News publications and other organizations are encouraged to reuse Direct Relief-published content for free under a Creative Commons License (Attribution-Non-Commercial-No Derivatives 4.0 International), given the republisher complies with the requirements identified below.

When republishing:

  • Include a byline with the reporter’s name and Direct Relief in the following format: "Author Name, Direct Relief." If attribution in that format is not possible, include the following language at the top of the story: "This story was originally published by Direct Relief."
  • If publishing online, please link to the original URL of the story.
  • Maintain any tagline at the bottom of the story.
  • With Direct Relief's permission, news publications can make changes such as localizing the content for a particular area, using a different headline, or shortening story text. To confirm edits are acceptable, please check with Direct Relief by clicking this link.
  • If new content is added to the original story — for example, a comment from a local official — a note with language to the effect of the following must be included: "Additional reporting by [reporter and organization]."
  • If republished stories are shared on social media, Direct Relief appreciates being tagged in the posts:
    • Twitter (@DirectRelief)
    • Facebook (@DirectRelief)
    • Instagram (@DirectRelief)

Republishing Images:

Unless stated otherwise, images shot by Direct Relief may be republished for non-commercial purposes with proper attribution, given the republisher complies with the requirements identified below.

  • Maintain correct caption information.
  • Credit the photographer and Direct Relief in the caption. For example: "First and Last Name / Direct Relief."
  • Do not digitally alter images.

Direct Relief often contracts with freelance photographers who usually, but not always, allow their work to be published by Direct Relief’s media partners. Contact Direct Relief for permission to use images in which Direct Relief is not credited in the caption by clicking here.

Other Requirements:

  • Do not state or imply that donations to any third-party organization support Direct Relief's work.
  • Republishers may not sell Direct Relief's content.
  • Direct Relief's work is prohibited from populating web pages designed to improve rankings on search engines or solely to gain revenue from network-based advertisements.
  • Advance permission is required to translate Direct Relief's stories into a language different from the original language of publication. To inquire, contact us here.
  • If Direct Relief requests a change to or removal of republished Direct Relief content from a site or on-air, the republisher must comply.

For any additional questions about republishing Direct Relief content, please email the team here.

Zika Virus

Issues & Solutions

In Brief

Zika virus is an insect vector-borne disease that can be transmitted via exposure to infected blood, through sexual contact, or from mother to child during pregnancy.

Outbreaks have been linked to increased incidence of microcephaly and Guillain-Barré syndrome.

There is no vaccine for Zika, so responding to outbreaks involves stepped-up public-health efforts, including vector control of mosquitoes, work to expand public awareness, staff training, and development of treatment protocols.

About the Zika Virus

Zika virus is an arbovirus, an insect vector-borne disease most commonly transmitted through Aedes (aegypti and albopictus) mosquitoes. Less commonly, Zika can be transmitted from mother to child during pregnancy. In some cases, Zika virus transmission also has been reported through exposure to infected blood or through sexual contact.

Zika is endemic to parts of Africa and Asia. Since early 2015, a large number of locally acquired cases (estimated to be as many as 1.5 million cases by the World Health Organization) have been discovered in Brazil, where the disease was previously unknown. Zika developed into a region-wide pandemic as human and mosquito travelers transmitted the disease to more than a dozen more countries throughout the Americas, leading the WHO to label it an international health emergency.

In 2018, there were 31,587 suspected and probable confirmed cases of the Zika disease in the Region of the Americas. However, only 3, 473 (11%) were confirmed in laboratories, according to the World Health Organization

Zika Virus Symptoms

Symptoms of Zika virus in most people are similar to those of other arboviruses such as Chikungunya, including fever, headache, and fatigue. Zika, however, is distinctively marked by detection of the disease in amniotic fluid and increased cases of microcephaly (small head size) in newborns. The vast majority of cases of microcephaly in Brazil have been reported in the country’s northeastern region. Given the virus’ novel introduction to the Americas, some epidemiologists have expressed concern that resistance may be low, leading to heightened transmission rates and severity of symptoms.

In rare cases, Zika symptoms have been associated with Guillain-Barré syndrome, in which the body’s immune system attacks nerve cells in the peripheral nervous system. This can lead to weakness, numbness, tingling, and paralysis. A study published by The New England Journal of Medicine looked at the incidence of both Zika and Guillain-Barré across 7 countries: Brazil, Colombia, the Dominican Republic, Honduras, El Salvador, Suriname, and Venezuela. The study looked at the 1,474 cases of Guillain-Barré syndrome that were reported in those countries from April 2015 to March 2016. Comparing the timeline of reporting of Zika and Guillain-Barré during this period showed a close coincidence of the two diseases. For more information, please see “Zika Virus and the Guillain–Barré Syndrome—Case Series from Seven Countries.”

Environmental Factors in Zika Transmission

Zika virus was first identified in rhesus monkeys from Uganda’s Zika Forest in 1947 during the course of routine surveillance for yellow fever. Thereafter it was diagnosed in humans starting in 1952. During the 20th century, Zika became endemic in Africa and parts of Asia, only making the jump to the Americas beginning in 2015.

Significant circumstantial evidence links the spread of Aedes mosquitoes in the 2015–16 outbreak with a confluence of environmental factors in part attributable to climate change and the influence of the El Niño phenomenon. This confluence of environmental factors manifested in the form of increased heat and precipitation, particularly at lower elevations, which opened up new breeding areas for Aedes mosquitoes. With Zika virus now endemic to regions within the range of Aedes mosquitoes, additional cases are likely to emerge on a seasonal basis.