Hi students. When we were learning about infectious diseases, I mentioned that enemies, old and new, were constantly emerging or reemerging, as the case might be. With that in mind, I wanted to create this brief addendum to talk about Zika and get the perspective of an expert fighting the disease in the Americas. At this point you've all heard about Zika, now while this virus may appear to have come out of nowhere, that's actually not the case. The virus was first identified back in 1947 and a monkey in Uganda in fact in the Zika forest there. But not identified in humans until the 1950s. So, like other zoonotic diseases, it likely jumped from animals to humans. But since that time there have been some reported cases and we know the virus is clearly spreading through mosquito populations in parts of Africa South Asia and Southeast Asia. And by 2007, there were still only 14 cases reported in the world. Things changed in 2007. There was a large outbreak in Yap Island and in Micronesia. And it spread through other Pacific islands, until it arrived in the Americas. Which rapidly spread all the way up to the southern part of the United States, into the Caribbean. And it seems at least at the time of this reporting, to have worked its way back to at least one country in the African continent. At the time of this reporting in October, 2016, Zika's been confirmed in about 70 countries and territories. And the WHO has declared it a public health emergency of international concern. This is a tricky virus. Not only is it spread via mosquitoes, the Aedes aegypti and Aedes albopictus, you'll remember those two. They can also be spread through sexual transmission. Transmitted from pregnant mother to fetus and actually likely through blood transfusion if the viral load is high enough. Now most people who get Zika, they just have minor symptoms, but it can cause paralysis, usually temporary and if transmitted to the fetus, can cause microcephaly, that's an abnormal brain development and a fetus with a smaller head than normal, and can also result in visual, hearing, and other cognitive defects. Now, the impact on the fetus and the fact this transmission is both, via vector and via sexual activity, creates great challenges for prevention and control. I recently visited the headquarters of PAHO, the Pan American Health Organization in Washington DC, towards there Emergency Operations center and spoke to doctor Ricardo Fabrega, a physician at PAHO is one of the key leader spearheading the fight against Zika In the Americas. I think it's important that you hear what Dr Fabrega has to say. Today we hear a lot about Zika and I hear people on the streets or people talking and saying, well I understand about Zika, why is it such a big deal? Why are people so concerned about Zika? So could you explain to the public, why Zika is so important? >> [FOREIGN] >> We talk about health systems, and I know that your specialty is working in health systems, strengthening, yes. How does Zika indicate, or how does Zika demonstrate, why health system strengthening is so important? >> Wow. Zika [FOREIGN] >> I think it's been laudable, after what I've learned today, to see the, actually the rapidity of the response that was played as a virus that in, I guess, what, the 1940s was discovered in a forest in Uganda. And now has, at this point, spread all over the world. >> Yeah. >> And in the last year we've seen it basically spread throughout the Americas. I think, it's also a very good lesson that we need to strengthen primary care. Because while Zika may be the latest virus to become a pandemic, others will follow and we must strengthen the health systems accordingly. >> [FOREIGN]. >> [FOREIGN] [LAUGH] [FOREIGN] It's true, and I think we should remember that you and I and many of our students may have passports, but viruses do not need passports. >> [LAUGH] No. >> In this globalized world. With that, as always, Dr. Fabrega, thank you so much. >> [FOREIGN] >> [FOREIGN] >> [FOREIGN] And students, to you Dr. Boyd signing out. Currently there is a massive campaign going on in areas that have been or could be affected by Zika. Apart from education about mosquito and sexual transmission, education about risks that pregnant women face and the importance of reproductive planning and decision making in Zika impacted areas. There's also scaled up development of tests, work on producing a Zika vaccine. And even experiments in introducing genetically modified mosquitos in the specific regions with the hope that they will breed with and eventually wipe out infected mosquito populations. A bit of controversy there as you can imagine. All in all, dozens of groups and organizations are working together. And this work must continue at a fast clip. We are fortunate that the virus has not undergone sufficient genetic shift or drift to make it more virulent. But who knows what the future might hold? So this virus and the global effort to fight it are something you should really keep an eye on. The WHO and CDC are constantly updating their websites with information. Zika reminds us that we are part of one great inter-dependent world. A world in which an infectious disease does not need a passport to travel all the way around the world, in less than 24 hours.
