3 lessons for covering the Zika virus going forward

On Monday, Obama administration officials at a White House news conference made a public plea for more funds to combat the Zika virus. The mosquito-borne illness’ continued spread throughout the Americas, including the United States, virtually ensures that the topic will draw domestic and international media attention throughout 2016.

The possibility that Zika will make a significant landfall in the US is of great importance to American media and their audiences. But that localized threat shouldn’t blind the press from global context, including close examinations of how Zika outbreaks compare with other mosquito-borne illnesses around the world. Missteps in coverage over the past few months have exoticized the virus, providing important lessons in the way journalists should proceed as it develops further. Repeating mistakes, on the other hand, may lead to the spread of a different sort of contagion—fear.

Focus on mosquitos

Zika was first discovered in 1947 in Uganda’s Zika Forest (hence, the name). The mosquito-borne illness is closely related to dengue fever, chikungunya, and West Nile virus, and all are carried by the Aedes species of mosquito. But very few news outlets have explained the relationship between Zika and these infectious diseases. Just after the WHO announced Zika to be a public health epidemic in February, initial articles, including those published by BBC, Yahoo News, The Huffington Post, and CBS, failed to mention other diseases transmitted by the same species of mosquito.

“Mosquitos need to be the focus of the discussion, rather than the virus,” says Dr. Amesh Adalja, an infectious disease physician at the University of Pittsburgh Medical Center. “When you narrowly focus on Zika, it misses the point that we’ve been in the battle for some time with mosquito-borne illnesses.”

Compared to other types of diseases, such as chikungunya and dengue, Adalja says Zika isn’t as big a threat to global public health. The WHO estimates there could be between 3 and 4 million new cases of Zika in the Americas over the next year. But dengue fever, whose symptoms include nausea, severe headaches, and possibly death, has an estimated 50-100 million infections annually, according to the Centers for Disease Control. 

Helen Branswell, a reporter covering Zika for STAT, The Boston Globe-owned health sciences site, says her experience reporting on Zika in Puerto Rico reinforced the importance of mosquito control, as well as the challenges to its implementation. “When you drive around and see they could breed there, they could breed there, they could breed there,” she says, “it kind of drives home how gargantuan a task it is.”

Challenge official comments with independent viewpoints 

Reporters have also tripped up by regurgitating official statements—a practice not unique to Zika reporting. Until late March, for example, there was no definitive evidence that Zika caused microcephaly, a birth defect that results in an infant’s head being significantly smaller than normal, or Guillain-Barré, which can weaken breathing muscles and affect the involuntary nervous system. Neither disease is exclusively related to Zika. 

The WHO believed the link to be sufficient enough to proclaim the crisis a public health epidemic; Margaret Chan, director-general of the WHO, announced in a speech earlier this year that the Zika virus was spreading “explosively.”

Directly after Chan’s announcement, dozens of news outlets ran the word in their headlines, but few explained what an explosive outbreak would actually entail. Relying on official information in the early stages of coverage is, to some extent, understandable. Still, it must be bracketed with outside analysis to provide balance—even if it tempers a grabby headline. The lack of such depth at the time was all the more glaring given that, as The New York Times reported, there was debate even within the WHO as to how serious a tone to strike.

Use statistics carefully

Continued confusion in coverage since has stemmed from one of the reasons Zika received so much attention in the first place: It affects fetuses. Until the WHO finally confirmed the link among Zika, Guillain-Barré, and microcephaly in a report released last month, that relationship wasn’t clear.

Even so, many outlets turned to numbers to back up the perceived association, often in a misleading fashion. The Huffington Post, for example, reported that Zika had been linked to several thousand cases of microcephaly in Brazil in January. A CNN article in February suggested the number of microcephaly cases had increased to about 4,000.

But only a fraction of those fetuses with microcephaly tested positive for the Zika virus. And, conversely, less than 1 percent of pregnant women infected with Zika will have fetuses that develop microcephaly, according to the most recent WHO estimates.

“There was a huge number of microcephaly cases reported in Brazil,” says Andrew Joseph, a reporter at STAT. “As they started looking more closely, some were microcephaly [seemingly caused by Zika], and some were caused by other things or not microcephaly at all.”

While numbers can help illustrate the scope of infectious diseases, if used improperly, they can be doubly deceiving. “If you get a cluster [of cases], that raises your suspicion that something is going on–that’s happened with outbreaks in the past,” says Stephen Morse, an epidemiologist at Columbia University. Cases of microcephaly or Guillain-Barré may have existed in the past, but there may not have been the critical mass required for the same sort of media frenzy. 

“People forget that dengue kills thousands of people every year,” says Adalja. “It’s not that Zika doesn’t cause bad disease, it just has to be put into the context of what other diseases are similar or can be contrasted to it.”

Clarification: This story has been updated to clarify STAT’s relationship with The Boston Globe.