Uncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisis
Kelly, Ann H. ; Lezaun, Javier ; Löwy, Ilana ; Matta, Gustavo Corrêa ; Oliveira Nogueira, Carolina de; Rabello, Elaine Teixeira - \ 2020
Social Science and Medicine 246 (2020). - ISSN 0277-9536
Brazil - Emergency research - Public health emergency - Uncertainty - Zika
Uncertainty was a defining feature of the Brazilian Zika crisis of 2015–2016. The cluster of cases of neonatal microcephaly detected in the country's northeast in the second half of 2015, and the possibility that a new virus transmitted by Aedes mosquitoes was responsible for this new syndrome, created a deep sense of shock and confusion in Brazil and around the world. When in February 2016 the WHO declared a Public Health Emergency of International Concern (PHEIC), it noted that it did so on the basis of what was not known about the virus and its pathogenic potential. To better understand the role that non-knowledge played in the unfolding of the Brazilian Zika crisis we differentiate between three different kinds of uncertainty: global health uncertainty, public health uncertainty, and clinical uncertainty. While these three forms of uncertainty were difficult to disentangle in the early weeks of the crisis, very soon each one began to trace a distinct trajectory. Global health uncertainty centered on the question of the causative link between Zika virus infection and congenital malformations, and was declared resolved by the time the PHEIC was lifted in November 2016. Public health and clinical uncertainty, in contrast, persisted over a longer period of time and did, in some important ways, become entrenched. This taxonomy of uncertainties allows us to explore the systematic nonproduction of knowledge in times of medical emergency, and suggests structural limitations in the framework of “emergency research” that global health institutions have developed to deal with unexpected threats.
Use, fate and ecological risks of antibiotics applied in tilapia cage farming in Thailand
Rico, A. ; Oliveira, R. ; McDonough, S. ; Matser, A. ; Khatikarn, J. ; Satapornvanit, K. ; Nogueira, A.J.A. ; Soares, A.M.V.M. ; Domingues, I. ; Brink, P.J. van den - \ 2014
Environmental Pollution 191 (2014). - ISSN 0269-7491 - p. 8 - 16.
fluoroquinolone antibiotics - veterinary antibiotics - ubiquitous occurrence - asian aquaculture - sediments - china - water - river - oxytetracycline - tetracyclines
The use, environmental fate and ecological risks of antibiotics applied in tilapia cage farming were investigated in the Tha Chin and Mun rivers in Thailand. Information on antibiotic use was collected through interviewing 29 farmers, and the concentrations of the most commonly used antibiotics, oxytetracycline (OTC) and enrofloxacin (ENR), were monitored in river water and sediment samples. Moreover, we assessed the toxicity of OTC and ENR on tropical freshwater invertebrates and performed a risk assessment for aquatic ecosystems. All interviewed tilapia farmers reported to routinely use antibiotics. Peak water concentrations for OTC and ENR were 49 and 1.6 µg/L, respectively. Antibiotics were most frequently detected in sediments with concentrations up to 6908 µg/kg d.w. for OTC, and 2339 µg/kg d.w. for ENR. The results of this study indicate insignificant short-term risks for primary producers and invertebrates, but suggest that the studied aquaculture farms constitute an important source of antibiotic pollution.