Zika: The Emerging Epidemic

Nursing Book Club

Zika: The Emerging Epidemic

By Donald G. McNeil, Jr. (W.W. Norton & Co., 2016)
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Reviewed By Christine Contillo, RN, BSN, PHN

In August 2015, during a powerful El Nino year, Brazil recorded 1.6 million cases of the mosquito-borne virus dengue — or so everyone initially thought. The Brazilian health minister was not really worried when the disease instead turned out to be Zika virus, a mild virus first seen in Africa years earlier.

Nine months later, the catastrophic consequences of that virus no longer looked so mild. In the wake of the Zika outbreak, Brazil has reported a 20-fold increase in microcephalic babies, born to mothers who had the virus during their pregnancies.

In the French Polynesian islands, which Zika swept two years earlier, the emergent concern was Guillain-Barré syndrome (GBS), a rare autoimmune response (sometimes associated with flu shots) that can result in paralysis or even a need for ventilator support.

The normal background rate of GBS is three to five cases per year, but in the islands, there were suddenly 42 cases, all of whom had had Zika virus symptoms (fever, rash, conjunctivitis and/or muscle aches) seven to 10 days earlier. Six of those patients needed intensive care.

Donald McNeil’s new book Zika: The Emerging Epidemic traces the course of the virus throughout the world, from Africa to French Polynesia and then to Brazil, where its arrival coincided with the 2015 World Cup. Since then, travel advisories have impacted the tourism and travel industries, particularly leading up to the Summer Olympic games.

The Politics of Epidemics

McNeil, who is a science writer for the New York Times, has many contacts with doctors and public health officials, which allow him to offer the reader insights into how governments develop and publicize health advisories. The process is nowhere near as straightforward as I would have expected. (As the author points out, not all governments are as accountable to their citizens as is the U.S.)

McNeil tells us exactly what is known about the virus, when it was known and what is still under investigation. A frightening recent addition to the “known” column is the possibility of sexual transmission.

The first known case of sexually transmitted Zika (to a woman who had not been in an area where the virus was present) was in 2008, but it wasn’t until a second case was confirmed in January 2016 that the CDC began advising people who may have been exposed to use barrier protection.

Family Trip

This past spring, my son, my daughter and I traveled to Guatemala, Nicaragua and Puerto Rico respectively. Besides a love for exotic, warm-weather travel, what we had in common was our indifference to the spread of Zika, despite the increasingly worrisome travel alerts from the CDC. We carried insect repellent with DEET, as recommended, but were otherwise more concerned with sunburns.

That’s reasonable for most people, but Zika is a serious danger for pregnant women and the risk may get a lot worse before it gets better. If you want to know the story behind the current events, or if you have a taste for medical procedural tales, you should find this book of interest.   

Christine Contillo, RN, BSN, PHN, is a public health nurse who suggests joining a book club as a reason to put down trashy magazines and look smart on the subway.

This article is from workingnurse.com.

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