Like many other parts of South and Central America, Surinam is suffering a zika epidemic. Erasmus MC doctors and researchers are collaborating with Surinamese researchers at Paramaribo’s Academic Medical Centre (AZP) to determine the consequences of the mosquito-borne virus. Virologist Eric van Gorp is spending this week in Surinam.

“Up till now, the zika virus has been relatively innocuous, compared with other diseases, like dengue and chikungunya,” Van Gorp reported from Paramaribo. Nearly every person living in Surinam comes down with it at some point in their lives, generally without serious consequences. However, zika has now been linked to paralysis disorder (Guillain-Barré syndrome) and birth defects (microcephaly). Erasmus MC and AZP researchers hope to find out whether there really is a relationship.

Not panicking

“In situations like this, what often happens is that one report will be picked up by the media, who will then present it as the ‘truth’,” said Van Gorp. A few weeks ago, images of babies with very small heads – a condition called microcephaly – made headlines the world over. “Our view of the situation is determined by exceptional cases,” stated Van Gorp. In Surinam, however, no one is panicking. “It hasn’t yet been demonstrated that there is a direct link. Surinam does often see cases of Guillain-Barré syndrome, but no one is sure whether these are caused by zika virus. ” While it is true that the 75-year-old Dutch tourist who recently died in Surinam had been infected with zika, it has not yet been demonstrated that zika was in fact the cause of his death.

The investigation at AZP is part of an on-going collaboration between Surinamese scientists and the Erasmus MC. “Our researchers regularly go to Surinam, to investigate how zika-like viruses affect the central nervous system,” Van Gorp told us. Even so, he believes the World Health Organization (WHO) was right to raise the alarm and declare zika a public health emergency of international concern. “It is important that this virus receive more attention. Eighty percent of people get zika virus without suffering any ill effects. These cases involving microcephaly and Guillain-Barré syndrome are just the tip of the iceberg.”

Hundreds of patients

According to Van Gorp, all the required expertise has now been gathered in Surinam. “We are carrying out research on many levels. In addition to virologists, our group includes entomologists from Wageningen, who are investigating the mosquitoes. As for me, I’m spending a lot of time with patients. We have hundreds of patients here, and the local doctors are very familiar with the clinical picture. Furthermore, we have specialist labs in the Netherlands carrying out more research, and they develop things which can be used here in Surinam.”

Intensive care

The current investigation involves three Erasmus MC departments, i.e. virology, neurology and intensive care medicine. “Our neurologists are involved due to the research being conducted into Guillain-Barré syndrome, while our intensive care doctors can provide Paramaribo with additional respiration capacity, if necessary. They’re already on call, so if more artificial respiration is required, they’ll be ready to provide it,” Van Gorp said.