#zika / #microcephaly in Colombia / Brazil

May 17th 2016

We were speculating on Colombia as a control group for microcephaly caused by Zika virus. 7 months later, we do not observe the same occurrence/prevalence for microcephaly than declared (without evidence) in NE Brazil. As of today less than 10 microcephalies has been recorded in Colombia. How explaining such a huge discrepancy between Brazil and Colombia?

  1. Lack of accurate reporting in Brazil leading to overestimation
  2. Possible non identified co-factors:
    • Poverty, poor hygiene, Vitamin deficit/malnutrition
    • chemicals:pesticides,larvicides,…
  3. Timeline of outbreaks: Dengue,Zika

During Zika summit hold in Paris, Institut Pasteur, there were some debate on the role and responsibility of immune system and microcephaly or Guillain-Barré Syndrome (GBS); We see emerging evidence for an autoimmune process as the main cause of central nervous system defects observed during Zika.

Colombia 2

Brazil and Colombia have both naive population with regards immunization for Zika. It looks as if Dengue antibodies might react with Zika virus as an enhancement of the immune response on the CNS of fetus during the first quarter of pregnancy, affecting neural cells.

The immune response to the previous infection of dengue is potentially one of the mechanisms that can make you more susceptible to Zika. It’s definitely not been 100% proven yet, but there’s a lot of work going on to investigate it.

Dr Abigail Culsh, Research Associate at Imperial College London

Recently, studies in mice are demonstrating that Zika virus is able to cross placenta barrier and to replicate, damaging the placenta by the way; same for the brain barrier.

These three reports provide conclusive evidence that Zika virus can cross the placenta and cause fetal defects in mice, and provide models to understand the biology and pathogenesis of infection.

by Vincent Racaniello,Earth’s virology Professor

More and more evidence describing physiopathogenesis of Zika virus and how it affects CNS in adult (GBS,myelitis,meningo-encephalitis) or fetus (birth defects, microcephaly or still born).

But also more and more evidence to support the key role of immunity interacting with Zika virus like Dengue antibodies, leading to neural damages and explaining microcephaly acquired during Q1 of pregnancy.

Better knowledge of Zika virus and its interactions with other substances, antibodies or environments are key elements helping to understand the gaps between Colombia and Brazil. As said before, not sure Brazil will get the capability and willingness to review and validate the entire non tested cases recorded as Zika causing microcephalies. Home State Politics and Olympics Games will now take the lead…

#Microcephaly / #Zika as Political issues?

On Feb.1st 2016, WHO declared PHEIC with regards Zika virus threats and its potential health impacts worldwide; since, we are observing  a surprising crisis management of Zika disease overwhelmed by an international political crisis.

  • Starting with WHO and the funds raisingwho-logo in order to sponsoring both studies on Zika virus in Vitro and epidemiology surveys in Vivo. More questions raised than answered so far since the arrival of the virus in South America, mid April 2015. The emergence of new neurological diseases in link with the virus like GBS, Myelitis or microcephaly which seem to be related to an autoimmune disease are responsible for fears leading to threats for Public Health/Global Health. Pictures of microcephaly posted in Newspapers and social medias are indecent but attracting to People. “Unfortunately”, Zika is responsible for less fatalities than Ebola and is less bankable, despite a urge need to fight the disease.
  • Looking at Brazil, we are focusingZikaMap on the huge amount of microcephaly cases occurring since April 2015 when the Zika virus arrived for the first time in South America. In a way, Zika is a “good opportunity” to hide some of critical points with regards Politics in Brazil including but not limited to corruption scandal with Petrobras, Impeachment procedure of Mrs President. But here are other corps in the cupboard, I mean socio-economics or environmental issues: lack of potable/drinkable water pipe system, sanitation, waste management, vector control by using toxic pesticide/larvicide, poverty leading to malnutrition. It is surprising noticing that the country where started in 1992 in Rio, The precautionary principle applied to Sustainable Development, poor Public Health policy is implemented in some areas like in NE Brazil for testing and monitoring whenever an infectious disease outbreak is emerging. No doubt that budgets have been absorbed by the Olympics Games this summer.
  • What is going on in US Capitol and White House? Congress is rejecting to vote funds for fighting mosquitoes and preventing vector borne diseases including Zika, Dengue and Chikungunya. white HousePresident Obama has decided to move Funds allocated for Ebola to Zika (600 M$). May be a political way to push Congress to feel more responsible and liable just in case of an outbreak of Zika or an increase of microcephaly and especially at the time where Republicans and its representative Donald Trump, are not in the best shape. How avoiding to think about the TV fiction House of Cards and how politicians manipulate each others to achieve their goals. But today is no longer a fiction but true real life.

We are far from Public/Global Health issues and PHEIC despite the need for sponsoring in Vitro Laboratory studies or in Vivo Epidemiology surveys in order to bring on the table some seeds to grind for a better understanding of the pathogenesis and neurotropism of Zika virus.