Zika is an elusive virus. It is most commonly transmitted by mosquitoes and goes unnoticed by its human hosts about 80% of the time. For the remaining 20%, symptoms range from very mild to pure havoc. One fact stands out: between 2013 and 2016, during the outbreak of the virus in Brazil women from minoritised groups overwhelmingly fell within the group that suffered the most dire consequences of the virus.

How come? To answer that question, we must look at the Zika epidemic through an intersectional feminist lens. 

To understand how Zika is gendered, we first need to know how it is transmitted. The virus first of all travels through the saliva of the tiny buzzing insect that keeps you up at night. It is also present in semen, vaginal fluids, blood, and urine and as such can be passed on from human to human during vaginal, anal, and (likely) oral sex, as well as blood transfusions. There is no evidence that Zika can be transmitted through saliva while kissing. And if a pregnant person becomes infected with the Zika virus, they can pass on the virus to the foetus. In these cases, it can lead to congenital anomalies in the foetus. This is relatively rare, but the pattern of disabilities linked to Congenital Zika Syndrome is severe: microcephaly (a very small skull), brain and eye damage, and problems with joints and muscles, often leaving the affected children bound to a wheelchair. 

Infection can be stopped in three ways: by preventing mosquito bites, having safe sex, and by preventing pregnancy. Public health campaigns seeking to prevent bites called upon the general population, and at times specifically on women and on “those responsible for the household,” to keep the house clean and “mosquito-proof”, for instance by bringing out the trash and getting rid of standing water. Several campaigns assigned the responsibility to protect the (nuclear) family from infection exclusively to women. Not a single campaign targeted men. 

Impoverished women were twice as likely as their wealthy counterparts to be infected when the Zika epidemic hit Brazil. Strikingly, 98% of “Zika babies” were born to medium to low-income mothers. One possible explanation for these statistics is that people in more impoverished communities often have substandard infrastructure and sanitation. Think: the difference between a neighbourhood with potholes and puddles of stagnant rain water (mosquito paradise!) and a meticulously designed and structured neighbourhood without asperities. 

Moving to safe sex and family planning campaigns, a highly gendered discourse burdened women with the responsibility to prevent viral spread. In virtually all campaign material it was women who were made aware of the risks of microcephaly, who were advised to delay pregnancy, who were encouraged to speak to a health professional about safe sex. The headline “Women Against Zika”, featured on a pamphlet, well illustrates the undue responsibilisation of women in fighting Zika. Perhaps because of stigma or taboo, very few campaigns mentioned condom use – arguably something that is, or at least should be, also men’s responsibility. This is particularly problematic in the Brazilian context, where women with low socio-economic status have difficulties negotiating condom use, research shows. 

In sum, since (also) in Brazil, differential medical treatment based on gender, class and ethnicity often go hand in hand, the reality was that impoverished, black, and indigenous women and their children were disproportionately affected by the virus. 

As of now, little is known about the precise role that factors related to poverty, such as malnutrition or genetics, play in Zika infection. It is also still a mystery why some children are born with severe abnormalities while others are not. When it turned out that the Zika epidemic stayed confined to tropical areas and did not tend to spread to other areas, foreign funding for research on the virus soon dried up. And as the world was distracted by the Covid pandemic, Zika researchers remained in the dark. 

At the time of writing (summer 2023) there is no major recorded outbreak of the Zika virus. The virus is still circulating on a low level in Brazil, as well as other Latin American, South and Southeast Asian countries. Nevertheless, climate scientists warn that climate change could lead to an increase in vector-borne diseases like Zika, Dengue, and Chikungunya. Therefore, governments and other relevant stakeholders can learn from the Brazilian case and tailor policies so that they mitigate Zika’s gendered aspects during a potential future outbreak.

Want to stay updated about the progress of Zika researchers? You can keep an eye on the Zika News section of Science Daily here