David E Bratt, MD

By now every­one knows about Zi­ka. It's all over the press.

It's named for a for­est just out­side Ugan­da's cap­i­tal, Kam­pala, where it was first iden­ti­fied in a mon­key in 1947. It is not con­sid­ered a threat in Ugan­da and there has nev­er been an epi­dem­ic there.

Cli­mate change, over­crowd­ed pop­u­la­tions with no re­sis­tance to the virus, poor san­i­ta­tion, easy in­ter­na­tion­al trans­porta­tion and world sport­ing events (it prob­a­bly got in­to Brazil from Tahi­ti dur­ing the 2014 FI­FA World Cup), have all played a part in its spread.

There have been more than a mil­lion cas­es in Brazil. That in­cludes near­ly 4,000 cas­es of mi­cro­cephaly in new­borns, a rare and in­cur­able de­for­ma­tion of the brain which re­sults in an ab­nor­mal­ly small head and se­vere men­tal re­tar­da­tion for life.

Brazil usu­al­ly re­ports about 150 cas­es a year. In the poor­er north-east re­gion, about one per cent of new­borns now have mi­cro­cephaly. Maybe it's be­cause of Zi­ka. Maybe it isn't.

It's next door, over 5,000 sus­pect­ed cas­es of Zi­ka have been record­ed in Venezuela, and it is in Guyana and Bar­ba­dos and the first case has just been re­port­ed in Ja­maica.

It caus­es a mild dengue-like ill­ness. On­ly one in every five peo­ple who get it feel any­thing, sud­den on­set of fever, the rash, some joint pain and con­junc­tivi­tis (red, itchy eyes). It can last for up to a week.

The main way you catch it is by be­ing bit­ten by the same friend­ly mos­qui­to liv­ing in or around your house that has been trans­mit­ting dengue and Chik V and which you have re­fused to do any­thing about, con­tent, like most Tri­nis, to crit­i­cise some­body else, the gov­ern­ment, traf­fic, BC Pires or the fem­i­nist move­ment.

There is no vac­cine, no wide­ly avail­able test and no cure for Zi­ka. The on­ly way to stop this thing is to get rid of the mos­qui­toes. Mos­qui­toes breed in stand­ing wa­ter in plant pots, old tyres, buck­ets, trash cans, so peo­ple should rid their im­me­di­ate area of things that can col­lect wa­ter. Spray­ing in pub­lic is very sat­is­fy­ing, "car­ing for we syn­drome." The sick­ly sweet smell of malathion is im­pres­sive, but it's does lit­tle.

You can al­so stop the bites by wear­ing clothes that cov­er arms and legs, es­pe­cial­ly the feet (the Aedes loves feet) us­ing air-con­di­tion­ing and screens and in­sect re­pel­lents con­tain­ing DEET. Per­son­al re­spon­si­bil­i­ty, how­ev­er, is a con­cept for­eign to Tri­nis.

The prob­lem with Zi­ka is the mi­cro­cephaly. Oc­ca­sion­al­ly an adult gets paral­ysed but in gen­er­al it is women and their chil­dren who may suf­fer. That's why it is "sooo" fun­ny (Hah hah hah!) to hear all these Trinida­di­an males mak­ing de­c­la­ra­tions about the dis­ease.

One of them had the gall to tell moth­ers to have "pos­i­tive thoughts" if they caught the dis­ease while preg­nant. No doubt the IRO spokesman who made this com­ment has plans in place for his or­gan­i­sa­tion to take care of the dozens of se­vere­ly re­tard­ed mi­cro­cephal­ic chil­dren that may be born when poor moth­ers con­tract Zi­ka.

Poor be­cause, 1) it is pre­cise­ly the poor­er neigh­bour­hoods which lack run­ning wa­ter and prop­er waste man­age­ment in con­junc­tion with over­crowd­ing and poor hous­ing that will suf­fer from Zi­ka the most, while 2) women with mon­ey will have abor­tions done as they al­ways have had in T&T while at­tend­ing church and mosque and tem­ple and par­rot­ing inani­ties.

In the mean­time some gov­ern­ments are ad­vis­ing women (women again) to avoid preg­nan­cy, as if preg­nan­cies in Latin Amer­i­ca and the Caribbean are planned, you see.

Ex­pec­tant moth­ers are al­so be­ing told to stay away from this sum­mer's Olympics in Rio de Janeiro.

Air­lines (Unit­ed, Amer­i­can and British) have start­ed of­fer­ing re­funds on tick­ets to coun­tries af­fect­ed by Zi­ka virus­es. So have some ho­tel chains.

To make things a bit more in­ter­est­ing, two cas­es sug­gest the virus could al­so be spread through sex.

In 2008 an Amer­i­can bi­ol­o­gist work­ing in Sene­gal in a mos­qui­to-in­fect­ed area re­turned home to Col­orado, de­vel­oped a flu-like ill­ness, lat­er con­firmed as Zi­ka. A few days lat­er so did his wife who had not been to Africa. There are no mos­qui­tos that trans­mit Zi­ka in Col­orado. Their chil­dren did not get sick. The most like­ly ex­pla­na­tion was that they had had sex, as ex­pect­ed, short­ly af­ter his re­turn. Then he got sick. Late in his ill­ness, the good doc­tor had had gen­i­tal pain and what ap­peared to be blood in his se­men.

In 2013 French sci­en­tists study­ing an out­break of Zi­ka in Tahi­ti, found high lev­els of Zi­ka virus in the se­men of a 44 year old man with Zi­ka, even af­ter the virus had dis­ap­peared from his blood. It was al­so found in his urine.

This is what we know. What we don't know about it is even scari­er. In a coun­try af­fect­ed by Zi­ka, how many peo­ple will get in­fect­ed? Does preg­nan­cy make a woman more sus­cep­ti­ble to the in­fec­tion? Do all ba­bies of women in­fect­ed with Zi­ka in preg­nan­cy get mi­cro­cephaly? Does it mat­ter when the woman gets the Zi­ka in­fec­tion? Are there oth­er neu­ro­log­i­cal prob­lems?

On the pos­i­tive side, if Zi­ka takes off in T&T this Car­ni­val and moth­ers be­gin hav­ing mi­cro­cephal­ic ba­bies by Sep­tem­ber, that may trig­ger off a na­tion­al de­bate on abor­tion.

You can't re­lax around mos­qui­toes and mess around with cli­mate change. First it was dengue, then Chikun­gun­ya, then Ebo­la, now Zi­ka on the march in the last 18 months. There are oth­ers out there, you know. They com­ing like Moko.