Why we will fail in the fight against Zika

zika

By Dr Amar-Singh HSS

I hope the title has encouraged you to read this article. It is not meant to be pessimistic but a realistic look at our current situation. The opinions expressed here are personal and do not reflect those of the organisation I work with.

As we stand today as a nation, with our poor health behaviours, the Zika epidemic that is coming (if not already here) will hit us hard.

The following realities or facts are the reason for my statement:

  1. The Zika virus is spread mainly by infected Aedes mosquitoes and also by sexual transmission. Our nation is ‘rich’ with Aedes mosquitoes.
  2. The virus is new to us, we are not immune to it, there is no definitive drug to treat it and any vaccine will take a few years to be developed and tested.
  3. Most importantly we have failed as a nation in our fight against dengue, and the same mosquito vectors carry Zika.

Dengue may kill, but if you recover you become well again.

Zika will maim and cause significant disability, especially to unborn children. And as we are still not immune to it, large numbers have the potential to be infected. Imagine all our children that may become disabled as a result of this virus. The numbers from countries struggling with the Zika virus are frightening, even to me as a medical consultant. Current evidence suggests that between 15-20 per cent of infected pregnant mothers will have a baby with brain damage, especially in early pregnancy.

We may want to believe that we can prevent Zika from reaching Malaysia but that is a myth. The symptoms of the Zika virus disease are very common (fever, rash, headache, red eyes, etc) and many people infected with Zika will have mild symptoms or no symptoms.

The best way to prevent Zika is to prevent mosquito bites. This means getting rid of Aedes mosquitoes. The public will demand that the Ministry of Health (MOH) take action on this, like they have for dengue. But Zika, like dengue cannot be controlled by the MOH alone, but only with the involvement of the people of this country, every person.

Vector borne diseases require us either to avoid the vector (preventing mosquito bites is not easy) or removing the vector (preventing mosquito breeding which is possible). But we are a dirty nation. We like to believe it is a minority that throw rubbish and the majority are civic minded. But the reality is that many Malaysians throw rubbish anywhere they like. A visit to recreational areas will show you how trashed we are. Our cities are rubbished, drains choked and even hospital compounds littered by visitors.

We have a small window of opportunity to prevent the wide spread of Zika virus in the nation. Every single Malaysian needs to act today to prevent Zika transmission.

We need to aggressively, proactively and consistently keep our home compounds, our neighbourhoods and our cities clean. We must empower our authorities to take action against those who do not do so and endanger the health of our children. These include construction sites, recreational areas, public amenities, etc. Our politicians must not be allowed to interfere when compounds are issued for mosquito breeding at projects or development sites – governmental or private. Our city councils must really work, not claim to work. We must work as communities to change our recalcitrant neighbours.

Some will say it cannot be done but this is not true. Singapore has been able to reduce its Aedes household/premises index (percentage of facilities breeding Aedes) from 50 per cent in the 1970s (i.e. every other house) to 0.2 per cent in 2013.

When our children become disabled as a result of Zika, let’s not blame others but ourselves as a nation.

Zika and Dengue prevention are the responsibility of all Malaysians.

We will win this fight as a nation united or not at all.

Dr Amar-Singh HSS is a senior consultant paediatrician.

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