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Zika Virus and Neurological Disease: Investing in Prevention

Published online by Cambridge University Press:  14 August 2017

Valentina Chiesa*
Affiliation:
Department of Medicine and Surgery, Unit of Biomedical, Biotechnological, and Translational Sciences, University of Parma, Italy Clinical Governance, Local Health Authority of Reggio Emilia, Emilia-Romagna, Italy
Pietro Ragni
Affiliation:
Clinical Governance, Local Health Authority of Reggio Emilia, Emilia-Romagna, Italy
*
Correspondence and reprint requests to Valentina Chiesa, Reggio Emilia, Emilia-Romagna, Italy (e-mail: valentina.chiesa@libero.it).
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Abstract

Type
Letters to the Editor
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

Zika virus has suddenly evolved into a global pandemic. It was first identified over 50 years ago in Africa and spread to various geographic areas of Asia, the Pacific Islands, and South America, especially BrazilReference Chang, Ortiz and Ansari 1 , and it has been at the center of global attention. In Rio de Janeiro, a study prospectively enrolling 88 pregnant women stated that Zika virus infection during pregnancy seems to be associated with fetal death, placental insufficiency, fetal growth restriction, and central nervous system injury.Reference Brasil, Pereira and Moreira 2 The outbreak of the virus in French Polynesia was followed by an increased number of central nervous system malformations. 3 A case-control study conducted in French Polynesia involved 42 patients who developed Guillain-Barré syndrome (GBS); serological investigations confirmed that all patients had experienced Zika virus infection.Reference Cao-Lormeau, Blake and Mons 4

The public consciousness, especially in high-income-counties, is currently alerted on this theme, but do at-risk populations really know how to prevent Zika virus? By asking—in the field—people who contracted the infection or those who traveled in at-risk countries, it seems that Zika virus, as well as its complications, is undervalued.

Efficient and effective interventions at the community level should encompass the following: (1) empowering vulnerable populations to be agents of their health, (2) strengthening inter-sectoral relationships, (3) understanding the culture and beliefs of the populations to build trust, and (4) integrating experts in the field for risk communication and community engagement working groups.

The main goal is to orient operational research funds as well as public interest toward prevention, which represents the key measure for controlling Zika virus infection.

In this scenario, the World Health Organization published an operational resource package, “Risk Communication and Community Engagement for Zika Virus Prevention and Control,” which proposed key messages (Box 1). 5 The messages are based on preventive actions that are grouped according to each level of action so that they can be put into practice.

Box 1 Key Messages and Behaviors for Zika Virus Risk Communication

Source: World Health Organization. Risk Communication and Community Engagement for Zika Virus Prevention and Control. A Guidance and Resource Package for Country Offices for Coordination, Planning, Key Messages and Actions. 5

Now that scientific consensus that Zika virus is a cause of microcephaly and GBS has been reached, it is time to act. The virus is spreading uncontrollably across the world: since 2015, a total of 70 countries or territories have reported vector-borne Zika virus transmission, 3 and at-risk countries need to be prepared to manage patients with neurological disorders. However, effective and joint strategies between all stakeholders worldwide focusing on prevention are most urgently required.

Acknowledgments

We declare no competing interests.

References

1. Chang, C, Ortiz, K, Ansari, A, et al. The Zika outbreak of the 21st century. J Autoimmun. 2016;68:1-13. https://doi.org/10.1016/j.jaut.2016.02.006.CrossRefGoogle Scholar
2. Brasil, P, Pereira, JP Jr, Moreira, ME, et al. Zika virus infection in pregnant women in Rio de Janeiro. N Engl J Med. 2016;375(24):2321-2334. https://doi.org/10.1056/NEJMoa1602412.CrossRefGoogle ScholarPubMed
3. World Health Organization. Zika situation report. Zika virus, Microcephaly and Guillain-Barré syndrome. http://www.who.int/emergencies/zika-virus/situation-report/en/. Published February 26, 2016. Accessed March 2016.Google Scholar
4. Cao-Lormeau, VM, Blake, A, Mons, S, et al. Guillain-Barre syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study. Lancet. 2016;387(10027):1531-1539. https://doi.org/10.1016/S0140-6736(16)00562-6.CrossRefGoogle ScholarPubMed
5. World Health Organization. Risk Communication and Community Engagement for Zika Virus Prevention and Control. A Guidance and Resource Package for Country Offices for Coordination, Planning, Key Messages and Actions. http://www.who.int/csr/resources/publications/zika/community-engagement/en/. Published March 11, 2016. Accessed November 2016.Google Scholar