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Past Outbreaks Offer Clues To How To Deal With Zika Virus


Let's turn once again to the Zika virus, which has dominated the news. The latest, a study just published in the Journal JAMA Ophthalmology finds that eye damage is another birth defect likely associated with Zika. The virus is now spreading across the Americas after seeming to come out of nowhere. But Zika does have a history, and our next guest has followed it. Microbiologist Duane Gubler has spent decades studying emerging infectious diseases, and among the latest, Zika. Good morning.

DUANE GUBLER: Good morning.

MONTAGNE: You, as I've just said, have been studying the Zika virus since clearly well before it got on most people's radar screens, certainly here in the U.S., especially, I gather, outbreaks on the island of Yap and also in French Polynesia. Tell us about those places.

GUBLER: Well, in 2007, when the Yap epidemic occurred, it was reported first as a dengue epidemic. But the clinicians there thought that it was clinically unique and different from dengue. But it became quite clear that we couldn't diagnose it. So I suggested they send it on to the CDC. And the rest is history. They diagnosed it as Zika, which was a surprise to everyone because Zika has been known for probably six or seven decades, but it's never been on anyone's radar screen because it's never been perceived to be a public health problem.

MONTAGNE: Having seen Zika in its early move across towards the Americas, what did you think about it?

GUBLER: It was not thought to cause severe illness. We didn't really take to heart the lesson of Yap until it showed up about six years later in French Polynesia. The difference there was it was associated, temporally at least, with the emergence of an autoimmune disease called Guillain-Barré Syndrome...

MONTAGNE: ...In adults.

GUBLER: In adults, yes. It was a much larger epidemic - over 30,000 cases. But even at that point, in 2013 and 2014, the alarm bells didn't ring.

MONTAGNE: Could the alarm have been sounded earlier? Could what's happened in Brazil have been prevented?

GUBLER: I don't know that we would have ever prevented what happened in Brazil. There are too many factors involved. I think, though, we have an epidemic, and we study the epidemic, and then we forget about them. If we would have studied the Zika virus a little bit more and followed it, we would have probably detected it earlier when it came into the South Pacific. If we would have done that, we may have been able to contain the virus. And if we had done that, we may have been able to prevent it from going to Brazil. Those are big ifs. But the point here is we never do anything to prevent disease. We wait for a crisis to occur, and we try to react. And it's always too little, too late.

MONTAGNE: You have said that the end of aggressive mosquito eradication efforts in the 1970s contributed to the spread of diseases. What about Zika?

GUBLER: Well, we were very successful in controlling Aedes aegypti, the principal factor of Zika and yellow fever and dengue and chikungunya. In fact, Brazil actually eliminated it from that country twice. And it was eliminated from about 22 other countries in tropical America. And it was so successful that it actually prevented epidemic yellow fever, and it also prevented epidemic dengue, so that during the 1960s and the end of the '70s, dengue was not even known in that part of the world. So policymakers in their wisdom don't like to spend money on diseases that don't occur. And even though people sounded the alarm and said that Aedes aegypti would re-invade those countries, they disbanded the program. And so yes, if they would have maintained that program, they would have prevented this Zika epidemic.

MONTAGNE: Thank you very much for joining us.

GUBLER: You're welcome.

MONTAGNE: Duane Gubler is the founding director of the Program on Emerging Infectious Diseases at the Duke National University Medical School in Singapore. Transcript provided by NPR, Copyright NPR.

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