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    Have we dodged another Zika bullet?

    Zika threat may have waned, but no time for complacency

    “I am rather like a mosquito in a nudist camp; I know what I ought to do, but I don’t know where to begin.”        —Stephen Bayne

     

    In 2015, a new epidemic in Brazil became apparent. Zika fever—caused by the RNA virus originally discovered in the 1940s in an African forest—exploded onto the scene. In February 2016, the World Health Organization declared the outbreak a Public Health Emergency of International Concern, and heart-rending photos of some of the thousands of severely affected infants appeared on the front pages of our newspapers and magazines.

    Many of these babies suffered from chronic seizures, CNS malformations, profound hearing loss, and—of note to us ophthalmologists—major macular and optic nerve lesions sufficient to cause severe vision loss. Adults also were infected, with cases of uveitis, retinitis, and neurologic dysfunction, including Guillain-Barré syndrome appearing.

    The epidemic spread rapidly to neighboring South/Central American nations, as well as to the Caribbean. The increased number of documented cases of infection grew exponentially.

    Then the disease reached the United States, with almost all cases appearing in individuals who had traveled outside the continental states, but a few cases appeared as the result of sexual transmission or from mosquito transmission.

    Experts pointed out that globalization and the frequent travel of potentially infected persons around the world make dissemination of infectious organisms a near certainty. It appeared that this past summer might result in this disease reaching epidemic proportions in our country, and a number of states and medical institutions prepared for the worst.

    This year, however, the number of newly diagnosed cases of Zika infection has plummeted, almost as dramatically as the number had skyrocketed the year before. More good news came with the finding that no cases of mosquito-transmitted infection occurred in the continental United States.

    Now with mosquito season past in most parts of North America, it seems we can be confident the predicted spread will not come to pass—at least in this year. Citing more important needs elsewhere, the U.S. government has cut back on funding for research related to Zika, and at least one large pharmaceutical company, Sanofi, has decided to discontinue its promising vaccine development program.

    Supposedly, we can now relax.

    Peter J. McDonnell, MD
    He is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of ...

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