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Global spread of Zika “of utmost concern” say experts

The President of the World Federation of Neurology (WFN) Prof Raad Shakir (London), said that following the first confirmed Zika-related case of microcephaly on US territory, in Puerto Rico, and the ever-growing number of sexually-transmitted Zika infections in Europe, “it is increasingly obvious that the Zika epidemic has long assumed global proportions.” As the opening of the Olympics in Rio de Janeiro draws closer, and with WHO warnings about the risk of Zika taking hold in Europe, more and more attention would be focussed on the relentless spread of the epidemic, said Prof Shakir.

Concerned about the increasing number of neurological complications related to the Zika virus, the WFN has recently established a working group to contribute expertise in support of the coordinated global response to the Zika crisis. A large percentage of people suffering from Zika virus infections are asymptomatic or show only mild symptoms. But potential neurological complications can be dramatic. “There is a lack of awareness that perhaps more risks are involved in Zika infections than the devastating foetal malformations when Zika is acquired during pregnancy such as the now-familiar microcephaly issue. With major neurological conditions such as Guillain-Barré syndrome (GBS), myelitis, or meningoencephalitis involved in Zika infections, the risks are much broader than originally thought,” says Prof John England (Louisiana State University, New Orleans) who chairs the WFN Zika Work Group.

In a follow-up to a recent meeting on the public health implications of Zika in Tegucigalpa, Honduras, Prof John England and Prof Marco Medina, of the Universidad Nacional Autonoma de Honduras, also a member of the WFN Zika Work Group, agreed on the need for formal guidelines outlining diagnostic criteria for neurological complications of the Zika virus. “We will be working over the next weeks to develop a broad consensus among experts on this,” said Prof England.

With no vaccination in prospect for the time being and lack of evidence about the risk factors influencing the development of neurological symptoms after Zika infection, the focus is now on surveillance, enhanced mosquito control, and prevention, says Prof England. “In particular at a time when thousands of athletes and fans will be travelling to Rio in July, we need to create awareness about the risks involved, and what needs to be done for personal protection.

As of 11 May 2016, 58 countries and territories report continuing mosquito-borne Zika transmission. Nine countries have reported evidence of person-to-person transmission of the virus.