Book Review of Diniz’s Zika

Diniz, D., & Grosklaus Whitty, Diane R. (2017). Zika : From the Brazilian backlands to global threat. London: Zed Books.

This brief book is built upon extensive ethnographic fieldwork with mothers, doctors and scientists during Brazil’s Zika outbreak. The translation from Portuguese by Diane Grosklaus Whitty is masterful. Translation is always hard, and I have read too many books by Brazilian authors that suffered from overly formal wording, or endless run-on sentences. On a very small scale I understand this challenge from translating quotes in my first two books, for which I could easily spend an hour for a single statement. Of course, a developed narrative -with multiple voices-  is an exceptional challenge.  Diniz was very fortunate with her or the press’s choice for a translator. The prose is clear, energetic and yet still carries the feel and beauty of Portuguese. …

Conspiracy Theories and Zika

Conspiracy theories have long fascinated me. I’ve published (with my colleague Leopoldo Rodriguez) on the death of Alberto Nisman in Argentina, and the conspiracy theories that tragedy spawned. I’ve also written about the conspiracy theories that circulated regarding the 2009 H1N1 influenza epidemic. More recently, I’ve been doing research on the Zika epidemic. I’ve just published an article, “Conspiracy Theories and the Zika epidemic,” which you can view in the open-access Journal of International and Global Studies. …

The sad human toll of Zika

There was a brief flurry of media coverage regarding Zika after the discovery that it was spreading within Florida last month. Over the last couple of weeks, however, it seems to have receded from the headlines. Some recent coverage, however, really provide a sense of the human toll of Zika. Reveal is a new podcast from the Center for Investigative Reporting, which provides long-form coverage based on work in the field. Their report, “From A to Zika” documents how people in Puerto Rico are experiencing the virus, and attitudes towards the outbreak in South Florida. It also describes the scale of the challenge that officials face fighting the virus during a deep financial crisis in Puerto Rico. …

Why Congress must act on Zika

Aedes aegypti mosquito in Dar es Salaam, Tanzania, 2009. Photo by Muhammad Mahdi Karim, Wikipedia Commons
Aedes aegypti mosquito in Dar es Salaam, Tanzania, 2009. Photo by Muhammad Mahdi Karim, Wikipedia Commons

In July 2016 the CDC issued an advisory notice that warned pregnant women -or women planning to become pregnant- against traveling to 45 different countries. With the virus’s arrival in Florida, however, the public in that state is now wrestling with what this means for mothers and their partners. The issue is now becoming a topic in the election contest in Florida, as Mark Sumner described in a (not impartial) recent article in Daily Kos. In the piece he quotes Trump’s vice-chairman for Miami-Dade as saying that Zika was an “insignificant issue,” which was less important than building a wall “to keep the illegals out.” Yesterday Donald Trump himself declined to say that Congress should reconvene to vote on funding Zika research and prevention. …

Zika in the continental U.S.

Digital photo taken by Marc Averette. The downtown Miami skyline as seen from I-195 5/16/2008. Wikipedia Commons
Digital photo taken by Marc Averette. The downtown Miami skyline as seen from I-195 5/16/2008. Wikipedia Commons

Zika has already become a significant health issue in Puerto Rico, where there have been more than 5,500 infections. More than 600 of these infections have been in pregnant women. The outbreak has also set off massive public debates on the island regarding everything from insecticides to the structure of local government. It was inevitable that Zika would eventually appear in the mainland United States. Still, it couldn’t help but be surprising to see a CDC warning about travel by pregnant women to two counties (Miami-Dade and Broward) in Florida. It’s important to keep this news in perspective. So far only 14 people have been reported to have locally acquired Zika, in a very restricted geographic area in Miami. Mosquito control activities have gone into high gear in this area. One can hear an audio copy of the briefing about this news here on the CDC website. The CDC also has a dedicated webpage on Zika, which is a helpful site for information regarding the epidemic. …

Resources on Zika

By CDC/ Cynthia Goldsmith (http://phil.cdc.gov/phil/details.asp?pid=20541) [Public domain], via Wikimedia Commons
Image of Zika virus from the CDC/ Cynthia Goldsmith (http://phil.cdc.gov/phil/details.asp?pid=20541) [Public domain], via Wikimedia Commons
There is still so much that we don’t know about Zika. I was recently speaking with a medical historian who wondered if people in eastern Africa and Asia might have resistance to the disease, since it originated in those areas, or whether the epidemic will spread as explosively as it did in South America? Will the rate of birth defects be lower in newly affected countries, because mothers have more information to protect themselves? Which species of mosquito will be able to transmit the virus? How rapidly will the epidemic spread? What percentage of babies born to mothers infected with Zika will have neurological issues, even when they do not have microcephaly?

There are a few useful resources that I’ve found for Zika. Vincent Racaniello is a highly respected virologist, who has a popular podcast called “This Week in Virology” or “TWIV,” and a free online virology course. His lab spent decades working on polio, but recently shifted its focus on Zika. His new blog, Zika Diaries, give a sense of what science is like in an emerging field. Nothing is easy for the lab, from obtaining the virus, to acquiring permission to do experiments with mice.

One of the first tools that I try to create when working on an article is a timeline for events. With Zika, Ben Hirschler at Reuters has already done that work, and created a detailed timeline.

For anyone interested in the early history of Zika’s discovery in Uganda, I recommend Thomas K. Grose’s piece on NPR, which discusses a researcher studying Alexander John Haddow’s records in the University of Glasgow archives. Overall, NPR has outstanding coverage of the Zika outbreak.

Lastly, the CDC website offers practical information on Zika, including those areas where the Zika virus is circulating, and how to protect yourself.

Shawn Smallman, 2016

Zika in Venezuela

In few countries is the current political, economic and social situation worse than in Venezuela. This is especially dispiriting given that the country faces an outbreak of the Zika virus at the same time that medicines and basic supplies are in short supply. The Institute for Tropical Medicine has been broken into 11 times in 2 months. The offices were cleaned out so completely that the institute was left without any microscopes or key equipment. The situation in Venezuela’s hospitals is catastrophic. The situation has grown so bad that international organizations, such as Human Rights Watch, are now trying to draw the world’s attention to the breakdown in the nation’s public health system. Given that the nation is failing to adequately prevent and treat other mosquito-born illnesses -such as dengue- Venezuela may be on the edge of repeating the disaster that has passed over Brazil. What is frustrating is that this disaster would be needless, because basic public health measures -eliminating mosquito breeding grounds, spraying, screens on windows, mosquito nets, and insect repellent- could do much to limit the damage. Venezuela also faces severe shortages in such common items, including those necessary for family planning, such as condoms. Couples will need these to delay pregnancies until after the epidemic has peaked. Health officials know what to do. Given the countless billions that the country has given away over the last decade, or which cannot be accounted for, it would be a tragedy if there was not a massive effort to stop Zika on the grounds that the country lacked funds. Still, there are grave doubts about even the validity of the health data that the Venezuelan government is sharing. One health group is providing information that suggests that 150 times more people have been infected by Zika in Venezuela than the government has stated.

Shawn Smallman, 2016


Zika fever in Brazil

"Rash on Arm due to Zika virus," uploaded to Wikipedia by FRED on January 10, 2014. See https://commons.wikimedia.org/wiki/File:Zika.Virus.Rash.Arm.2014.jpg
“Rash on Arm due to Zika virus,” uploaded to Wikipedia by FRED on January 10, 2014. See https://commons.wikimedia.org/wiki/File:Zika.Virus.Rash.Arm.2014.jpg

The health news from Brazil is truly remarkable, as the Ministry of Health is advising women in the northeast not to become pregnant at this time because of the emergence of a new disease in the Americas called Zika fever. Historically, Zika fever has been a very rare disease, which until 2007 had caused only a small number of diagnosed cases in Africa and Asia. The Zika virus was native to the forest of Zika in Uganda, where it circulated amongst monkeys. The disease suddenly appeared in 2007 in Micronesia, then spread to French Polynesia in 2013, followed by Easter Island in 2014, before finally arriving in Brazil. The disease causes many of the same symptoms as dengue (high fever, headache, joint and muscle pain, nausea, stomach pain, exhaustion, pain in the back of the eyes, conjunctivitis, a maculopapular rash, and swelling of the legs). This is unsurprising because dengue and the Zika virus are members of the same viral family (flaviviridae), and are both spread by the same species of mosquitoes, particularly Aedes aegypti and Aedes albopictus. There is no treatment or vaccine for Zika fever.

When it first appeared in Bahia, in northeastern Brazil, in April 2013, it was not immediately obvious that this was a new disease. As patients were tested for dengue, however, and the results came back negative, the medical system soon realized that something unusual was happening. While worrying, the disease did not seem disastrous when it appeared in Brazil. People can be infected with Zika fever only once. The symptoms typically last four to seven days, then the patients recovers. In some cases, patients suffer from immunological or neurological disease (Guillain-Barre syndrome) as a result of their infection, but this is atypical. When it appeared, the disease seemed to be less serious than dengue. Very few people have died from it in Brazil. As the epidemic continued, however, doctors began to report a bizarre increase in the number of babies born with a serious birth defect, microcephaly. This disorder is characterized by a reduction in the size of the head of the baby. The rate of this disorder has increased sharply, perhaps ten-fold over the last year. Some doctors at Brazil’s Hospital Oswaldo Cruz are now suggesting that the problem is unrelated to Zika fever, but rather is tied to another emerging infectious disease in the region, Chikungunya. …

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