“As an infection, Zika is generally a relatively mild—in fact—inconsequential infection,” Dr. Anthony Fauci, director of the National Institute of Health, told reporters at the White House on Monday.
It was a surprising way to describe the mosquito-borne virus, which has prompted President Obama to request $1.8 billion in emergency funding, and the U.S. Olympic Committee to recommend some athletes skip the Rio games.
Despite the harrowing pictures of infants with smaller heads that have accompanied stories about Zika, Fauci’s statement has truth to it. Thus far, the Zika story doesn’t include words like “inconsequential.” Instead, it centers on how the infection can potentially spread through sexual intercourse, how it has been linked to a severe birth defect called microcephaly (characterized by a underdeveloped brain), or how it’s been found in saliva.
But these concepts, which have dominated the narrative, tell only half the story. As Fauci and the Center for Disease Control and Prevention’s Dr. Anne Schuchat explained to reporters Monday, the truth about Zika is more complicated.
Zika can, in very rare cases, cause an autoimmune disease called Guillain-Barre, but in four out of five cases, it doesn’t cause so much as a cold. It has no known cure, but the body can rid itself of the virus in under a week. And though it has been connected to microcephaly in pregnant women, no one has yet found a causal link.
Despite these facts, misconceptions abound. One of the greatest is that Brazil has had 4,000 confirmed cases of microcephaly since the outbreak began. While authorities in Brazil have confirmed an increase in Zika cases, they have not seen the surge that’s being reported. The 4,000 microcephaly cases that have populated headlines are suspected cases, not confirmed.
Brazilian authorities have been the first to admit that they’ve found false negatives. Of the initial 700 suspected cases of microcephaly that were tested, just 270 infants turned out to actually have the condition—meaning more than 400 were falsely identified.
To be sure, 270 cases of infants with microcephaly are not insignificant. According to the Cleveland Clinic, most children who are born with the neurological disorder also have some sort of mental retardation. Many suffer from severe developmental delays, while others experience extreme difficulty in movement.
But again, there is another side to the story. In 15 percent of cases, children with microcephaly have normal intelligence and live average lives. In the wake of the Zika news, parents of children with microcephaly have come forward to assuage fears about the condition. “We love our three children, feel blessed by each unique child, and wouldn’t change one thing about our life or what we’ve been through,” a mother of two daughters with microcephaly told The Guardian.
But even if kids with microcephaly can go on to lead normal lives, protecting pregnant moms from the birth defect that may be preventable is, of course, critical. Still, as the “worse case scenario” in the outbreak—and seemingly, the reason for canceling the Olympics and setting aside $1.8 billion in emergency funds—it’s a bit odd.
It’s odd not because birth defects are not worth protecting against, but because—unlike Ebola—they’re something that already permeates America. According to the CDC, birth defects affect one in every 33 babies born in the U.S. each year. Every 4½ minutes, a baby is born with a birth defect.
Some defects are not harmful; others are deadly. Only a small number can be prevented because doctors and scientists have yet to find what causes them, a process that takes a significant amount of resources and money. In the CDC’s 2015 fiscal budget, the National Center for Birth Defects and Developmental Disabilities received just $11 million of the organization’s $5 billion budget.
Without more funding, the causes of congenital heart defect, for example, a birth defect that affects 40,000 babies a year, remains unknown. This isn’t to say that Zika, and its link to microcephaly, is not cause for alarm. It is.
But in the world of dangerous birth defects, microcephaly is far from a stand-alone. And in the world of infectious diseases, Zika is more nuanced than it seems.