Artikel 45 – Zika Virus (The Fake Ghost)

ZIKA VIRUS (THE FAKE GHOST)

Taufiq Muhibbuddin Waly

For real intellectual people, there’s no need to be afraid of questioning something that you believe to be right, even when the entire world seems to just agree. Even the truth so many people believe to be sent by God couldn’t escape human’s doubt. To be called a freak, a rebel or an atheist wouldn’t make a curious one back down and stop finding the truth.

If we mentioned WHO, our mind will instantly think of an organization where the most intellectual people in medicine gathered and there’s no way that they’d make a mistake. But personally, if those people said that LGBT was not a mental illness, they clearly just made a mistake (search LGBT No Way). I also thought the same when those people supported the Halstead theory in the pathogenesis and pathophysiology of Dengue infection, because hypersensitivity Type 3 as a main pathogenesis and pathophysiology of Dengue Hemorrhagic Fever sounded more logical. A theory which is made by depending on cleverness, with the submission of every available researches about Dengue infection (including Halstead’s research) and conclude it as Hypersensitivity type III reaction or immune complex reaction. The strength of this theory can be seen by the achievement of this writing to take place as rank 1 in Google in various problems about Dengue infection (search DHF pathogenesis and pathophysiology, DHF and SLE, DHF vaccination and controversy of corticosteroid in Dengue infection). To called the heartbeat sound as loop-doop instead off Alloo-Hu was also a mistake me. They also made a mistake when they forced the entire world to get vaccinated, because this vaccination program would only add the financial debt that underdeveloped countries already had for so long. WHO should just improve worldwide nutrional care and quality so the only vaccination people should get was those they really needed, using clinically proven vaccine. Same goes with the basic theory of psychiatry, in my opinion, WHO should just suggest id Allooh or the instinct to find God to all psychiatrist on this entire world to cure human’s mental condition and to maintain human’s mental health (search LGBT No Way)

WHAT ABOUT ZIKA VIRUS?

People are so afraid of Zika virus because this virus was claimed to be the cause of human musculoskeletal impairment, especially tetraplegia in Guillain-Barre Syndrome/GBS, a very rare condition caused by autoimmune reaction. Zika virus is called the demon or ghost that people so afraid of by causing microcephaly (small size of skull and brain) on the newborn. Zika virus was officially blamed for causing microcephaly and GBS by WHO on March 2016 and made the entire world, especially South America and Southeast Asia countries, panicking. President Obama as the leader of a superpower country asked every scientist to create a vaccine for Zika virus as quick as possible. And the rumor said that this vaccine will be finished this year.

A. Zika Virus as the Ghost who Cause Guillain-Barre Syndrome

There’s no valid proof that Zika virus is the cause of GBS, except for what Van-Koi Cao Lormeau, Alexander Blake, Sandrine Mons and colleague said in Guillain-Barre Syndrome Outbreak Associated with Zika Virus Infection in French Polynesia: a case-control study, a written report of a GBS outbreak in French Polynesia on October 2013 until April 2014.

Zika virus is transmitted by Aedes Aegypti mosquitos, therefore a Dengue virus transmission should also be examined. Zika virus and Dengue virus are both RNA virus from Flavivirus genus of Flaviviridei family. Both are transmitted by Aedes Aegypti mosquito as vector. The research in French Polynesia reported that:

  • There are 42 GBS patients treated in hospitals. But writer found that there are only 5, 10, 3 and 3 patients were treated in French Polynesia on 2009, 2010, 2011, and 2012, respectively.
  • There are 31 GBS patients reported to have fever. The other 11 GBS patients didn’t.
  • RT-PCR examination for Zika virus was done to every 42 GBS patients.
  • The RT-PCR result was: positive for Zika virus on 41 patients, positive for Zika IgM on 39 patients, positive for IgG Zika on 29 patients, positive for IgG Dengue on 40 patients, and positive for IgM Dengue on 8 patients.
  • From 36 patients positive GBS, RNA isolation with more than 2 strains (36 patients) positive IgG Zika virus and no history of fever make a Dengue infection possible to be the cause of GBS with 86% of probability (25 patients, positive for IgG Dengue) on patients with positive RT-PCR result for Zika virus (29 patients). But, if the patients are negative for Zika IgG, the probability for Dengue virus to be the cause of infection is 85% (11 patients, positive IgG Dengue) on patients with positive RT-PCR result for Zika virus (13 patients).
  • But, if 2 strains or more of RNA virus was isolated from patients with no GBS symptoms and positive Zika IgG (65 patients), the Dengue infection could also be positive until 92% (23 patients with positive Dengue IgG) on patients with positive RT-PCR result for Zika virus (25 patients). But if Zika IgG is negative, the probability for the positive RNA virus finding to be Dengue virus reach 56% or 42 patients (positive Dengue IgG)

Writer’s analysis on the research mentioned above are:

  1. Dengue infection could be the cause of GBS on feverish patients with positive IgM Zika (with no RT-PCR result) if the patient’s IgG for Dengue is positive. However, the probability for Dengue virus to cause GBS was rejected by the researcher and WHO because from 42 patients positive GBS, there are 39 patients who were positive for IgM Zika (92%) but only 8 patients who were positive for IgM Dengue, because Dengue infection only show the increase of IgG (40 patients). So the researchers conclude that the GBS condition was caused by Zika infection, because positive IgM could cause acute GBS symptoms (42 patients). And in this research, 39 patients (92%) were founded to have positive Zika IgM, compared to 8 patients (19%) with positive Dengue IgM and 40 paatients (95%) with positive Dengue IgG. Based on these findings, the researchers and WHO concluded that GBS was caused by Zika virus.

In writer’s opinion, this kind of reasoning is a fraud. Positive IgM doesn’t always mean acute and positive IgG doesn’t always mean chronic. Positive IgM shows production of IgM which theoretically known as the first antibody to start attempting to bind virus (without causing antigen-antibody complex) to later be destroyed by macrophag. Because of the low number of IgM (+/- 25% of immunoglobulin), there are so little of antigen-antibody complex made during the process, therefore causing mild clinical symptoms. Writer agrees with Halstead research that suggest there’s no shock on the Thai kids suffered with DHF caused by primer infection/positive IgM (S.B Halstead Dengue Hemorrhagic Fever: Two infection and antibodi dependent enhancement, a brief history and personal memoir. Rev Cubana Med Trop, vol 54 n.3 Ciudad de la Habana sep.-dic. 2002).

On DHF, IgM will present on the fifth day of sickness. Therefore, the number of antigen-antibody complex formed before the fifth day is so little. Or on another saying, it also means that there are still so many unbound viruses. This will cause weak activation of complement and won’t cause cytokin storm because unbound viruses won’t activate C1, C2 and C4. With this reasoning, GBS will be caused by IgG instead of IgM, that could mean that the cause of GBS in French Polynesia is Dengue virus. Even if the patients mentioned above would have RT-PCR examination to check for Zika virus and got positive results, Dengue virus was still be the main cause, even with only positive Dengue IgG (without viral isolations). Based on that, whenever a patient is present with GBS and has a history of visiting Dengue endemic areas, the initial diagnosis that should be made is Dengue infection, instead of Zika even without lab examination.

The theory will be more rational if we agree with T. Mudwal who said that the basic pathogenesis and pathophysiology of Dengue infection is Hypersensitivity Type 3 or immune complex. With that concept, autoimmune reactions in GBS, SLE, Evan Syndrome, HELLP Syndrome, ITP and etc could possibly happened. You can search for “Again Let’s Discuss About DHF Pathogenesis and Pathophysiology” and “Can Dengue Infection Virus Provoke Autoimmune Fulminant Hepatitis and SLE” for further explanation. With these explanations, we can start to understand how IgM and IgG actually don’t show acute and chronic condition and that on Dengue virus infection, IgG is stronger than IgM to produce some kind of reaction.

The question is: is it impossible for IgM produced by Zika infection to cause stronger reaction than IgG produced by Dengue infection? Or is Zika virus alone able to destroy human body’s cells through apoptotic mechanism? On Dengue infection, it is known that when the antigen hasn’t been bound to antibody the clinical symptoms it produced is a lot milder (search “Again Let’s Discuss”). Is that also happened in Zika infection? Because they came from same genus and family, the mechanism that happened on Dengue infection should also be happened during Zika infection. Compared to Dengue virus, Zika is weaker. It is very possible to find Zika virus in people who infected by Dengue virus who lives in an endemic area like Indonesia or Singapore or other Southeast Asia countries. That’s also what happen right now in Latin America. Because they came from the same family, with the same vector and living hospes (monkey).

  1. Feverish patients with positive IgG and RT-PCR for Zika can’t instantly be diagnosed to have Zika because the probability of Dengue infection (positive IgG Dengue) to cause it is still high (86%).
  2. Based on the first and second statement, Dengue infection is still the most probable diagnosis for patients who presented with red eyes, joint pain, redness on skin who lives in Dengue endemic area, and haven’t got any lab examination compared to Zika. The migration of immune complex to the eye could cause redness in the eye. Writer also has meet 3 confirmed Dengue patients with red eyes and bleeding in the eye.

With this analysis, it was suggested that the Zika virus is still not the main cause of GBS, because the probability that GBS was caused by Dengue infection is still higher. Even until know, there are so many other probable condition that could cause GBS such as other virals and bacterial infections, or other possibilities.

B. Zika Virus as the ghost who caused microcephaly on newborn

The world was shocked by the report of the Brazilian Ministry of Health which mentioned that there are 3530 cases of microcephaly on the first week of January 2016 on the entire Brazil. On the contrary, writer found that the mean incidence of microcephaly from 2010-2014 in the entire Brazil is only 163 annually and from the latest report from Brazilian Ministry of Health on April 2016, there are 4908 cases of microcephaly on the entire Brazil. The number of Bazilian people who were suspected for Zika from February-April 2016 are 91.387 people. The currently known main causes of microcephaly are alcohol consumption, toxoplasmosis, cytomegalovirus, rubella, chemical substances, malnutrition and radiation.

Reasons that Zika was blamed to be the ghost who caused microcephaly:

  1. Zika virus was detected in January 2016 on 4 pregnant women with babies suffered from congenital malformation. Two fetuses were stillborn on 37 weeks pregnancies and 2 others were born alive but died in 24 hours. Zika virus was found on those babies.
  2. Zika virus was found in the amniotic fluid of 2 pregnant women in Paraiba region, Brazil on December 2015. Both babies from these women were suffered from microcephaly.
  3. Seventy percent (25) of 35 pregnant women who lived in or visited a Zika endemic area in Brazil has babies with microcephaly.
  4. From a research by Patricia Brasilm ose P. Pereira Jr., Claudia Raj Gabaglia and colleague (Zika Virus Infection in Pregnant Women in Rio de Janeiro – Preliminary Report) suggested that Zika virus was indeed infecting pregnant women in Brazil. Writer pick this article because it provided a complete report on the relationship between Zika virus and microcephaly as mentioned below:
  • The sample for this research is 88 pregnant women.
  • Eighty-two percent (72 women) of these women have positive RT-PCR result for Zika.
  • Fever was present on 20 women with positive Zika virus (72.8%) and 5 women tih negative Zika virus (31,2%).
  • Conjunctiva injection was present on 58,3% Zika positive women and 13,3% of Zika negative women.
  • Rash or redness on the skin was present on 44% Zika positive women and 12% Zika negative women.
  • Joint pain was present on 63,9% of Zika positive women and 43,8% of Zika negative women.
  • From ultrasound imaging on 42 Zika positive pregnant women, fetal growth impairment was present on 12 women (29%). And fetal growth impairment wasn’t found on 16 Zika negative women.
  • All 88 pregnant women are positive for IgG Dengue.

Discussion

Almost every city in Brazil is endemic for Aedes Aegypti. The Brazilian Ministry of Health Report on January 2016 shown that probable dengue cases was increased by 50% (74.000) compared to January 2015. Probable Dengue cases on 2014 was 600.000 cases and increased to 1,6 million cases in 2015.On the other hand, the outbreak of microcephaly that was blamed to Zika virus was already started on 2015. The 2 viruses were infecting side by side with the most attention was still given to Dengue.

According to our discussion about GBS in French Polynesia, the pathogenesis and pathophysiology of these viruses doesn’t have many differences. Viral infection and viremia without any bond to the antibody (doesn’t form immune complex) will not produce a reaction as fatal as GBS or microcephaly, so the finding of Zika virus in 4 pregnant women and amniotic fluid sample of 2 pregnant women are insignificant. Congenitl malformation on the fetus and microcephaly on the newborn were caused by structural impairment of the tissue from immune complex destruction (Zika virus and its antibody). However, with positive Dengue IgG on GBS patients, it’s more probable that the microcephaly was caused by immune complex destruction of Dengue virus and its antibody.

The question is, why are there thousands of microcephaly newborn in Brazil? Brazil is a Dengue endemic area, so it’s possible for Dengue virus there to genetically mutated or evolved to super antigen or changed in hospes’ nature that could cause the spreading of immune complex to uterine and to fetus to be easier. Or there are probably some structural impairment on the fetus or uterus caused by other microorganism that made the immune complex attached to the abnormal tissue that would cause greater damage and toxoplasmosis is one of the most possible causes. World Cup 2014 could be the triggering moment for massive toxoplasmosis transmission. Toxoplasma enter human body through the mouth, from the food or drinks, or contaminated hands. Toxoplasma usually attacked the eyes and brain. Toxoplasma is the main cause of retinocoroiditis in the USA. Toxoplasma transmission to the fetus keeps increasing throughout the year. Toxoplasma oocyt could survive in the soil for more than a year. Because of World Cup 2014, raw or medium cooked meat consumption, also cat’s and dog’s stool and feathers are spread widely in the entire Brazil. More than 50% cause of toxoplasmosis is the swallowing of incompletely cooked raw meat. The probability of toxoplasmosis and its combination with Dengue virus could be the most probable cause of microcephaly outbreak in Brazil.

With those mentioned reasons above, writers could conclude that 35 people who lived in or visited Zika endemic area in Brazil could also be counted as those who lived or visited Dengue endemic area. The fact could also mean that the 71% (25) of these 35 people who suffered with microcephaly babies could still be caused by Dengue instead of Zika. And 12 of 42 pregnant women with positive Zika virus and fetal growth impairment on the ultrasound could alse be caused by Dengue infection. Because, from the research of Patricia Brasial and colleagues, all of 88 sample of pregnant women are positive for Dengue IgG. The other probability is that microcephaly was caused by the combination of toxoplasmosis and Dengue infection. Same goes to the symptoms of fever, joint pain, skin redness, conoidritis and conjunctivitis that were also mentioned in Patricia Brasil and colleagues.

Conclusion

The proofs that were found to blame Zika as the ghost who caused GBS in French Polynesia and microcephaly in Brazil are still weak. The report which mentioned 12.000 Zika infections on pregnant women in Colombia were found to have 0% case of microcephaly. This fact supports what writer state in this article that Dengue infection was a more probable condition to cause GBS and microcephaly.

The combination of Dengue infection needs to be considered as the cause of thousands of microcephaly cases in Brazil. As for the hypothesis that mentioned Piryproxifen larvicide as the cause of microcephaly is also weak because piryproxifen larvicide has been mixed with Brazilian clean water for ages in order to killed mosquitos larves and the microcephaly outbreak has only been reported for one year. The combination of Dengue infection and toxoplasmosis caused by World Cup 2014 is stronger and a more logical theory compared to pyriproxifen.

The important conclusion from all of these writing is there’s no need for Zika vaccine the same can be said to Dengue vaccine too (search DHF vaccination profit or loss).

At the end, only Allah, God The Almighty, is our only source of truth. He gives us knowledge to whom He deem worthy. The truth has come and the wrong will be destroyed.

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