Zika: A Year in Review

by Ann Tomoko Rosen

A Critical Thinker’s Guide to Zika

Zika will most certainly be remembered as the pandemic of 2016, but like many pandemics of recent memory (think Swine Flu, Avian Flu, Ebola), it failed to live up to the inflated numbers and devastating statistics that the CDC ceaselessly projected through mainstream and social media. As a narrative, the Zika Crisis of 2016 rivaled Hollywood blockbusters with its global threats and dramatic turns, but as our villain, the Zika threat remained elusive. As the year came to a close it seemed that perhaps a better detective and less of a S.W.A.T. team might help us navigate the medical mysteries that plague us in the 21st Century.

Zika Crisis: A Year in Review
In January 2016, health authorities in Brazil reported an explosion of microcephaly cases and noted that they coincided with a Zika outbreak. In February, the WHO declared an international health emergency prompting President Obama to ask Congress for $1.9 billion to stop the spread of Zika. Two months later, a “scientific consensus” was reached by the CDC, WHO and National Institute of Health (NIH), confirming Zika as the culprit for these microcephaly cases. In May, the House of Representatives introduced the Zika Vector Control Act to loosen restrictions on toxic pesticides (linked to birth defects) so we could manage the coming Zika storm. Then, over the summer, scientists quietly admitted that other factors may have contributed to the cluster of microcephaly cases in Brazil as numbers of microcephaly cases failed to rise in other Zika-stricken countries, but the scientific community forged ahead with multi-million dollar plans to kill mosquitoes and make vaccines. By November, the WHO acknowledged that the Zika virus was no longer an international emergency, but rather another infectious disease to be managed globally. To that end, a vaccine is scheduled to come out in 2018 and Oxitec will soon be releasing its GMO mosquitoes in the Florida keys.

Fast and Furious
The long-term solutions for what the WHO has now determined to be “an ongoing threat” have been in the works for some time now. In fact, the race for a “cure” began before most of us had even heard of Zika. On January 29, 2016, just days after the Zika story first made headlines, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases was reassuring the public, saying “We are already on our way on the first steps to developing a vaccine.” In fact, the World Health Organization had set up an incident control center in May of 2014 to track the virus, six months before a November meeting that addressed concerns about a microcephaly spike.

It is likely that a program for managing Zika will precede a comprehensive understanding of the true cause of an alarming cluster of microcephaly cases in Northeastern Brazil. In November, the National Institutes for Health (NIH) announced that a vaccine could be rushed to the market as early as 2018 and, according to the World Health Organization (WHO), there are 26 other experimental Zika vaccines in development, but many of us are still trying to understand why a virus that has been around since 1947 and was previously considered one of the milder mosquito-borne illnesses is now being linked to serious health problems.

We have reason to be concerned about this given the cast of characters in the Zika narrative. The CDC, WHO and NIH have yet to explore other suspects in the medical mystery behind Brazil’s microcephaly cases and, to date, their resources have gone primarily towards a global Zika awareness campaign, research to confirm links between Zika and a growing list symptoms, data collection to track Zika outbreaks, methods of testing for Zika, and, of course, vaccines. This is a very fortunate coincidence for the pharmaceutical industry, producers of toxic pesticides, and synthetic mosquito-maker, Oxitec, who are among the other suspects in Brazil’s mysterious microcephaly spike. They are all poised to make billions from the Zika crisis and, in our fear, we are speeding up clinical trials and bypassing environmental laws and precautionary measures that were put in place to protect our health, safety and ecosystem, to make it easier for big corporations to expedite “solutions”. In sharp contrast, these corporate interests and the government organizations that are working with them, would face some dire financial consequences if it were determined that any of them had a role in exacerbating Brazil’s health problems.

The Birth of a “Crisis”
On January 20, 2016, Brazil’s health ministry reported 3,893 cases of microcephaly had been recorded since the start of 2015. The greatest number of cases (1,306, or about 35%) came out of Pernambuco. Mainstream media jumped on the story and some staggering statistics were soon reported. By February 2016, the Los Angeles Times reported 4,443 “suspected and confirmed” cases of microcephaly.

On January 29, 2016, The New York Times reported that the Zika virus was “spreading explosively” through the Americas, claiming that as many as four million people could be infected by the end of 2016. The story referred to Zika as a virus that “may cause birth defects” and then went on to note a sharp rise in cases of microcephaly in Brazil as Zika spread. But, even then, the “strong circumstantial link” seemed pretty flimsy:

“The (Brazilian) Health Ministry said it had examined over 700 reported cases of microcephaly and found Zika in only six of the infants, though what that means exactly is unclear.”

But Dr. Marcos Espinal, director of communicable diseases and health analysis at the Pan American Health Organization, considered the Zika virus “guilty until proven innocent” . The medical community followed suit and quickly incorporated Zika theories into its literature. The NIH website added the following information to its Microcephaly page:

“Some children with microcephaly will have normal intelligence and a head that will grow bigger, but they may track below the normal growth curves for head circumference. Some children may have only mild disability, while those with more severe cases may face significant learning disabilities, cognitive delays, or develop other neurological disorders. Many, if not most, cases if Zika microcephaly will be very severe, possibly requiring lifelong intensive care.”

The CDC also made immediate changes to the “Causes and Risk Factors” section of their Microcephaly page adding, “Researchers are studying the possible link between Zika virus infection and microcephaly.” And in less than four months, the CDC went from reporting a “possible connection” between a Zika virus outbreak and a surge in microcephaly cases to putting out press on April 16, 2016 concluding that Zika does in fact cause microcephaly, based on “rigorous weighing of evidence” as reported in the New England Journal of Medicine despite the protests of multiple scientific organizations. Based on that report, however, Zika earned its infamous reputation not by having the most conclusive evidence, but by incorporating both “presumed and confirmed” cases of Zika virus infections and giving a nod to “biological plausibility”. Incidentally, presumed cases can include people who merely recalled having a headache, fever, joint pain and/or conjunctivitis. In other words, there is no “mounting evidence”, unless we are willing to accept the conveniently low standards that have been applied exclusively to Zika virus research (relative to other speculated causes).

Inflated numbers early on also amplified Zika fears. Most people still don’t realize that Brazil’s Health Ministry had implemented a “more case sensitive” definition of microcephaly to assist with “surveillance” of the emerging problem, changing the parameters from < 30.3cm (for full term females) and 30.7cm (full term males) to

In February, 2016, the NY Times had some new numbers to report:

“Of the cases examined so far, 404 have been confirmed as having microcephaly. Only 17 of them tested positive for the Zika virus…
Another 709 babies have been ruled out as having microcephaly … underscoring the risks of false positives making the epidemic appear larger than it actually is. The remaining 3,670 cases are still being investigated.”

Many of the “suspected” cases were based on women recalling “Zika-type symptoms” or coming from areas where “outbreaks” had occurred. However, these symptoms (fever, rash, red eyes, muscle aches) are vague and can be reflective of many conditions, including other mosquito-borne illnesses common to the area that are more likely to cause symptoms. Subsequent stories frequently mentioned “presumed cases”, “traces of Zika” and “Zika-linked microcephaly”, but confirmed cases were few and far between.

Furthermore, the numbers did not stack up in other parts of the world where Zika has been prevalent. The New England Journal of Medicine published preliminary results from a study involving 12,000 pregnant women infected with Zika virus in Colombia showing zero cases of microcephaly. By the year’s end, 47 microcephaly cases were reported in the country with the second-largest Zika outbreak. So it seems reasonable and responsible to consider other possible culprits in these microcephaly cases in Brazil. Here are some other theories that other groups and organizations have proposed:

Two organizations, Physicians for Crop-Sprayed Towns (PCST) and the Association for Collecctive Health (ACH) questioned the government’s claims that Zika was to blame for the birth defects coming out of Brazil. They pointed to the widespread use of an endocrine-disrupting larvicide, pyriproxyfen, in areas where the largest numbers of birth defects were reported. Eighteen months prior to the surge of birth defects, the Brazilian Health Ministry injected pyriproxyfen into the reservoirs in order to prevent mosquito larvae from growing in drinking water tanks. This was done throughout the state of Pernambuco, where 35% of Brazil’s microcephaly cases were reported. In October of 2012, Brazil also lifted its ban on the spraying of Imidacloprid, a neonicotinoid shown to cause skeletal malformations in animal studies.

In October of 2014, Brazil’s Health Ministry launched an aggressive vaccination campaign, mandating that all pregnant women must receive the pertussis-containing Tdap (tetanus, diptheria and pertussis) vaccine, called Boostrix. The label on the vaccine clearly states that “there are no adequate and well-controlled studies in pregnant women” . Despite this, the Brazilian government has vaccinated tens, if not hundreds, of thousands of pregnant women since the campaign began. The pertussis vaccine has previously been linked to brain inflammation and neurological damage in infants. The Tdap vaccine contains thimerosal, aluminum adjuvants and polysorbate-80, which compromise the blood brain barrier and may allow toxins (and possibly viruses) to access the brain and nervous system.

PBS’s “Frontline” featured an 18-year-old mother of a child recently diagnosed with microcephaly who, along with many other women in her community, believed that vaccinations were a likely culprit. She never had any symptoms of Zika virus, but did receive a monthly shot from her public health clinic throughout her pregnancy. According to this mother “I don’t believe it’s a mosquito that causes (microcephaly). That’s an invention of the government… They’re pushing this story about the mosquitos because they’re worried about indemnity — they don’t want to have to pay everyone for the damage their vaccines are causing, it would be too expensive to tell the truth. So they say it’s mosquitos causing microcephaly.”

Genetically engineered mosquitoes
British biotechnology firm, Oxitec, had been conducting experiments with genetically modified Aedes aegypti mosquitos in Brazil since 2011 and opened a mosquito facility in Piracicaba. These mosquitoes, which are carriers of the Zika virus, were designed to mate with wild female mosquitoes that would produce larvae that could not survive to adulthood in the absence of tetracycline. Hundreds of millions of these mosquitoes were released in Brazil in the hopes of reducing the mosquito population. However, as an internal Oxitec document reveals , even a small amount of tetracycline in the environment could result in a 15% survival rate of these self-destructing mosquitoes. Tetracycline is an antibiotic used in food animal productions and Brazil is ranked third in the world for its “global antimicrobial consumption in food animal production”. Since up to 75% of antibiotics are not absorbed in the body, they are later excreted as waste, providing GMO mosquitoes a potential means for survival. We do not yet know the repercussions of releasing those mosquitoes in nature, but we do know that Brazil is ground zero for this particular experiment.

Choosing Solutions from Suspected Causes
Interestingly, when it comes to Zika, the suspected problems and the proposed solutions are eerily similar. Throughout 2016, Oxitec both denied responsibility for the Zika outbreak and offered its mosquitoes as a potential remedy. In fact, in the same week that the Zika-microcephaly link was making headlines, Oxitec put out a press release boasting unprecedented success in suppressing the Zika, dengue and chikungunya carrying Aedes aegypti mosquito population in Brazil . However, the “success” of the their mosquito technology failed to prevent outbreaks of mosquito-borne disease. In Februrary 2014, Jacobina, Brazil, one of the locations where Oxitec conducted research, experienced a dengue emergency. Brazil also experienced its first chikungunya and Zika outbreaks that year in the midst of Oxitec’s most extensive open release GMO mosquito trail. The company has met with resistance in its pursuit of clinical trials in the Florida Keys since 2011, but with Zika fears heightened, residents finally agreed in November to the limited release of the genetically modified mosquitoes. Billions more will also be released in Brazil.

Pesticides and vaccines also share the dubious distinction of being both suspects and potential heroes in Brazil’s microcephaly narrative. Unfortunately, it may prove difficult to come to any definitive conclusion about the origins of the surge in birth defects in a developing country that is riddled with poverty, disease and environmental pollution. Much of the country’s population suffers from widespread vitamin A and zinc deficiency – both nutrients are required for healthy fetal development. The majority of women who gave birth to babies with microcephaly were young, single, black and poor. Taking this initial vulnerability into account, then adding toxic pesticides, the introduction of genetically modified mosquitoes, a mandatory vaccine campaign and outbreaks of Zika, dengue and chikungunya, it is easy to imagine how any number of toxic combinations may arise. Yet, mainstream media sources report that theories about these other possible links have been “debunked” due to lack of scientific evidence. Others argue that the jury is still very much out on this. What is especially troubling, then, is that the proposed solutions may be complicit in the spike in microcephaly cases and there is big money at stake.

Revisiting Numbers and Redefining Crisis
In September, President Obama approved a $1.1 billion budget to address this crisis, but the proposed distribution of resources was based on the assumption that Zika remained the solitary problem. Meanwhile in Brazil, some new theories were emerging. When microcephaly cases failed to turn up in anticipated numbers throughout Zika impacted countries, Fatima Marinho, director of the noncommunicable disease department at Brazil’s Ministry of Health, acknowledged, “We don’t believe that Zika is the only cause.”

As late as July, 90% of Brazil’s 1,709 confirmed cases of microcephaly occurred in a relatively small region in the northeast. Dr. Adriana Melo, who first reported an association between Zika and mircrocephaly has since raised the question of whether bovine viral diarrhoea virus (BVDV), which causes serious birth defects in cattle, may play a role.

Other scientists suggest that co-infections with other mosquito-borne viruses, such as dengue or chikungunya, could be contributing to birth defects. According to research from Imperial College London, previous exposure to the dengue virus may increase the potency of Zika infection. Professor Gavin Screaton, senior author of the research, said: “Although this work is at a very early stage, it suggests previous exposure to dengue virus may enhance Zika infection. This may be why the current outbreak has been so severe, and why it has been in areas where dengue is prevalent.”

The Zika virus is strikingly similar to the dengue virus, which has four different strains. They all belong to the Flaviviridae family. Research from the NIH’s Biomedical Research Centre suggests that, due to similarities in their genetic make-up, pre-existing dengue antibodies can amplify a Zika infection through a phenomenon called antibody-dependant enhancement (ACE). This same phenomenon explains why most people who get dengue fever have a mild first infection, but can experience severe, hemorrhagic symptoms with a second infection. Immunity from one strain of dengue does not protect someone from the other strains; instead antibody-dependent enhancement allows other strains to “piggyback” into the immune system undetected, leaving the body more vulnerable. This has plagued dengue vaccine efforts for decades, as vaccine antibodies can act like a silent initial infection, making way for a severe reaction if a person is exposed to a different strain in the future.

In September of 2014, vaccine developer Sanofi Pasteur also announced that it had conducted the final landmark efficacy study of its dengue vaccine candidate in dengue endemic areas in Brazil, Colombia, Mexico, Honduras and Puerto Rico , all significant sites of Zika outbreaks. This is particularly relevant since a York University study suggests that vaccinating against dengue could cause additional Zika outbreaks.

“We concluded that vaccination against dengue among humans can significantly boost Zika transmission among the population and hence call for further study on integrated control measures on controlling dengue and Zika outbreak,” says Professor Yanni Xiao, who was part of the research team. Clearly, this has some far-reaching implications as clinical trials go forward with both Zika and dengue vaccines and should be watched closely.

Despite these possibilities, the CDC seems to have doubled down on Zika and Big Pharma, Oxitec and pesticides producers are all heavily invested in the new long-term plan. About $400 million will go towards developing a vaccine and diagnostic tests and, not surprisingly, over a dozen pharmaceutical companies have vaccines in the works, some teaming up with the CDC, NIH and WHO. According to FiercePharma.com:

“Analysts estimate a Zika vaccine could be a $1 billion opportunity, or more, because travelers from the U.S. and Europe would be able to pay a high price for protection. In endemic areas, disease experts envision vaccination campaigns targeting girls before puberty, because of the virus’ links to birth defects. In boys, a vaccine could protect against future sexual transmission.

Larger companies in the Zika vaccine R&D effort are Sanofi, GlaxoSmithKline and Takeda, which each have paired with U.S. government entities to advance their research.”

Oxitec, which currently has a monopoly on genetically-modified insects, has already shown itself to be somewhat “ethically-challenged” having done its first field trial with this new technology in Grand Cayman amidst the island’s uninformed public in 2009. And new conflicts of interest are already surfacing as we develop a plan here. In response to the strong resistance Florida residents have demonstrated with regards to GMO mosquitoes over the last five years, Oxitec’s parent company, Intrexon Corporation, launched the Florida Keys Safety Alliance, a PAC (political action committee) “dedicated to informed decision-making on the use of genetically engineered mosquitoes to suppress the invasive mosquito that carries the Zika virus.” As part of this campaign, Intrexon hired one-time lobbyist, Stephen Vancore, and posted an ad in Craigslist, offering $15/hour for “door-to-door canvassers” to help with “an education awareness campaign” aimed at residents in Monroe County who were to vote on a non-binding referendum related to the use of genetically modified mosquitoes to suppress the mosquito population. In November, following months of pesticide spraying and aggressive fear campaign, Key residents voted in favor of the referendum.

Florida Governor, Rick Scott, who signed an executive order in June allocating $26.2 million in state emergency funds to combat Zika, may also reap some personal benefits. He failed to disclose his wife’s multimillion-dollar stake in Mosquito Control Services LLC through a private investment firm she co-owns.

The pesticide industry has also benefited from the Zika scare. The industry has been pushing for relaxed restrictions on pesticide use since 2011, when the EPA determined that pesticides should be treated as pollution under the Clean Water Act. In response it proposed the Reducing Regulatory Burdens Act, which never made it out of the Senate. But in May, the bill resurfaced as the “Zika Vector Control Act”, ostensibly to help fight the potential spread of Zika virus. However, the bill does nothing to facilitate emergency response with regards to pesticide use for combating Zika – the Clean Water Act permit already approved pesticides for mosquito control in emergency outbreak situations. “The reality is that the majority has been pushing this legislation for years under whatever name is convenient at the time,” claimed Rep. Raul Ruiz (D-CA) in a debate prior to the vote. “This bill has nothing to do with combating Zika.”

Learning from the Past
We may never know precisely what caused the unusual cluster of microcephaly cases that initiated what ultimately became the global health crisis of 2016, but there is a lot we can learn from reviewing some very inconvenient truths. Brazil is a country that has been riddled with health problems, many of which were rooted in environmental problems. In the years leading up to the Zika outbreak, Brazil’s Health Ministry chose to welcome the assistance and intervention of vaccine developers, biotechnology companies and pesticide producers to combat mosquito-borne illness and pertussis. And in 2015, despite those efforts, Brazil experienced the world’s largest Zika outbreak as well as outbreaks of chikungunya and dengue. Brazil also experienced an unusually high number of microcephaly cases. Despite the many “solutions” implemented by these organizations, Brazil’s health crisis remains and a new global problem has emerged.

Today, the same organizations and corporations have some very similar proposals for new problems they claim may devastate us. Perhaps we should be asking ourselves if we really want what Brazil got.

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