Brazil is ripe for another Zika outbreak, report says
Emergency is lifted, but water, sanitation problems remain
Brazilian authorities have not addressed the longstanding issues that led to the Zika epidemic in the country, leaving it vulnerable to another outbreak of the virus, according to a Human Rights Watch report.
“There is this idea that Zika is gone, the emergency has been lifted,” said Amanda Klasing, senior women’s rights researcher at Human Rights Watch and co-author of the report. “But the risk for another outbreak is there.”
Despite declaring an end to the national public health emergency over the mosquito-borne virus in May, problems with public water and sanitation systems remain, the report said. More than onethird of Brazilians lack access to a continuous water supply, so many must fill tanks and other containers with water, which can become potential mosquito breeding grounds if they are not treated or covered.
Researchers also described seeing untreated sewage flowing near communities that were often obstructed by debris, creating dirty, standing water — also ideal conditions for breeding of the Ae
des aegypti mosquito, the primary transmitter of the virus.
“The Aedes mosquito is programmed to breed in standing water close to human populations,” said William May, co-director of the Johns Hopkins Zika Center and an associate professor of ophthalmology at the Johns Hopkins Wilmer Eye Institute, who travels often to lecture in Brazil.
The Zika virus is linked to a birth defect known as microcephaly, which results in smaller heads and brain damage in infants. It also has been linked to infant eye abnormalities and Guillain-Barré Syndrome, a neurological disorder in which the body’s immune system attacks the nerve cells, causing weakness and, sometimes, temporary paralysis. There is no vaccine to prevent Zika and no treatment for microcephaly.
Brazil’s Health Ministry said in a statement Thursday that the administration has increased spending on improving basic sanitation and water facilities, along with budgeting more for health surveillance, including controlling mosquito populations.
But Human Rights Watch said too much of Brazil’s work has focused on the household level, such as encouraging families to clean their water storage containers and eliminate standing water in their homes. That places too much of the burden on women and girls and “cannot fill the gap left by inadequate government action,” the report said.
Researchers urged the government to decriminalize abortion, saying penalties force women and girls to turn to secret and often unsafe procedures to terminate unwanted pregnancies. In Brazil, abortions are illegal except in cases of rape, incest, danger to the mother’s life or anencephaly, a brain defect in the fetus. A study in July 2016 in the New England Journal of Medicine found a 108% increase in requests during the Zika outbreak to a non-profit organization providing abortion medications.
The report also called on the government to give more financial and logistical support to the caregivers of the more than 2,600 babies born with microcephaly and other Zika-related conditions.
Caring for a baby with Zika syndrome is expensive, May said. “They have seizures and feeding problems,” he said. “They require special formula and they require anti-seizure meds.”
In the United States, Zika cases have declined dramatically since last year. In 2016, more than 5,000 cases were reported, 224 of them acquired through local mosquitoes, according to the Centers for Disease Control and Prevention. The number has dropped to 163 this year, and none of those cases were acquired locally.
“In the United States, it is the travel-related cases that come up,” May said. “Because we have wonderful health departments, we’ve been able to control the virus.”