Assignment:
Article:
New Zika warning from health leaders: Consider delaying pregnancy.
Why this article was selected:
The disease caused by Zika virus in the general population usually runs a mild course with fever, rash, joint pain and conjunctivitis lasting several days to one week after infected Aedes mosquito bite. Infection during pregnancy however can lead to serious birth defect, microcephaly and other severe fetal brain defects. The article covers a differing view from WHO and CDC.
The Problem:
According to the CDC website, the first confirmed Zika virus infection in Brazil was reported in May 2015 triggering an alert. Prior to this it was reported in tropical Africa, Southeast Asia and the Pacific Islands. WHO on February 1 2016 declared Zika virus a Public Health Emergency of International Concern. Outbreaks are occurring in many countries and territories including Puerto Rico, the US Virgin Islands and American Samoa. There has been no local mosquito-borne transmission in the US states, but there have been travel-associated cases. Both the WHO and CDC agree on the seriousness of the problem, but the question is whether pregnancy should be discouraged.
Policy Stream:
The WHO on 6/7/10 issued an update to its guideline, in which it said couples of reproductive age in the affected countries should be "correctly informed and oriented to consider delaying pregnancy".
The CDC and federal government have refrained from issuing specific guidance on what is considered an "intensely personal" decision. According to the article from The Hill "It's a controversial move that stands in contrast with the strong insistence by U.S. health officials not to weigh in on the issue", referring to the WHO guideline.
Political Stream:
The WHO in its guideline recommends all male and female with Zika virus infection and their sexual partners (especially pregnant women) receive information about the risks of sexual transmission of the virus, contraceptive measures and safer sexual practices. It states people of reproductive age living in areas with ongoing local transmission consider delaying pregnancy as a measure to prevent adverse fetal outcome.
The CDC on its website leaves the decision up to women and their partners to consider after having a discussion with their healthcare provider. Both the WHO and CDC agree on safe sexual practices and access to contraception for those at risk and following exposure.
Public opinion on Zika virus has not been strong given the current political campaign that has drowned most issues, and also the fact there has been no reported local transmission in the US. I believe this will change with first reported local transmission. The US however recognizes the imminent danger, and President Obama asked Congress for $1.9 billion to fight Zika, which has drawn support from both parties, and supported by Senator Rubio. The Senate approved $1.1 billion and $622.1 million by the house. This demonstrates the Kingdon model as ‘Senate and House negotiators are set to begin talks on reconciling Zika funding' (Kaiser Health News, 06/09/16). I think the CDC does not want to start a war on the ‘right of women to be pregnant' given the timing and political climate. I do agree with the WHO guideline, let's not wait to see the effect before we take action.
References:
The Hill, 06/09/16, New Zika warning from health leaders: Consider delaying pregnancy.
Kaiser Health News, 06/10/16, WHO says women in Zika-infested areas should consider delaying pregnancies.
www.cdc.gov, Zika Virus, Women & their Partners who are thinking about pregnancy.
World Health Organization: Prevention of sexual transmission of Zika virus, Interim guidance update, 7 June 2016 (apps.who.int/iris/bitstream).