By Neil Murthy

The World Health Organization will hold an emergency meeting Monday to consider whether Zika should be designated a global health crisis, in light of the spreading virus linked to birth defects.

“We need to take action now,” said Dr. Margaret Chan, WHO’s Director-General, speaking at an informational session at the organization’s headquarters in Geneva Thursday. She said she is assembling a team of health experts to discuss the organization’s response to controlling the burgeoning spread of Zika virus.  Members of the team will be identified Monday.

Public health experts in the United States published a Viewpoints article in the Journal of the American Medical Association Wednesday, which called for the World Health Organization to ramp up its efforts against the mosquito-borne illness.

“The situation today is dramatically different,” Chan said. “Last year, Zika was detected in the Americas and it is now spreading explosively. The level of alarm is extremely high.”

“WHO is deeply concerned about this rapidly evolving situation,” said Chan.

According to the Centers for Disease Control and Prevention, 30 laboratory cases are confirmed in the United States with 20 laboratory confirmed cases in U.S. territories. All cases in the states have been imported, while the 19 cases in Puerto Rico and the single case in the U.S. Virgin Islands were acquired locally. The virus spreads when a mosquito bites an infected person and then carries the virus and bites a healthy person. CDC is advising pregnant women not to travel to areas with active transmission from mosquitoes.

Zika Affected Areas – Countries and Territories Reporting Active Transmission

The emergency meeting could lead to the WHO Director declaring Zika virus as a Public Health Emergency of International Concern, or “PHEIC.” If it were to occur, this would be the fourth time ever the organization has declared a PHEIC since the International Health Regulations were implemented in 2005. Previous PHEICs include swine flu in 2009 and Ebola and polio resurgence, both in 2014.

Declaring a threat as a PHEIC rapidly mobilizes the WHO into “action mode,” which would strengthen communication channels between WHO headquarters and nation states, and mobilize needed resources to affected areas.

Attorney Lawrence Gostin, one of the co-authors of the JAMA piece, said in a statement after Chan’s speech that WHO has taken a “critical first step,” in its mission to fight the virus.

“It is far better to be over-prepared than to wait until a Zika epidemic spins out of control,” said Gostin, a public health lawyer with the O’Neill Institute for National and Global Health Law at Georgetown University.

Dr. Carissa Etienne, regional director for WHO’s Pan American Health Organization, “wholeheartedly welcomed” the announcement of the emergency meeting, calling the meeting a “vital step in [the] efforts” against Zika virus.

“Throughout the past eight months, we have worked as one WHO,” said Etienne. “We must all work together.”

Dr. Marcos Espinal, WHO Director of Communicable Diseases and Health Analysis, urged for calm in the face of the epidemic.

“We should not panic, we should not be afraid, but we should try to have aggressive vector control,” said Espinal.

Public health experts at WHO acknowledged that a great number of questions remain unanswered in the wake of this outbreak. Scientists have not yet determined a causal relationship between Zika virus and microcephaly (or “shrunken heads”) in babies, although the impact is strongly suspected. Likewise, scientists have not proven a causal link between the virus and Guillain-Barré Syndrome—a condition that paralyzes a patient’s arms and legs.

“Of course we can’t talk about causality,” said Espinal. “We need more evidence. But that doesn’t minimize the public health action we take now.”

But the repeated associations between Zika infections in pregnant mothers and microcephalic babies prompted public health authorities to become more concerned.

Dr. J. Barbosa da Silva Junior, Secretary of Health Surveillance from the Ministry of Health in Brazil, joined the informational session in Geneva by telephone and described how the outbreak began in his home country.

“We used to have 10 to 12 cases of microcephaly [in a state] per year,” said Barbosa da Silva Junior. “We then noticed that we had 28 cases in two months.”

Now, the secretary said, more than 4000 cases of microcephaly have been confirmed throughout Brazil since the start of the outbreak.

Dr. Lyle Peterson, Director of the Division of Vector-Borne Diseases from the Centers of Disease Control and Prevention, acknowledged that the current methods to control mosquito populations have “limited efficacy,” and that the CDC is not only trying to expand vector control options, but is also trying to develop and implement efficient diagnostic testing.

Despite these challenges, the WHO Director called for an urgent and immediate public health response.

“We are not going to wait for science, we need to take action now,” Chan said.

For more details, please see “Public health experts urge World Health Organization to ramp up zika response”