Revenge of the Aztecs- Part II
Lessons and challenges from the outbreak of Zika virus.
Although it was discovered 69 years ago in the Zika Forest of Uganda, even as a physician I had not previously known of the Zika virus. I first read about it a month ago in the daily two-page news brief on a cruise ship as it left the harbor of San Juan, Puerto Rico – one of the very places we were now warned by pubic health authorities to avoid! Additional concern was generated by the fact that our cruise itinerary included two other islands in the Caribbean where the disease was breaking out.
The Zika virus belongs to the flavivirus family which includes Yellow Fever, West Nile Virus, and Dengue – serious players. It did not help matters that I had lost a friend to hemorrhagic Dengue fever on the Caribbean island of St. Croix a few years earlier. Like its sister viruses, Zika appeared to be transmitted primarily by mosquitoes carrying blood from one bitten person to another – the usual mechanism of arthropod vector transmission.
Where did it come from?
Although the primary infection itself may be asymptomatic, Zika’s usual symptoms are relatively mild and include fever, headache, joint pains, and conjunctivitis (red-eye). The first well documented epidemic of Zika in humans occurred on the Pacific island of Yap in 2007, and then in French Polynesia in 2013. Impressive was the high proportion of individuals infected. On the French islands, a possible connection was made to an increased incidence of the reactive and probably auto-immune Guillain-Barré syndrome which can cause life-threatening paralysis by attacking the nervous system . In 2015, some traveler, perhaps attending a world cup soccer match, probably brought the virus to South America where it exploded to infect over a million individuals so far. Additional millions are expected to become ill as the epidemic runs its course. Public anxiety and my own was amplified by the fact that so little is known about the disease and its natural history. Continue reading “A Herd of Humans – A Murder of Mosquitoes.”