WASHINGTON DC and SAN JOSE, COSTA RICA – The Pan American Health Organization says Latin America will have between 2 million and 3 million Zika cases, warning that the 100,000 cases reported thus far do not reflect the magnitude of the situation because many infected people with either no symptoms or very mild ones do not go to the doctor.

“That figure does not represent the scope we think Zika has. We need better diagnostic tests. Brazil has already estimated that it will have 1.3 million (cases) and Colombia a half million,” Marcos Espinal, the director of PAHO’s Department of Communicable Diseases and Health Analysis, said Friday at the American Association for the Advancement of Science’s annual meeting in Washington.

The expert based his estimate on Latin America’s 2015 tally of 2.3 million cases of dengue and 600,000 of chikungunya – viral diseases that, like Zika, are transmitted by the Aedes aegypti mosquito.

“It wouldn’t surprise me if we had 2 or 3 million Zika cases because we’re seeing that the mosquito transmits (that disease) as or more effectively than chikungunya,” Espinal said.

Latin America is the region hardest hit by the current Zika epidemic, accounting for 26 of the 30 countries and territories where local transmission of the virus has been reported.

“The entire population is at risk because the virus is new in the hemisphere, and therefore no one has immunity,” Espinal said.

The expert stressed, however, that it was still too early to say that Zika was the direct cause of a surge in Brazil in the number of babies born with abnormally small heads, a condition known as microcephaly.

“We can only talk about a potential link. Brazil and Colombia are conducting case studies that will tell us a lot about this question,” Espinal said.

The World Health Organization’s director of strategy, Christopher Dye, said for his part that “the case for a causal link” between Zika and microcephaly “is quite strong.”

“We should now say that Zika is guilty until proven innocent,” he added.

Dye said there would be many more microcephaly cases in Latin America, although he acknowledged that it was impossible at this time to offer a more precise prediction.

Brazil has reported 4,000 cases of microcephaly, and the number of cases in Latin America is going to rise, Dye said, adding that the explosion in the number of babies born with that condition was a “cause of great concern.”

Costa Rica could see up to 60,000 Zika cases, health official says

Medical epidemiologist and newly-appointed coordinator of Costa Rica’s National Disease Vector Control Program, Rodrigo Marin Rodriguez said that Costa Rica could see up to 60,000 cases of Zika infection in a worst case scenario in an interview published by the daily La Nacion on January 29th.

Marin bases his “worst case” scenario on estimates from Colombia, which currently has an indigenous outbreak of Zika and where conditions are very similar to Costa Rica.

According to Marin, officials there expect 600,000 cases of Zika and 500 cases of microcephaly, in a country of 50 million inhabitants. Given the similarities between the two countries, Marin thus estimates that Costa Rica could see some 60,000 Zika cases amongst the country’s 5 million inhabitants.

Marin said that the government plans to aggressively eliminate mosquito breeding sites throughout the country, but urged the public to also do their part in ensuring to eliminate mosquito breeding sites in and around their homes, and to take all measures possible to avoid mosquito bites.

 

Despite potential, Costa Rica argues it should be removed from warning list

Despite what some experts describe as an almost “inevitable” outbreak of Zika in Costa Rica, the country has so far registered only a single case in which it is highly believed that a patient contracted the virus in-country.  As such, Costa Rica requested this week be to removed from a list of countries with active, indigenous transmission of the virus.

Costa Rica’s Ministry of Health on Tuesday sent a formal request to the World Health Organization (WHO) asking to be removed from the list, while Minister of Health, Fernando Llorca said that in the view of Costa Rican health officials, there is no evidence that the virus is actively circulating in the country at this time.

On February 2nd, the US Centers for Disease Control (CDC) included Costa Rica in a list of countries where Americans should avoid travel as a result of the virus, after a tourist from the United States fell ill with the virus after visiting the country. The WHO followed suit three days later.

While many Costa Rican health officials have described as “likely” that the tourist in question did in fact catch the virus while visiting Costa Rica, officials say that the case is still not fully confirmed, and that there have been no other cases of indigenous transmission of the virus either in the province of Guanacaste, where the tourist had visited, or anywhere else in the country.

Costa Rican health officials also say they continue to wait for additional information from the CDC in order to determine conclusively if the tourist contracted the virus in Costa Rica or elsewhere.

Meanwhile, lab tests have ruled out some 30 suspected cases of Zika as negative.

Besides the US tourist, Costa Rica has only two other confirmed cases of Zika, both imported from abroad. One case was confirmed in a Costa Rican man who had returned from a trip to Colombia, where he is believed to have contracted the virus. The second case was in a man who was visiting from Honduras.

 

Costa Rica draws battle plans to fight Zika-spreading mosquito, including use of bacteria

Health Minister Llorca and Security Minister, Gustavo Mata announced on Monday plans for a massive mobilization of some 14,000 workers from the Ministry of Public Security (MSP) to be deployed alongside workers from the Ministry of Health to fumigate and eliminate breeding grounds of the Aedes aegypti mosquito, which spreads the Zika virus as well as dengue and Chikungunya.

Dr. Lllorca said that given the pressing need to fight the mosquito, it is necessary to involve all sectors of Costa Rican society, including workers from the MSP – which includes police and other security officials – to fight the threat posed by the mosquito. “Other countries have deployed their militaries to fight them [the mosquitos], so we need their help,” the health chief said.

“Costa Rica is facing a very difficult situation in eradicating this mosquito, the plan is that 14,000 officials (from the MSP) with assist officials (from the Ministry of Health); If vehicles, helicopters, or boats are needed to transport health officials, we will provide them, in order to respond promptly,” Minister of Public Security, Gustavo Mata said.

Security personnel will also assist health workers in gaining access to private property where mosquitos are believed to be breeding, officials said.

Earlier this month, Costa Rica’s Ministry of Health announced it also plans to use a bacteria to fight the mosquito.

The bacterium, known as Saccharopolyspora spinosa, is the only bacterium known to secrete spinosad, a natural pesticide consisting of spinosyn A and spinosyn D and which kills mosquito larvae in 48 hours, according to Costa Rican health officials.

According to the National Insitutes of Health (NIH) in the United States, the bacterium has no toxic effect on humans.

The bacterium is applied in tablet form to standing water where mosquitos are believed to be reproducing. The tablets can also be used in potable water tanks and storage facilities.

While the bacterium is effective in destroying mosquito larvae, it is not effective on adult mosquitoes, according to Costa Rica health officials.

In a statement, Costa Rica’s Ministry of Health described the bacterium as “the best choice in biological technology to control [mosquito] larvae available in the market,” adding that a single application can control breeding for 10 weeks, even with water circulation rates of up to 80 percent.

The bacterium is expected to be deployed in areas such as drainage ditches, streams, ponds, fountains, potable water storage areas, and other places where the mosquitos reproduce. The bacterium is also expected to be deployed at hotels, schools, industrial sites, and other large facilities.

 

Microcephaly not the only concern as Honduras registers 35 cases of rare nerve disorder linked to Zika

Honduran health authorities reported Tuesday that they have registered 35 cases of the nerve disorder known as Guillain-Barre syndrome linked to the Zika virus.

“At this time, we have 35 cases of Guillain-Barre, of which one adult and one little boy are on artificial respirators,” Deputy Health Minister Francis Contreras, accompanied by World Health Organization representative Ana Treasure, said at a Tuesday press conference.

Guillain-Barre syndrome is a disorder in which the body’s immune system attacks part of the peripheral nervous system, leading to numbness, muscle weakness and, in extreme cases, paralysis.

The link between Guillain-Barre and Zika is “rather high,” Contreras said.

EFE contributed to this report.