WHO extends Zika emergency as Singapore count rises to 189

Singapore reported another big batch of Zika virus cases on Friday, bringing its total count in just a week to 189, prompting comments from World Health Organisation officials that the spread of the virus still constitutes a global health emergency.

WHO officials are worried over Zika's apparent quick spread out of Latin America back to Asia and Africa and they are not sure if the virus will spread explosively, causing a fresh wave of birth defects and side-effects such as the paralysing Guillain-Barré syndrome.

WHO has received detailed information on microcephaly, GBS and other neurological disorders occurring in the presence of Zika virus transmission as well as control measures being implemented  in Brazil, the United States of America and Singapore.

The Emergency Committee of the World Health Orhanisation (WHO) which met on Thursday, decided to continue to treat Zika virus infection and its associated congenital and other neurological disorders as a Public Health Emergency of International Concern (PHEIC) in the backdrop of continuing geographic expansion and considerable gaps in understanding of the virus and its consequences.

The committee restated the advice it provided to the director-general in its previous meetings in the areas of public health research on microcephaly, other neurological disorders and Zika virus, surveillance, vector control, risk communications, clinical care, travel measures, research and product development related to vaccines, therapeutics, and laboratory tests.

The committee noted that activities based on this advice remain in place and are all being implemented.

The committee also reaffirmed its previous advice that there should be no general restrictions on travel and trade with countries, areas and / or territories with Zika virus transmission, including the cities in Brazil that will be hosting the Paralympic Games.

Furthermore, acknowledging that the impact of Zika virus is a long term concern, the committee recommended that the director deneral consider developing an appropriate infrastructure and response plan within the World Health Organisation to provide longer term coordination and accountability for ensuring an effective response.

The committee emphasized the need for a better scientific understanding of Zika virus epidemiology, clinical disease, and prevention, recommending focus on several new research issues along with other issues recommended previously, in order to:

• Enhance understanding of the different viral lineages, including cross reactivity and cross-immunity between them as well as their clinical implications;
• Assess possible co-factors or risk factors that might impact disease severity;
• Better understand the natural history of the disease in children who are congenitally infected, pregnant women, and other children and adults;
• Determine length and location of viral persistence in humans, and its impact on transmissibility;
• Better establish the risk of infection and modes of transmission;
• Assess the utility of effective vector control tools and their operational feasibility; and
• Continue development of safe and effective prevention measure (e.g., vaccine).

Recognising the impact that Zika virus disease and its consequences will have on weak health systems, the committee also recommended that WHO provide appropriate guidance on effective surveillance and management of Zika virus disease in countries with high vulnerability, low capacity.

The committee congratulated Brazil on their successful application of appropriate public health measures during the Olympic Games.

To date, there have been no reports of confirmed cases of Zika virus among people who attended the Games, both during the games and since their return. The lack of cases supports the conclusions of the risk assessment regarding the Olympic Games made during the 3rd EC meeting, the committee noted.