When the Zika virus became a full-blown epidemic this year and global health officials began to anticipate its spread across the Americas, their worst fears settled on the place that looked most vulnerable: Haiti.
The poorest nation in the region appeared to be primed for a Zika explosion, with woeful sanitation, urban overcrowding, a threadbare health system and plenty of mosquitos.
But nearly six months after the first Zika cases were confirmed in Haiti, the most dire predictions have not materialized. That is the good news. The bad news is that no one is really sure why.
After the World Health Organization declared Zika a “global health emergency” in February, Haiti was tallying 300 infections a week. Now it’s down to about 30.
“The peak seems to have reached Haiti already,” said Jean-Luc Poncelet, the top official for the Pan American Health Organization (PAHO) in Haiti. “But we don’t really know.”
Haiti hasn’t registered a single case of Zika-related microcephaly, the congenital birth defect that results when the virus interferes with fetal brain development. The country has reported a dozen cases of Guillain-Barre syndrome, the sometimes fatal neurological disorder that Zika can trigger.
Across the border in the Dominican Republic, a more prosperous country with a slightly larger population and a significantly better health system, authorities have reported 123 cases of Guillain-Barre — more than 10 times as many as in Haiti.
While Zika is thought to be declining in South America, global health officials think the rate of new infection is increasing in the Caribbean. On Friday, the head of the U.S. Centers for Disease Control and Prevention, Tom Frieden, said the virus was spreading so fast in Puerto Rico that the island could see “dozens to hundreds of babies” with Zika-related birth defects in the coming year.
Haiti’s comparatively low infection numbers do not indicate that it is becoming Zika-free, or even that the outbreak is declining here, experts warn. Rather, they say, Zika’s mysterious trajectory in Haiti may reflect some of the inherent challenges in identifying what happens when the virus fans out across countries with l ittle ability to track it.
Unlike infections such as Ebola, or cholera, or even other mosquito-borne viruses like chikungunya and dengue fever, Zika produces no symptoms in as many as 80 percent of the people who get it. Others typically experience a low-grade fever, skin rash and joint pain that go away after a few days.
In a place like Haiti, that’s not enough for most people to seek medical attention.
“Most Haitians who get a fever don’t go to the doctor. They drink tea,” said Joseph Donald Francois, the national coordinator for cholera and Zika at Haiti’s Public Health Ministry. “I had Zika,” he added, with a shrug.
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SOURCE: The Washington Post – Nick Miroff