The International New York Times
February 18, 2016

by Vanessa Barbara
Contributing Op-Ed Writer

SÃO PAULO, Brazil — Last December, I suddenly found myself in possession of two bottles of the most precious liquid in town: Exposis Extrême, an extra-strong insect repellent. It’s deemed the best protection against the Aedes aegypti mosquito, which transmits dengue, chikungunya and, now, the Zika virus. Its active ingredient is icaridin, which also repels ticks and the mosquitoes that carry malaria. I’d bought the bottles earlier in the year, during an outbreak of dengue fever, in the hope that a high-quality bug spray would keep me safe from the virus. (It didn’t. I came down with dengue, anyway.)

As soon as the Brazilian government confirmed in late November the link between Zika and microcephaly — a rare, incurable neurodevelopmental disorder in newborn babies — pregnant women rushed to drugstores and cleared them out of their supply of the spray. For more than a month, the shelves remained empty. People put their names on waiting lists, tried to bribe drugstore employees and ordered overpriced bottles online. On the black market, a bottle of Exposis Extrême reached two or three times the official price.

My sister-in-law is four months pregnant with a baby girl and she unabashedly took part in the frantic search for Exposis Extrême. Like an undercover narcotics agent, my brother received a tip: A drugstore had received a re-up. He ran out in the hope of getting his wife a fix — only to find that it was just a rumor. So my sister-in-law spent part of the summer wearing long-sleeved shirts and trousers. It was only in the middle of January that they were finally able to buy six small bottles of Exposis Extrême for about $15 each. (Brazil’s monthly minimum wage is $224.)

Health officials from the United States, Canada and other countries have warned pregnant women to postpone trips to Latin America and the Caribbean. But while pregnant women from rich countries are being urged not to travel, women from poor countries are being urged not to become pregnant. The authorities in Ecuador, Colombia and El Salvador have all advised avoiding pregnancy. Here in Brazil, it’s not official policy. But gynecologists — including mine — are strongly discouraging it, at least while it’s summer.

The level of concern Brazilians feel depends on several factors. Of course, pregnant women everywhere are worried. But geography matters: In the richer southeast, where I live, Zika is still no match for dengue fever, which is both more common and more lethal — last year, 1.6 million Brazilians were infected; 863 died. In São Paulo, concern about Zika is still seen as overblown. My sister-in-law recently went to see two different doctors about a rash and both told her that they wouldn’t know how to diagnose a Zika infection because they had never treated anyone with the disease.

Money also matters. Wealthier women can afford as many bottles of insect repellent as they can get their hands on (not to mention ultrasound exams to find out if their unborn children are showing signs of microcephaly); the poorest can count only on chance. And not many women can follow the example of a pregnant middle-class woman from Rio de Janeiro who recently packed her bags and left for Europe, planning to stay abroad at least through the end of her first trimester.

It seems that money can even buy the illusion of safety. My gynecologist told me about one of her pregnant patients, who, despite doctor’s orders, recently traveled three times to northeast Brazil, where most of the Zika infections have been reported. When my doctor asked the woman why she kept going to the area despite the risks of contracting the virus, she explained that she didn’t worry because she always stays in upscale resorts.

The idea that mosquitoes can’t make their way into four-star hotel rooms is absurd, but so is much of the thinking here these days when it comes to the Zika virus. More than fear, confusion has been the dominant response: In WhatsApp groups and on social networks, people have spread rumors that Zika can cause serious neurological complications in infected children or that the government has been hiding the real number of victims or that the outbreak was caused by genetically modified mosquitoes. These claims have been debunked, but Brazilians are still lacking strong, categorical truths. The number of cases is still being disputed and a causal relationship between the virus and microcephaly has not been scientifically established.

There are even fears that foreign athletes will pull out of the 2016 Olympic Games in Rio in August. That’s not an unfounded concern. Some governments have told their teams that they can stay home if they’re worried about diseases. I prefer a more amusing possibility: that the Brazilian committee is lobbying to include a new sport in this year’s Games, a kind of tennis to be played with electric mosquito swatters. There could be three categories: dengue, chikungunya and Zika.

Rumors aside, there’s not much that we in Brazil can do now but wait for more studies and, maybe a few years down the line, a vaccine. For the moment, there’s no alternative plan for most Brazilian women but to spend another season wearing long sleeves, avoiding pregnancy and getting as much Exposis Extrême as they can find and afford.

Vanessa Barbara is a columnist for the Brazilian newspaper O Estado de São Paulo, the editor of the literary website A Hortaliça and a contributing opinion writer.