What does need explanation, however, is why Brazil’s neighbour Colombia, reported to have had over 30,000 cases of Zika , including 5,000 in pregnant women, has not shown one case of microcephaly so far. Although this may be due to the fact that it takes time between an infection with Zika and subsequent neurological damage to occur, the Colombian government are considering downgrading their estimate of potential microcephaly cases, which had been based on the Brazilian figures. If there is not a spike in the microcephaly cases in Colombia later this year, the role of Zika in its causation may be more complex; other factors may be required in addition to the Zika virus.
Colombia has, however, reported a sharp increase in the other neurological condition associated with the Zika virus: Guillain-Barré Syndrome. This usually rare disease results when an individual’s own immune cells attack its nervous system, causing a progressive weakness of the muscles, often resulting in the patient being unable to breathe. The failure of the respiratory muscles which can occur with Guillain-Barré, means that in order to treat the affected patients, long stays in intensive care units (ITU) are often required whilst artificial ventilation is administered.
For some regions of the world which are affected by Zika, the provision of good intensive care units is relatively poor. The Caribbean, for example, has excellent intensive care facilities located principally in only Martinique and Guadeloupe. In fact, critically ill patients from surrounding islands are frequently evacuated to Martinique to receive superior medical attention. At present, however, the ITU in Martinique is said to have several long-term Guillain-Barré patients caused by the Zika virus, making the accommodation of other critically unwell patients very difficult. For those who need ITU services following traffic accidents or severe heart attacks, for example, there are few alternatives. In the Caribbean at least, the effects of Zika are casting a long shadow over the whole of their emergency healthcare provision. In Martinique, five more ITU beds are said to have opened this week.
Dr Simon Worrell, Head of Medical Communications, Healix International