Even though the Zika virus did not make national headlines until November 2015 when Brazil declared a national emergency after reporting an abnormally high number of cases of babies born with microcephaly or Guillain-Barré syndrome, the virus was actually first identified in 1947 in a rhesus monkey in the Zika forest of Uganda. Zika is a mosquito-borne disease that shows mild-to-moderate symptoms in adult humans. Its symptoms are similar to dengue fever and chikungunya. The first human case of Zika was found in Uganda and The United Republic of Tanzania in 1952.
In the intervening sixty years, some cases of Zika were found throughout western Africa and Asia. However, these populations seemed to have a fairly good immunity to the disease. It was not until the virus hit the Pacific Islands in 2007 that it became an outbreak. In 2013, a Zika outbreak occurred in several more Pacific Island nations, and it was during this time that Zika was suspected of causing neurological and autoimmune problems.
By March 2015, Brazil reported an illness that expressed a skin rash, and by May, Brazil confirmed that Zika was in the country. In July, they found that certain neurological disorders correlated with Zika infection, but this was isolated to the state of Bahia. Then, in October, Brazil reported an inordinate number of cases of microcephaly among newborns, and declared a national emergency in November. Meanwhile, cases of Zika were increasingly reported throughout northern South America and Central America. By January 2016, researchers had drawn preliminary links to pregnant mothers infected by Zika and babies born with microcephaly.[1]
At bioethics.com we have kept up with the spread of Zika and the related bioethical questions that this disease brings. Because Zika is dangerous to unborn infants, some have questioned if it would be appropriate to loosen abortion laws in several Latin American countries so that mothers do not have to raise a neurologically disabled child, thus introducing questions of disability ethics, poverty, and human dignity, including the problem of potential misdiagnosis. Additionally, research for effective treatments and/or vaccination poses additional bioethical considerations. Any kind of medications or vaccines for Zika would need to be tested on pregnant women and infants, and some people have called for allowing research on fetal tissue left over from abortions.
Here are some of the headlines that we have documented on Bioethics.com.
by Ariana Eunjung Cha, The Washington Post, December 23, 2015
Brazilian health authorities are sounding the alarm about a mosquito-borne virus that they believe may be the cause of thousands of infants being born with damaged brains. The pathogen, known as Zika and first discovered in forest monkeys in Africa over 70 years ago, is the new West Nile—a virus that causes mild symptoms in most but can lead to serious neurological complications or even death in others. (http://tinyurl.com/hg882d5)
by Donna Bowater, National Post (Originally published in the Telegraph), January 25, 2016
Olympic organizers are stepping up their efforts to battle the spread of Zika virus to try to contain the mosquito-borne outbreak ahead of the Rio 2016 Games. Rio’s City Hall announced Sunday night that it would mount extra inspections around venues in the month before the opening ceremony as Brazil sees a rising number of birth defects associated with the virus. (http://tinyurl.com/jxldzr5)
by Greg Allen, NPR, January 26, 2016
The company breeds and releases into the wild male mosquitoes that don’t produce viable offspring. When females mate with the GMO males, they lay eggs that hatch but the larvae die before adulthood. Oxitec says trials conducted in Brazil and other countries over the past decade show releasing bioengineered male mosquitoes can reduce the wild Aedes aegypti population by 90 percent. (http://tinyurl.com/j8lzj5r)
by Declan Butler, Nature, January 28, 2016
Researchers at the body responsible for monitoring birth defects in Latin America are questioning the size of an apparent surge in the number of Brazilian children born with ‘microcephaly’—abnormally small heads and brains. Alarm is growing about a reported rise in suspected cases of the rare condition, which has been tentatively linked to the rapid spread of the Zika virus through the Americas. But Jorge Lopez-Camelo and Ieda Maria Orioli, from the Latin American Collaborative Study of Congenital Malformations (ECLAMC), say that the surge might largely be attributed to the intense search for cases of the birth defect, and misdiagnoses, because of heightened awareness in the wake of the possible link with Zika. (http://tinyurl.com/zxc897h)
by Salim Al-Gailani, The Guardian, January 29, 2016
As historian Ilana Löwy has recently written, a crucial factor unites those Rubella experiences with the experiences of women in contemporary Brazil faced with Zika—access to abortion. Through the 1950s and most of the ’60s, abortion was illegal in Britain, as it is in much of Latin America today. An expectant mother who had contracted Rubella was confronted with the emotional toil of imagining a future for, and the potential suffering of, a seriously disabled child, and what this might mean for her family. (http://tinyurl.com/jt2hn7k)
by Robert Lowes, Medscape, February 1, 2016
The World Health Organization (WHO) today declared outbreaks of microcephaly and other neurologic abnormalities that may be linked to the Zika virus a ‘public health emergency of international concern,’ the same designation given to the Ebola outbreak 2 years ago. The virus, spread by the Aedes aegypti mosquito, is strongly suspected of causing microcephaly in thousands of newborns in Brazil. Public health authorities also are investigating whether the virus has triggered cases of Guillain-Barré syndrome. (http://tinyurl.com/z5qvyln)
by Dom Phillips, Nick Miroff, and Julia Symmes Cobb, The Washington Post, February 8, 2016
Across Latin America, calls to loosen some of the most restrictive abortion laws in the world in the face of the Zika virus outbreak are gaining momentum but encountering strong and entrenched opposition. In El Salvador, where abortions are banned under any circumstance, the health minister has argued for a revision of the law because of the dangers the virus poses to fetal development. (http://tinyurl.com/hhc98mz)
by Gretchen Vogel, Science, February 10, 2016
Data from studies of Zika virus and its clinical effects should be shared as soon as possible, without scientists having to worry that they’re endangering a later publication, dozens of leading journals and research funding agencies said today in a statement. The 11 journal publishers that signed the declaration—including The New England Journal of Medicine, PLOS, Springer Nature, and Science journals, pledge that they will make all papers concerning Zika virus freely available to anyone, and that data or preprints that are made publicly available won’t preempt their journals from later publishing the work. (http://tinyurl.com/howcsh5)
by Gillian Mohney and Terry Moran, ABC News, February 18, 2016
With the mosquito-borne Zika virus continuing to spread through Central and South America, Pope Francis said today that contraception could be seen as “the lesser of two evils” if women are concerned about having children with the birth defect microcephaly. The Zika virus is usually mild, but has been associated with a rise of the alarming birth defect, characterized by an abnormally small head and brain, often leading to significant developmental delays. (http://tinyurl.com/gtafkrw)
by Stephanie Nebehay, Reuters, February 19, 2016
The World Health Organization said on Friday there was an increasing accumulation of evidence of an association between the Zika virus and microcephaly, a neurological disorder in babies, but it could take 4–6 months to prove. The WHO said it was convening a meeting on March 7–9 on research into Zika diagnostics and vaccines “similar to what we did in the early days of Ebola”. It will also convene an advisory group on mosquito control in 3–4 weeks. (http://tinyurl.com/hwrf29y)
by Hannah Kuper, SciDev Net, February 24, 2016
But what are the implications for the thousands of babies born with microcephaly? This is barely considered within the WHO response: disability is mentioned just twice. Microcephaly has many different causes, all with varying impacts. This means the implications for babies with what appears to be Zika-related microcephaly are not yet clear. But we do know that microcephaly can cause wide-ranging physical and mental disabilities, including learning difficulties, hearing problems and physical impairments. (http://tinyurl.com/j79hb68)
by Katherine Ellen Foley and Akshat Rathi, Quartz, February 25, 2016
Researchers already suspect (although have not yet proven) that Zika is associated with microcephaly, a condition which results in babies being born with unusually small brains. The condition causes a range of cognitive and physical disabilities, and in rare cases it can prove fatal. Now, a case study of a Brazilian women who suffered a stillbirth, published today (Feb. 25) in PLoS Neglected Tropical Diseases, has them concerned that the virus may additionally be associated with fatal birth defects. (http://tinyurl.com/j9sxkl6)
by Gretchen Vogel, Science, March 4, 2016
As fear of the Zika virus spreads nearly as quickly as the pathogen itself, two new laboratory studies offer the first solid evidence for how it could cause brain defects in babies: The virus appears to preferentially kill developing brain cells. The observation bolsters the growing case for a connection between the virus, which is spreading rapidly across Latin America, and an increase in the number of cases of microcephaly, a birth defect in which the brain fails to grow properly. (http://tinyurl.com/hpuu5x2)
by Stephen Eisenhammer, Reuters, March 11, 2016
Single parents are common in Brazil where some studies show as many as 1 in 3 children from poor families grow up without their biological father, but doctors on the frontline of the Zika outbreak say they are concerned about how many mothers of babies with microcephaly are being abandoned. With the health service already under strain, abortion prohibited, and the virus hitting the poorest hardest, an absent father is yet another burden on mothers already struggling to cope with raising a child that might never walk or talk. (http://tinyurl.com/jn9t28d)
by Andrew Pollack, The New York Times, March 11, 2016
The federal government on Friday moved to clear the way for the release of genetically engineered mosquitoes into the wild for the first time in the United States, tentatively approving a field test that might help slow the spread of the Zika virus. The genetically engineered insects, which contain a gene that will kill their offspring, have already shown effectiveness in small tests in Brazil and other countries in suppressing the populations of the mosquitoes that transmit both Zika and dengue fever. (http://tinyurl.com/joxotx7)
by Erika Check Hayden, Nature, March 30, 2016
A protein that helps Zika virus infect adult skin cells might also give the virus access to stem cells that make brain cells, suggests a study carried out on donated human fetal tissue. The result—published today in Cell Stem Cell—is part of a growing body of research that seeks to determine how Zika might cause birth defects, but that requires a type of tissue that is increasingly controversial for researchers in the United States. Recent advances in neuroscience and cell technology have given hints as to why some babies born to Zika-infected mothers have abnormally small heads—a condition called microcephaly—and other problems, such as eye damage. But to fully understand what is happening in the womb, some scientists say that they need to study tissue from fetuses, which can be donated by couples who terminate pregnancies. (http://tinyurl.com/gwgmqqt)
by Debra Goldschmidt, CNN, April 7, 2016
The World Health Organization says the mosquito-borne Zika virus causes microcephaly and Guillain-Barre syndrome. “Based on a growing body of preliminary research, there is scientific consensus that Zika virus is a cause of microcephaly and Guillain-Barre syndrome,” the World Health Organization said in its weekly Zika virus situation report Thursday. Previously, the agency said there was not yet enough scientific evidence to say the virus caused these conditions, although it was likely. (http://tinyurl.com/z47tswh)
by Martina Shabram, Quartz, April 14, 2016
Much of the media coverage of the Zika virus has focused on the disabilities and deformities associated with microcephaly, and on the difficulties faced by women who are pregnant with, or have given birth to, babies with the condition. These are all important subjects for discussion. But as a disability-rights scholar, what concerns me is that the language and imagery we use to discuss disability. Too often, the narrative surrounding microcephaly relies on familiar—and disturbing—assumptions about what kind of lives are worth living. (http://tinyurl.com/j66z39a)
by Dennis Thompson, UPI, May 6, 2016
The terrible birth defects caused by Zika virus appear to be the result of an immune system response that triggers prenatal brain cell suicide and obstructs fetal brain development, a new lab study reports. The virus apparently activates an immune receptor called TLR3, which the body uses to identify and defend against invading viruses, said lead researcher Tariq Rana. He is a professor of pediatrics and genetics at the University of California, San Diego. (http://tinyurl.com/hr6wv8e)
by Brady Dennis, The Washington Post, May 20, 2016
The Centers for Disease Control and Prevention said Friday that it is monitoring 279 pregnant women with likely Zika virus infections across U.S. states and territories. The largest number of cases by far are in Puerto Rico, where officials are keeping tabs on 122 pregnant women. But they also are tracking 157 other pregnant women across the country. (http://tinyurl.com/gp5ftjq)
by Lena H. Sun, The Washington Post, May 27, 2016
More than 100 prominent physicians, bioethicists and scientists from around the world posted a letter Friday urging World Health Organization Director-General Margaret Chan to exert pressure on Olympic authorities to move the Olympics from Rio de Janeiro or delay the Games because of public health concerns over the Zika virus. Brazil, which is hosting the Olympics and the Paralympics, is at the epicenter of the rapidly evolving mosquito-borne epidemic. (http://tinyurl.com/gme9nsn)
by Ryan Cross, MIT Technology Review, June 21, 2016
The first clinical trial for a Zika virus vaccine just received a green light from the FDA. Inovio Pharmaceuticals and GeneOne Life Science announced on Monday that their vaccine, called GLS-5700, will undergo phase I clinical testing for safety in 40 healthy volunteers within a few weeks. Inovio’s effort has plenty of company—the National Institutes of Health, the French pharmaceutical giant Sanofi, and the India-based Bharat Biotech all have Zika vaccines in the works. (http://tinyurl.com/gp38vd7)
by Gillian Mohney, ABC News, July 13, 2016
The risk of Zika virus transmission during the upcoming Olympic games in Rio will be low due to colder weather, the U.S. Centers for Disease Control and Prevention said today. In a new risk-assessment report, the CDC found that since the games are occurring during winter in Brazil, the cooler, drier weather will reduce mosquito populations, thus lowering the chance of Zika transmission to visiting athletes and spectators. Additionally, the agency found that even though there will be increased travel to the area for the Olympics, the overall risk of the virus being transmitted to new areas due to Olympics-related travel is low. (http://tinyurl.com/gvq2t83)
by Declan Butler, Nature, July 25, 2016
Government researchers in Brazil are set to explore the country’s peculiar distribution of Zika-linked microcephaly—babies born with abnormally small heads. Zika virus has spread throughout Brazil, but extremely high rates of microcephaly have been reported only in the country’s northeast. Although evidence suggests that Zika can cause microcephaly, the clustering pattern hints that other environmental, socio-economic or biological factors could be at play. (http://tinyurl.com/zsn8dz7)
by Dennis Thompson, UPI, August 3, 2016
A potential vaccine for the Zika virus has entered early clinical trials to assess its safety in humans, U.S. health officials announced Wednesday. The DNA-based vaccine contains genetic pieces of the Zika virus. It is intended to promote an immune response that would protect against the mosquito-borne virus that can cause devastating birth defects, according to a statement from the U.S. National Institute of Allergy and Infectious Diseases (NIAID). (http://tinyurl.com/zc2a6j4)
by Sarah Knapton, The Telegraph, August 18, 2016
The Zika virus may cause long-term damage to the memory which mirrors the effects of Alzheimer’s disease a new study suggests. Scientists had thought that the virus only impacted the brains of developing foetuses and did not believe an infection posed serious problems for adults. But a new study suggests that Zika can also infect the brain cells of adults, causing long term damage to memory. (http://tinyurl.com/hlma3ek)
by Alexandra Sifferlin, TIME, August 26, 2016
Health authorities are recommending that all donated blood for the United States and its territories be tested for the Zika virus. Previously, the U.S. Food and Drug Administration (FDA) had recommended that blood be tested for Zika in areas where there is active spread of the virus among mosquitoes. Now, all states are asked to test their donated blood for the virus, according to an announcement by the FDA Friday morning. (http://tinyurl.com/hs4gp85)
by Faith Ungku and Aradhana Aravindan, Scientific American, September 2, 2016
Many of Singapore’s five million people are covering up and staying indoors to avoid mosquito bites as health experts warned that the outbreak of the Zika virus in the tropical city-state would be difficult to contain. One of the world’s leading financial hubs, Singapore is the only Asian country with active transmission of the mosquito-borne virus, which generally causes mild symptoms but can lead to serious birth defects in pregnant women. (http://tinyurl.com/jg38jw6)
BBC, September 30, 2016
Thai health officials have confirmed two cases of microcephaly, a severe birth defect linked to the Zika virus. It is the first time in South East Asia that the disease has been linked to the condition, which causes abnormally small brains and heads. (http://tinyurl.com/hak4mlt)
by Lena H. Sun, The Washington Post, November 3, 2016
Now researchers have concluded that a Zika infection during pregnancy is linked to a distinct pattern of birth defects that they are officially calling congenital Zika syndrome. In a report released Thursday in JAMA Pediatrics, researchers from the Centers for Disease Control and Prevention describe five types of birth defects that are either unique to Zika or occur rarely with other infections during pregnancy. (http://tinyurl.com/jp6xx6f)
by Debra Goldschmidt, CNN, November 18, 2016
The Zika virus outbreak and related clusters of microcephaly are no longer a public health emergency of international concern, the World Health Organization said Friday. This ends the declaration made by the organization in February due to the simultaneous spread of the virus and “extraordinary clusters” of microcephaly among babies born in areas where the virus was spreading. (http://tinyurl.com/hvxldqf)
by Christopher Landry, The Washington Post, November 22, 2016
Many women are understandably frightened at the prospect of having a child with significant disabilities, who may require ongoing—and costly—medical care. But there’s a problem with the level of alarm raised by various organizations’ Zika warnings to pregnant women. The latest data on the rate of microcephaly from Zika suggest that abortion demand driven by fear is greatly outpacing the actual risk of birth defects. (http://tinyurl.com/hoz862s)
by Julie Steenhuysen and Lisa Shumaker, Reuters, December 13, 2016
U.S. researchers have found evidence of the Zika virus replicating in fetal brains for up to seven months after the mother became infected with the virus, and they showed the virus can persist even after birth, according to a study published on Tuesday. The findings confirm earlier observations from case studies suggesting that the mosquito-borne Zika virus can grow in fetal brains and women’s placentas. (http://tinyurl.com/gs8rezo)
by Robert Preidt, HealthDay News, December 22, 2016
Nearly $184 million has been earmarked to protect Americans against Zika virus infection, the U.S. Centers for Disease Control and Prevention announced Thursday. The funding will go to states, territories, local governments and universities. It’s part of $350 million awarded to the CDC by Congress earlier in 2016 for Zika response and preparedness, the agency said. (http://tinyurl.com/hk2jeno)
[1] “The History of Zika Virus” World Health Organization, http://www.who.int/emergencies/zika-virus/history/en/ (accessed on 01/11/16).
