Playing hide and Zika with Aedes aegypti

For quite a while, I have wondered why the country of Brazil (“Brasil” to its citizens) has bothered to have an army. By law, military service is compulsory, but about 75% of its male citizens are excused because of lack of need.

A peace-loving people, the Brazilians have had no enemies in recent times. Hence, its military has not been called to defend the populace. Until now.

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Unless you have chosen to ignore the medical literature and lay press for the past several months, you know that the Zika virus-transmitted by a mosquito, Aedes aegypti-has recently come to the new world. First identified in Africa in 1946, the virus has found a susceptible population without immunity in South and Central America.

Sadly, the pathogen has been associated with microcephaly and potentially blinding ophthalmic malformations in the babies of women infected during pregnancy. The eyes of these newborns have been shown to have atrophic lesions in the posterior segment and optic nerve lesions. Up to one-third of the babies might be expected to have severe visual loss. The causal relationship is apparently not definitively established, but the virus has been found in the placentas and in the malformed brain tissue of children who did not survive.

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To fight the mosquito vector, Brazil has mobilized 220,000 soldiers who are going from home to home looking for the mosquitos and for standing water in which they might breed. Their goal is to decimate the population of the mosquitos and thereby protect pregnant women and their unborn children.

To play or not to play?

To play or not to play?

The clock is also ticking in that Rio de Janeiro, a former capital of Brazil, is due to host the Olympic Games in August. Speaking of the Olympics, according to Jacques Wagner, the Chief of Staff of Brazil's President, while travel of pregnant women to attend the games “is not recommended,” he also asserts “there's no chance Brazil will call off the games.”

According to Arthur Caplan PhD, professor of bioethics at NYU Langone Medical Center, however, "holding the Olympic Games in Rio de Janeiro as scheduled is senseless and irresponsible. It could be devastating to public health, to tourism, and to the image that Brazil is hoping to project to the world. Postponing the games for 6 months to a year would be good for athletes, spectators, and Brazil."

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The Brazilian military may make progress against the mosquito in time, but Caplan argues we should not be taking chances.

“The Olympic Games are a grand tradition, as well as big business,” he points out, “but in the end they are just games.”

To me, this is a tough call. But unless it is soon clear that Brazil and its military are very shortly eradicating the pathogen and its vector mosquito, my vote would be to follow the advice of Dr. Caplan and delay the Olympics.

And you, dear reader? If asked to balance the desires of athletes eager to compete after years of training and the host country's desire to conduct the games as scheduled versus the public health risk of the Zika virus and Aedes aegypti duo, what would you advise?

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