April 18, 2016

The Zika Outbreak: What Can Canada Do?

By

Y. Annie Cheung, PhD, RPP

When we wake up to songs of chirping birds, we know spring is at our doorstep. When a polar front is gradually retreating, we begin to think of summer, dreaming of sunny days and outdoor living, hiking, and sandy beaches. It’s usually the time to make holiday travel plans!
But wait, travel planners. How much do you really know about the Zika outbreak? Already twenty Central and South American countries have reported cases of the virus. An anticipated outbreak this summer may well spread to parts of North America as well as to the South Pacific. Fortunately, according to the Pan American Health Organization, Canada and Chile will most likely be spared.
Nevertheless, while Canadian health authorities maintain that the type of mosquito that carries the virus is not present in Canada, by April 14 we already had 46 travel-related cases. While the Zika virus is spread by certain types of mosquito, it can also be transmitted through contaminated blood from infected donors, as well as through sexual transmission of the virus present in semen. Since Zika virus has spread through Central and South America, a large pool of the blood supply needs to be carefully screened for the presence of the virus. Problems in the blood reserve might necessitate backup from sources external to the infected areas. On March 30, the U.S. Food and Drug Administration took a significant step by making available an investigational test to screen domestic blood donations for Zika virus.

Starting from February 5, 2016, the Canadian Blood Services took steps to mitigate the risk of the virus entering the Canadian blood supply by implementing a 21-day wait period for blood donors. Other measures like mosquito nets are apparently of limited use since the targeted mosquitoes identified are mainly active in the daytime.

While Zika symptoms vary, they often include headache, fever, rash, joint pain, conjunctivitis, or complications in pregnancy resulting in stillbirths and blindness. This week it was confirmed that microcephaly in newborns can result from the virus passing through blood barriers in the womb from mothers who contracted the virus before or during pregnancy. These babies are born with abnormally small heads, resulting from failure of the brain to grow at a normal rate. Since the recent outbreak, 4,700 cases of microcephaly have been reported in Central and South America. Severe effects of Zika infection for adult patients can include the Guillain-Barre syndrome, a nervous system disorder.
Fortunately for Canada, its temperate climate and living conditions have not been easy breeding grounds for Zika-carrying mosquitoes, and for the time being, we are expected to be free from these mosquitoes. Accordingly one might anticipate Canadian travelers will make the wise decision to spend summer holidays closer to home. There’s a cost to be sure – with a drop-off in “destination weddings” in sunny locales and exotic tropical resorts. While it’s clear that the anticipated Zika outbreak could turn these plans into very reckless endeavours for both hosts and guests, will Canadian hospitality entrepreneurs and tourist promoters be nimble enough to sell alternatives to Canadian holiday-goers and would-be brides and grooms?
Canada may also consider extending a helping hand to our southern neighbours, who are seeking a “baby refuge” — Yes, a safe place for prospective parents free from worries of being bitten by the Zika virus carrying mosquitoes. Canada, with its pristine amenities and hospitality infrastructure, may be just that safe haven and one not far from home for our neighbours in the Americas. What’s unclear is whether the existing provisions and capability exists in Canada to service the growing need and to take advantage of related opportunities. In other words, do we have spare capacity in our housing and rental markets to fill demand over the short-term? Is our healthcare and natal care system up to snuff to provide for this “niche market”, including with respect to support services like midwifery, medical practitioners and suitable healthcare insurance? Will the Canadian immigration rules and existing bilateral agreements be able to accommodate, appropriately, this new and special market need? Can Canada look beyond existing categories of legitimate travel and short-term stays, such as student visas and tourism, to capture and respond to the demand arising from public health crises within the Americas? Can this also be a part of Canada’s job creation strategy?
Other questions follow.
Does Zika pose a new kind of public health crisis, one with likely regional (if not yet international) ramifications that should lead to a rethinking of parochial parameters for response and preparedness? What, if any, ethical quandaries are posed by a reframing of the issue from purely humanitarian to one that includes market principles to meet the growing demand for services and a safe haven to grow families over the next few years? How can Canada make a difference to those most in need, as well as those who can pay? Do these have to be mutually exclusive?
Meanwhile, Canada strives to maintain a Zika virus-free environment. A Canadian researcher, working with a Mexican team, has developed a mosquito trap, called “ovillanta”, whose inexpensive DIY design together with a prescribed procedure, has proved to be very effective in disrupting the lifecycle of mosquitoes in the Mexico field study.
We might also begin to imagine how Canada could, through its entrepreneurial spirit, make gains from serving these sojourners – ie, the young couples who feel that they have had the choice of expanding their families taken away. Canada can offer them hope, helping them to overcome their immediate predicament while the Zika virus is in full force in their homelands, with no effective treatment, vaccine or panacea in sight.