Ask the Experts

Ask the Experts: Should Americans worry about Zika?

Amber Roach | Contributing Illustrator

The Centers for Disease Control and Prevention issued a travel warning this month advising pregnant people and their partners not to travel to an area near Miami, Florida to avoid the Zika virus.

Local mosquitoes in Miami have transmitted the disease after biting people that contracted it while abroad in Latin American countries. This is the first time that the CDC has issued a warning about a neighborhood in the United States.

The Daily Orange spoke with David Larsen, an assistant professor of public health at Syracuse University who specializes in the epidemiology of infectious diseases, about the Zika virus and its effect on American lives.

The D.O.: There have been more than 15 cases of babies born with microcephaly in the United States to mothers who had contracted Zika on travels to South America. How is this disease spreading so rapidly?

David Larsen: Zika was always on the track to go to areas of the country that have Aedes aegypti mosquitoes. So, the Aedes aegypti is probably the most efficient mosquito for spreading disease in humans. And that is because it tends to thrive within human civilization. So the virus is always going to spread to those areas in the U.S. with Aedes aegypti. Why we won’t have an epidemic like most of Latin America and why it won’t be as bad as in most of Latin America is first because there are fewer places in the United States with Aedes aegypti.

The D.O.: Why is this considered a global emergency?

D.L.: Eighty percent of the people that get Zika never even know they have it and only 20 percent of those the people actually get sick. The majority of those that get sick don’t need to be hospitalized at all.

If you compare diseases, for every case of polio paralysis that is found, there are about 1,000 polio cases without paralysis. And so polio is pretty terrifying as well. It’s because they’re going to be paralyzed for the rest of their lives; and Zika is that way. It’s not going to make everybody sick but that is like a Russian roulette kind of game. I get that it’s terrifying that there could be microcephaly in their brand new baby and it’s going to impact their baby’s entire life.

The D.O.: At this point, particularly in North America, is it worth rolling out preventative measures in the hopes of avoiding an outbreak?

D.L.: This is an interesting issue, because to most people, there’s no difference between an Aedes aegypti mosquito that can carry Zika and a mosquito that can transmit yellow fever or encephalitis. The county health departments should have surveillance going and warning people about Zika and issuing travel warnings. I wouldn’t be against tax dollars going to surveillance and education.

The D.O.: What can be done differently in South America, specifically where the Zika virus is most active?

D.L.: The surveillance needs to happen. Viruses are spread by human movement, not by the movement of mosquitoes. So if they find a house that they like, they’ll just hang out in that house their whole lives. They’re not going to disperse very widely. It’s people that will have a virus and they go from house to house to visit friends or go to the market and get bit by mosquitoes there that then start carrying the virus. So that means that the surveillance can’t have a fine spatial resolution, it needs to be systematic surveillance. That’s what, in my view, should be done in these areas.

The D.O.: Do you think there will be a vaccine to provide immunity to this disease in the future?

D.L.: It looks like right now there is a vaccine developing, which should be good. But a vaccine is challenging. Some vaccines to viruses like HIV are shaky because it keeps changing its shape so it’s hard to find a successful vaccine.

The D.O.: If you could rate the level of alert that Americans should be on out of 10, what would you say?

D.L.: This is such a highly charged subject. One disappointing thing is about the reporting in Brazil. The amount of fear mongering that the media did has been really bad. That’s a really unfortunate thing.

As an American, it would be as far from my mind unless I’m going on a trip to Latin America or Puerto Rico. And if I were to do that, I would think about, all right am I pregnant or do I want to become pregnant or does my partner want to become pregnant over the next six to 12 months? If that’s a yes … then I probably won’t travel to that place until after the baby, I’d go somewhere else. But if it’s a no, then I’m not going to care. I’m going to go, I’m going to enjoy myself, and I’m going to understand that this risk of complications from Zika is so much smaller than the risks we take in everyday life, things that we do not let dictate our lives.

So we just have to figure out what level of risk we are going to tolerate and try to be safe but also not let it change the way we live. So I would say around a three or a two, but it’s only risky for people who are going to travel somewhere, and really, if you’re going to travel anywhere, you should be figuring out what shots you need to take or what kind of things you need to avoid.

The D.O.: So rather than a global emergency, is this a local or place-by-place public health emergency?

D.L.: The majority of the people in the world will be affected by it, so I view it as a global health emergency. But for American citizens, it’s not a public health priority.

I personally view it as a huge, huge issue and I’m not trying to be flippant about how big of an issue it is. But then for the American citizens, the average person in the United States, it’s not really something to worry about.


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