WHO Declares Zika Cases a Public Health Emergency of Global Concern; Travel Restriction Not Needed

By: Jet Villa, InterAksyon.com
February 2, 2016 7:38 AM

MANILA – The World Health Organization (WHO) has declared the recent cluster of small head (microcephaly) cases and other neurological disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes a “Public Health Emergency of International Concern.”

In a statement, WHO Director General Dr. Margaret Chan said a coordinated international response is needed to improve surveillance, detection of infections, congenital malformations, and neurological complications, to intensify the control of mosquito populations, and to expedite the development of diagnostic tests and vaccines to protect people at risk, especially during pregnancy.

But Chan said International Health Regulations (2005) Emergency Committee on Zika virus “found no public health justification for restrictions on travel or trade to prevent the spread of Zika virus.”

“At present, the most important protective measures are the control of mosquito populations and the prevention of mosquito bites in at-risk individuals, especially pregnant women,” Chan said.

Last Monday, Chan convened the committee, under the International Health Regulations, to gather advice on the severity of the health threat associated with the continuing spread of Zika virus disease in Latin America and the Caribbean.

The Committee met Monday by teleconference.

Health advice

During the teleconference, the committee has advised the WHO Secretariat that clusters of microcephaly and Guillain-Barré Syndrome (GBS) that have been temporally associated with Zika virus transmission in some settings.

The Committee provided the following advice to the Director-General for her consideration to address the Public Health Emergency of International Concern (clusters of microcephaly and neurologic disorders) and their possible association with Zika virus, in accordance with International Health Regulations (2005).

Surveillance for microcephaly and GBS should be standardized and enhanced, particularly in areas of known Zika virus transmission and areas at risk of such transmission.

Research into the etiology of new clusters of microcephaly and neurologic disorders should be intensified to determine whether there is a causative link to Zika virus and/or other factors or co-factors.

As these clusters have occurred in areas newly infected with Zika virus, and in keeping with good public health practice and the absence of another explanation for these clusters, the Committee highlights the importance of aggressive measures to reduce infection with Zika virus, particularly among pregnant women and women of childbearing age.

As a precautionary measure, the Committee made the following additional recommendations:

1. Zika virus transmission

• Surveillance for Zika virus infection should be enhanced, with the dissemination of standard case definitions and diagnostics to at-risk areas.
• The development of new diagnostics for Zika virus infection should be prioritized to facilitate surveillance and control measures.
• Risk communications should be enhanced in countries with Zika virus transmission to address population concerns, enhance community engagement, improve reporting, and ensure application of vector control and personal protective measures.
• Vector control measures and appropriate personal protective measures should be aggressively promoted and implemented to reduce the risk of exposure to Zika virus.
• Attention should be given to ensuring women of childbearing age and particularly pregnant women have the necessary information and materials to reduce risk of exposure.
• Pregnant women who have been exposed to Zika virus should be counseled and followed for birth outcomes based on the best available information and national practice and policies.

2. Longer-term measures

• Appropriate research and development efforts should be intensified for Zika virus vaccines, therapeutics, and diagnostics.
• In areas of known Zika virus transmission health services should be prepared for potential increases in neurological syndromes and/or congenital malformations.

3. Travel measures

• There should be no restrictions on travel or trade with countries, areas, and/or territories with Zika virus transmission.
• Travelers to areas with Zika virus transmission should be provided with up-to-date advice on potential risks and appropriate measures to reduce the possibility of exposure to mosquito bites.
• Standard WHO recommendations regarding disinfection of aircraft and airports should be implemented.

4. Data sharing

• National authorities should ensure the rapid and timely reporting and sharing of information of public health importance relevant to this Public Health Emergency of International Concern.
• Clinical, virologic, and epidemiologic data related to the increased rates of microcephaly and/or GBS, and Zika virus transmission, should be rapidly shared with WHO to facilitate international understanding of the these events, to guide international support for control efforts, and to prioritize further research and product development.

WHO conference meeting

In assessing the level of threat, the 18 experts and advisers looked in particular at the strong association, in time and place, between infection with the Zika virus and a rise in detected cases of congenital malformations and neurological complications.

The experts agreed that a causal relationship between Zika infection during pregnancy and microcephaly is strongly suspected, though not yet scientifically proven.

All agreed on the urgent need to coordinate international efforts to investigate and understand this relationship better.

The experts also considered patterns of recent spread and the broad geographical distribution of mosquito species that can transmit the virus.

The lack of vaccines and rapid and reliable diagnostic tests, and the absence of population immunity in newly affected countries were cited as further causes for concern.

After a review of the evidence, the committee advised that the recent cluster of microcephaly cases and other neurological disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes an “extraordinary event” and a public health threat to other parts of the world.

In their view, a coordinated international response is needed to minimize the threat in affected countries and reduce the risk of further international spread.

Members of the committee agreed that the situation meets the conditions for a Public Health Emergency of International Concern.

(Source: InterAksyon.com)