Zika Virus: controversy over abortion

On February 5, 2016, the United Nations (UN) requested that countries concerned by the Zika virus epidemic authorize women to have access to contraception and abortion. Three days earlier, on February 2, the World Health Organization (WHO) decreed a state of “public health urgency on an international scale”.

In terms of spreading, this arbovirus is a mosquito-borne virus transmitted by mosquitoes of the Aedes genus, leading to the Zika fever in human beings. The infection is symptomatic in only 18% of cases and its’ clinical diagnostic is difficult. The Zika virus is suspected to be linked to the Guillain-Barré neurological syndrome. For the moment the consequences to man are still largely unknown by specialists. The virus has been spreading since May – June 2015 in both Central and Latin America. In Brazil, more than 1.5 million people have been affected.

It is against this backdrop that in January 2016; a study was published demonstrating an unusual number of children born with microcephaly in South America since October 2015: out of 4,180 suspected cases, 270 have been confirmed. Health authorities suspect the source to be the Zika virus. For the moment, the causal relationship between Zika virus infection and neonatal malformations has not been formally established, but more advanced studies are currently underway.

Professor Yves Ville, head of the maternity unit at Necker Hospital in Paris, explains that “for other viruses, such as the cytomegalovirus, the placenta acts as a barrier. Not all infections in pregnant women are transmitted to the fetus.”

Jean-Yves Nau, doctor and journalist states: “We seem to be entering into a medical and scientific haziness here. Dr Isabelle Catala, in a paper dedicated to Zika on the Medscape site, resumes best this disagreeable sensation of uncertainty which prevails today. We could even say ‘uncertainty multiplied by 2’. Firstly concerning the causal relationship (still mentioned, never demonstrated) between the infection of the pregnant woman and fetal microcephaly. Secondly the measures to take (according to health authorities) faced with this hypothetical risk”.

In this context, the pressure to propose abortion to pregnant women is clearly a pretext: Silvia Camurça, SOS Corp president admitted that this epidemic offers a rare opportunity to push abortion forward in Brazil… In Brazil, abortion has been allowed since 1940 in cases of rape or risk for the mother, and more recently since 2012 for cases of anencephaly.

Women On Waves, an ONG in the Netherlands proposes mailing packages of abortion pills to countries affected by the epidemic or where abortion is limited. Invoking bad sanitary conditions for clandestine abortions, this ONG however recommends using these abortion pills up until 12 weeks of pregnancy without any medical care; whereas in France these pills are administered in a hospital environment and only up until 7 weeks of pregnancy.

It is important to recall that screening can only be performed during the first week of viral infection, where the majority of cases are asymptomatic. Additionally, one generally needs to wait for sonogram results to know if the fetus is affected by microcephaly, which in principle is not diagnosed before 32 weeks; meaning practically at birth.

Currently there is neither treatment, nor vaccine available, and the authorities have delayed responding to the contamination: for the moment prevention consists in distributing anti-mosquito products. On February 6, there were massive demonstrations in Honduras and Brazil, the countries most affected by the epidemic. Carissa Etienne, the director of the Pan-American Health Organization, following an emergency meeting with the Health Ministers from 14 Latin American countries, explained that “the response to this problem will focus on fighting against the mosquito-borne virus transmitter.”