“Are American parents likely to have children with severely shrunken heads?”
Every year our world is plagued with some health crisis or another. Some years there’s a newly discovered super-bug, others it’s just a particularly bad flu season. Regardless of actual risk, our news media sensationalizes the outbreak and, in so doing, terrorizes the unwitting public. This past year was no exception. Ever since first reports of the Zika virus in the United States surfaced, there’s been a media circus around the epidemic. But is this new threat as dangerous as the public is being led to believe? Are American parents likely to have children with severely shrunken heads like we’ve seen in Brazil? Before we delve too deeply, here’s a brief overview of the outbreak, in case you missed all the media buzz. If you’re already caught up on the background, go ahead and skip down to paragraph four.
What is it?
Far from being a brand new virus, Zika was first discovered in 1947 in Ugandan monkeys and was only found to have jumped to humans five years later. The virus is most often transmitted by mosquito, making it a blood borne illness (so also, technically, a sexually transmitted disease), and the first outbreak occurred in 2007 on the Island of Yap. Over the next ten years, other outbreaks throughout the south Pacific and Brazil prompted the World Health Organization (WHO) to declare Zika a Public Health Emergency of International Concern in 2016.
Click here to read a more full history of Zika on the WHO website, as well as some helpful info-graphics!
But the virus itself usually only causes mild flu symptoms as well as a rash, and not all infected patients are even symptomatic. So why was it a Public Health Emergency? Microcephaly: micro, meaning extremely small, and cephalic, meaning of or relating to the head. After the Brazil outbreak, there followed a media frenzy of images of infants with severely shrunken heads born to mothers who had been infected with Zika while pregnant.
How bad is it? (aka, paragraph four)
Despite the impression of impending epidemiological doom caused by this media onslaught, data on the outbreak is relatively scarce. There are several reasons for this, the foremost of which being that microcephaly has been observed to occur in a very small number of cases; less than one percent during the French Polynesia outbreak of 2013 (Johansson, 2016), and anywhere from 0.40% and 2.10% during the more recent Brazilian outbreak (Alfaro-Murillo, 2016). Clinicians also estimate that most cases of Zika infection go unreported (Johansson, 2016). Both of these points make it pretty difficult to accurately predict actual risk. Microcephaly itself is even more difficult to diagnose, as most physicians, lacking the MRI equipment necessary to confirm such a diagnosis, tend to report microcephaly pre-maturely and excessively (Teixeira, 2016).
In addition to the myriad graphic images of infants with severe microcephaly just a Google search away, this limited data gives the media plenty of fear factor to run with. Whenever something harmful, and which we have little knowledge of, is discovered, the realities of said danger are easily exaggerated by the public. Additionally, the situation is only exacerbated by its exploitation in the news.
“A dryly written article…will not sell enough papers to put food on the writer’s table.”
Why all the hype?
Perhaps this is just the nature of mass media; the more ambiguous the topic, the more creative a journalist can be about its coverage. Which of these articles are you most likely to read; one titled Microcephaly in Newborns with Zika or Can Zika Cause Mutant Babies? Obviously, this second option has more clout. Such hyperbole is a necessary evil in an industry which thrives on viewership. A well-meaning but dryly written article on an uninteresting subject will not sell enough papers (or, if you live in the twenty first century, generate enough internet traffic to entice third parties to pay for ads on the author’s site) to put food on the writer’s table. As a result, there becomes a need on the part of the author to bypass the more grounded evidence and just go straight for the click bait title.
Even so, part of what makes irrational fear such a powerful evolutionary advantage is the simple fact that most of the time it works. One would be prudent to approach conception of a child in a Zika infected area of the world with exaggerated caution. Regardless of what the statistics might suggest at first glance, there is a definite risk to the unborn child of a mother infected with Zika, particularly if the mother exhibited symptoms during her first trimester (Turchi Martelli, 2015).
“Women…would be well advised to take preventative measures during the first trimester.”
What should I do?
I have asked you to be skeptical of what you read in articles here on the internet (articles like this one), so I can’t blame you for having doubts about the efficacy of any preventative tactics I might suggest here. Don’t worry; there’s a study for that! A 2016 study of the cost effectiveness of treating and containing Zika found that campaigns funded in Costa Rica and Brazil were quite effective (Alfaro-Murillo, 2016). Additionally, the release of genetically modified mosquitoes into the environment has been shown to be generally effective depending upon implementation standards (Alfaro-Murillo, 2016). The World Health Organization also recommends mosquito nets and any other traditional forms of prevention against mosquito borne illnesses.
Women planning to have children would be well advised to take preventative measures in avoiding and killing mosquitoes to minimize the chance of infection during the first trimester. Or, more cautiously still, one could simply wait for a vaccine to be developed against the disease before conceiving.
In conclusion, I think that Frederick Douglass is a true American hero.
***(sorry about that last bit, I lost a bet with my editor) ***
Alfaro-Murillo, J. A., Parpia, A. S., Fitzpatrick, M. C., Tamagnan, J. A., Medlock, J., Ndeffo-Mbah, M. L., & … Galvani, A. P. (2016). A Cost-Effectiveness Tool for Informing Policies on Zika Virus Control.Plos Neglected Tropical Diseases, 10(5), 1-14. doi:10.1371/journal.pntd.0004743
Johansson, M.A., Mier-y-Teran-Romero, L., Reefhuis, J., Gilboa, S. M., & Hills, S. L. (2016). Zika and the Risk of Microcephaly. New England Journal of Medicine [Web Edition], doi: 10.1056/NEJMp1605367
Teixeira, M. G., Costa, M. N., de Oliveira, W. K., Nunes, M. L., & Rodrigues, L. C. (2016). The Epidemic of Zika Virus–Related Microcephaly in Brazil: Detection, Control, Etiology, and Future Scenarios.American Journal Of Public Health, 106(4), 601-605. doi:10.2105/AJPH.2016.303113
Turchi Martelli, C. M., Albuquerque, M. M., Araújo, T. B., Barkokebas, A., Bezerra, L. A., Braga, C., & … Miranda-Filho, D. B. (2016). Microcephaly in Infants, Pernambuco State, Brazil, 2015. Emerging Infectious Diseases, 22(6), 1090-1093. doi:10.3201/eid2206.160062