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Saturday, June 10, 2017


A mother in Areia, in Brazil's Pernambuco state, holds two of her children, both of whom were born with microcephaly.

A mother in Areia, in Brazil's Pernambuco state, holds two of her children, both of whom were born with microcephaly. MARIO TAMA/GETTY IMAGES

Zika has faded from the headlines like a mosquito’s dying buzz.

Puerto Rico declared its outbreak over this week. Brazil said its emergency was over in May. In the United States, summer approaches with little discussion of the virus outside public health circles.

But the risk the insidious pathogen poses to a pregnancy hasn’t gone away, and public health authorities are grappling with how to get the message out to pregnant women. Despite public confusion over whether Zika remains a public health threat, the Centers for Disease Control and Prevention continues to warn women who are pregnant to avoid traveling to wide swathes of Latin America and the Caribbean.

“People are just going to have to accept that as part of the new reality,” Dr. Martin Cetron, director of the CDC’s global migration and quarantine division, told STAT in an interview. “Until we have better prevention tools, we’re just facing this as part of the new normal.”

“If this were my daughter, I would want her to know and I would caution her not to go there at this time. And that’s tough medicine. I understand that.”

For most people, Zika infection is mild, if that. It’s believed that as many as 4 of 5 who are infected don’t experience any symptoms.

But an infection in pregnancy carries a life-altering risk to the developing fetus. The virus is neurotropic — it gravitates to and attacks key cells in the developing central nervous system. 

Microcephaly — an abnormally small head and often an underdeveloped brain — is the most obvious of Zika’s harms. But a range of defects including brain tissue destruction as well as visual and hearing deficits are seen in babies born after prenatal infection.

Some of the defects are profound and are not problems these children will outgrow. And the risk is not small. New data on Zika-infected pregnant women from the U.S. territories found 5 percent of those pregnancies were affected.

Researchers studying the virus fear other, more subtle problems will only become apparent as children infected in the womb start lagging, developmentally, behind their peers.

Public health officials have been desperate to try to prevent these kinds of birth outcomes since Zika’s link to birth defects was first recognized. And that hasn’t changed as the public’s sense of alarm over the Zika outbreak has subsided.

But officials know they’re up against a challenge in trying to keep this issue on the radar of the people who need to pay attention.

“Last year, health experts were concerned that the media overstating the threat from Zika would make ongoing messaging to manage the actual level of risk more difficult. That’s where we are now,” said Sandra Mullin, a New York-based risk communications consultant.

“Zika, West Nile virus, and other mosquito-borne diseases that once seemed urgent and novel and captured the attention of the news media and policymakers now face the fatigue of other chronic conditions and diseases that present similar challenges for public health communicators.


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