Abstract
In 2016, the Zika virus took the world by storm, as after much debate and controversy, it was recognized that the virus could cause microcephaly and other developmental problems in fetuses. While the center of this storm was Brazil, other countries in Latin America were also getting ready for the epidemic due to the widespread presence of the vector, the Aedes mosquito, on the continent. For the last two decades, Costa Rica has struggled with high rates of dengue, another virus from the same family as Zika and which also shares the same vector. For this reason, a Zika epidemic was considered imminent. Yet, even though there were cases of Zika in the Central American nation, an epidemic of the proportions seen in Brazil never happened. This chapter examines the elements that made possible for Costa Rica to have lower-than-expected rates of Zika infection. It also looks at the conditions in the Costa Rican health care system that would potentially minimize the long-term effects on maternal and child health of such an outbreak, especially within indigenous communities who are among the most vulnerable populations.
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References
Alvarado, M. G., & Schwartz, D. A. (2016). Zika virus infection in pregnancy, microcephaly, and maternal and fetal health—What we think, what we know, and what we think we know. Archives of Pathology & Laboratory Medicine, 141(1), 26–23. https://doi.org/10.5858/arpa.2016-0382-RA. Retrieved from http://www.archivesofpathology.org/doi/full/10.5858/arpa.2016-0429-ED
Alvarado, M. G., & Schwartz, D. A. (2017). Zika virus infection in pregnancy, microcephaly, and maternal and fetal health: What we think, what we know, and what we think we know. Archives of Pathology & Laboratory Medicine, 141(1), 26–32.
Area de Salud de Coto Brus. (2012). Sistematización de buenas prácticas: Desarrolladas para la promoción de estilos de vida saludables y la atención de la salud materno-infantil en la población indígena Ngöbe. Caja Costarricense del Seguro Social. Coto Brus.
Bell, B. P., Boyle, C. A., & Petersen, L. R. (2016). Preventing Zika virus infections in pregnant women: An urgent public health priority. American Journal of Public Health, 106(4), 589–590. https://doi.org/10.2105/AJPH.2016.303124
Benavides Lara, A., María de la Paz Barboza Arguello, Hernandez de Mezerville, M., Gonzalez Elizondo, M., Prevencion y Control de Infecciones Hospital Nacional de Ninos. (2016). Protocolo de vigilancia de microcefalia en el marco de vigilancia del virus del Zika en Costa Rica. San Jose. Retrieved from https://www.ministeriodesalud.go.cr/index.php/vigilancia-de-la-salud/normas-protocolos-y-guias/2995-protocolo-de-vigilancia-microcefalia-en-rn-el-marco-de-la-vigilancia-del-virus-del-zika-en-costa-rica/file
Buse, K., Mays, N., & Walt, G. (2012). Making health policy (understanding public health) (2nd ed.). London: Open University Press.
Cairney, P., & Jones, M. D. (2016). Kingdon’s multiple streams approach: What is the empirical impact of this universal theory? Policy Studies Journal, 44(1), 37–58. https://doi.org/10.1111/psj.12111
Caminade, C., Turner, J., Metelmann, S., Hesson, J. C., Blagrove, M. S. C., Solomon, T., et al. (2016). Global risk model for vector-borne transmission of Zika virus reveals the role of El Niño 2015. Proceedings of the National Academy of Sciences, 114(1), 119–124. https://doi.org/10.1073/pnas.1614303114
Campo-Engelstein, L. & Meagher, K. (2011). Costa Rica’s ‘White legend’: how racial narratives undermine its health care system. Developing World Bioethics, 11(2), 99–107.
CDC (Centers for Disease Control and Prevention). (2016). CDC concludes Zika causes microcephaly and other birth defects. Retrieved April 19, 2017, from http://www.cdc.gov/media/releases/2016/s0413-zika-microcephaly.html.
Chan, J. F. W., Choi, G. K. Y., Yip, C. C. Y., Cheng, V. C. C., & Yuen, K. Y. (2016). Zika fever and congenital Zika syndrome: An unexpected emerging arboviral disease. Journal of Infection, 72(5), 507–524. https://doi.org/10.1016/j.jinf.2016.02.011
Cofresi, I. M. (1994). Migration and health in Talamanca, Costa Rica: An applied medical anthropology approach. Georgia State University.
Comision Economica para America Latina y el Caribe, Organizacion Panamericana de la Salud, UNFPA, & Naciones Unidas. (2010). Salud materno infantil de pueblos indigenas y afrodescendientes de America Latina: una relectura desde el enfoque de derechos. Santiago. Retrieved March 17, 2017, from http://www.cepal.org/publicaciones/xml/8/41668/lcw346.pdf.
Costa, F., Sarno, M., Khouri, R., de Paula Freitas, B., Siqueira, I., Ribeiro, G. S., et al. (2016). Emergence of congenital Zika syndrome : Viewpoint from the front lines. Annals of Internal Medicine, 164(10), 689–691. https://doi.org/10.7326/M16-0332
Costello, A., Dua, T., Duran, P., Gülmezoglu, M., Oladapo, O. T., Perea, W., et al. (2016). Editorial: Defining the syndrome associated with congenital Zika virus infection. Bulletin of the World Health Organization, 94(6), 406–406A. https://doi.org/10.2471/BLT.16.176990
Culjat, M., Darling, S. E., Nerurkar, V. R., Ching, N., Kumar, M., Min, S. K., et al. (2016). Clinical and imaging findings in an infant with Zika embryopathy. Clinical Infectious Diseases, 63(6), 805–811. https://doi.org/10.1093/cid/ciw324
da Cruz Ferreira, D. A., Degener, C. M., de Almeida Marques-Toledo, C., Bendati, M. M., Fetzer, L. O., Teixeira, C., et al. (2017). Meteorological variables and mosquito monitoring are good predictors for infestation trends of Aedes aegypti, the vector of dengue, chikungunya and Zika. Parasites & Vectors, 10(1), 78. https://doi.org/10.1186/s13071-017-2025-8. Retrieved from http://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-017-2025-8
de Fatima Vasco Aragao, M., van der Linden, V., Brainer-Lima, A. M., Coeli, R. R., Rocha, M. A., Sobral da Silva, P., et al. (2016). Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study. British Medical Journal, 353. https://doi.org/10.1136/bmj.i1901
de Oliveira, W. K., Cortez-Escalante, J., Gonçalves Holanda De Oliveira, W. T., Ikeda do Carmo, G. M., Pessanha Henriques, C. M., Coelho, G. E., et al. (2016). Increase in Reported prevalence of microcephaly in infants born to women living in areas with confirmed Zika virus transmission during the first trimester of pregnancy—Brazil, 2015. MMWR: Morbidity & Mortality Weekly Report, 65(9), 242–247. https://doi.org/10.15585/mmwr.mm6509e2
de Paula Freitas, B., de Oliveira Dias, J. R., Prazeres, J., Almeida Sacramento, G., Icksang Ko, A., Maia, M., et al. (2016). Ocular findings in infants with microcephaly associated with presumed Zika virus congenital infection in Salvador, Brazil. Journal of the American Medical Association Ophthalmology, 134(5), 529–535.
Escobar, L. E., Romero-Alvarez, D., Leon, R., Lepe-Lopez, M. A., Craft, M. E., Borbor-Cordova, M. J., et al. (2016). Declining prevalence of disease vectors under climate change. Scientific Reports, 6, 39150. doi:https://doi.org/10.1038/srep39150. . Retrieved from https://www.nature.com/articles/srep39150
Fallas Hidalgo, G., Quiros Valverde, M., Gamboa Quesada, M., Viales Araya, E. (2006). Diagnostico Socioeconomico region Brunca. San Jose. Retrieved from http://www.infoagro.go.cr/Inforegiones/RegionBrunca/Documents/Planes, Proyectos, Programas/DIAGNÓSTICO REGION BRUNCA 2006 VERSION FINAL.pdf.
Fuller, D. O., Troyo, A., & Beier, J. C. (2009). El Niño Southern Oscillation and vegetation dynamics as predictors of dengue fever cases in Costa Rica. Environmental Research Letters, 4(1), 14011. https://doi.org/10.1088/1748-9326/4/1/014011
Hernandez Chaves, O. N., César Gamboa, P., Daniel Salas, P., Rafael Salazar, P., Porras, H., & Griselda Ugalde, U. (2016). Lineamientos nacionales para el abordaje integral de la mujer embarazada y el recién nacido, relacionado con la infección Zika. San Jose. Retrieved from https://www.ministeriodesalud.go.cr/index.php/biblioteca-de-archivos/3054-lineamientos-nacionales-para-el-abordaje-integral-de-la-mujer-embarazada-y-el-recien-nacido-relacionado-con-la-infeccion-del-zika/file
Hodgson, D. L. (2011). Being Maasai, becoming indigenous. Postcolonial politics in a neoliberal world. Bloomington, IN: Indiana University Press.
INEC. (2013). Territorios indígenas principales indicadores demográficos y socioeconómicos 2011. San Jose. Retrieved from http://www.inec.go.cr/sites/default/files/documentos/inec_institucional/estadisticas/resultados/repoblaccenso2011-02.pdf.pdf
INEC. (2015). Mortalidad materna y su evolucion reciente. San Jose. Retrieved from http://www.inec.go.cr/sites/default/files/documentos/poblacion/mortalidad/publicaciones/mmerd14.pdf
INEC. (2016). Mortalidad infantil y su evolucion reciente. San Jose. Retrieved from http://www.inec.go.cr/sites/default/files/documetos-biblioteca-virtual/repoblaciodef-is2016.pdf
International Labour Organization. (n.d.). C169—Indigenous and tribal peoples convention, 1989 (No. 169). Retrieved from http://www.ilo.org/dyn/normlex/en/f?p=NORMLEXPUB:12100:0::NO::P12100_ILO_CODE:C169
IWGIA (International Work Group for Indigenous Affairs. (2016). Indigenous peoples in Costa Rica. Retrieved from http://www.iwgia.org/regions/latin-america/costa-rica
Ladhani, S. N., O’Connor, C., Kirkbride, H., Brooks, T., & Morgan, D. (2016). Outbreak of Zika virus disease in the Americas and the association with microcephaly, congenital malformations and Guillain–Barré syndrome. Archives of Disease in Childhood, 101(7), 600–602. https://doi.org/10.1136/archdischild-2016-310590
Low, S. (1985). Culture, politics and medicine in Costa Rica. An anthropological study of medical change. Bedford Hills, NY: Redgrave.
Martinez, M. E., Cortez-Escalante, J., Tenório, W., Holanda, G., Madeleine, G., & Eyrolle-Guignot, D. (2016). Preventing Zika virus infection during pregnancy using a seasonal window of opportunity for conception. PLoS Biology, 14(7), e1002520. https://doi.org/10.1371/journal.pbio.1002520
Mena, N., Troyo, A., Bonilla-Carrión, R., & Calderón-Arguedas, O. (2011). Factors associated with incidence of dengue in Costa Rica. Revista Panamericana de Salud Publica, 29(4), 234–242. Retrieved March 17, 2017, from http://www.ncbi.nlm.nih.gov/pubmed/21603768.
Ministerio de Salud de Costa Rica. (2014a). Aproximación a la condición de salud los pueblos indígenas de Costa Rica. San Jose. Retrieved March 17, 2017, from https://www.ministeriodesalud.go.cr/ops/documentos/docEpidemiologi del Pueblos Indigenas de Costa Rica.pdf.
Ministerio de Salud de Costa Rica. (2014b). Analisis de situacion de salud Costa Rica. San Jose. Retrieved from https://www.ministeriodesalud.go.cr/index.php/vigilancia-de-la-salud/analisis-de-situacion-de-salud/2618-analisis-de-situacion-de-salud-en-costa-rica/file
Ministerio de Salud de Costa Rica. (2016). Boletín epidemiológico No 1—2016 Zika, Chikungunya y Dengue. San Jose. Retrieved from https://www.ministeriodesalud.go.cr/index.php/vigilancia-de-la-salud/analisis-de-situacion-de-salud/2861-chikungunya-2016/file
Ministerio de Salud de Costa Rica. (2017). Resumen 2016 de la situacion Zika, Chikunguya y Dengue. San Jose. Retrieved from https://www.ministeriodesalud.go.cr/index.php/biblioteca-de-archivos/3189-resumen-de-la-situacion-en-america-del-zika-chikungunya-y-dengue-para-el-ano-2016/file
de Miranda, H. A., Costa, M. C., Frazão, M. A. M., Simão, N., Franchischini, S., & Moshfeghi, D. M. (2016). Expanded spectrum of congenital ocular findings in microcephaly with presumed Zika infection. Ophthalmology, 123(8), 1788–1794. https://doi.org/10.1016/j.ophtha.2016.05.001
Morgan, L. M. (1993). Community participation in health. Cambridge: Cambridge University Press.
National Institutes of Health. (2017, March 31). Phase 2 Zika vaccine trial begins in U.S., Central and South America. Retrieved from https://www.nih.gov/news-events/news-releases/phase-2-zika-vaccine-trial-begins-us-central-south-america
Nunes, M. L., Carlini, C. R., Marinowic, D., Neto, F. K., Fiori, H. H., Scotta, M. C., et al. (2016). Microcephaly and Zika virus: A clinical and epidemiological analysis of the current outbreak in Brazil. Jornal de Pediatria, 92(3), 230–240. https://doi.org/10.1016/j.jped.2016.02.009
Ortiz, P., Fernandez, W., & Tropper, E. (2009). Proyecto Dotacion De Infraestructura Nueva Para Un Ebais: “Construcción De Un Ebais Modelo En El Territorio La Casona Coto Brus. Coto Brus.
Panchaud, A., Stojanov, M., Ammerdorffer, A., & Vouga, M. (2016). Emerging role of Zika virus in adverse fetal and neonatal outcomes. Clinical Microbiological Reviews, 29(3), 659–694. https://doi.org/10.1128/CMR.00014-16.Address
Paul, L. M., Carlin, E. R., Jenkins, M. M., Tan, A. L., Barcellona, C. M., Nicholson, C. O., et al. (2016). Dengue virus antibodies enhance Zika virus infection. Clinical & Translational Immunology, 5(12), e117. https://doi.org/10.1038/cti.2016.72
Perez, H. (1997). Estimates of the indigenous population of Central America (16th to 20th Centuries). In A. R. Pebley & L. Rosero-Bixby (Eds.), Demographic diversity and change in the Central American isthmus (pp. 95–115). Santa Monica: RAND.
Perez, S., Tato, R., Cabrera, J. J., Lopez, A., Robles, O., Paz, E., et al. (2016, March). Confirmed case of Zika virus congenital infection, Spain. Euro Surveillance, 21(24). https://doi.org/10.2807/1560-7917.ES.2016.21.24.30261
Petersen, L. R., Jamieson, D. J., Powers, A. M., & Honein, M. A. (2016). Zika virus. New England Journal of Medicine, 374(16), 1552–1563. https://doi.org/10.1056/NEJMra1602113
Rey, J. R., & Lounibos, P. (2015). Ecología de Aedes aegypti y Aedes albopictus en América y transmisión enfermedades. Biomédica, 35, 177–185.
Santos, J., & Meneses, B. M. (2017). An integrated approach for the assessment of the Aedes aegypti and Aedes albopictus global spatial distribution, and determination of the zones susceptible to the development of Zika virus. Acta Tropica, 168, 80–90. https://doi.org/10.1016/j.actatropica.2017.01.015
Schliemann, C. (2012). La autonomía de los pueblos indígenas de Costa Rica una contrastación del estándar internacional con la legislación nacional y su implementación. Revista Latinoamericana de Derechos Humanos, 23(1), 145–185.
Schwartz, D.A. (2017a, March 20). What do we know about Zika virus in indigenous populations? Interview by Sarah Anwar, Washington, DC. Contagion Live. Retrieved from http://www.contagionlive.com/videos/what-do-we-know-about-zika-virus-in-indigenous-populations
Schwartz, D. A. (2017b). The origin and emergence of Zika virus, the newest TORCH infection—What’s old is new again. Archives of Pathology & Laboratory Medicine, 141(1), 18–25. Retrieved from http://www.archivesofpathology.org/doi/full/10.5858/arpa.2016-0429-ED
Schwartz, D. A. (2017c). Autopsy and postmortem studies are concordant: Pathology of Zika virus infection in neonates and stillborn fetuses with microcephaly following transplacental transmission. Archives of Pathology & Laboratory Medicine, 141(1), 68–72. Retrieved from http://www.archivesofpathology.org/doi/full/10.5858/arpa.2016-0343-OA
Simmons, C. P., Farrar, J. J., van Vinh Chau, N., & Wills, B. (2012). Dengue. New England Journal of Medicine, 366(15), 1423–1432. https://doi.org/10.1056/NEJMra1110265
Steele, R. W. (2016). Zika Virus: An explosive pandemic and a new TORCH agent. Clinical Pediatrics, 55(8), 698–700.
Swanstrom, J. A., Plante, J. A., Plante, K. S., Young, E. F., McGowan, E., Gallichotte, E. N., et al. (2016). Dengue virus envelope dimer epitope monoclonal antibodies isolated from dengue patients are protective against Zika virus. mBio, 7(4), e01123-16. https://doi.org/10.1128/mBio.01123-16
Tilak, R., Ray, S., Tilak, V. W., & Mukherji, S. (2016). Dengue, chikungunya … and the missing entity – Zika fever: A new emerging threat. Medical Journal Armed Forces India, 72(2), 1–7. https://doi.org/10.1016/j.mjafi.2016.02.017
Torjesen, I. (2016). Zika virus outbreaks prompt warnings to pregnant women. British Medical Journal, 352, i500. https://doi.org/10.1136/bmj.i500
Troyo, A., Calderón-Arguedas, O., Fuller, D. O., Solano, M. E., Avendaño, A., Arheart, K. L., et al. (2008). Seasonal profiles of Aedes aegypti (Diptera: Culicidae) larval habitats in an urban area of Costa Rica with a history of mosquito control. Journal Of Vector Ecology: Journal Of The Society For Vector Ecology, 33(1), 76–88. Retrieved from http://ezproxy.gsu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=18697310&site=eds-live
Troyo, A., Fuller, D. O., Calderón-Arguedas, O., Solano, M. E., & Beier, J. C. (2009). Urban structure and dengue incidence in Puntarenas, Costa Rica. Singapore Journal of Tropical Geography, 30(2), 265–282. https://doi.org/10.1111/j.1467-9493.2009.00367.x
Unger, J., De Paepe, P., Buitron, R. & Soors, W. (2008). Costa Rica: achievements of a heterodox health policy. American Journal of Public Health, 98(4), 636–643.
Vargas Gonzalez, W. (2006). Atencion primaria de salud en accion. San Jose: EDNASSS.
Wen, J., Tang, W. W., Sheets, N., Ellison, J., Sette, A., Kim, K., & Shresta, S. (2017). Identification of Zika virus epitopes reveals immunodominant and protective roles for dengue virus cross-reactive CD8+ T cells. Nature Microbiology, 2, 17036. https://doi.org/10.1038/nmicrobiol.2017.36
World Bank. (2016). Maternal mortlaity ratio. Retrieved from http://data.worldbank.org/indicator/SH.STA.MMRT
World Health Organization. (2017). World Health Organization. Costa Rica. Retrieved from January 1, 2017, http://www.who.int/countries/cri/en/
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Alvarado, G., Benavides-Rawson, J. (2018). From Dengue to Zika: Environmental and Structural Risk Factors for Child and Maternal Health in Costa Rica Among Indigenous and Nonindigenous Peoples. In: Schwartz, D. (eds) Maternal Death and Pregnancy-Related Morbidity Among Indigenous Women of Mexico and Central America. Global Maternal and Child Health. Springer, Cham. https://doi.org/10.1007/978-3-319-71538-4_35
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