2 September 2016 | GENEVA - The fourth meeting of the Emergency Committee (EC) on
Zika and microcephaly convened by the Director-General under the International Health
Regulations (2005) regarding microcephaly, other neurological disorders and Zika virus
was held by teleconference on 1 September 2016, from 13:15 to 15:45 Central European
Time.
The Committee was briefed on the implementation of the Temporary Recommendations issued
by the Director-General on advice from the three previous EC meetings. The Committee
was updated on the situation during and after the Olympic Games held in Brazil, the
latest developments on Zika virus geographic spread, natural history, epidemiology,
microcephaly and other neonatal complications associated with Zika virus, Guillain-Barré
syndrome (GBS) and current knowledge on sexual transmission of Zika virus.
The following States Parties provided information on microcephaly, GBS and other neurological
disorders occurring in the presence of Zika virus transmission as well as control
measures being implemented: Brazil, the United States of America and Singapore.
The Committee congratulated Brazil on their successful application of appropriate
public health measures during the Olympic Games. To date, there have been no reports
of confirmed cases of Zika virus among people who attended the Games, both during
the games and since their return. The lack of cases supports the conclusions of the
risk assessment regarding the Olympic Games made during the 3rd EC meeting.
Having considered the evidence presented, the Committee agreed that due to continuing
geographic expansion and considerable gaps in understanding of the virus and its consequences,
Zika virus infection and its associated congenital and other neurological disorders
continues to be a Public Health Emergency of International Concern (PHEIC).
The Committee restated the advice it provided to the Director-General in its previous
meetings in the areas of public health research on microcephaly, other neurological
disorders and Zika virus, surveillance, vector control, risk communications, clinical
care, travel measures, research and product development related to vaccines, therapeutics,
and laboratory tests. The Committee noted that activities based on this advice remain
in place and are all being implemented. The Committee also reaffirmed its previous
advice that there should be no general restrictions on travel and trade with countries,
areas and/or territories with Zika virus transmission, including the cities in Brazil
that will be hosting the Paralympic Games.
Furthermore, acknowledging that the impact of Zika virus is a long term concern, the
Committee recommended that the Director General considers developing an appropriate
infrastructure and response plan within the World Health Organization to provide longer
term coordination and accountability for ensuring an effective response.
The Committee emphasized the need for a better scientific understanding of Zika virus
epidemiology, clinical disease, and prevention, recommending focus on several new
research issues along with other issues recommended previously, in order to:
enhance understanding of the different viral lineages, including cross reactivity
and cross-immunity between them as well as their clinical implications
assess possible co-factors or risk factors that might impact disease severity
better understand the natural history of the disease in children who are congenitally
infected, pregnant women, and other children and adults
determine length and location of viral persistence in humans, and its impact on transmissibility
better establish the risk of infection and modes of transmission
assess the utility of effective vector control tools and their operational feasibility
continue development of safe and effective prevention measure (e.g., vaccine)
Recognizing the impact that Zika virus disease and its consequences will have on weak
health systems, the Committee also recommended that WHO provide appropriate guidance
on effective surveillance and management of Zika virus disease in countries with high
vulnerability, low capacity.
Based on this advice, the Director-General declared the continuation of the Public
Health Emergency of International Concern (PHEIC). The Director-General reissued the
Temporary Recommendations from the 2nd and the 3rd meeting of the Committee, endorsed
the additional advice from the Committee’s 4th meeting, and issued them as Temporary
Recommendations under the IHR (2005). The Director-General thanked the Committee Members
and Advisors for their advice. The Committee will reconvene in 3 months.
Available from: http://www.who.int/mediacentre/news/statements/2016/zika-fourth-ec/en/