo Castro told Reuters that Brazil will start mandatory reporting of cases by local governments next week when most states will have labs equipped to test for Zika, the mosquito-borne virus that has quickly spread through Latin America.

The rapid arrival of Zika to Brazil has sparked fear especially among pregnant women after local experts linked the virus to thousands of cases of microcephaly, or abnormally small brains, in newborns.

“Eighty percent of the people infected by Zika do not develop significant symptoms. A large number of people have the virus with no symptoms, so the situation is more serious that we can imagine,” Castro said in an interview.

With no Zika vaccine available for the foreseeable future, Brazil’s only option is to eradicate the mosquito that has spread the virus, and the government is mobilizing all possible resources and people to destroy its breeding places, he said.

An estimated 1.5 million Brazilians have caught Zika, a virus first detected in Africa in the 1940s and unknown in the Americas until it appeared in May in the poverty-stricken northeastern region of Brazil.

The Pan-American health Organization said the virus has since spread to 24 countries and territories in the hemisphere.

By next week, labs in all but three of Brazil’s states will be able to test whether a person has had Zika or not, Castro said.

By next month, the labs will have a test that can detect all three viruses borne by the Aedes aegypti mosquito — dengue, chikungunya and Zika. The test, however, will only be effective during the initial infection period of five days.

Castro said Brazilian researchers are convinced that Zika is the cause of the 3,700 confirmed and suspected cases in Brazil of microcephaly in newborns. He said the virus cannot be transmitted from person to person, only by mosquito.

Brazil will follow the U.S. decision last week to prohibit blood donations from people who have been infected with Zika, he said.

The U.S. Food and Drug Administration, however, has said it is planning to require people who have traveled to an affected country to defer giving blood, but details on how that might work are still being determined.

Panama on Monday said it has 50 cases of Zika virus infections and warned that the mosquito-borne disease will end up spreading across the Central American nation.

“Let’s be clear: it (Zika) is going to enter, it is going to spread,” the head of the health ministry’s epidemological department, Israel Cedeno, told the television network TVN-2.

The WHO on Monday declared the virus a global health emergency.

The 50 cases confirmed so far in Panama were concentrated in the predominantly indigenous Guna Yala region along its Caribbean coast.

Vice President Isabel De Saint Malo last week had spoken of 38 cases in Guna Yala and said at the time that “there is no big public health risk.”

Although symptoms of the disease are relatively mild, it is believed to be linked to a surge in cases of microcephaly, a devastating condition in which a baby is born with an abnormally small head and brain.

It is also believed to be linked to a neurological disorder called Guillain-Barre syndrome.

Infections have been reported in 13 countries in the Americas, according to WHO, as well as in Asia, and in Africa, from where it originated.

Panama borders Colombia, which has so far reported more than 20,000 cases of Zika, including 2,100 in pregnant women. Colombia is forecasting it will see more than 650,000 infections.

Colombia meanwhile fears an explosion in cases of the potentially paralyzing nervous disorder Guillain-Barre syndrome, linked to the mosquito-borne Zika virus that is devastating Latin America, the government said Monday.

Health Minister Alejandro Gaviria said he expected more than 1,500 cases of Guillain-Barre in the South American country, one of the worst hit by Zika.

Scientists suspect Guillain-Barre is linked to Zika, which is also blamed for brain damage in newborn babies, though the World Health Organization says neither link has yet been proven.

“We are currently talking about a rate of 2.3 cases of Guillain-Barre for every 1,000 patients with Zika. That is quite a lot,” Gaviria said on Colombian radio.

Since Colombia is forecasting about 657,000 cases of Zika during the epidemic, it expects over 1,500 cases of Guillain-Barre, he said.

Colombia is the second worst-hit country in the current Zika outbreak, after Brazil.

Brazil has recorded thousands of suspected cases of microcephaly — a disorder that causes babies to be born with abnormally small heads.

Brazilian scientists claim Zika causes microcephaly when it is transmitted by a pregnant mother to her fetus. The WHO’s director-general, Margaret Chan, has called that possibility “extremely worrisome.”

A rare neurological disorder, Guillain-Barre makes the immune system attack the nervous system, causing weakness and sometimes paralysis.

Gaviria said about 4 percent of sufferers were estimated to die from the disease.

Citing neurologists, he said Colombia was seeing an “explosion” of Guillain-Barre cases lately.

“There is enough of a coincidence in the timing and location of them to say there is clearly a link,” he said.

“The two great concerns are microcephaly and neurological complications,” said Gaviria. “It is like a perfect storm.”

In their latest epidemic bulletin, Colombian health authorities reported more than 20,000 cases of Zika, including 2,100 in pregnant women.

The government has advised women to avoid getting pregnant until at least June.