The Zika virus brings up many concerns and questions—some of which medicine cannot yet answer. The important thing is to not let fear or sensationalism cause hysteria, writes Nathanael J. Smith   

Since spring of 2015, the Zika virus has become a major problem in South America. The number of cases is expected to reach 3 to 4 million—a scary amount for a disease that is similar to dengue fever and chikungunya.  The majority of those cases have been in healthy people, some of which never realized that they were sick. In fact, if it was not for its relationship to microcephaly, we might not be discussing it now.

Microcephaly has been correlated with Zika virus infection being transferred from pregnant mother to unborn child. Whether there is causation –that is the infection itself is causing the microcephaly is not yet known. But we do know that microcephaly and Zika infection are closely related. Cases of the Zika virus have been reported in 24 different countries. In Brazil alone there are an estimated 1.6 million cases.

However, with all of the media attention and public hysteria, we have to ask ourselves is the Zika virus an epidemic? And if it is an epidemic, what do we know about it and how can it be addressed? An epidemic is defined as “an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area.”

Since April 2015, we have indeed seen an increase in the number of Zika infections compared to what is normally seen in South America. The Zika virus was first discovered in 1947 in Uganda, where it was characterized in monkeys and mosquitoes. In the subsequent years, there have been numerous outbreaks of the disease—with the one currently occurring in the Americas being the biggest one. Despite the estimated number of cases in South America being over 1.6 million, the Centers for Disease Control (CDC) reports that the United States has only had 153 confirmed cases and all of those cases are from people infected while traveling in South America. There have been no cases of people getting infected with the Zika virus while in the United States. And only 1 in 5 people infected with the virus actually develop the symptoms of the illness. The most common symptoms are fever, rash, joint pain, and conjunctivitis (reddening of the eyes).

What do we know about the Zika virus?

 What we do not know about the Zika virus is what the incubation period is or if we can cure it. Viruses, due to their tendency use the body’s own cells as factories, storage spaces, and transportation are hard to treat effectively, let alone cure. Given all that we know and do not know about the Zika virus, our primary question should be whether or not the Zika virus is a major global problem or whether mass hysteria is getting the best of us.

The most careful of global health researchers are skeptical in making a claim either way, but it seems like the Zika virus is isolated in terms of area. Granted, the area in which the outbreak is occurring is large, the outbreak has not spread to distant parts of the world as was seen in Severe Acute Respiratory Syndrome (SARS). Another important fact to consider is the death rate amongst those infected with the virus. According to the World Health Organization (WHO), there have been no deaths associated with the virus.

The Zika virus is correlated with microcephaly, but causation has not been proven. The Zika virus infection level has epidemic status in South America, but there have been no reported deaths from the virus. Separating fact from hysteria is important when discussing any illness, especially one that is relatively unknown in the Western world and has been associated with other exotic illnesses such as dengue and chikungunya.

How best can we protect ourselves from Zika?

The WHO recommends that the best way to deal with Zika is to prevent infection and that infection is best prevented by avoiding mosquito bites (wearing bug spray, sleeping under mosquito nets, etc.) The world’s best global and public health practitioners are researching the Zika virus, particularly in connection to dengue and chikungunya, and a vaccine might only be 18 to 24 months away (according to a podcast given by Dr. Noreen A. Hynes on 2/24/16)—which is a fast in the world of medicine. The Zika virus brings up many concerns and questions—some of which medicine cannot yet answer. The important thing is to not let fear or sensationalism cause hysteria, instead we need to keep informed about this and other illnesses, looking to public health organizations, such as the CDC and the WHO, to give credible and timely advice. Time, and the revelations about the virus that we gain with it,  will be the true measure of whether the Zika virus has the potential of being a global epidemic.        

Nathanael J. Smith is a Howard Hughes Medical Fellow at Vanderbilt University Medical Center and a Robert Wood Johnson Health Policy Scholar at Meharry Medical College, where he is also a medical student....

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