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Zika Virus
A Danger with Several Unknowns
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    An acute Zika infection does not pose a danger for adults, however, viral infections can cause medium to long-term complications after the patient has recovered from the acute illness. There is a high probability that there is a connection between the Zika virus epidemic and the frequent occurrence of a neurodevelopmental disorder in neonates. According to our present knowledge, the impact of the Zika virus epidemic on life insurance is limited.
    200,000 soldiers use pesticides to fight the Zika virus in Brazil. They are travelling from house to house, distributing brochures with tips, how to protect themselves, and distribute free protection for pregnant women. Genetically-manipulated male mosquitoes are also being used in order to prevent further spread of the insects. Before the Olympic Games begin in Rio de Janeiro, visitors should be able to travel without hesitation. The 3-4 mm large mosquito "Aedes aegypti" is the problem: they spread very quickly and also transmit viruses that trigger dengue fever and chikungunya fever. Vaccination development is starting from zero. The exact method of transmission of the virus and the cause of the currently very rapid spread are also unknown. Until now, researchers have assumed that once you are ill, you will be immune to the virus in the future.

    Risks of the infection are not yet known

    The virus causes a skin rash, head and joint pain and mild fever in sick adults. The symptoms are not particularly dangerous. However, viral infections can cause medium to long-term complications after the patient has recovered from the acute illness, according to Karsten Filzmaier, Head of the Center of Competence Medical Research & Consulting in Munich Re. This could also be observed in the recently resolved Ebola epidemic, in which eye problems or neurological symptoms occurred even months later in those who had survived the infection. A Zika infection could therefore entail risks that are not yet known. Pregnant women infected with Zika virus are at risk. There is a high probability that there is a connection between the Zika virus and the frequent occurrence of cranial malformations (microcephaly) in neonates in affected areas. Microcephaly is a severe congenital malformation of the skull which can lead to severe cognitive and neurological developmental disorders. Overall, however, it is still too early to specify the extent of the consequences, warns Filzmaier.

    Virus spreads in South and Central America

    "If the virus is only transmitted by mosquitoes – and that’s our present knowledge, then we can rule out a global pandemic and regional epidemics will be restricted to the mosquitoes' habitat ", explains Karsten Filzmaier. The epicentre lies in the state of Pernambuco, the capital city of which is Recife. By now, it is estimated that half a million to one and a half million people are ill. The virus, which was barely known until recently, is now affecting not only Brazil, but 22 other countries in South and Central America as well as the Caribbean, among which is Colombia, which is also severely affected. 13,500 cases of the conditions have reportedly occurred since October. Females have been advised to temporarily avoid pregnancy in the meantime, the number of abortions are increasing. Zika virus will continue to spread further: the deprived areas of large cities provide ideal conditions for the breeding of mosquitoes.

    Probable relationship between Zika virus and neurological conditions

    As the progress of an acute Zika infection is harmless, according to the current level of knowledge, an immediate impact on the morbidity or mortality rate is not to be expected. The above-mentioned medium to long-term complications of a viral infection, however, could definitely influence that. "In recent weeks, an increased number of patients in Latin America have become ill with Guillain-Barré syndrome. This neurological disease can be triggered by a viral infection", states Filzmaier. "A relationship between the Zika virus and this or other neurological conditions is therefore conceivable, but not yet scientifically proven." Filzmaier says that the risk of dying from Guillain-Barré syndrome, provided that good medical treatment is available, is low. Around a fifth of those affected have, however, long-term neurological damage.

    Life insurance: Possible effects on Critical Illness Products

    In the event that there is a significant increase in the number of Guillain-Barré cases in the countries affected, this could have an impact on Critical Illness Products. The paralysis typically occurring in Guillain-Barré syndrome is often covered by this insurance policy. In the case of some Critical Illness Products, neonates are automatically insured in the context of their parents' insurance policy. Congenital malformations of a child are sometimes also covered by these policies. Depending on the terms and conditions of these products, an increase in neonates with microcephaly also could lead to an increase in the entitlements to benefits. "The Zika epidemic is therefore a classic example of a medical-epidemiological risk of change in life insurance", states the Head of the Center of Competence Medical Research & Consulting.

    The Federal Foreign Office of Germany are advising pregnant women against travelling to the affected regions. 
    More informations of the World Health Organisation: WHO Q&A
    Expert
    Karsten Filzmaier
    is in charge of the Center of Competence Medical Research & Consulting in the Life/Health department.

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