GULC Professors Urge Action on Zika

The World Health Organization convened an International Health Regulations Emergency Committee on the Zika virus Feb. 1, a week after Georgetown University Law Center professors criticized the organization for responding too slowly to the virus’ spread.

Georgetown’s O’Neill Institute for National and Global Health Law Director Lawrence Gostin and O’Neill Senior Scholar Daniel Lucey published a commentary in the Journal of the American Medical Association Jan. 27 urging the WHO to take action by raising the international alarm on Zika.

“By many accounts the agency’s failure to act decisively cost thousands of lives,” Gostin and Lucey wrote. “Despite internal reforms, however, WHO is still not taking a leadership role in the Zika pandemic.”

Gostin and Lucey laid out specific strategies that the United States needs to take in approaching the Zika crisis, including risk communication, enhanced surveillance, travel advisories, advanced research and development and public health emergency declarations.

“The International Health Regulations requires every country to develop core health system capacities, but most fail to meet international standards,” Gostin and Lucey wrote in the commentary. To ensure national preparedness for Zika, countries—including the United States—should fund and adopt these strategies, particularly countries already affected and those with significant Aedes mosquito populations.”

Though Zika has mostly impacted countries in Latin America and the Caribbean, the WHO named the virus, which is expected to infect up to four million people by the end of the year, a “public health emergency of international concern” at its Feb. 1 committee meeting. The designation is meant to initiate a worldwide response to prevent the spread of the virus and minimize its threat in countries already affected.

Zika is transmitted from infected Aedes mosquitoes to humans through mosquito bites, and may be sexually transmitted, according to the Centers for Disease Control and Prevention. It is typically considered an insignificant disease with only about 20 percent of affected people experiencing symptoms that last from several days to a week. There is no specific antiviral treatment.

Hospitalizations and deaths rarely occur, but pregnancy losses have been reported. Researchers are currently exploring whether these are linked to the virus. Although very rare, a small percentage of people may develop the autoimmune neurological disease Guillain-Barre Syndrome, which causes paralysis and loss of breathing.

The highest risk Zika poses is to pregnant women. The virus is possibly linked to microcephaly, a condition that causes babies to be born with unusually small heads and, in most cases, damaged brains. In Brazil, where the disease is most prevalent, cases of microcephaly are rising rapidly.

Gostin discussed the possible relationship between Zika and microcephaly and emphasized the need to investigate the connection further.

“We strongly suspect that the association will be proven as a causal relationship. But we need definitive studies and we need them urgently,” Gostin wrote in an email to The Hoya.

Lucey said there is potential for a widespread appearance of microcephaly in Latin American countries.

“Importantly, if Zika virus does cause microcephaly then there will be more epidemic waves of microcephaly in other nations such as Columbia, Venezuela, and El Salvador where the Zika virus went after Brazil,” Lucey wrote in an email to The Hoya. “This would be a nightmare so I hope it does not happen.”

Gostin highlighted the possibility that international travel will amplify the spread of the virus, but expressed confidence in the ability of the United States to combat it.

“It is very likely to come to the United States because we have a lot of international travel with Latin America and the Caribbean and the Aedes mosquito is found in the Southern United States and comes up as far north as Washington in the summer,” Gostin wrote. “Having said that, I think Zika will not spin out of control in the U.S. as it has in Brazil. The main reason is that the United States has an aggressive policy of mosquito control and surveillance.”

However, Lucey emphasized the lack of experience the United States has with the virus and stressed the need to implement an improved strategy in response.

“We have minimal to no experience with Zika in the U.S.A.,” Lucey wrote. “No one has any immunity because Zika has never been in the Americas. … We need to take a more integrate 3-part ‘One Health’ approach (Human, animal, and EcoHealth) to understand and control infectious disease epidemics.”

O’Neill Director of Global Health Law Ana Ayala expressed the urgent need for the United States to be aware of Zika cases.

“It is important that the U.S. continue to monitor Zika cases, including locally transmitted ones, as well as keep the public well informed about basic public health measures to avoid mosquito bites should Zika become a greater threat in the country,” Ayala wrote in an email to The Hoya.

Tashi De Sousa (NHS ’17) said that her professors in the Nursing School have been especially concerned about the dangers that Zika poses.

“We talk about it in all my classes,” De Sousa said. “All my professors are healthcare professionals that are worried about not only the health of people in the United States, but also about global health and the disparities that are particularly prevalent in Latin America.”

De Sousa added that concern should be also focused on the athletes and spectators planning on travelling to Brazil for the Olympics this summer.

“It really worries me that the Olympics are going to be held in Brazil because there will be a large population travelling there,” De Sousa said. “It’s scary that this virus can affect not just the direct people infected but also future generations.”

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