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From:TheBahamasWeekly.com International
Although Zika is new and spreading fast in the region, countries are responding proactively with PAHO/WHO support. Reducing mosquito populations is the most important prevention and requires strong multisectoral action by both governments and citizens Geneva, 28 January 2016 (PAHO/WHO) — Zika virus is spreading rapidly through the Americas and could potentially reach all countries except Canada and continental Chile, the Director of the Pan American Health Organization (PAHO), Dr. Carissa F. Etienne, told health officials from around the world today during a briefing of the Executive Board of the World Health Organization (WHO) in Geneva. Etienne added, however, that the countries of the Americas have been responding robustly to the Zika threat in collaboration with PAHO/WHO and other international partners. This cooperation will continue as countries work to mitigate the impact of Zika on people living in PAHO/WHO member countries. The most important prevention is effective mosquito control, which requires action by national and local governments but also by individuals, families and communities to eliminate potential mosquito breeding sites in and around homes, workplaces and schools. “PAHO is a region with long experience in tackling mosquito-borne diseases, including dengue and chikungunya,” Etienne said. “I congratulate Brazil --and all the other 21 countries in the Americas-- for their prompt reporting under the International Health Regulations.” IHR, as the regulations are known, is the WHO-managed global system through which Member States report on outbreaks of potential international concern. WHO Director Margaret Chan announced she would call a meeting of the IHR Emergency Committee on Feb. 1 to discuss the Zika epidemic and what needs to be done at the global level to address the disease. The committee will ascertain whether the outbreak constitutes a Public Health Emergency of International Concern. PAHO/WHO action Since May 2015, 22 countries and territories in the Americas have reported to PAHO/WHO local transmission of Zika virus infections. PAHO/WHO anticipates that the virus is likely to spread to all countries in the region that have Aedes mosquitoes, the mosquitoes responsible for transmitting the virus. The mosquito is present in all of the region except Canada and continental Chile. Etienne noted that proactive collaborative action on the outbreaks at the regional level has been ongoing since Brazil first reported local transmission of Zika to PAHO in May 2015. PAHO/WHO has been working closely with affected member countries since then, mobilizing staff and members of the Global Outbreak and Response Network (GOARN) to assist ministries of health in strengthening their abilities to detect the arrival and circulation of Zika virus through laboratory testing and rapid reporting. The aim has been to ensure accurate clinical diagnosis and treatment for patients, to track the spread of the virus and the mosquito that carries it, and to promote prevention, especially through mosquito control, which is key. PAHO/WHO has been working with member countries for a number of years on vector control and in the coming weeks will convene experts from throughout the Americas to discuss new, more effective and integrated mosquito control strategies that would help reduce not only Zika infections but also cases of dengue, chikungunya, yellow fever, and West Nile virus—all of which are spread by mosquitoes and are significant public health problems in the Americas. PAHO/WHO is also supporting scaling-up and strengthening of surveillance systems in countries that have reported cases of Zika, and of microcephaly and other neurological conditions that may be associated with the virus. Surveillance is also being heightened in countries to which the virus may spread. In addition, PAHO/WHO has been working with Brazilian health authorities, the Oswaldo Cruz Foundation (Fiocruz) in Brazil, and the U.S. Centers for Disease Control and Prevention (CDC) to support research and investigation on Zika, pregnancy and microcephaly. In the coming weeks, PAHO/WHO will convene experts to address critical gaps in scientific knowledge about the virus and its potential effects on fetuses, children and adults. Difficulty of counting cases In a press briefing following Etienne’s presentation, PAHO/WHO experts explained that reliable case counts of Zika virus infection were difficult to obtain for several reasons: only around 1 in 4 infected people develop symptoms; the virus is only detectable for a few days in infected people’s blood; tests for antibodies—which can be detected for a much longer period after infection—cannot distinguish well between Zika and infections with similar viruses such as dengue and chikungunya; and clinicians face major challenges in distinguishing Zika cases from cases of diseases such as dengue and chikungunya, which have similar symptoms. Suspected link to microcephaly Although Zika infections typically cause only mild symptoms, concerns have been heightened by Brazil’s reports of an unusual increase in microcephaly—unusually small head size--in babies born in areas where the virus is circulating. Since October, Brazil has reported more than 4,000 suspected cases of microcephaly in areas with Zika circulation. Other complications aer also suspected of being linked to the virus, including Guillain–Barré syndrome, an autoimmune syndrome. “Many unanswered questions remain about the links between Zika virus disease, microcephaly and Guillain–Barré syndrome,” noted Etienne. “Although we are still working to establish causality with Zika, we cannot tolerate the prospect of more babies being born with neurological and other malformations, and more people facing the threat of paralysis due to Guillain–Barré syndrome. We must all work together to prevent the further spread of this potentially debilitating disease.” HER REMARKS in Geneva, Switzerland (28 January 2016) at 138th WHO Executive Board Thank you for the opportunity to address our WHO Member States. As PAHO Director, and regional director for the WHO office for the Americas, I wholeheartedly welcome the Director-General's announcement that she is calling an Emergency Committee meeting on Zika virus and the observed increase in neurological disorders and neonatal malformations, which may be related. This meeting will mark a vital step in our efforts to halt the spread of Zika, and the conditions that may be associated with this disease within the Americas region and beyond. As we look ahead to this meeting, I'd like to take a quick look back to last May, when Brazil first reported cases of Zika virus disease to us under the IHR, the International Health Regulations. I congratulate Brazil - and all the other 21 countries in the Americas, for their prompt reporting under the IHR. This is key. PAHO is a region with long experience in tackling mosquito-borne diseases, including dengue and chikungunya. Since May 2015, we have issued monthly epidemiological alerts advising countries what to do if they have Zika cases, and how to monitor and prepare for its eventual arrival. Through weekly meetings with the national IHR focal points, we have kept all countries informed about the evolving situation. We have worked with Member States to mobilize community engagement, particularly around vector control: rolling out clean-up campaigns, promoting the use of insecticides and wearing protective clothing. Brazil first reported an upsurge in microcephaly in October [2015]. We promptly convened an expert group that worked round the clock to produce recommendations to help countries improve surveillance and follow-up. Many unanswered questions remain about the links between Zika virus disease, microcephaly and Guillain–Barré syndrome. So, PAHO has brought together experts from Brazil and the international community, including HQ colleagues, to improve our epidemiological understanding. We have recognized the important role of the media in keeping the public informed. We have been working for several months with the media in the Americas. For the past two weeks, since the CDC travel advisory, we've been responding to heightened interest in the US and globally. Before I end, I must say how grateful I am to partners like US CDC, the Pasteur Institute, Fiocruz and others for so swiftly responding to our call - under the GOARN [Global Outbreak Alert and Response Network] umbrella. Throughout the past eight months we have worked as one WHO, and I look forward to continuing this integrated approach to face the Zika challenge. As the disease spreads across other regions we look forward to deepening collaboration and sharing our experiences. We must all work together to prevent the further spread of this potentially debilitating disease. Although we are still working to establish causality with Zika, we cannot tolerate the prospect of more babies being born with neurological and other malformations, and more people facing the threat of paralysis due to Guillain–Barré syndrome. With me today is Dr. Marcos Espinal, our spokesperson for the Zika event and Director of the Department of Communicable Diseases and Health Analysis at PAHO, and Dr. Sylvain Aldighieri, PAHO Incident Manager for Zika. Dr. Espinal will now make a presentation on key aspects of the Zika outbreak for the Americas.
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