Ship of Fools: zika

Thread: zika Board: Oblivion / Ship of Fools.

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Posted by Josephine (# 3899) on :

I've been seeing lots of stories about zika.

Some of them talk about travel. Some of them talk about the difficulty of mosquito control. Some of them talk about the need for cheap, reliable contraception. Some of them talk about the need for liberalizing abortion laws.

But the one thing I haven't seen discussed is the need for increasing the availability of medical care and services for children with special needs and their families. Have I just missed it? Or is that not part of the discussion?

Posted by jacobsen (# 14998) on :

Zika? Could you post a link, please.

Posted by jacobsen (# 14998) on :

An initial search brought up swimwear adverts, but now I understand. Definition here I just needed the reminder thast zika is a virus.

Posted by Golden Key (# 1468) on :

Pardon my ignorance, but do you mean they'd have a special vulnerability to zika? Or that kids affected by it will have special needs? (From what I understand, babies affected pre-birth have many severe problems.)

Besides overall concern, I'm concerned about the Olympics. They seem to be going ahead, and there will be an influx of people from all over, and they'll be stressed and tired and likely more susceptible, and then they'll go back home...

[Votive]

Posted by Penny S (# 14768) on :

Synchronicity struck while reading, as the BBC was discussing an appeal by medical folks for delaying or moving the Olympics, turned down by the WHO. The discussion went into the behaviours which should be adopted by people returning from Brazil, even if they didn't think they had been infected. Especially men, who should consider themselves capable of infecting their partners for months after exposure.

It sounded as if the disease had been carefully constructed to cause the maximum damage by passing itself on even as producing the next victim of the ghastly neurological problems it causes in the developing foetus.

Posted by Barnabas62 (# 9110) on :

Josephine

I think you make an excellent point about planning for, and responding to, the consequences of zika virus.

It looks as though the growing awareness of the means by which the virus can be transmitted is leading to a better appreciation of the risks, the best precautions to be applied, and the urgent need to develop vaccines. I don't know how severe the risk of microcephaly is, I'm not sure if the WHO has reliable data yet.

Microcephaly is incurable, but as the Mayo clinic article indicates, support from speech and occupational therapists can make a difference. So I can understand the concentration on prevention. It looks as though any increased incidence of microcephaly will put some extra pressure on pre-existing resources (speech and occupational therapists). Currently, microcephaly is rare, so my surmise would be that the support techniques and procedures are still being developed. An increased incidence of the condition will probably speed up that development, produce greater understanding for the therapists who can help.

Posted by Golden Key (# 1468) on :

Looking at the "Symptoms" page of the Mayo article, I found this:

quote:
A child with more severe microcephaly may also have a backward-sloping forehead.

I saw such a child in the news coverage, a few weeks ago. {Possibly TMI.} My clumsy way of describing to myself what I saw was that it looked like the baby's head was too small, but its face wasn't proportional. It looked like the face was full-sized, and had to wrap over the top of the small head. That's burned into my mind.

Even with supportive services, a person with that level of zika is going to have severe problems just moving around among people, let alone socializing, because they're stuck with a startling face.

Posted by Soror Magna (# 9881) on :

quote:
Originally posted by Josephine:
...

But the one thing I haven't seen discussed is the need for increasing the availability of medical care and services for children with special needs and their families. Have I just missed it? Or is that not part of the discussion?

It is part of the discussion, and the "discussion" is mostly just the premise that the places most affected by zika 1) have very limited, if any, resources to support persons with disabilities, and 2) don't have a culture or a legal framework that values people with disabilities. They may not talk openly about 2, but it's definitely a consideration. Hence the conclusion that prevention plus testing and abortion is the only implementable response at this time in those places.

<tiptoeing up to dead horse> ISTM there's a horrible tangled irony here that prejudice against people with disabilities may lead to loosening of abortion restrictions in order to pressure women to abort to avoid the bother of caring and inclusivity. That's both awful and shortsighted. <tiptoes back>

Posted by Curiosity killed ... (# 11770) on :

Microcephaly is pretty major in its effects. I've worked with kids with microcephaly (I know, I've worked with lots of SEN kids), one in mainstream, and that student was one that really found mainstream secondary school a difficult place, both academically and socially. Lots of special needs that will need a lot of support for life.

Posted by no prophet's flag is set so... (# 15560) on :

Canadian travel advice is to use birth control when travelling to Zika infected areas and for minimum 3 months thereafter. Zika is also suggested to be sexually transmitted in addition to mosquitos.

DEET containing repellants are a good idea in general re skeeters.

Posted by Gramps49 (# 16378) on :

Lets face it, as the Zika virus spreads into more developed countries, there will be an all out effort to find a vaccine for it. No one was much concerned when it was first discovered in monkeys in 1946 in Uganda. Human cases first stated showing up in 1952, also in Uganda.

But once the rich countries start getting impacted, more concern develops.

Too bad we did not start to work on this earlier

Posted by Schroedinger's cat (# 64) on :

My mum told me that when she was a midwife, after the war, she saw a lot of microencephaly. It was the same sort of reason - soldiers coming back from foreign parts bringing infections.

She also told me they would often euthanise them, because that is what they did.

It is not a new problem. If - as others have said - we had dealt with it decades ago, we would probably not be bothered now. As always, it is never about "this is a threat to babies", it is "this is a threat to our white western babies".

Posted by Lamb Chopped (# 5528) on :

Oh come on, seriously now. It's just another case of "now that it's close enough to my own life, I suddenly notice it and try to do something." Which is a universal human characteristic, not a racist one.

Posted by Honest Ron Bacardi (# 38) on :

SC wrote:-

quote:
It is not a new problem. If - as others have said - we had dealt with it decades ago, we would probably not be bothered now. As always, it is never about "this is a threat to babies", it is "this is a threat to our white western babies".

Zika virus has been known about for a long time, but I don't think its neurological side effects have been. Most people who catch it are asymptomatic. About one in five develop fairly minor symptoms of the rash/ache/general malaise type which passes in a few days. That's just not something anyone is going to spend money on. There are loads of viruses that do that.

My understanding is that it was some statistical studies done by the French Government in French Polynesia that threw up clusters of neurological symptoms that correlated with zika infections. That would be around ten years ago I think. From being an observation, it seems to be an accepted risk factor for a minority of zika cases now, and I think that has all happened within the last 2/3 years.

Just from memory, having read a WHO document a while back.

Posted by Josephine (# 3899) on :

quote:
Originally posted by Barnabas62:
Microcephaly is incurable, but as the Mayo clinic article indicates, support from speech and occupational therapists can make a difference. So I can understand the concentration on prevention.

Absolutely we should concentrate on prevention. We need vaccines. We need mosquito control. We need contraception being readily available.

But even with all of that, there will be babies born with microcephay because their mother contracted zika during the pregnancy. There are still babies born with a variety of developmental impairments because their mother contracted rubella during the pregnancy.

We know that there are zika-affected children in other countries, and there will be zika-affected children here. And I haven't heard anything at all about increasing budgets for OT and SLP services, about training teachers, about making sure that these children can get medical care, about ensuring that their parents have enough income to take care of the family while taking care of a severely disabled child.

It's going to be a huge challenge. We need to start planning for it now.

Posted by Nicolemr (# 28) on :

Oh come on, Josephine. You know the Republicans don't give a damn about any of that. They're already fighting Obama's requests for funding for Zika.

Posted by Belle Ringer (# 13379) on :

quote:
Originally posted by Golden Key:
I'm concerned about the Olympics. They seem to be going ahead, and there will be an influx of people from all over, and they'll be stressed and tired and likely more susceptible, and then they'll go back home...

I read an article somewhere explaining why Olympics cannot be cancelled or moved to a different counter. Money. Specifically commitments to corporations who can sue if they don't get what they were promised. True? Not?

Posted by simontoad (# 18096) on :

Probably true belle. I have heard medicos saying the Olympics should be delayed or moved. I have heard nothing from Olympic officials about it.

On more support for disabilities, I noted, as a worker myself, a Parliamentary Committee report into the abuse of people with disabilities, mental, physical and sexual recently found it rife. That's adults with disability in residential and day placement services. In Victoria, the system is underfunded, staff are underpaid and mushroomed, and management is impossibly bureaucratic. We exist in an authoritarian space, and clients are often treated like they are at the bottom of that nasty little organisational triangle.

If there is going to be an influx of clients after the zika virus, we are in deep trouble. Hell, we are already there.

[ 29. May 2016, 05:20: Message edited by: simontoad ]

Posted by Barnabas62 (# 9110) on :

It looks like the funding issues fall into three separate categories.

1. Extra money for vaccine research and distribution once one is developed. My best guess is that the large pharmaceutical companies are already going for that, for commercial reasons. The extent to which purchase and distribution costs will require public funding (or additional charitable) support will depend a lot on how healthcare is normally funded from country to country;

2. Extre funding for medical abortions. How those costs are met will depend again on pre-existing policies and will vary from country to country. It seems likely that there will be an additional demand.

3. Long term support for microcephalic children and their parents. Because of the time it takes to train speech and occupational therapists, it's hard to see how there can be a quick response to funding additional training needs even if accurate forecasts of need were available. It seems likely that the existing services will have to take the strain while extra capacity is built up.

Leaving aside the DH ethical question I'm not surprised to hear that there may be a political divide in the US over finding more federal or state funds to support these present or future extra costs. The political polarisation is too well entrenched. I doubt whether there would be too much movement even if there was a pandemic in the US.

Posted by Enoch (# 14322) on :

quote:
Originally posted by Honest Ron Bacardi:
... Most people who catch it are asymptomatic. About one in five develop fairly minor symptoms of the rash/ache/general malaise type which passes in a few days. ...

Back when polio was a scourge, I believe that was also true of polio. It was permanently present unnoticed in the population. Its terrible consequences only arose when something went inexplicably and unpredictably wrong.

[ 29. May 2016, 07:19: Message edited by: Enoch ]

Posted by Moo (# 107) on :

quote:
Originally posted by Enoch:
Back when polio was a scourge, I believe that was also true of polio. It was permanently present unnoticed in the population. Its terrible consequences only arose when something went inexplicably and unpredictably wrong.

I had undiagnosed polio when I was five months old. Two aunts came to visit from an area where there was an epidemic. Five days later I came down with a fever and respiratory symptoms. My two older brothers, who had been away, developed the same symptoms five days after they returned home. It did not appear serious.

Six months later, my father, who was a doctor, was playing with one of my brothers. He grabbed him by both ankles and immediately realized that one was smaller than the other. He checked on me and my other brother and found no abnormalities.

Moo

Posted by Moo (# 107) on :

It is possible that the Zika virus we are dealing with now is more serious than that we have known before. Viruses have a nasty habit of mutating. It was a mutated virus that caused the 1918 flu epidemic.

Mutations are not always for the worse, but the fact that serious problems are appearing in Brazil is disturbing.

Moo

Posted by Brenda Clough (# 18061) on :

It is all coming together like some Michael Crichton novel. The upsurge of the virus. The Olympic games, to be held in Brazil. Even the sexual transmission angle (so helpful when you want to market the movie rights). The plot would involve a major disease outbreak worldwide as the virus is carried by athletes back to their home countries. Crichton would write it with valiant scientists developing a vaccine with unrealistic rapidity. Alas, I could just as easily see one of those dystopian novels. Bleak empty streets, grass growing tall in town squares.

Posted by Moo (# 107) on :

One reason the 1918 flu epidemic spread so fast was that men in the U.S. army who had come in contact with infected people were shipped from one military camp to another. The medical teams urged that camps be quarantined, but the army authorities said that military training must go on.

Moo

[ 29. May 2016, 22:58: Message edited by: Moo ]

Posted by RuthW (# 13) on :

Brazil estimates that half a million people will attend the Olympics (CNN). Given that 6.4 million international tourists visited Brazil in 2014 (World Bank), I don't see why the Olympics should be moved or cancelled. People from all over the world are already travelling to Brazil and back.

Posted by Golden Key (# 1468) on :

Ruth--

Your CNN article mentions they expect half a million Olympic attendees in Rio. That's going to be a lot of people, crowded in together.

Since it seems it can be sexually transmitted, I hope they're helping sex workers to take precautions.

(Tangentially) Then there's the possibility of rape, which AIUI is very common there. (Not to mention extreme horrors, like the recent case of approx. 30 men gang-raping a teenage girl, and putting video of it online.)

Posted by simontoad (# 18096) on :

Ruth's response is what I heard from organisers when I caught a glimpse of some news today.

Posted by Alan Cresswell (# 31) on :

In relation to the Olympics, and rich western tourists in general, the risks are much lower than those experienced by locals (especially the poor). The developed city centres, the nice hotels and stadia, will be kept largely clear of mosquitos - the ornamental water features will be disinfected, there won't be old tires etc left to collect water. Unless you decide on an excursion up the Amazon or wander into the slum districts you won't encounter very many mosquitos, and therefore will not be exposed to Zika to any significant extent. The poor living in squalid conditions, further than a mosquito can fly from the main tourist areas, are those who live in almost constant contact with mosquitos and are at risk from Zika.

Posted by RuthW (# 13) on :

Of those half million, some of them will be Brazilians - they won't all be foreigners travelling in. And they won't all be packed in close together. The Olympic venues aren't all close together. If I were a pregnant woman in the northeast part of the country I'd be very worried. But if I won a free ticket to Rio, I'd worry a lot more about the crime rate than zika.

Posted by Moo (# 107) on :

There is now some evidence that Zika can be spread by sexual contact. Also, a man who has had Zika may still have the virus in his semen months after he has apparently recovered.

Moo

Posted by Honest Ron Bacardi (# 38) on :

It's not certain, Moo. There is I think one confirmed case which was of a man infecting his wife. But he also suffers from a rare condition whereby there is blood in his sperm, so that may be the infective route. (There are also a few other reported cases though as yet unconfirmed).

But until it is sorted out it is wise to take adequate precautions.

Posted by no prophet's flag is set so... (# 15560) on :

Canada’s first case of sexually-transmitted Zika virus, from April 25. Must be a different case, nothing about blood, everything about the virus living in semen for 2 months.

Posted by Honest Ron Bacardi (# 38) on :

quote:
Originally posted by no prophet's flag is set so...:
Canada’s first case of sexually-transmitted Zika virus, from April 25. Must be a different case, nothing about blood, everything about the virus living in semen for 2 months.

Yes, I think that's a separate case.

Of course, infection by semen containing blood is still a sexually transmitted route, so the claim that it is a sexually transmissible disease is technically correct, though not in quite the way normally meant.

Semen definitely contains the virus, though, so the risk is there. I wouldn't want my technical cautiousness about drawing conclusions about causation to be misinterpreted. The correlation in certain cases is definitely there.

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