In light of the recent increase in Zika cases, discussion about how to address the disease and the array of symptoms has been marked by confusion and misinformation about how Zika is transmitted and what steps officials need to take.
A Brief Recap
As of Sept. 2, the virus was in more than 70 countries, and the World Health Organization declared it an ongoing international health emergency.
Zika, a mosquito-borne virus, is usually transmitted through the bites of the Aedes aegypti mosquito. But recent cases strongly suggest that the virus is passed through sexual and intimate contact.
The public knows that the virus can be transmitted through mosquito bites and is aware of the growing link between Zika and microcephaly, a birth defect that may result in poor intellectual and motor function, poor speech, abnormal facial features, seizures and dwarfism.
People joke about bathing in bug spray or avoiding travel to regions with large mosquito populations. But few understand that Zika can be transmitted through sexual or intimate contact.
Although the WHO has broadened its recommendations about the sexual transmission of Zika virus, advising people who have been in Zika-affected areas to practice safe sex for at least six months, much uncertainty remains in the medical community. Medical personnel remain unsure about the amount of contact required for Zika to pass from one partner to another.
Some reports suggest the exchange of saliva is enough, and earlier theories posited semen with traces of Zika-infected blood as the main vehicle for sexual transmission. The Centers for Disease Control and Prevention recently expanded its list of body fluids viable for transmission to include semen, vaginal fluid and blood.
WHO recommends safer sex or abstinence for a period of 6 months for men & women who are returning from areas of active #ZikaVirus spread
— WHO (@WHO) September 6, 2016
The first suggestion of sexual transmission came in 2011, when a male professor was infected during a 2008 trip to southeastern Senegal. Upon his return to the United States, he infected his wife.
Since that encounter, sexual transmission has been reported in 11 countries, including the United States. Most cases resulted from vaginal intercourse.
On Feb. 2, the first case of same-sex Zika transmission was reported between men.
What makes Zika a particularly tricky virus is its ability to pass from people who do not show symptoms. According to the WHO, the longest time between the onset of symptoms and sexual transmission of the virus is 41 days.
Top federal health agencies, however, have been slow to respond to this new information about sexual transmission.
On the Local Level
On a national scale, Zika-related research has reached an impasse after politicians failed to pass a bill that would have channeled $1.1 billion toward helping federal health agencies fight the spread of the virus.
This spread has been significant worldwide. In the continental United States, Florida has been hit hardest.
“To date, Florida has verified 596 travel-related cases, 56 non-travel related cases and 80 cases involving pregnant women,” said Sarah Revell, a Florida Department of Health representative. In each case, officials spray and lay traps for mosquitos and reach out to nearby residents, she said.
Billboards in the Miami area display unwrapped condoms and tout the efficacy of sex with male condoms or abstinence to combat Zika’s sexual transmission. But these solutions do little to increase public understanding of how it can be transmitted.
Doctors, politicians and researchers knew little about the disease until recently.
A recent WHO update provided the most comprehensive report on sexual transmission. Other leading governmental health agencies, besides the CDC, have had little to say about the disease.
On the local level, resource centers and health-care providers depend on Florida state government and the Department of Health for funding for resources and programs.
As state agencies process the slowly emerging and sometimes conflicting information about Zika, this delayed response is hampering distribution of resources about sexual health, said Dr. Listron Mannix, testing and outreach manager for the Pride Center at Equality Park.
“When we look at HIV, Zika and STDs, they’re all public health issues,” Mannix said. “The Department of Health is taking on the efforts. I’m quite sure as we progress forward and funding becomes available, agencies such as mine, where we already do education in our communities, will have a chance to be a part of that process.”
The state’s delayed response is part of a strategy to ensure that communities receive effective resources and information, observers say. Although, others would say the approach only intensifies a clear desire for information and guidance on how to respond to Zika.
— Dr. Tom Frieden (@DrFriedenCDC) September 9, 2016
Professionals like Dr. Stephen Fallon have to maintain a relatively delicate balance when distributing health-care information: finding the right amount of information to circulate without causing public panic.
“That’s always the risk,” said Fallon, executive director of Latinos Salud, an organization aimed at fostering community among gay Latinos and educating people on healthy sex practices.
Meanwhile, these health and resource centers are still waiting for the federal health agencies to provide assets to better understand and educate the communities for which they feel responsible.
“I know from personal experience that they are definitely taking an active role in providing information and resources,” Mannix said.
Mannix recalled a recent audit meeting with colleagues who work in HIV-related positions who rushed out after getting Zika-related text messages.
“I’m, like, ‘What’s wrong? We’re in the middle of an audit,’ ” Mannix said. “They said, ‘Zika! We gotta go.’ And they left in the middle of the audit.”
Mannix’s confidence in the health systems comes at a time when Florida Gov. Rick Scott recently allocated $26.2 million in state general revenue for Zika preparedness and response, according to the Florida Department of Health.
“Once things become a little bit more available to them funding-wise on all accounts, I’m sure that we will be a little more brought into the fold on how to talk about Zika and it being sexually transmitted,” Mannix said.
Until then, they — and the rest of the country — will have to wait.
Dade County residents can request a mosquito inspection or report a mosquito nuisance by calling 3-1-1.
The department also recommends using screens to cover doors and windows. To avoid bites while outside, cover skin with clothing and use mosquito repellent. Those with DEET, picaridin, oil of lemon eucalyptus, and IR3535 are effective. Florida has a Zika Virus Information Hotline managed by the Department of Health that can be reached at 1-855-622-6735.
About the Author
Jesse Sparks is a senior at Northwestern University. Learn more about him here.