Who’s Afraid of The Zika Virus? How We Perceive Threat With Infectious Disease

My fellow Americans, there is a new disease among us. It has only recently begun to make its way to our country from Latin America, but it will surely spread farther. Discovered in Sub-Saharan Africa shortly after World War II, this mosquito-borne alphavirus lay low for decades, popping up sporadically until the last few years, when it exploded on the international scene, ravaging not just Africa, but Asia and the more tropical portions of the Americas. Carried aloft in the bloodstreams of unsuspecting travelers, this virus has finally made landfall in the United States, with 44 states having reported cases. In adults who contract the virus, the predominant symptoms are fever, joint pain and rashes, although pregnant women are at greatest risk, as they can pass it on to their babies, potentially causing neonatal encephalopathy and leading to diminished neurological functioning. There is no known cure and no effective treatment has been developed. It seems like nothing can stop Chikungunya from wreaking havoc throughout the US.

If you were expecting to see the Zika virus name-dropped at the end of that paragraph, I certainly can’t fault you. In recent weeks, certain corners of the media have begun whipping the American public into a panic over Zika, a tropical disease that has been relatively active in recent years in parts of Africa, Southeast Asia and the South Pacific. In 2014, likely because of the major influx of tourists for The World Cup, the Zika virus was transferred to Brazil, where it has turned into a health crisis and spread to other portions of South and Central America.

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Health workers fumigate a cemetery in Lima, Peru to prevent the spread of Dengue, Chikunguya and Zika viruses (AP Photo/Martin Mejia)

Over the past year, prevalence of Zika throughout Latin and South America has sky rocketed, leading Brazil to declare a national health emergency and for El Salvador, Ecuador and Columbia to release official government statements asking citizens to not have children for varying lengths of time due to the disease’s possible negative impact on neonatal health. For its part, the Centers for Disease Control have recently recommended that that women who are pregnant or trying to become pregnant avoid traveling to countries that have ongoing transmission of the virus. The impetus of the unprecedented severity of this particular Zika outbreak is thought to lie in climate change, specifically in the increased rains brought on by this year’s particularly strong El Nino, which has provided more breeding grounds for Zika carrying mosquitos in these tropical nations.

With that being said, none of the information provided above really explains why the Zika virus has received such a wealth of media exposure, while other mosquito-borne viruses get comparatively short shrift. As a member of the Flavivirus family, Zika bears a great resemblance to many of its virological brethren, sharing traits with viruses like Chikungunya, West Nile, Dengue and Yellow Fever. In fact, these viruses are so analogous that it’s currently impossible to know just how prevalent Zika is because the only tests we have for it have a very small window of efficacy during the virus’s infectious phase and because the virus is so similar to Dengue and Yellow Fever that past exposure or vaccination to these viruses make Zika testing a crap shoot. Based on the level of alarm that’s being raised in the US media, it would be reasonable to assume that Zika is virus on par with Ebola, but Zika has historically been considered one of the tamer Flaviviruses and is still being described by many as “Dengue Light”.

As the western world goes into a collective conniption fit over Zika, Dengue Fever has quietly infected 1.6 Brazilians in the past year, killing 863 people. Dengue, which is transmitted by the same Aedes aegypti mosquitos that transmit Zika, is also a virus that has grown at a disturbing rate, undergoing a 30-fold increase in incidence over the last 50 years with 390 million infections occurring annually. With this being the case—and with a slew of infectious diseases like Tuberculous, HIV/AIDS and Malaria that kill millions each year—why has the Zika virus ignited a media firestorm? After all, Chikungunya cases were reported in the vast majority of US states last year, West Nile has been constant presence in America throughout the 21st Century and Hawaii is currently dealing with an outbreak of Dengue Fever so big that Representative Tulsi Gabbard (D-HI) is urging the state’s governor to declare a state of emergency. Why isn’t Dengue Fever plastered across the front pages of newspapers and homepages throughout America?

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The distribution of cases of microcephaly in Central and South America since 2010

To answer those questions, we have to look at the sorts of stories that capture our attention and the types of diseases that frighten us. Up until very recently, there was nothing about Zika that made it terribly exciting or newsworthy. It was an obscure virus that elicited a variety of hum-drum symptoms (mild fever, rash, joint pain, pink eye) and was confined to portions of the globe that American media largely doesn’t cover and the average American rarely thinks about. Had the Zika remained in Africa, Southeast Asia and Oceania it would still be a non-story in this country. However, when the virus entered into Central & South America, everything changed.

One would think that the major cause for the sudden interest in Zika by the American public would be the virus’s closer proximity to the United States, but that is only half the story. After all, there’s an outbreak of Dengue Fever going on in a US state as I write this and it’s not grabbing headlines, while Zika—a less severe disease that has yet to make significant landfall in America—is. The reason for this, I propose, lies predominantly in the ways we perceive and internalize the harm and risk surrounding microcephaly, a birth defect that has been associated, but not linked, to the spread of Zika in Latin America.

Since the Zika virus began to spread throughout Brazil in earnest last spring, physicians and nurses began noticing an abnormally large number of newborns with a condition known as microcephaly, wherein an infant is born with a significantly underdeveloped brain and skull. Brazil has seen 4,000 babies born with this irreversible condition in the past year—a twenty-fold increase over the usual rate—at the same time the Zika epidemic has broken out. No causal link has been established yet between Zika and microcephaly, with the virus’s genetic material being found in only 6 of the 4,000 cases of infants born with the birth defect, but it is strongly suspected that the link is there.

The substantial increase in babies being born with microcephaly in Latin America is certainly tragic, but I would argue that our collective response to Zika in America is based more on the macabre and horrifying nature of the way the virus is manifesting itself than the actual danger it poses to us. Dengue Fever, which is prevalent wherever Zika is, already kills roughly 25,000 people each year, has been shown to lead to miscarriage, fetal death and maternal death, and is currently running roughshod through Hawaii, hasn’t made much of a splash in American media while Zika has because it occupies the realms of the known and the mundane.

If we as a nation really cared about infectious disease and the totality of the unacceptably large portion of humanity that is still ravaged by it, we’d be freaking out in even greater measure about the growing Tuberculosis pandemic that caused 1.5 million people to die TB-related deaths in 2014 as multi-drug resistant strains of the virus become more and more prevalent. If the average American was worried about the state of infectious disease in their country and the world, we wouldn’t have a news media that largely ignores the 50,000 Americans who contract HIV each year and that never mentions the over half a million people who die from Malaria each year.

The argument could be made that the Zika virus has generated such headlines because it seems to have had its effect primarily on newborns and young children, but that hardly makes it novel. Malaria, Pneumonia and Infectious Diarrhea all have their most damaging effect on children under 5, with an estimated annual death toll between the 3 of them of roughly 2.5 million kids, the vast majority of whom live in Sub-Saharan Africa. We aren’t fascinated with the Zika virus here in America because of the small, yet legitimate threat it poses to pregnant women and their newborns who travel to Central and South America. We are fascinated because it would appear that Zika silently sabotages the miracle of birth, turning a moment of unparalleled joy into a nightmare and delivering in the place of a healthy baby boy or girl, a wailing, underdeveloped infant that will likely never know a normal life.

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New parents in the Brazilian city of Recife pose with their daughter, who was born with microcephaly (Ueslei Marcelino/Reuters)

The term microcephaly may not have registered in most American households prior to the appearance of the Zika virus, but show those same households a photo or a video of an adult suffering from microcephaly and odds are that their first association would be the same: the circus. Ever since the advent of the circus sideshow in the mid 19th-century, microcephalics—or “pinheads” as they were known at the time—were frequently featured. From the introduction of “Zip the Pinhead”, played by a black microcephalic from New Jersey named William Henry Johnson, into P.T. Barnum’s circus in the 1860s, to the use of Schlitzie in the cult 1930’s film Freaks and the microcephalic character Pepper in American Horror Story (played by an actress without microcephaly), the neurological condition has always been rooted in freak show culture.

While it is an unequivocally good thing that WHO, the international community and the US media are taking note of the outbreak of Zika virus in Central and South America and taking what appears to be swifter action against it that it did with Ebola in 2014, I feel that it’s still important to take a long hard look at why this particular virus has so captured our attention when similar viruses that are arguably more severe and pose bigger threats to public health in America have not. If we truly ask ourselves what it is about the Zika virus that so scares and intrigues us, we cannot help but notice that we are drawn to it more by the bizarre, aberrant way in which the virus seems to be effecting those who contract it than by any empirically validated threat. Much like the man who’s terrified of losing his life in a plane crash, but winds up dying while texting on the freeway, we cannot allow the fear of Zika to occupy too much space in our minds while there are other, more deadly infectious diseases already flourishing both in United States and abroad.

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Categories: infectious disease, Public Health

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3 replies

  1. And let’s not forget about the boring flu, which probably kills more people in the US than all the new and exciting tropical infectious diseases combined.

  2. Now I know more than I wanted to know about another virus, but the misquotes are going to be worse this year which is something to be concerned about. Thanks.

  3. Enlightening, as always. Really glad to be post-menopausal!

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