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What Can We Learn From Outbreaks of HIV and Zika?

Viruses have been around for at least 450 million years,1 and for the past 110 years, we have been studying them, always trying to catch up to the latest outbreak. An increase in globalization may help facilitate the fruitful exchange of ideas and research on infectious diseases, but it also enables the rapid spread of these diseases. Advances in science and technology are enabling us to respond to these outbreaks faster and more effectively; however, there is much room for improvement in this regard. To this end, in this article I present parallels seen between the recent outbreak of Zika virus in Brazil and the HIV pandemic experienced in the 1980s, highlighting actions and outcomes that are creating a similar response.

In late 1981, HIV became an epidemic in the United States, and soon after became a global pandemic.2 Initially thought to be a disease of male homosexuals, not much attention was given to the virus until it came to be considered deadly.3 Up to that point, it was hypothesized that HIV caused “minor” issues, such as Kaposi sarcoma.4 Soon after, however, the virus was identified as the cause of a weakened immune system that allowed multiple opportunistic diseases, such as pneumonia, to infect those who were already suffering with HIV.5 Because of a lack of expertise in the field, governmental financial aid to address the problem only arrived after a long scientific and political fight that required scientific proof of the presence of the infectious agent. This delayed researchers’ ability to improve their response to the pandemic and speed up research on HIV.6 During this time, medical professionals also learned a valuable lesson about preventive efforts, and how much they can save not only in terms of resources, but human lives.

Moving forward in time to late 2015, we can see parallels between the HIV pandemic and the impact of the Zika virus in Brazil. Initially thought to be only a mild disease, the virus was also given little attention until the point it was considered deadly.7 Before that, it was proposed that the virus only caused rash, fever, and joint pain; however, a connection was finally made between the virus and fetal neuropathogenesis, as well as Guillain-Barré syndrome.8,9 After these devastating effects were realized, government response and financial aid was deployed; however, this delay cost those affected much more than it would have if we had taken preventive measures sooner.

The histories of HIV and Zika overlap on several fronts as well, including where both diseases originated (Africa), their modes of transmission (although mainly transmitted by the Aedes aegypti mos­quito, Zika is also sexually transmissible, which raises the concern of it as a new STD10), and the response to them. Like HIV, Zika-infected pregnant mothers can transfer the virus through the placenta,11 which could com­promise the development of the fetus. Rates of sexual transmission of Zika are low, and from what we know so far, the virus does not stay in the host cells for longer than a few months.

Rates of HIV diagnoses per 100,000 people

Big advances in treatment can