Zika (11 page)

They had been on a big loop trip lasting several weeks, most of it at high altitudes in the Andes where they hadn't worried about mosquitoes. But in Polynesia, the stop before Hawaii, they had stayed in a friend's large family compound, and had camped in the central courtyard. They had arrived wary of dengue.

“We had a tent—it was like a mosquito net on steroids, with a bottom and everything,” his wife said. “So our nighttime exposure was zero.”

“You spray up with DEET first thing in the morning,” Stephen continued. “So the only time there was nothing on us was the few minutes when I was in the shower. I had two visible bites. And I killed a mosquito in the shower. It was bloody, so I knew it had got me.”

The backache and fever kicked in a few days later, in Hawaii, eventually becoming so fierce that “Tylenol wouldn't knock it down even a percentage.” A rash started on his shoulder, but at first he thought it was just an allergic reaction to his camera strap.

By the time they arrived in New York, his fever peaked at 103, which is high for Zika, although it hadn't been diagnosed yet. That, he thought, could have been anything, including a flu. He and his wife decided to wait another day before calling a doctor.

The next day, the fever had broken. “I knew my immune system had taken care of it,” he said. “But then I looked in the mirror. From the waist up, it looked like I had measles. I said, ‘Something's wrong.'”

“Yeah,” his wife said. “It was the whole shebang.”

They came into the clinic, thinking that, if it was dengue, they wanted to know quickly, because a second infection carried the risk of hemorrhagic fever.

But “it had been buzzing in the local paper that Zika was around,” Stephen said. After they left, it turned out that two children in his friend's family compound had also gotten it. “So that's why I suspected it.”

It was a good call. I later learned from reading PowerPoints by Dr. Mallet, the French Polynesia epidemiologist, that the week they were there was the outbreak's absolute apex. Doctors on the 76 inhabited islands were reporting new cases at the rate of 3,600 a week. The Guillain-Barré, Stephen said, he had heard about from a local journalist who was a friend, who had heard about it from a doctor or nurse and was still looking into it.

In Dyan's journal article about his case, Stephen, like Joy Chilson Foy, appears only as a rash-covered back. “I'm a curious person, so it's kind of cool to be my own scientific experiment,” he said in February. “But now I'm Zika Man. So hey—I should get a costume!”

9

The Rumors

T
HE RUMORS STARTED
just as the first alarm bells began to ring, well before the CDC issued its travel advisories or the WHO declared a public health emergency.

The pictures of the children in Brazil were so shocking that people seemed to have a hard time believing that an otherwise mild disease had done such damage. They reminded many of the aftermath of major disasters: radiation victims from Hiroshima, children deformed by thalidomide or Agent Orange or by mercury poisoning in Minamata, Japan.

The rumors were similar: the virus was not the real cause. The media was a bunch of gullible idiots. The real cause was X.

Some rumors I read about in other publications or by following links down the rabbit holes of the Internet. Some I learned about because readers wrote to me, saying more or less that I was the gullible idiot and should look into cause X.

According to the first rumor, the culprit was genetically modified mosquitoes released in Brazil to fight dengue.

Another put the blame on some form of chemical pesticide. The first version of that rumor that I heard claimed it was Roundup, the herbicidal weed killer. The second, which became much more tenacious, was that it was a larvicide put into standing water to kill mosquito larvae, including the drinking water barrels that millions of poor Brazilians had attached to pipes running off the tin roofs of their shacks.

A third set of rumors blamed it on vaccines. One version held that Brazil had imported a bad batch of rubella vaccine, so mothers were left unprotected, and rubella was known to cause microcephaly. Another version pointed to the new vaccine against pertussis—whooping cough—that Brazil had recently introduced.

Another rumor—which caused me a lot of difficulty because it was initially argued persuasively by a prominent Yale mosquito researcher working in Brazil—maintained that there was actually no surge in microcephaly cases at all. It was all just a big misunderstanding. Brazil, the argument went, had seriously undercounted its microcephaly cases for years. Now that a few hospitals had had clusters—and clusters are normal in statistics—the media panic had led the health ministry to alert doctors all over the country, who were now reporting every child with a small head. It was just a massive overcount.

For several weeks, I felt I was just putting out fires. Serious news developments were taking place, including the WHO's emergency declaration. But everything seemed to feed the rumors. For example, when Dr. Chan and Dr. Heymann announced the PHEIC, they emphasized that the emergency was not the rapid spread of the virus but the suspected microcephaly connection, and Dr. Chan's words were particularly cautious: “Although a causal link between Zika infection in pregnancy and microcephaly—and I must emphasize—has
not
been established, the circumstantial evidence is suggestive and extremely worrisome.”

That caveat—that it was
not
established, after all those days of headlines emphasizing it—was jumped on by reporters and columnists and Twitter opinion leaders. Everyone wanted to prove he or she was too smart to believe the conventional wisdom. Every telephone press conference I listened to from Geneva or Atlanta had the same question over and over: “Do you
really
know that Zika causes microcephaly? What's the evidence? Some people say it's some sort of X—how do you answer them?”

The frustrating thing about telephone press conferences is that everyone is usually allowed only one question, and it was an embarrassment to the profession how stupid some of those “Some people say it's X” questions were. The best health reporters asked good ones, but everyone waiting in line got one brief turn, and then it was over. As each conference ended, I threw my headset off in frustration—which was easier on the office equipment than in the old days, when AT&T's stout receivers could put some serious scars in the paint of the
Times
's gray Royal typewriters.

Each of the rumors had some kernel of truth that made it credible. And, as each one was debunked, another would take its place. Top health officials were tearing their hair out; they were trying to explain the science and warn people to protect themselves, and instead they were constantly being asked to respond to new proofs that the world was flat. Worse, in the countries themselves, each rumor made people in the path of the virus more dismissive. If the government says, “This mosquito disease is dangerous!” but a guy in the barbershop says, “Oh, I heard the Brazilians just panicked—you know Brazilians” or “I heard it's some American chemical in the drinking water—Monsanto, you know,” then the other customers skip buying window screens so as not to look like chumps.

Something similar had happened during the 2014 Ebola epidemic: the initial outbreak was among the Kissi people in the interior where the borders of Guinea, Liberia, and Sierra Leone meet. But those three countries are run by elites in their capitals—in the cases of Sierra Leone and Liberia, by descendants of freed American and British slaves. They were dismissive of the “backwards Africans” in the interior, who distrusted them in return. So when word came down from the capitals that Ebola was a killer and people had to let their sick relatives be taken away by teams in space suits commanded by white foreigners and spraying bleach everywhere, and that they had to abandon deeply cherished and perfectly sensible customs like washing the blood and vomit off a body before a funeral or being able to lay a hand on a loved one to say goodbye, they rebelled. The rumor spread that it was all a plot by the elites to soak the Europeans and Americans for money. People hid their sick and held funerals clandestinely. One medical team was even hacked to death with machetes. The epidemic spread partly because it took months to get average people to take it seriously.

This is sadly normal. Every new disease rides a wave of rumors. I had a long talk with Dr. Howard Markel, a medical historian at the University of Michigan. “Rumors are the lifeblood of every epidemic,” he said.

He cited a whole series of examples. The Black Death in the Middle Ages was blamed on the Jews, who were accused of poisoning Christian wells. AIDS was initially blamed on the “gay lifestyle,” including anal sex, intense disco dancing, and getting high on amyl nitrate poppers. His favorite was the rumor that spread during the 1892 cholera epidemic in New York City: it was the fish. Fishmongers' sales plummeted, so the fishmongers lobby leaned on the Board of Health, whose president held a public fish dinner to dispel the rumors.

But every rumor had some logic to it. Medieval cities had Jewish ghettoes, and plague sometimes struck there later. Not that the ghettos didn't have rats, but no one realized rats and fleas were the problem. Even rat diseases are spread by people—rats ride with loads of grain coming to market from outside the city, for example. Jewish and Christian markets might be separate; Jewish markets might not be as connected to the agrarian countryside as Christian ones were. Wells are dug in neighborhoods, so Jews and Christians often drew water from different wells. If one neighborhood was dying and another was not, the well-poisoning theory could seem plausible.

Fish are a logical target to blame for cholera.
Vibrio cholerae
is a water-borne bacterium. Sewage, not fish flesh, spreads these bacteria. But they do live in filter feeders like oysters, and New York's harbor in those early days was so famously full of huge oysters that they were a standard food of the poor. So, while fish were probably completely innocent, shellfish possibly were not, even though polluted drinking water was the real problem.

The “AIDS is a gay lifestyle disease” rumor was ridiculous, even more so when doctors realized within a year or two that the syndrome was the same as “slim disease,” which was all over Central and East Africa. But it took another two years to find the virus that caused it. And rumors persist when prominent people endorse them. Peter H. Duesberg, a respected molecular biologist at the University of California at Berkeley, insisted for almost a decade that recreational drugs and the first HIV medicine, AZT, were the real causes of the symptoms and death. And more than a decade later, when the disease was widespread in South Africa, that country's president, Thabo Mbeki, read “AIDS denialist” websites and refused to let public hospitals offer antiretroviral triple therapy, saying it was a plot by Western pharmaceutical companies to sell pricey drugs to Africa.
A 2008 study by Harvard researchers estimated that his policy had led to 365,000 deaths, including those of 35,000 babies.

There were so many Zika rumors, with so many facets, that my editors asked me to write one long piece wrapping them up and explaining why they weren't true.

The kernel of truth behind the mosquito one was that Oxitec, a British company founded by Oxford scientists, had bred a genetically modified male mosquito. It sought out and mated with female mosquitos but had a gene that shortened its own life and, more importantly, was passed on to all their offspring and caused 95 percent of them to die before reaching adulthood. (Oxitec was already modifying
Aedes aegypti
mosquitoes because they spread dengue, which had been raging through the Asian and African tropics for decades and in Brazil since 1981.) Oxitec had recently done field trials in Brazil, with the largest release taking place in Piracicaba. That created headlines because the words “genetically modified” make many people nervous, in Brazil as in Brooklyn. But Piracicaba is 1,700 miles from Recife, the microcephaly epicenter—about the distance from New York to Bismarck, North Dakota. Mosquitoes fly less than a mile in their lifetimes. Besides, the numbers the company bred and released were meant to cover a few neighborhoods. They were a drop in the ocean of billions, even trillions, of mosquitoes infesting South America. Also, male mosquitoes drink flower nectar, not blood. They don't bite people. Moreover, Oxitec had undergone earlier field trials—in the Cayman Islands, Malaysia, and Panama. There had been no microcephaly outbreaks.

The Roundup rumor I heard from a former newspaper colleague I hadn't seen in many years. She wrote a long passionate email to a neighbor of hers, who happened to be my former mother-in-law, who forwarded it to me.

“My conspiratorial reporter's brain,” it began, “has been ruminating through the Zika virus panic about whether those birth defects might have another cause.”