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Today, it is common to hear the average American say they wish things would “go back to normal.” This expression is code for “before COVID-19.” However, life prior to the current pandemic was not as fabulous for those already battling other viral diseases. In 2015, many South American countries faced a major Zika virus outbreak, devastating the health and pockets of low-income families. A recent study from a team of medical professionals in Brazil suggests that an overwhelming number of families lack the resources to properly care for children who were born with abnormalities as a result of the Zika virus (Freire 2020).

The Zika virus (ZIKV) epidemic of 2015 originated in Brazil and spread throughout South America, primarily through the transmission of mosquitoes. While the symptoms of the virus are mostly mild and short-lasting, women who contract Zika while pregnant are likely to miscarry or face birth defects. The most common birth defect is microcephaly, a condition involving damaged brain tissue that prevents typical intellectual development (Pettersson 2016).

In 2016, a team of pediatric physical therapists conducted an observational study to identify the correlation between the Zika virus and major birth defects among children in Brazil. 250 children who were born with congenital microcephaly or were exposed to Zika virus in the womb were admitted by appointment to the Triage Center in Rio de Janeiro, Brazil to receive imaging, hearing and eye exams. The children were evaluated by a rotation of four different physical therapists assessing their neurological reflexes, muscle tone, motor delay, and orthopedic hinderances. While orthopedic malformations could be visibly observed, some tests were performed to identify abnormalities that could not be seen by the naked eye. For example, muscle tone was assessed based on the reflexes of the limbs. Each practitioner had thirty minutes to complete their portion of the exam which provided clinical information and possible aid to families (Freire 2020).

Upon observing children who were potentially impacted by the Zika virus, significant abnormalities were identified. 71% of the children over four months of age showed signs of motor delay, including those who were not born with congenital microcephaly. 62% of the patients also experienced abnormal muscle tone, in addition to a considerable number of orthopedic abnormalities in places such as the feet, hips, and wrists. Many of these children were in need of serious medical attention. Unfortunately, aid is virtually unattainable (Freire 2020).

The extreme poverty rates in Rio de Janeiro leave most families with roughly 5,000 U.S. dollars for a single year. Additionally, public healthcare is extremely lacking. Although it may be zero-cost, the system is essentially corrupt. Families are unable to receive adequate treatment in a timely manner. For some, participating in the study at the Triage Center meant extremely far travel without any concrete expectations (Freire 2020). The observations made by the physical therapists recorded occurrences of birth defects in this population, but it also highlighted a larger issue. While many complain about attending conference calls via Zoom, select Brazilian families are still battling the impacts of their broken healthcare system, trifling economy and a virus that predates COVID-19.

The haste exhibited throughout the examination process could have had a negative impact on the accuracy of the results. The examiners had to adjust to the eating and sleeping schedule of the infants, which created harsh time constraints. This long, difficult day for the participating children was ethical, but it produced irritability and resistance. This was acknowledged by the researchers, who noted that finances were the greatest issue. No funders were reported in this article, and the Triage Center was simply overwhelmed. They lacked the financial resources to perform blood tests and conduct a smooth study (Freire 2020). Again, this reflects the state of healthcare and economics in Brazil. To an extent, thoroughness had to be sacrificed to complete this study and reach as many families as possible. With proper funding, these observations could be repeated to benefit a new sample of children in Brazil.

While this study provided statistical data regarding the consequences of the Zika virus, it is crucial to consider how these outlined issues can be further addressed. A better healthcare system and economy in Brazil would require immense reform. Until then, families would benefit from donated medical services, such as those performed by the Triage Center study. The study also serves as a reminder that diseases cause suffering on multiple levels. The Zika virus in Brazil may have been thousands of miles away, but it has been made clear that diseases can spread. Globalization has brought COVID-19 to the United States, and we have yet to see all of the potential effects this can have on our society. If the Zika virus epidemic was able to bring devastation, then a global pandemic can easily have unidentified impacts on public health, the economy, and other aspects of our daily lives.




Freire R., Gaspari C., Albuquerque L., Jaccoud A., Fialho F., Darragh A., Campo M. 2020. Role of physical therapy in a triage center during the Zika Virus epidemic. American Physical Therapy Association. 100(6):890-893


Pettersson J., Eldholm V., Seligman S., Lundkvist A., Falconar A., Gaunt M., Musso D., Nougairéde A., Charrel R., Gould E., Lamballerie X. 2016. How did Zika Virus emerge in the Pacific Islands and Latin America? American Society for Microbiology. 7(5):e01239-16 doi:10.1128/mBio.01239-16


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