In the opening session on February 23, 2017, the keynote speaker, Annelies Wilder-Smith, MD, PhD, DTM&H, MIH, FAMS, FACTM, professor of infectious diseases, Vaccine Preventable Diseases & Emerging Infectious Diseases Laboratory, Lee Kong Chian School of Medicine, Nanyang Technological University, in Singapore, discussed the evolution of the Zika outbreak to a full house at the First International Zika Conference in Washington, DC.
Through the exploitation of what Dr. Wilder-Smith refered to as “the triad of the modern world”—globalization, urbanization, and the ability to move easily on an international scale—diseases that are spread by Aedes
mosquitoes are increasing their spread around the world, and as they do so, they are expanding the impact that they have on public health. Dr. Wilder-Smith said, “Zika virus has joined the quartet of enzootic arboviruses [yellow fever, chikungunya, Dengue virus] in West Africa with a history of urban emergence,” in that it has “now entered the human-to-human cycles” and this “human-mosquito-human transmission” is resulting in a number of unprecedented epidemics.
In her presentation, Dr. Wilder-Smith shared a brief historical timeline of Zika with conference attendees, one that spanned from 1947, when Zika virus was first discovered by Alexander Haddow, up until 2016. Dr. Wilder-Smith went on to highlight how in 1954 the first human case was reported in Nigeria, how it was described for the first time outside of Africa in 1966, how in 1977 the first case was described in Asia, and, how from the 1970s up until now, “it was really a disease between Africa and Asia.”
She then went on to discuss how the modern Zika outbreak originated in the Yap islands of Micronesia and later spread to French Polynesia in 2014, where Guillain-Barré syndrome (GBS) was first noted in Zika-infected individuals. However, GBS wasn’t recognized as a complication until August 2015. On May 7, 2015 the first epidemiological alert was issued and on the first of February of the following year, the “unusual clusters of birth defects and GBS were declared as a public health emergency of international concern,” due to “its risk of global health security.”
The Zika-related birth defect, microcephaly
, has continued to make headlines throughout the past years; a telltale sign of microcephaly is when an infant’s head is much smaller than expected, and often this birth defect results in improper brain development. According to Dr. Wilder-Smith, “Microcephaly appears to be the tip of the iceberg; there’s so much more” when it comes to Zika-related complications
. She went on to list: “spontaneous abortion, stillbirths, epilepsy, visual problems, hearing loss,” and even severe dysphasia. In addition, Dr. Wilder-Smith listed problems that may not be witnessed until later on, such as: "mental retardation, psychotic disorders, [and] learning difficulties,” among others.