Has The Zika Virus Triggered An Epidemic Of Birth Defects In Brazil?

The Brazilian government has urged its citizens to take every possible measure to avoid being bitten by mosquitoes, and has even encouraged women to delay getting pregnant, after more than 2,700 babies were born with unusually small heads and at least 40 died of the condition last year. In 2014, the year before, only 147 cases of the condition, called microcephaly, were reported.

Angela Rocha, a Brazilian pediatric infectious diseases specialist, warned: "These are newborns who will require special attention their entire lives. It's an emotional stress that just can't be imagined. We're talking about a generation of babies that's going to be affected."

What is going on?

Mexico, El Salvador, Panama, Venezuela, Suriname, the Dominican Republic, Guatemala, Colombia, and Paraguay have all had cases, and on January 1, the first case of the Zika virus was reported in Puerto Rico as well. Could this be the next ebola, perhaps with a somewhat delayed fatality instead? Where did the virus come from, and how did it end up in South America?

What Is The Zika Virus?

The Zika virus, often shortened to ZIKV, is a mosquito-borne flavivirus, a close cousin to yellow fever, dengue, the West Nile Virus, and the Japanese encephalitis virus. It was first discovered in 1947 in a Rhesus monkey in the a African country of Uganda, in the Zika forest that gave the virus its name. The virus later showed up in Nigeria and other African countries, making its way to Yap Island in the Federated States of Micronesia by 2007 and only recently rearing its head in South America. Climate change is a likely culprit — rising temperatures across the globe have allowed the mosquito that spread the Zika virus, Aedes Aegypti, to proliferate and reach areas where it previously wasn't present.

The first well-documented human case happened in 1964, when a researcher got the virus and described its symptoms in detail:

• First, a mild headache. 
• Next, a rash that covered the face, next, torso, and upper arms, later spreading to the extremities. 
• Then, fever, malaise, and back pain. 
• After two days, he started feeling better and recovered. 

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The Centers for Disease Control and Prevention's information reflects the observations of the researcher — the CDC notes than only one in five people infected with the virus become ill, and that the most common symptoms are "fever, rash, joint pain, or conjunctivitis", with other symptoms being "muscle pain, headache, pain behind the eyes, and vomiting". They add that most cases don't last more than a few days to a week and hospitalization isn't usually necessary, as well as that no deaths have been reported due to the virus.

That begs the question: how did we get from a seemingly benign virus that runs its course within days and leaving no permanent consequences to an epidemic in which thousands of babies are being born with microcephaly?

Are The Brazilian Microcephaly Cases Really Caused By The Zika Virus?

The Brazilian government has linked the microcephaly "outbreak" to the Zika virus and has rightfully declared a public health emergency, but what does the evidence say?

Between 440,000 and 1,300,000 people are believed to have caught the Zika virus in Brazil after the first case was reported in May 2015. According to Claudio Maierovitch, the director of the department of surveillance of communicable diseases at Brazil’s Health Ministry, the origins of the microcephaly cases are clear. "There is no doubt that the majority of the microcephaly cases are related to the Zika virus," he said in a press conference in December 2015. 

The European Center for Disease Prevention And Control, the ECDP, isn't yet so sure. It concluded that "there is currently only ecological evidence of an association between the two events. A possible causative nature of the association cannot be ruled out with the evidence available.".

Meanwhile, the American CDC is takes a similar view, based on current evidence. It notes that the Brazilian Ministry or Health has its suspicions, and goes on to say that "it will take time to determine the cause of microcephaly for the cases being reported in Brazil".

Does That Really Matter?

The link between the Zika virus and the Brazilian microcephaly cases hasn't been officially confirmed yet, and it's interesting to note that there have been no reports of dramatically increased microcephaly cases in other regions where the virus is present. Yet CNN notes that most moms who gave birth to babies with unusually small heads developed symptoms of the Zika virus in the early stages of their pregnancies, and traces of the virus were found in the placentas of a few babies born with the condition. 

Evidence regarding the link between ZIKV and microcephaly will doubtlessly come out soon. In the meantime, it is all too clear that the associated can't be ruled out by any means. Therefore, since no vaccine currently exists for the Zika virus, trying to avoid being bitten by a mosquito that might carry the virus is the best preventative measure anyone can take.

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Here's what you can do:

• If you do not live in Brazil or another country affected by the Zika virus, avoid traveling there if possible.
• Wherever you live, use an insect repellent containing DEET for long-lasting protection against mosquito bites (in accordance with the instructions, which include not applying it to the skin underneath your clothes).
• Sleep under a mosquito net. 
• Either close windows and doors and use air conditioning, or use mosquito screens to keep mosquitoes outdoors. 
• If you do live in Brazil and are of reproductive age, strongly consider following the advice the Brazilian government is offering right now, and don't get pregnant or get your partner pregnant until more evidence becomes available about the link between Zika and microcephaly.