Zika, Like Rubella, a Game-Changer?

I’ve been collecting links on the Zika virus for weeks now.

If you haven’t been keeping up, here are some points to know:
• there isn’t a concrete link yet between reported cases of microcephaly and the Zika virus in Central and South America;
• some researchers in Latin America suggest that it is not Zika but a Monsanto-linked larvicide causing microcephaly;
• microcephaly is a variable diagnosis depending on the size of the head, unlike anencephaly, which literally means “no in-head”;
• microcephaly is also a variable condition affecting some infants not much, others catastrophically;
• microcephaly cannot be reliably diagnosed in utero until quite late in pregnancy and then, see above for variable diagnosis and prognosis.

So, while this is a fascinating epidemiology narrative, it has devastating consequences for the region.

And may well serve as a game-changer in reproductive rights.

Several writers have drawn parallels between the Zika and Rubella viruses.

The Guardian:

It’s early spring in London. Some of Britain’s leading medical researchers have convened to discuss alarming new evidence linking a virus long presumed to be harmless with a spate of defects in newborn babies. It’s not 2016, it’s 1946, and the disease is not Zika, but German Measles, or Rubella.

The writer goes on:

Such women [infected with Rubella and seeking an abortion], historian Leslie Reagan has eloquently argued, were ‘moral pioneers’. The accidental combination of pregnancy and disease put women in the complicated position of having to assess scientific information about the probability of foetal malformation, and confront the anxieties and uncertainties associated with either terminating a pregnancy or carrying it to term. Not all medical practitioners agreed that infection with Rubella in early pregnancy justified abortion. But many did, to the extent that termination had become the ‘recognised treatment’ for maternal Rubella in British hospitals at least a decade before abortion was made legal.

But beyond individuals’ ethical and medical quandaries, there is now in Latin America a helluva public health mess.

Ilana Löwy, historian of science and medicine, writes:

Brazil is facing an epidemic of a severe birth defect: microcephaly (abnormally small head size), a condition linked with important neurological impairments and developmental delays.

Brazil, don’t forget, is also hosting the Olympics this summer.

Brazil and other countries are focussed on trying to control the spread of Zika infection, as Löwy says, “undoubtedly an important goal, but difficult to achieve rapidly.”

But the point here, as with Rubella, is that even if the cause of microcephaly can be nailed to Zika and even if a rapid diagnosis for Zika-infected fetuses is devised, what bloody good will it do?

Abortion — and in many countries in the region, contraception as well — is pretty much totally illegal.

So, there will be not only thousands, perhaps tens of thousands, of panicky women demanding some recourse, but there will be entire states gazing with despair at a generation of brain-damaged children.

Löwy again:

Microcephaly is scary. As reported in an article published by BBC Brazil on December 15, 2015, pregnant women in rural zones of Pernambuco say they are terrified by what they know about the zika epidemic and its consequences. Brazilian doctors have no answer to their fears. Public health experts are predicting 15,000 cases of microcephaly—and possibly up to 50,000 zika-induced birth defects—before the end of 2016. When asked about the possibility that women will be allowed to abort fetuses at risk of birth defects induced by zika, the answer is: “Abortion is a crime.”

In response to the Rubella epidemic, many doctors in Western countries acted in the best interests of their patients and risked their careers to offer terminations.

Löwy concludes: “One must wonder whether Brazilian doctors’ unwillingness to consider interventions beyond the strict limits of the law reflects such strong convictions, or is influenced also by the fact that the majority of women at high risk of giving birth to children with microcephaly live in poor, often neglected areas.”

And Brazil is just one of the affected countries (animated map of Zika’s spread).

Will Zika start to change the discussion of women’s own moral agency as Rubella did? Will a massive public health emergency force priest-ridden states to reconsider privileging medieval views over ordinary citizens’ well being?

We live in hope.