In an effort to get ahead of Zika virus epidemic, the Centers for Disease Control and Prevention (CDC) is collaborating with a familiar U.S. partner country: Colombia. But instead of the military aid that usually marks this relationship, American public health resources are making their way to the South American nation. A delegation from the 2016 Zika Virus Response team recently returned from Bogotá, where they lent their expertise to their Colombian counterparts in the battle against Zika virus. The country is home to the second-highest number of cases of Zika virus outside of Brazil, with numbers hitting nearly 47,700 cases according to the country’s National Health Institute (INS).
“Our goal here is to collaborate with the INS and the Ministry of Health in Colombia on the Zika response,” says Dr. Peggy Honein, the Pregnancy and Birth Defects co-team lead for the 2016 CDC Zika Virus Response team. “This an urgent public health situation and we want to work together to address this in the best way possible to particularly focus on pregnant women with Zika virus disease and their infants.”
Zika is a mosquito-transmitted virus that scientists believe may trigger birth defects when the mother is infected during pregnancy. As of early March, Colombia reported 8,890 cases of pregnant woman infected by Zika, with 1,237 reported in just the previous week. Additionally, at least one case of Zika-linked microcephaly, a birth defect that results in an abnormally small head and cognitive impairment, has been reported in the country.
One of the challenges of Zika virus is that so little is known about how it affects the people who become infected. Scientists have struggled to keep up with the rapidly expanding numbers of cases of this relatively new disease—previous outbreaks have been small and isolated. Health organizations, including the CDC and the World Health Organization, are still lacking sufficient evidence to decisively say that there is proof of a link between Zika and microcephaly or Guillian-Barre Syndrome.
In Brazil, the birth defects and paralysis came as a surprise to doctors and health experts. They were left depending on retrospective studies to try to figure out what happened and how the new outbreak of Zika they were also seeing might be linked to these devastating medical conditions.
Colombia will be different. The CDC is working with the INS to take advantage of the lessons learned in Brazil by setting up an expansive health surveillance system to track the exact course of the virus. They’ll know who is infected, and they’ll know what happens to them. “A key to this collaboration is that we are making sure that we are using the same processes for surveillance in Colombia as is being used in other countries…so that the conclusions that are coming out of this collaboration are very thoughtful and careful conclusions,” says Martha Lucía Ospina Martínez, the director of the Colombia INS.
Health experts in Colombia are focusing on tracking the pregnancies of women infected with Zika virus. They want to know what factors—such as the timing of infection during pregnancy—make a fetus more or less susceptible to microcephaly. But they want to take it a step further and continue medical surveillance for a full year after birth.
“With some other viruses there can be later onset problems like hearing problems or eye problems, so we really want to monitor the health of children even beyond birth,” says Honein. “Obviously microcephaly is a serious outcome, and we are very concerned about microcephaly, but when I look at other viral infections like rubella or cytomegalovirus, you can have microcephaly with those infections but you can also have a lot more subtle affects with those infections.” In Brazil, one peer-reviewed study has already found a link between babies exposed to Zika virus in the womb and being an increased risk for vision-threatening conditions.
As Zika continues to spread north, the CDC is investing in Colombia with hopes of being able to better tackle the disease as it permeates the U.S. Through information and technology sharing, experts seem confident that they are finally getting a jump on the disease. “We are really hoping to understand in Colombia is the full range of outcomes that might be associated with Zika virus disease,” says Honein. “Things are progressing very, very well and it’s an extremely positive collaboration for CDC.”