WHO: Zika virus is a global health emergency

Health experts convened by the World Health Organization declared Monday that the Zika virus is an international emergency, clearing the way to mobilize funds for research and escalate efforts to fight the virus, which is exploding in Latin America.

The announcement also establishes WHO as the leader in the fight, a role that it failed to take on during the Ebola epidemic in West Africa.

The current outbreak of the Zika virus, which is transmitted by mosquitoes, has taken the world by surprise. It was first identified in 1947 in Uganda but for years lived mostly in monkeys. But in Brazil in May, cases began increasing drastically, and since then it has spread to more than 20 countries in Latin America, where populations have no immunity to it. The WHO has estimated that 4 million people could be infected by the end of the year.

“After a review of the evidence, the committee advised that the clusters of microcephaly and other neurological complications constitute an extraordinary event and public health threat to other parts of the world,” WHO Director-General Margaret Chan said.

WHO estimates there could be up to 4 million cases of Zika in the Americas in the next year, but no recommendations were made to restrict travel or trade.

“It is important to understand, there are several measures pregnant women can take,” Chan said. “If you can delay travel and it does not affect your other family commitments, it is something they can consider.

“If they need to travel, they can get advice from their physician and take personal protective measures, like wearing long sleeves and shirts and pants and use mosquito repellent.”

The real alarm is the possible connection to microcephaly, a condition that causes babies to be born with brain damage and unusually small heads. The number of cases of microcephaly reported in Brazil has also increased sharply, and researchers are scrambling to figure out whether Zika is the reason.

The WHO could help with that, global health experts say.

“This is something that screams out for the attention of the World Health Organization in Geneva,” said Lawrence O. Gostin, director of the O'Neill Institute for National and Global Health Law at Georgetown University. “This is a classic global health emergency. It fits the definition almost precisely. It is novel. There is potential for rapid growth and already a large international spread.”

The last time the WHO declared a public health emergency was when Ebola was tearing through West Africa. But the agency was strongly criticized for weighing in very late, and many global health experts said Chan wouldn’t let that happen again.

“The WHO took a very serious hit to their reputation,” said Dr. Ron Waldman, a professor of global health at the Milken Institute School of Public Health at George Washington University. “They do have to be mindful of the politics, but they have to get the science right, too. They don’t have much room for slip-ups.”

Zika and Ebola are very different. Ebola was incredibly deadly, and it spread through contact with bodily fluids. Zika is not known to be fatal, and it has mild symptoms for most people. So far, the evidence is inconclusive that the virus is the cause of the birth defects, so some health officials have been cautious about drawing too dire a picture.

The designation of Zika as a “public health emergency of international concern” sounds a global alarm and spur action and funding from governments and nonprofits around the world. The step would elevate the WHO to the position of global coordinator and give its decisions the force of international law. It would deliver global travel advisories and, crucially, would coordinate global efforts to combat the mosquitoes that spread Zika, a role that is badly needed as mosquito populations are fluid and know no boundaries. It would also help coordinate efforts to do surveillance, including keeping track of cases of Zika and microcephaly.

“It would give the WHO and the international community a lot of power to go in and help these countries,” Gostin said. “You need global leadership on this.”

But politics can get in the way of such designations.

Affected countries sometimes resist the declaration of a public health emergency for fear that restrictions on travel, trade and tourism could have serious economic repercussions. The agency has convened committees more than 10 times on the Middle East respiratory syndrome, for example, but has never declared the virus a public health emergency of international concern, Gostin said. The reason, many health experts believe, is resistance by Saudi Arabia, ground zero of the virus.

The WHO has to strike a balance between alerting the public, and scaring it. Overreaction could have the effect of punishing countries that are experiencing epidemics, experts said. It is only recently that Zika became a matter of concern, since November when regional health authorities met to discuss the alarming rise of microcephaly cases.

“It’s a fine line to draw for public health authorities between how much to alert people versus how much to scare people for little or no reason,” Waldman said. “Zika was not on anyone’s list of the most dangerous disease threats of the 21st century.”

The Associated Press contributed.

This story was originally published February 1, 2016 at 11:41 AM with the headline "WHO: Zika virus is a global health emergency."