Issue: December 2016
December 19, 2016
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WHO: Zika is no longer a global health emergency

Issue: December 2016
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WHO recently announced that the Zika virus outbreak no longer constitutes a Public Health Emergency of International Concern, or PHEIC.

Margaret Chan

The announcement came more than 9 months after an unusual rise in cases of microcephaly and other neurological disorders associated with Zika, which led WHO Director-General Margaret Chan, MD, to declare the PHEIC on Feb. 1. The announcement does not mean that the virus no longer poses a threat to global health, officials said.

David L. Heymann, MD, director of WHO’s Zika emergency committee and professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine, said Zika remains a global health priority, but that because research has already demonstrated a link between the virus and microcephaly, what is needed now is a “robust technical response” to the worldwide outbreak.

“The Zika virus and associated complications remain a significant and enduring public health challenge requiring intense action within WHO,” Heymann said during a telebriefing, “but it no longer represents a Public Health Emergency of International Concern.”

The end of the PHEIC was declared after the fifth meeting of WHO’s Zika emergency committee. It may have come even earlier if not for the committee’s focus on the potential impact of the Olympics and other events, Heymann said.

“Now is a time when all the elements fell into place so that we could acknowledge the end of the PHEIC as defined under the International Health Regulations,” he said. “The PHEIC was never meant to stop the outbreak such as it was for other outbreaks like Ebola. It was called so the world could come together and better understand what was going on.”

Heymann said it was “appropriate” that Brazil was not declaring an end to the emergency within its own borders because Zika still represents an emergency there and in other places. South America’s largest country has seen the bulk of the world’s Zika infections and associated cases of microcephaly.

“It is an emergency in many countries,” Heymann said.

The Brazilian government has notified WHO that it is conducting studies to determine if there are co-factors beyond Zika that are contributing to the large number of microcephaly cases that have been reported in the northeast part of the country. These co-factors might include genetics or history of previous infection with another virus, Heymann said.

Of the 10,276 cases of microcephaly that have been reported since last November in Brazil, 6,755 have come from the northeast, including 77% of the 2,189 cases that have been confirmed. So far, no co-factors have been discovered, but Brazil continues to look for them, Heymann said.

“Many things are being studied, but these things can’t be studied overnight,” he said.

Mosquito-borne Zika infection has been reported in 75 countries or territories around the world since 2007 — including 58 since 2015, according to WHO. Approximately 28 countries or territories have reported cases of microcephaly or other central nervous system malformations potentially related to Zika — including the United States — and 20 have reported either an increase in Guillain-Barré syndrome (GBS) or confirmed Zika virus infections among GBS cases.

WHO notes that any country with populations of Aedes mosquitoes is at risk for Zika. The virus can also be sexually transmitted by both men and women. – by Gerard Gallagher

Disclosures: Chan and Heymann report no relevant financial disclosures.