Brazil Struggles to Contain Zika Virus – Wall Street Journal

SÃO PAULO—As Brazil scrambles to contain the Zika virus, some health authorities here say an initially slow government response and a deep recession have hampered efforts to curtail an epidemic that is now threatening to spread across the Western hemisphere.

Brazil is ground zero in the Americas for three genetically similar mosquito-borne diseases—dengue, chikungunya and Zika—that have hit record levels here in recent months.

Global attention has turned in particular toward Zika, which many health authorities believe can cause microcephaly, a condition in which human fetuses develop undersized brains and skulls when a virus or other harmful agent is transmitted through the placenta of an infected mother.

As many as 1.5 million Brazilians may be infected with Zika, slightly fewer than the record 1.65 million who contracted dengue last year. The South American nation has reported more than 3,500 cases of microcephaly, which also has surfaced in Puerto Rico and in the case of a Hawaiian newborn whose mother lived in Brazil for at least part of her pregnancy.

Those U.S. cases last week prompted the Centers for Disease Control and Prevention to issue a warning for pregnant women to avoid traveling to Brazil and several other Latin American countries.

But no country has been hit harder by the virus than Brazil, and some health analysts here believe the government’s reaction so far has been slow and inadequate.

“The initial response…was to overlook its importance,” said Dr. Artur Timerman, a leading specialist who is president of the Society of Dengue and Arbovirus, a nongovernmental organization. “It was said that Zika was a poor cousin of dengue, without much relevance.”

Dr. Timerman attributed Zika’s rapid spread, in large part, to Brazil’s economic recession, which he said has weakened the nation’s infrastructure of laboratories and other primary-care services.

He predicted the country could eventually tally as many as 100,000 microcephaly cases. He believes Brazil needs to be working more closely with the CDC, the World Health Organization and other international agencies to develop a vaccine.

“We cannot act as Pollyanna and think it will all be fine,” he said.

Brazilian health authorities say they have mounted an unprecedented offensive to combat the Aedes aegypti and Aedes albopictus mosquitoes that transmit Zika. Those efforts include working with schools to educate the public about preventative measures, and deploying army troops to search for and remove stagnant water supplies, such as pools and rain-trapping debris, where mosquitoes can breed.

“We are fighting against Aedes like never before in history,” said Marcelo Castro, Brazil’s health minister.

Mr. Castro rejected claims that the economic recession has impeded the government’s anti-Zika campaign. He said the federal budget for combating mosquito-borne viruses will be about the same as last year’s $ 300 million, plus an additional $ 125 million this year targeted at microcephaly.

Mr. Castro said that in coming weeks Brazil will develop and distribute a rapid diagnostic test for the three viruses, and that it will be compulsory to notify health authorities of all Zika cases by “no later than the end of June.” The total number of Brazilian Zika cases is unknown because not all infected persons develop symptoms or receive medical care.

There is no vaccine for Zika, but Mr. Castro has said federal funds will be directed to the São Paulo-based Butantan Institute, a biomedical center, to develop a Zika vaccine “in record time.” In an interview this month, the institute’s director, Jorge Kalil, said Butantan is in the third and final stage of testing a new dengue vaccine but noted that a Zika vaccine is still several years from development.

“Undoubtedly the economic recession in Brazil hinders the fight against the disease and even research on the subject, since there is a lessening of resources,” Mr. Kalil said.

Last week, the CDC issued an advisory to pregnant women to avoid traveling to Brazil and other countries where Zika has been found, including Mexico, El Salvador, Colombia and Panama. In Brazil, the impoverished northeast has been particularly afflicted: About one-third of the country’s reported microcephaly cases have occurred in Pernambuco state.

Iran Costa, health secretary of Pernambuco, said he couldn’t explain why his state has been so adversely affected, but affirmed that the economic crisis had reduced municipal health authorities’ staffing levels.

“The economic crisis had no influence in the beginning of the problem, but surely the economic recession hinders coping with the disease,” he said.

The virus also has been spreading fast in Rio de Janeiro state, where a number of hospitals face funding shortfalls; some even closed temporarily late last year for lack of money and supplies.

Luiz Antonio de Souza Teixeira Jr., Rio de Janeiro’s health secretary, said the state’s health-funding crisis stemmed in part from a drop in oil royalties paid to the state by the slumping local petroleum industry. Still, he believes the worst is over. He said Zika cases may peak during the current rainy season, which ends in March, several months before Rio de Janeiro will host the Summer Olympic Games in August.

“With relation to the Olympic Games, I do not see risks to the games and for tourists,” he said.

Brazilian health authorities are testing other measures to combat the virus, including a $ 500,000 project at the Fiocruz Institute in Rio de Janeiro to release mosquitoes infused with a bacteria that inhibits dengue and Zika transmission.

Luciano Moreira, the project’s leader, said results so far are encouraging, but that a delay in receiving promised federal funds last year had forced the project to rely on private funding and to shift funds from other sources.

Mr. Moreira said Brazil’s political and economic crisis, as well as the density of its crowded urban areas, were key factors in the spread of dengue and Zika.

“There is no magic bullet. There is no one solution to this,” Mr. Moreira said.

Write to Reed Johnson at Reed.Johnson@wsj.com and Rogerio Jelmayer at rogerio.jelmayer@wsj.com