Belize’s Ministry of Health and others are ratcheting up their activities in preparation for the Zika Virus now raging in the Americas. A committee composed of the Epidemiology Unit, the Central Medical Laboratory, the Maternal and Child Care Unit and the critically important Public Health and Vector Control Departments met on Tuesday morning of this week at the Ministry of Health in Belmopan to look at preliminary measures on vector and clinical surveillance, as the Zika Virus, a member of the flavivirus family, wreaks havoc outside of Belize’s borders.
The Zika Virus is spread by the female Aedes Aegypti mosquito, which also spreads dengue and chikingunya. As the mode of spread, the female mosquito drinks the blood of an infected person; they can then infect subsequent people they bite. The virus was first found in a monkey in the Zika forest near Lake Victoria, Uganda, in 1947, and has historically occurred in parts of Africa, Southeast Asia and the Pacific Island. Only until last year has the Zika Virus come under new scrutiny and investigation by virologists and other scientists across the globe.
While the literature now abounds of the Zika Virus, alarming connection to congenital deformities, particularly microcephaly, Belizean epidemiologist Dr. Russell Manzanero, who works for the Ministry of Health urges greater scientific scrutiny. (In microcephaly the infant has a head circumference of less than 42 centimeters at full growth, often caused by failure of the brain to grow at normal rate.)
“It’s not only that the concern behind the malformations (microcephaly), that’s not a definite answer and is still being investigated,” he says.
Dr. Manzanero maintains that there are a series of illnesses that a pregnant woman can experience throughout the pregnancy that can cause microscephaly, such as toxoplasmosis, which is a disease that results from infection with the Toxoplasma gondii parasite. He admits however that the Brazilians have reported higher incidences of microcepahly, when there was an increase in Zika.
Last year, Brazil reported about 20 times its average level of microcephaly. Between October 2015 and January 2016 there have been more than 3,500 cases of the incurable condition.
Manzanero also says that there is a strong link between the Zika Virus and the Guillian-Barre syndrome now being reported in El Salvador, which is an autoimmune disease that can cause paralysis. Also as a neurological disorder, Guillian-Barre can in rare cases affect any age group and is a secondary reaction to post viral infection where the immune system reacts excessively; causing paralysis that develops from the extremities and eventually shuts down the brain system.
While Zika is yet to be declared in Belize, Dr. Manzanero is urging the capture of samples and sending them out for testing. Because the Zika virus can only be diagnosed through polymerase chain reaction and virus isolation from blood samples, the Ministry of Health has had to establish partnerships with the Caribbean Public Health Agency CARPHA in Trinidad, the Center of Disease Control CDC in Atlanta and most recently with a specialized laboratory in Panama; as had been the cases for both dengue and chikingunya. But an algorithm must be followed, Kim Bautista, Chief for Vector Control tells the Guardian, where the patient is first tested for dengue, then chikingunya, and if both are negative then the sample is tested for Zika.
The good news for Belizeans is that the Vector Control Unit within the Ministry of Health has already done considerable ground work to effectively deal with mosquitoes. As described by Kim Bautista, the Ministry of Finance has been providing about $800,000.00 Belize dollars to the Vector Control Unit over the past years, in addition to the $2,000,000.00 that has been received in grants in the past two years from both the Global Fund and the European Union. These monies have allowed the Vector Control Unit to replace its formerly dilapidated vehicle fleet, procure equipment and train personnel at both the community and technician level.
“I believe that the funding is adequate at this time, our experience has always been, where there is a sudden outbreak and a necessary requirement for quick injection of funds, the Ministry of Finance has always been facilitating to us in terms of giving us funding for emergency activities,” he says.
“You look at Zika, Dengue and Chikingunya, all being transmitted by the same Aedes Aegypti mosquito, so you are not dealing with a new vector, we are dealing with the same problem that we have been facing since the 70s’,” he reiterates.
As a result Belizeans are now being urged to keep our yards clean, remove containers that hold water from our yards to prevent mosquitoes from breeding. Experts are also advising us to avoid mosquitoes at all costs by using long sleeves when outdoors, to avoid the peak biting times in the mornings or early in the evenings and to use repellents. Pregnant women are also being advised that if they should be travelling to any of the countries that have seen cases of Zika, they should talk to their doctors before doing so. The Center for Disease Control is now recommending that women in any trimester of pregnancy “should consider postponing travel to the areas where Zika virus transmission is ongoing.”
According to the World Health Organization WHO, people with the Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis, where these symptoms normally last for two to seven days. There is no specific treatment or vaccine currently available to fight Zika, states the WHO, and American scientists studying the Zika virus have warned that it could be a decade before a vaccine is publicly available.
This disease linked to the Zika virus in Latin America poses a global public health emergency requiring a united response, said the World Health Organization on Monday.
WHO director general, Margaret Chan called Zika an “extraordinary event” that needed a coordinated response.
“I am now declaring that the recent cluster of microcephaly and other neurological abnormalities reported in Latin America following a similar cluster in French Polynesia in 2014 constitutes a public health emergency of international concern,” she was quoted as saying by the International Press.