Zika virus: What do we need to know?

February 3, 2016

In May 2015, health officials reported confirmed cases of Zika virus infection in areas of northeast Brazil. By the end of 2015, further reports emerged regarding an increased number of Brazilian infants born with abnormally small heads and neurologic impairment. Since the beginning of the outbreak, active transmission of Zika virus has spread to other regions of the Americas, and health officials indicate that continued spread to the United States is likely. In the face of this threat, here are some basic considerations to help you understand what is happening.

1. What is Zika virus and how is it transmitted?

Zika virus is a mosquito-borne pathogen currently causing outbreaks in several countries in South America, Central America, the Caribbean and the Pacific Islands. Zika is a flavivirus, which means it is in the same family of viruses as dengue, yellow fever and West Nile viruses. The primary mode of Zika virus transmission is through the bite of an infected Aedes mosquito—the same species that can serve as the vector for other tropical and subtropical viruses such as dengue, yellow fever and Chikungunya. Direct transmission of Zika virus through sexual contact has been reported, and it is also likely that pregnant women can pass the infection to infants in the womb.

2. Where did Zika virus come from?

Zika virus is not a new pathogen. It was first identified in a rhesus monkey in 1947 in the Zika Forest of Uganda. Sporadic human infections occurred in Africa and Southeast Asia, and the first human outbreak was recorded on a Micronesian island in 2007. Additional outbreaks in the Pacific Islands occurred, all of which were associated with mild, self-limited disease.

Beginning with the outbreak in Brazil in May 2015, the virus was introduced into new geographic regions conducive to sustained transmission of the infection. Conditions in the newly affected areas in South and Central America are likely to lead to continued spread of the infection because the areas are home to the vector of transmission (the Aedes mosquito), as well as large populations of susceptible people within which the infection can proliferate. Given the likelihood of international travel among asymptomatic infected individuals and the fact that the range of certain species of Aedes mosquitoes extends into southern portions of the United States, it is probable that pockets of local transmission of Zika virus will eventually occur in certain parts of the United States.

3. What medical problems are associated with Zika virus infection?

Most people who become infected with Zika virus have no discernable symptoms and are therefore unaware of the infection. About 20 percent of infected individuals will have clinically apparent disease, but even in these cases the illness is typically mild. The most common symptoms are fever, rash, joint pain and conjunctivitis. These symptoms typically begin within one week of being bitten by an infected mosquito. When symptomatic, the illness usually lasts a few days to a week and resolves on its own. In rare cases, infection with Zika virus may act as a trigger for Guillain-Barré Syndrome (GBS), an autoimmune illness characterized by muscle weakness and paralysis. Most people with GBS make a full recovery.

A noteworthy pattern emerging in some areas affected by the current Zika virus outbreak is the increase in the number of infants born with a condition called microcephaly. Microcephaly is a birth defect where a baby is born with an abnormally small head, indicating some degree of impaired brain development during gestation. There are many known causes of microcephaly, including congenital infections (infections passed from a pregnant mother to her developing child while in the womb), poor nutrition and certain drugs or toxins. While the increased incidence of microcephaly in areas of Zika virus outbreak indicate a possible association, it is important to note that microcephaly rates have not yet increased in all areas of outbreak. Zika outbreaks prior to 2015 did not report increases in the incidence of microcephaly. Further investigations are underway in attempt to definitively determine if there is a causal link.

4. What measures are being taken to control the outbreak?

There are no specific antiviral therapies for Zika virus disease. The standard course of care for symptomatic individuals involves supportive therapies such as rest, hydration and fever and pain reducing medications. Eighty percent of infected individuals have no symptoms and require no additional care.

No vaccine is available for the prevention of Zika virus infections in humans. In areas with active or potential Zika virus transmission, the most effective methods of preventing the spread of infection center around avoidance of mosquito bites via mechanical and chemical barriers. Mechanical mosquito barriers include bed nets, air conditioned interior spaces, screened doors and windows, as well as wearing long sleeve shirts and long pants. Chemical interventions are intended to prevent mosquito bites (through the use of insect repellants) and reduce the overall number of mosquitoes present in a community (through pesticide fumigation practices).

While studies of the possible association between infection and birth defects are ongoing, the Centers for Disease Control and Prevention (CDC) issued a Health Advisory urging pregnant women to postpone travel to areas with active transmission of Zika virus. If postponement of such a trip is not possible, pregnant women or women trying to become pregnant are advised to speak with a healthcare provider prior to traveling and should carefully follow all instructions on how to avoid mosquito bites.

5. How should Christians respond to the Zika virus outbreak?

While the impending spread of Zika virus and the potential harm to congenitally infected infants represent real public health challenges, we should be careful to wisely consider the proposals for infection control and prevention. Commendable responses to this outbreak are marked by resolve, not panic. Yes, we should recognize the potential severity of the threat and act accordingly, but we should also refuse to allow fear to trump our core convictions of compassion and the dignity of all human life.

The avoidance of unnecessary travel into areas of active transmission is a prudent step in curtailing the spread of Zika virus to further areas. And yet, even if we cancel our Brazilian vacations, we would do well to take interest in the growing burden of disease and be willing to come to the aid of others in need. Even as some pray that the outbreak stays “their” problem, others are thinking of ways to partner with affected communities, healthcare workers and researchers to help stop the spread of infection and care for the people impacted by it. Whether serving on the field (as many colleagues in the medical field do in various ways) or contributing in tangible ways from afar, the point is that our response should not be primarily driven by a self-centeredness that neglects the needs of those around us, but by Christ-like compassion for the suffering of others.

In addition to the temptation to ignore the problem and hope it doesn’t come our way, other proposals for mitigating the effects of the outbreak have the potential to raise significant ethical questions. Several countries have recommended that citizens postpone pregnancies while Zika virus continues to circulate. Some of the countries, such as El Salvador, are predominantly Roman Catholic, which potentially puts the government’s recommendation at odds with the religious convictions of many people regarding birth control.

Even if one does not oppose all forms of birth control, it would be wise to consider whether these proposals will cause an increase in the use of abortifacient birth control measures. These measures include birth control medications and devices that have the potential to prevent the development of a fertilized egg, as well as surgical procedures designed specifically to do away with an infant found to have a birth defect in the womb. Sacrificing the life of an offspring to avoid the possibility of infection or the prospect of living with disability is a wicked trade. The God-given dignity of human life is more valuable than having our fear of earthly suffering assuaged.

Scott James

Scott James serves as an elder at The Church at Brook Hills. He and his wife, Jaime, have four children and live in Birmingham, Alabama, where he works as a pediatric physician. He is the author of The Expected One: Anticipating All of Jesus in the Advent, and Mission Accomplished: A Two-Week Family … Read More

Article 12: The Future of AI

We affirm that AI will continue to be developed in ways that we cannot currently imagine or understand, including AI that will far surpass many human abilities. God alone has the power to create life, and no future advancements in AI will usurp Him as the Creator of life. The church has a unique role in proclaiming human dignity for all and calling for the humane use of AI in all aspects of society.

We deny that AI will make us more or less human, or that AI will ever obtain a coequal level of worth, dignity, or value to image-bearers. Future advancements in AI will not ultimately fulfill our longings for a perfect world. While we are not able to comprehend or know the future, we do not fear what is to come because we know that God is omniscient and that nothing we create will be able to thwart His redemptive plan for creation or to supplant humanity as His image-bearers.

Genesis 1; Isaiah 42:8; Romans 1:20-21; 5:2; Ephesians 1:4-6; 2 Timothy 1:7-9; Revelation 5:9-10

Article 11: Public Policy

We affirm that the fundamental purposes of government are to protect human beings from harm, punish those who do evil, uphold civil liberties, and to commend those who do good. The public has a role in shaping and crafting policies concerning the use of AI in society, and these decisions should not be left to those who develop these technologies or to governments to set norms.

We deny that AI should be used by governments, corporations, or any entity to infringe upon God-given human rights. AI, even in a highly advanced state, should never be delegated the governing authority that has been granted by an all-sovereign God to human beings alone. 

Romans 13:1-7; Acts 10:35; 1 Peter 2:13-14

Article 10: War

We affirm that the use of AI in warfare should be governed by love of neighbor and the principles of just war. The use of AI may mitigate the loss of human life, provide greater protection of non-combatants, and inform better policymaking. Any lethal action conducted or substantially enabled by AI must employ 5 human oversight or review. All defense-related AI applications, such as underlying data and decision-making processes, must be subject to continual review by legitimate authorities. When these systems are deployed, human agents bear full moral responsibility for any actions taken by the system.

We deny that human agency or moral culpability in war can be delegated to AI. No nation or group has the right to use AI to carry out genocide, terrorism, torture, or other war crimes.

Genesis 4:10; Isaiah 1:16-17; Psalm 37:28; Matthew 5:44; 22:37-39; Romans 13:4

Article 9: Security

We affirm that AI has legitimate applications in policing, intelligence, surveillance, investigation, and other uses supporting the government’s responsibility to respect human rights, to protect and preserve human life, and to pursue justice in a flourishing society.

We deny that AI should be employed for safety and security applications in ways that seek to dehumanize, depersonalize, or harm our fellow human beings. We condemn the use of AI to suppress free expression or other basic human rights granted by God to all human beings.

Romans 13:1-7; 1 Peter 2:13-14

Article 8: Data & Privacy

We affirm that privacy and personal property are intertwined individual rights and choices that should not be violated by governments, corporations, nation-states, and other groups, even in the pursuit of the common good. While God knows all things, it is neither wise nor obligatory to have every detail of one’s life open to society.

We deny the manipulative and coercive uses of data and AI in ways that are inconsistent with the love of God and love of neighbor. Data collection practices should conform to ethical guidelines that uphold the dignity of all people. We further deny that consent, even informed consent, although requisite, is the only necessary ethical standard for the collection, manipulation, or exploitation of personal data—individually or in the aggregate. AI should not be employed in ways that distort truth through the use of generative applications. Data should not be mishandled, misused, or abused for sinful purposes to reinforce bias, strengthen the powerful, or demean the weak.

Exodus 20:15, Psalm 147:5; Isaiah 40:13-14; Matthew 10:16 Galatians 6:2; Hebrews 4:12-13; 1 John 1:7 

Article 7: Work

We affirm that work is part of God’s plan for human beings participating in the cultivation and stewardship of creation. The divine pattern is one of labor and rest in healthy proportion to each other. Our view of work should not be confined to commercial activity; it must also include the many ways that human beings serve each other through their efforts. AI can be used in ways that aid our work or allow us to make fuller use of our gifts. The church has a Spirit-empowered responsibility to help care for those who lose jobs and to encourage individuals, communities, employers, and governments to find ways to invest in the development of human beings and continue making vocational contributions to our lives together.

We deny that human worth and dignity is reducible to an individual’s economic contributions to society alone. Humanity should not use AI and other technological innovations as a reason to move toward lives of pure leisure even if greater social wealth creates such possibilities.

Genesis 1:27; 2:5; 2:15; Isaiah 65:21-24; Romans 12:6-8; Ephesians 4:11-16

Article 6: Sexuality

We affirm the goodness of God’s design for human sexuality which prescribes the sexual union to be an exclusive relationship between a man and a woman in the lifelong covenant of marriage.

We deny that the pursuit of sexual pleasure is a justification for the development or use of AI, and we condemn the objectification of humans that results from employing AI for sexual purposes. AI should not intrude upon or substitute for the biblical expression of sexuality between a husband and wife according to God’s design for human marriage.

Genesis 1:26-29; 2:18-25; Matthew 5:27-30; 1 Thess 4:3-4

Article 5: Bias

We affirm that, as a tool created by humans, AI will be inherently subject to bias and that these biases must be accounted for, minimized, or removed through continual human oversight and discretion. AI should be designed and used in such ways that treat all human beings as having equal worth and dignity. AI should be utilized as a tool to identify and eliminate bias inherent in human decision-making.

We deny that AI should be designed or used in ways that violate the fundamental principle of human dignity for all people. Neither should AI be used in ways that reinforce or further any ideology or agenda, seeking to subjugate human autonomy under the power of the state.

Micah 6:8; John 13:34; Galatians 3:28-29; 5:13-14; Philippians 2:3-4; Romans 12:10

Article 4: Medicine

We affirm that AI-related advances in medical technologies are expressions of God’s common grace through and for people created in His image and that these advances will increase our capacity to provide enhanced medical diagnostics and therapeutic interventions as we seek to care for all people. These advances should be guided by basic principles of medical ethics, including beneficence, non-maleficence, autonomy, and justice, which are all consistent with the biblical principle of loving our neighbor.

We deny that death and disease—effects of the Fall—can ultimately be eradicated apart from Jesus Christ. Utilitarian applications regarding healthcare distribution should not override the dignity of human life. Fur- 3 thermore, we reject the materialist and consequentialist worldview that understands medical applications of AI as a means of improving, changing, or completing human beings.

Matthew 5:45; John 11:25-26; 1 Corinthians 15:55-57; Galatians 6:2; Philippians 2:4

Article 3: Relationship of AI & Humanity

We affirm the use of AI to inform and aid human reasoning and moral decision-making because it is a tool that excels at processing data and making determinations, which often mimics or exceeds human ability. While AI excels in data-based computation, technology is incapable of possessing the capacity for moral agency or responsibility.

We deny that humans can or should cede our moral accountability or responsibilities to any form of AI that will ever be created. Only humanity will be judged by God on the basis of our actions and that of the tools we create. While technology can be created with a moral use in view, it is not a moral agent. Humans alone bear the responsibility for moral decision making.

Romans 2:6-8; Galatians 5:19-21; 2 Peter 1:5-8; 1 John 2:1

Article 2: AI as Technology

We affirm that the development of AI is a demonstration of the unique creative abilities of human beings. When AI is employed in accordance with God’s moral will, it is an example of man’s obedience to the divine command to steward creation and to honor Him. We believe in innovation for the glory of God, the sake of human flourishing, and the love of neighbor. While we acknowledge the reality of the Fall and its consequences on human nature and human innovation, technology can be used in society to uphold human dignity. As a part of our God-given creative nature, human beings should develop and harness technology in ways that lead to greater flourishing and the alleviation of human suffering.

We deny that the use of AI is morally neutral. It is not worthy of man’s hope, worship, or love. Since the Lord Jesus alone can atone for sin and reconcile humanity to its Creator, technology such as AI cannot fulfill humanity’s ultimate needs. We further deny the goodness and benefit of any application of AI that devalues or degrades the dignity and worth of another human being. 

Genesis 2:25; Exodus 20:3; 31:1-11; Proverbs 16:4; Matthew 22:37-40; Romans 3:23

Article 1: Image of God

We affirm that God created each human being in His image with intrinsic and equal worth, dignity, and moral agency, distinct from all creation, and that humanity’s creativity is intended to reflect God’s creative pattern.

We deny that any part of creation, including any form of technology, should ever be used to usurp or subvert the dominion and stewardship which has been entrusted solely to humanity by God; nor should technology be assigned a level of human identity, worth, dignity, or moral agency.

Genesis 1:26-28; 5:1-2; Isaiah 43:6-7; Jeremiah 1:5; John 13:34; Colossians 1:16; 3:10; Ephesians 4:24