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May 25, 2017: Mosquito Season In Full Swing In Ohio

Mosquito and tick season is officially off and running in Ohio. Mosquitoes will be at their blood-sucking worst from May through October, while ticks have been active since April and will stay active until September.

The mosquito species that is most active in Ohio has been known to carry the West Nile virus. Last year, there were 17 confirmed cases of West Nile among Ohio residents. About 80 percent of people who are infected with West Nile will not show symptoms, the Ohio Department of Health (ODH) says. Only one in 150 people infected with West Nile will develop serious symptoms, like high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis. These symptoms may last several weeks, and neurological effects may be permanent, the ODH says.

On the bright side, there is less reason to fear the Zika virus which has spread through parts of Central America and the Southeast U.S. The mosquito species that is known to transmit Zika has not been established in Ohio. However, a “cousin” of the mosquito has been found in different regions throughout Ohio and that speces has been known to transmit Zika.

The ODH says there were 95 travel-associated Zika cases in Ohio last year, all from travelers returning to the Buckeye State from Zika-impacted areas. There have been three travel-associated cases of Zika in 2017.

“You can take some simple precautions at home and when traveling to prevent potentially serious mosquito-borne diseases,” said Sietske de Fijter, ODH State Epidemiologist and Bureau Chief of Infectious Diseases, in a statement.

Source: Cleveland Patch

May 24, 2017: Health Officials Say More Cases Are Coming This Summer to Philadelphia

This from Mark Dent at BillyPenn.

The signs are already up. At the airport and on SEPTA buses and Regional Rail trains, the city’s Department of Public Health has posted ads zoomed in on a mosquito with the warning, “Keep These Suckers Out.” Underneath, a slogan reads, “Fight the bite. Prevent Zika.” In another ad, the Department of Health warns, “Mosquitoes aren’t the only ones that spread Zika. Wear a condom.”

The department’s goal is to get the word out quickly in hopes of curbing a Zika problem. While Philadelphians need not worry as much as residents of southern states, the disease is expected to be a bigger issue than last summer. Of the approximately 200 cases Pennsylvania has experienced since late 2015, about 25 percent were in Philadelphia. Steve Alles, bioterrorism and public health preparedness manager for the Department of Public Health, said he expects that number of infections to rise this summer compared to last year.

“The biggest concern we have,” he said, “is not letting Zika get into our own mosquito pools.”

“The way we could get a Zika outbreak here,” said Dr. Kathleen Hall Jamieson, director of the Annenberg Public Policy Center at Penn, “is through our airport.”

The CDC expects the Aedes aegypti to carry the virus into parts of the southern United States, like Florida, Texas and other Gulf states. This breed of mosquito has been found farther north in rare cases, including once in Bucks County.

Philadelphia does have the Asian Tiger mosquito, known as the Aedes albopictus. It’s the same genus as the aegypti but a different species. It can carry Zika but would have to get it from a host.

So when Alles speaks of the concern, he’s referring to the possibility of Philadelphia’s Asian Tiger mosquitoes contracting Zika by biting somebody who returns from a southern state or foreign country with the virus. For every case last year, Zika patients were successfully prevented from spreading the virus in that fashion.

To reduce the possibility of Zika-carrying mosquitoes, which again are highly unlikely in Philadelphia, Jamieson recommends being mindful of standing water and making sure screens in houses are repaired. Another concern regarding Zika here — and elsewhere — is the spread of the disease through sexual contact. Both men and women can spread it sexually.

About 80 percent of people who contract Zika show no symptoms, but they can still pass on the virus. Those with symptoms experiencing a sickness similar to the flu.

Pregnant women or women about to become pregnant face the greatest risk. They can give birth to children with microcephaly or other development conditions. Last year, the CDC tracked 442 pregnant women in the US who had Zika and six percent had a child with Zika-related birth defects.

“Though it will have low impact on our city,” Alles said, “it will have high impact on people that get the disease.”

Jamieson said the Health Department’s warnings about practicing safe sex after visits to infected areas and controlling the mosquito population are important to make people aware of these risks. She recommends making sure screens on windows are prepared and preventing mosquitos from breeding in watery areas.

“I pass West Philly and see tires on the side of the street,” she said. “If I’m in that community I should tip those tires or they’re going to gather water. These mosquitoes can breed in a bottle cap.

“We don’t know the extent to which we are vulnerable. We do know the preventive actions to take are good things to do anyway because we don’t want to breed mosquitoes.”

Source: BillyPenn

May 23, 2017: Double Trouble? Zika Mosquito May Transmit Dengue, Chikungunya with One Bite.

Aedes aegypti, the primary mosquito that carries Zika virus, may also transmit chikungunya and dengue viruses with one bite, a new study has found.

The findings shed new light on what is known as a co- infection, which scientists say is not yet fully understood and may be fairly common in areas experiencing outbreaks.
“A mosquito, in theory, could give you multiple viruses at once,” said Claudia Ruckert, post-doctoral researcher at Colorado State University (CSU) in the US.

The team infected mosquitoes in the lab with multiple kinds of viruses to learn more about the transmission of more than one infection from a single mosquito bite.
The researchers found that mosquitoes in the lab can transmit all three viruses simultaneously, although this is likely to be extremely rare in nature.

While they described the lab results as surprising, researchers said there is no reason to believe that these co- infections are more severe than being infected with one virus at a time.
“Dual infections in humans, however, are fairly common, or more common than we would have thought,” Ruckert said.

The researchers had expected to find that one virus would prove to be dominant and outcompete the others in the midgut of the mosquito where the infections establish and replicate before being transmitted to humans.

“It is interesting that all three replicate in a really small area in the mosquito’s body,” Ruckert said.

“When these mosquitoes get infected with two or three different viruses, there is almost no effect that the viruses have on each other in the same mosquito,” she said.

The first report of chikungunya and dengue virus co- infection occurred in 1967, researchers said. More recently, co-infections of Zika and dengue viruses, Zika and chikungunya, and all three viruses have been reported during various outbreaks, including the recent outbreak of Zika virus in North and South America.

Source: Daily Excelsior

May 22, 2017: Zika Babies Negatively Impacted by Trump

Although one of Donald Trump’s first acts as president was reinstating the Global Gag Rule, on Monday his administration announced it had expanded the policy targeting non-governmental organizations (NGOs) that provide family planning services.

The Global Gag Rule, also known as the Mexico City Policy, blocks any U.S. Agency for International Development funding from going not only to organizations and clinics that perform abortions, but even agencies that merely give patients information about abortions. In spite of the fact that no U.S. funding goes toward paying abortion, Trump decided to reinstate the Global Gag Rule while framing it as a pro-life venture with the title Protecting Life in Global Health Assistance.

The Global Gag Rule has been rearing its head since 1984, when Ronald Reagan instated it. Republican presidents have maintained and reinstated it, while Democratic president have rescinded it. However, critics argue that Trump’s version of the Global Gag Rule is even more far-reaching than any previous president’s.

With Trump’s plan, roughly $8.8 billion of global health funds coming from the Department of Defense, the State Department, and USAID will be blocked from clinics abroad that provide family planning services, such as offering birth control and HIV/AIDS prevention as well as maternal health, primary care, and Zika treatment. The effects of this span even wider than the rule under George W. Bush, which prohibited $600 million in family planning funds.

While the effects of the Global Gag Rule on maternal death rates and increased abortion rates is of top concern, it could also greatly affect Zika response efforts.

“By targeting not only family planning programs but all global health programs including those that address Zika response efforts and other health and disease areas, this policy threatens to gut funding for many of the most effective and well-positioned health organizations in more than 60 low and middle income countries,” Lori Adelman, the global communications director for the U.S. sector of the International Planned Parenthood Federation (IPFF), tells Bustle in an email.

May 20, 2017: Scientists to Test Whether Zika Can Kill Brain Cancer Cells

Scientists in Britain plan to harness the Zika virus to try to kill brain tumor cells in experiments that they say could lead to new ways to fight an aggressive type of cancer.

The research will focus on glioblastoma, the most common form of brain cancer, which has a five-year survival rate of barely 5 percent.

Zika causes severe disability in babies by attacking developing stem cells in the brain – but in adults, whose brains are fully formed, it often causes no more than mild flu-like symptoms.

In glioblastoma, the cancer cells are similar to those in the developing brain, suggesting that the virus could be used to target them while sparing normal adult brain tissue.

Experts say existing treatments have to be given at low doses to avoid damaging healthy tissue.

Researchers led by Harry Bulstrode at Cambridge University will use tumor cells in the lab and in mice to assess Zika’s potential.

The mosquito-borne virus has spread to more than 60 countries and territories in a global outbreak that was first identified in Brazil in 2015.

“Zika virus infection in babies and children is a major global health concern, and the focus has been to discover more about the virus to find new possible treatments,” Bulstrode said in a statement.

“We hope to show that the Zika virus can slow down brain tumor growth in tests in the lab,” Bulstrode added. “If we can learn lessons from Zika’s ability to cross the blood-brain barrier and target brain stem cells selectively, we could be holding the key to future treatments.”

Source: Reuters

May 5, 2017: A Speedy, Sensitive, and Low-Cost Detection Test for Zika Virus

A fast, highly sensitive, and inexpensive new test not only detects Zika virus in mosquitoes and human bodily fluids, but can also distinguish between African and Asian strains — a result that could improve efforts to more effectively track the virus’ spread.

The Asian-lineage strain of Zika virus, which has been implicated in causing severe birth defects such as microcephaly, rapidly infiltrated the Americas after its introduction in 2015, transmitted by mosquito species in the genus Aedes.

According to recent Centers for Disease Control estimates, 5,238 cases of Zika virus infection have been reported in the United States, 223 of which were presumed to have been acquired locally.

Nunya Chotiwan et al. devised an assay to directly detect Zika virus from mosquitoes and several different types of unprocessed clinical samples (including human blood, saliva, and semen). They amplified Zika virus genomes using a specialized technique called LAMP, an approach that proved comparably sensitive to the current gold-standard detection method, qRT-PCR.

Unlike qRT-PCR, however, LAMP does not require costly reagents. Importantly, LAMP did not yield false-positives for closely-related pathogens such as Dengue virus and Chikungunya virus. The researchers validated the LAMP test using virus artificially spiked into materials obtained from healthy individuals, and also in clinical specimens collected from confirmed cases of Zika virus infection. LAMP was also sufficiently sensitive to identify one single infected mosquito from a collection pool of 50 uninfected insects.

The authors say that LAMP’s minimal processing requirements and accelerated turnaround time will be valuable for Zika virus surveillance and control.

Source: Outbreak News Today

May 3, 2017: Zika Epidemic in U.S. Could Be a Costly Scenario

An outbreak of the mosquito-borne Zika virus in the United States could be very costly, a new study warns.

“This is a threat that has not gone away. Zika is still spreading silently and we are just now approaching mosquito season in the United States, which has the potential of significantly increasing the spread,” said study leader Dr. Bruce Lee. He is an associate professor in the department of international health at Johns Hopkins University’s Bloomberg School of Public Health.

“There’s still a lot we don’t know about the virus, but it is becoming clear that more resources will be needed to protect public health. Understanding what a Zika epidemic might look like, however, can really help us with planning and policy making as we prepare,” Lee said in a Hopkins news release.

In the study, computer models of outbreaks in Florida, Georgia, Alabama, Mississippi, Louisiana and Texas suggest that even a mild Zika outbreak, with an infection rate of only 0.01 percent, could lead to more than 7,000 infections and $183 million in medical costs and lost productivity.

More severe outbreaks could strain the bank, the study findings suggest.

The impact of a 1 percent infection rate could reach $1.2 billion, while a 10 percent infection rate could cost more than $10.3 billion, the researchers found.

The states included in the analysis have the highest populations of Aedes aegypti, the mosquito most likely to carry and spread the Zika virus, the study authors noted.

Last year, Congress approved just over $1 billion for mosquito-control efforts and Zika vaccine development, as well as for emergency health care for Puerto Rico, where more than 35,000 people have been affected by the virus, the researchers said.

“Without details regarding the Zika-prevention measures that would be implemented and how effective these may be, it is unclear what percentage of these costs may be averted,” Lee said.

“But our model shows it is very likely that preventing an epidemic — or at least finding ways to slow one down — would save money, especially since epidemics like Zika have hidden costs that aren’t always considered,” he added.

There is no treatment or vaccine for Zika. Most infected people have only mild symptoms, but the virus can cause severe, neurological birth defects that include microcephaly, where a baby is born with a smaller-than-normal head and an underdeveloped brain. The virus can also trigger a nervous system disease called Guillain-Barre syndrome.

In the United States, 5,264 people had been infected with Zika as of April 26, according to the U.S. Centers for Disease Control and Prevention. Meanwhile, 1,762 pregnant women had tested positive for the virus, while 58 babies have been born with Zika-related birth defects as of April 11, the agency reported.

Source: Tucson.com

May 2, 2017: Senate Committee Unanimously Approves King-Authored Bill to Combat Spread of Zika Virus

On April 26, 2017, the Senate Health, Education, Labor and Pensions (HELP) Committee unanimously approved the Strengthening Mosquito Abatement for Safety and Health (SMASH) Act, bipartisan legislation introduced by Senator Angus King (I-Maine) that would help give states and localities the tools they need to fight back against mosquitos and the viruses they carry. The bill will now be sent to the full Senate for its consideration.

The HELP Committee’s unanimously approval of the legislation, which is also cosponsored by Senators Richard Burr (R-N.C.), Bill Nelson (D-Fla.) and Marco Rubio (R-Fla.), comes in the wake of a recent report from the Centers for Disease Control and Prevention that said one in 10 pregnant women confirmed with the Zika virus gave birth to a child with virus-related birth defects. It also comes ahead of the warm summer months when mosquitos carrying the virus are expected to transfer

In considering the legislation today, HELP Committee Chairwoman Patty Murray (D-Wash.) said the bill “will be very critical in our efforts to combat the Zika virus.”

“This is a positive step forward in the ongoing work to prepare for the fight against the Zika virus as we move into the warmer summer months,” Senator King said. “And states and localities are where the battle can most effectively be fought. As we know, Maine has been fighting insect-borne diseases like Lyme for decades. Now, with the CDC outlining the serious and growing dangers of this virus, it’s critical that Congress move in an expedited manner to provide states with the funding they need for mosquito abatement efforts. I hope the Senate can quickly pass this common-sense bill.”

More specifically, the Strengthening Mosquito Abatement for Safety and Health (SMASH) Act would reauthorize critical public health tools that support states and localities in their mosquito surveillance and control efforts, especially those linked to mosquitos that carry the Zika virus, and improve the nation’s preparedness for Zika and other mosquito-borne threats.

Zika is a mosquito-borne infectious disease that is primarily transmitted to humans by the female yellow fever (A. aegypti) and Asian tiger (A. albopictus) mosquitos. The U.S. Centers for Disease Control and Prevention, which recently said that 44 states reported cases of pregnant women with evidence of Zika in 2016, has linked the Zika virus to serious health condition, including birth defects in infants such as microcephaly as well as neurological disorders.

Despite the very real and imminent threat posed by Zika, the United States remains woefully unprepared to prevent and address the spread of the virus. To help change that, the SMASH Act takes the following three immediate steps to combat the threat of Zika and other mosquito-borne diseases:

Strengthens our ability to respond to Zika by reauthorizing and improving mosquito control: The legislation reauthorizes and makes targeted improvements to the lapsed Mosquito Abatement Safety and Health (MASH) Act, which was enacted in 2003 in response to the West Nile virus. It also authorizes increased support for state and local mosquito control work – efforts that are critical for controlling and reducing the mosquitos that spread infectious diseases. Under the bill, up to $100 million in grants will be authorized each year in addition to matching funds to state and local governments.

Improves public health preparedness through laboratory research: The legislation reauthorizes the epidemiology laboratory capacity grants under the Public Health Service Act, which support state and local health departments in surveillance for, and response to, infectious diseases, including Zika. Laboratory capacity plays a pivotal role in preparation for and response to public health threats.
Inform how we can refine and improve mosquito control: Requires timely study, report, and recommendations by the Government Accountability Office regarding existing mosquito and other vector-borne surveillance and control programs. This analysis will help Congress to identify opportunities to strengthen our public health preparedness programs in partnerships with states and local communities. Ultimately, such analysis will better protect Americans from emerging mosquito-borne infectious diseases. Applying the lessons learned from responses to public health threats is critical for continuing to optimize our nation’s medical and public health preparedness and response.

The legislation has been endorsed by the National Pest Management Association, the American Mosquito Control Association, the Entomological Society of America, the Infectious Diseases Society of America, and the American Academy of Pediatrics.

Source: https://www.king.senate.gov/newsroom/press-releases/senate-committee-unanimously-approves-king-authored-bill-to-combat-spread-of-zika-virus

April 20, 2017: Research Finds Zika in Second Florida Mosquito

A study out of the University of Florida has put the spotlight back on the Zika virus. In research published in a scientific journal last week, Chelsea Smartt, a molecular biologist at the University of Florida Institute of Food and Agricultural Sciences in Vero Beach, reported finding Zika RNA in Aedes albopictus mosquitoes in Brazil.

Public health officials suspected that the Aedes albopictus could spread Zika. The research confirms that suspicion.

Aedes aegypti (also known as the yellow fever mosquito) and Aedes albopictus (the Asian tiger mosquito) both abound in Florida, according to the U.S. Centers for Disease Control and Prevention.

The CDC doesn’t rule out the threat of Aedes albopictus, but the agency says “because these mosquitoes feed on animals as well as people, they are less likely to spread viruses like Zika, dengue, chikungunya and other viruses.”

As for Palm Beach, Deputy Town Manager Jay Boodheshwar said the information about Aedes albopictus is nothing new.

Boodheshwar said the town in its public messaging has referred to both types of mosquitoes as potential Zika carriers, and said that both are active in Palm Beach. But the town has focused on aegypti “because that is the prevalent mosquito that carries the virus here on the island.”

Now that the annual hot and rainy season is returning, the town is preparing for another larvicide treatment of all catch basins on public property, Boodheshwar said.

The catch basins were treated last fall, but the larvicide tablets are only effective for six months, he said.

The public will be notified when the treatment is scheduled, he said.

State and federal officials said in December that Zika no longer was being actively transmitted in Florida. But public health officials say Zika is likely to return with summer rains.

Tim O’Connor, spokesman for the state Department of Health’s Palm Beach County unit, said the latest research won’t affect the health district’s efforts to fight Zika.

“The main prevention is avoiding mosquito bites,” O’Connor said.

Town Councilwoman Margaret Zeidman, who has helped spearhead Zika education and prevention on the island, said aegypti and albopictus are similar. Both are found in tropical and subtropical habitat. But albopictus, unlike aegypti, tolerates cooler climes, up into the Carolinas and New England, she said.

“It’s everyone’s personal responsibility to protect themselves from mosquito bites and to get rid of containers that might fill with water,” Zeidman said.

Containers that hold water should be turned over or treated with a larvicide, she said. Packets are available at Town Hall. To protect from bites, cover your skin with clothing or apply DEET, which is safe for everyone except babies 2 months old or younger.

Source: Palm Beach Daily News

April 14, 2017: Trump Budget Cuts Threaten Emergency Response to Zika And Other Disease Outbreaks

As a presidential candidate last summer, Donald Trump promised to lead an aggressive fight against the spread of the Zika virus. He urged Congress to fund a proposed $1 billion-plus Zika response plan.

But now, the public health community is expressing strong concerns about President Trump’s commitment to maintaining and strengthening the country’s infectious disease prevention infrastructure.

Many credit Trump’s draft budget, released last month, for proposing the creation of a new federal emergency fund designed to rapidly respond to public health crises. That’s something public health leaders have advocated for years.

Creating such a fund would end the need to call on Congress to provide crisis funding when an infectious disease outbreak occurs, as happened with Ebola and then Zika.

“There could be events quite frankly where (having an established emergency fund) could be the difference between a successful response and a failed response,” said James Blumenstock, chief program officer for Health Security for the Association of State and Territorial Health Officials.

Yet the Trump budget lacks details on how much money the administration would appropriate for the proposed emergency fund, or how the president wants to pay for it.

If Trump dedicates new funding, then it has the potential to be a powerful tool to aid prevention and response effort in emergencies, experts say. But if funding comes from cutting other public health programs, they say its potential impact would be greatly reduced.

“Any significant reduction in any program that (the Centers for Disease Control and Prevention) administers will have a cascading effect on state and local health departments and would result in a reduction in prevention activities in the communities,” Blumenstock said.

Establishing an emergency fund would not be enough to assuage larger concerns among public health experts over Trump’s move to repeal and replace the Affordable Care Act and impose other domestic spending cuts that could undermine prevention and response efforts.

Included in the president’s draft budget was a proposal to cut the National Institutes of Health by $5.8 billion. The NIH has been the leading funding source for vaccine research and development for several infectious diseases that have had outbreaks in recent years, including Ebola and Zika.

“If you defund the scientific infrastructure in general, all aspects are going to have to suffer and that includes preparedness for new diseases as well as research and therapy for existing diseases,” said Dr. David Freedman, professor of medicine and epidemiology at the University of Alabama at Birmingham.

Trump’s skepticism about the human-caused sources of climate change is reflected in his proposed 31% cut to the Environmental Protections Agency’s budget, which would force layoffs of an estimated one-fifth of the agency’s workforce. Climate change have been linked to an increased risk of infectious diseases.

Extreme weather events coupled with milder winters as global temperatures rise have created environments that are breeding ground for diseases, including mosquito-borne infections, that traditionally have spread only in the tropics but now are found in the U.S.

“It’s been one of the warmest winters on record, and that’s good for the Aedes Aegypti (mosquito) but not good for us,” said Dr. Peter Hotez, dean of Baylor College of Medicine’s National School of Tropical Medicine. “I’m quite worried that all of that means that it’s going to be a pretty bad Aedes Aegypti season this spring and into the summer, and that means there’s a pretty high risk for a Zika virus transmission.”

Even seemingly unrelated Trump policy decisions could have large public health ramifications. A repeal of the Affordable Care Act would not only mean a loss of health coverage for millions but also would eliminate the CDC’s Prevention and Public Health Fund. Created under ACA, the fund provides more than $930 million for CDC programs, accounting for 12% of the agency’s total annual budget.

A loss of the that funding would mean slashing $40 million from the CDC’s Epidemiology and Laboratory Capacity for Infectious Disease Cooperative Agreement program (ELC), which provides funding to public health laboratories around the country to quickly respond to emerging infectious disease threats.

The ELC program receives around half of its annual funding through the ACA’s Prevention and Public Health Fund. Program funds played a crucial role in helping state laboratories rapidly test suspected Zika samples months before Congress approved emergency federal funding last year.

Repealing the ACA and the prevention fund would eliminate ELC’s nimble ability to address public health concerns like Zika before lawmakers can react, said Peter Kyriacopoulos, senior director of public policy at the Association of Public Health Laboratories.

Erasing the prevention fund also would be a big blow to the CDC’s immunization program, which receives more than $324 million for states to improve their immunization infrastructure and increase vaccine coverage among children.

It’s questionable whether Trump’s proposed budget would have an immediate impact on the response effort to the spread of Zika this season. Many state and local public health departments already have received at least a portion of the $1.1 billion in emergency Zika funding approved by Congress last year.

But the question remains how the Trump budget cuts would affect the nation’s response efforts once that money is used up, when a new disease threat could emerge. There is worry that if health departments were faced with an outbreak of Zika plus a sudden epidemic of measles or influenza, it could push some agencies beyond their limits.

“So far we have been extraordinarily lucky in this country to have sequential public health emergencies instead of simultaneous emergencies,” Kyriacopoulos said.

Freedman said a larger concern lies in the potential impact Trump’s budget cuts could have on efforts to recruit the next generation of scientists and researchers. “The best and the brightest aren’t going to pursue a career in science if there are no opportunities for either jobs or funding,” he said.

Source: Modern Healthcare

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