On the 1st of February 2016, the World Health Organisation (WHO) declared a cluster of cases of microcephaly amongst newborn children within Latin America to be a public health emergency. This declaration came with details of a strong association between the instances of microcephaly and the Zika virus, a mosquito borne virus which causes flu like symptoms. The Zika virus had been identified within South and Central America in 2015 and was found to have an increasing geographical distribution throughout the year.  The symptoms of the virus include mild fevers, rashes, muscle and joint pain, and conjunctivitis which can last from 2-7 days. In more extreme cases, an individual with the virus can suffer from Guillain-Barré syndrome in which there is temporary paralysis or weakness of muscles. The mechanism through which the virus is thought to cause Guillain-Barré syndrome – damaging the myelin insulation of nerves – has brought many to study the relationship between the Zika virus and microcephaly within children of women who contracted the virus. Microcephaly is a disorder in which a baby is born with an underdeveloped brain and thus a head size much smaller than a healthy child. The virus is mostly contracted through mosquito bites from the species Aediesegypti who can also contract the virus by biting an infected individual. Non-vector transmission of the virus can occur through sexual contact but such passage of the virus is less common than mosquito transmission.
The combination of the current epidemic of Zika in Latin America, its ability to be passed through mosquito bites and sexual contact, as well as the dangerous consequences contracting the virus poses for pregnant mothers has made the possibility of a global epidemic to be cause for concern throughout the world. With Brazil hosting the 2016 Olympic and Paralympic games, there is the added potential for foreign competitors and spectators to contract the virus and subsequently bring it back to their home countries. This mass influx of people from around the world to the near epicentre of the Zika virus epidemic adds further pressure on government public health departments as well as specialised agencies such as WHO to ensure information about the virus is readily available and people are aware of precautions they must take to prevent being infected. Such pressure is already building within the USA, given that it is a direct neighbour of Mexico and the Caribbean islands where Zika has been found. The main focus of worry is that the USA mosquito season is fast approaching with the months of May – September seeing a huge increase in the prevalence of mosquitoes throughout the USA. A recent study conducted by the Harvard School of Public Healthreinforces the idea that misinformation about Zika and how it is contracted is still widespread throughout populations within the US. The survey of 1275 American adults showed that 42% of respondents did not know that the virus could be transmitted through sexual contact.  A further 71% of people believed that all those who contract the virus will show symptoms – the reality being that only 1 in 5 infected individuals will show any signs of infection.  The prevalence of such misinformation is worrying as people may not be aware of methods of transmission such as sexual contact and blood transfusions and thus not be able prevent themselves from avoiding the danger of infection. Given that at the timeof the study (March 2016) there were only 2 months until the mosquito season arrived, there is now a level of urgency to deliver accurate information to residents in the USA about the virus. The same study also showed that 54% of the population were informed of the virus through TV news networks with a further 31% receiving information from internet resources. Governmental public health departments such as the Centre for Disease Control (CDC) were only cited as the main source of information for 2% of the population. 
With such a high level of misinformation about the disease in the USA so close to the prime mosquito breeding season, the results of studies like this indicate that there must be a greater responsibility on the part of news networks operating on TV and online to provide correct information to their audiences. In particular, emphasis on the role of sexual transmission in the spread of the virus cannot be neglected, especially within a country like the USA where sex education is only compulsory in 25 states and a female’s access to contraception can be impeded by third parties such as her health insurance provider or her employer.  The education efforts of news networks can thus decrease the chances of a woman contracting the virus while pregnant and therefore remove all the possible consequences of exposure to Zika for the fetus such as microcephaly and miscarriage. While results of this preliminary study can betaken to show a pessimistic outlook for any potential Zika epidemics in the US, it does highlight that people are already knowledgeable on precautions to take during the mosquito season – 67% of those surveyed said they routinely take precaution against mosquito bites in the summer already.  Thus, given that many in the USA are already accustomed to dealing with mosquitoes, the scale of education on the Zika virus needed in the USA can mostly focus on other areas of transmission and protection.
As has been shown by this preliminary study on education of American adults on Zika, there has been disconnect between the information available from public health offices and the information portrayed through TV and online news outlets. Given the geographical closeness of the USA to the Latin American Zika epidemic as well as the impending mosquito season, the potential for cases to increase in the USA is being taken seriously. With there being no current treatment for the virus and vaccine development only in early stages, the education of the public must be considered as the most important weapon in fighting epidemics.
Abby Fraser is a second year Human Sciences undergraduate at Magdalen College, Oxford, who has experience working in doctors surgeries and attending WHO simulations.
 WHO Zika Situation report 31/3/16, access at http://www.who.int/emergencies/zika-virus/situation-report/31-march-2016/en/
 Press release: ‘Many USA families considering pregnancy don’t know Zika facts’ Harvard School of Public Health, access at http://www.hsph.harvard.edu/news/press-releases/zika-virus-awareness-pregnant-women/
 Guttmacher Institute State Policies in Brief 2016, access at https://www.guttmacher.org/sites/default/files/pdfs/spibs/spib_SE.pdf