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December 3, 2016: How the Art World Is Contending with The Specter of Zika At Art Basel Miami Beach

The virus has darkened the forecast of this week’s fair and parade of parties — even as some opt for blissful ignorance of the threat.

“’It’s beautiful, sunny, perfect Miami weather,’ the dealer Jeffrey Deitch said on the phone from South Florida last week, where he’d arrived early to prepare for the weeklong circus that accompanies Art Basel Miami Beach, which unofficially kicks off today. ‘Everything is completely normal.’

“Deitch, who’s been heading to Miami every year since even before the fair started in 2002, was not just offering blithe small talk. His comments on the weather — and assertions that he hadn’t yet been hit with a blast of bug spray, nor encountered a single mosquito — also served as a reckoning on the current status of Zika in Miami Beach. Since late July, the virus has found a home in the city, marking the first continental United States outbreak of what the World Health Organization deemed an international health emergency earlier this year. And, as it turns out, the problem areas — Miami Beach, Wynwood, Little Haiti — are also ground zero for Art Basel and its ancillary fairs and events, which all told brought 77,000 people to town last December.

“Zika causes birth defects, including microcephaly, a type of brain damage, in newborns whose mothers are infected during pregnancy. The mosquitos that transmit it were reportedly cleared from Wynwood in September, and from a three-mile stretch of Miami Beach just last week. But worries about the virus still run rampant in the art world, particularly among women of childbearing age. Bring up Zika at any of the many parties and galas in the last month, and most gallerists, collectors, and dealers would have revealed they know at least a few people — likely women — who consider the threat reason enough to stay home this year.

“At least, they’ll do so off the record. ‘The art world has taken a rather ‘let’s not talk about it’ approach,’ said Elena Soboleva, a 30-year-old art market observer and special projects manager at Artsy who has opted to go to Miami, her 35th art fair this year. In part, honest, open discussion can be impossible because ‘it also puts a woman’s personal information on view,’ said the dealer Loring Randolph, a 35-year-old partner at Casey Kaplan gallery. ‘If you say you’re not going, it means you might be trying to get pregnant or are thinking about getting pregnant. Those aren’t the kinds of things that you necessarily want to tell your employer. It puts you in a vulnerable position.’

“Of course, the overwhelming concern does not correlate to an overwhelming percentile of women in the art world planning to have children within the next year. The worry stems more from a ‘fear of the unknown,’ as Anne Huntington, a collector in her early thirties who cancelled her trip to Miami just a few weeks ago, explained. This year is the first she won’t be attending the fair in a decade. The threat of Zika is among the reasons why, and it’s the primary deterrent for the art adviser friend she had planned to travel with. Together, they decided that ‘if there was a year not to go, it would be this year.’

“The art world, Soboleva suggested, begs for clarity when it comes to the virus. But it doesn’t appear that information will be coming from the Art Basel fair itself, whose website yields a total of zero results when you search for the Z word. When I reached a spokesperson, they did maintain that none of the fair’s partners or 250-plus galleries have pulled out as a result of the scare. Pre-registration numbers have been in line with those of previous years, and organizers have kept in regular and direct contact with both the CDC and officials of the City of Miami Beach, who say that ‘the rigorous abatement measures they have collectively taken throughout the city since late summer are proving to be effective.’

“On its own website, however, the CDC still recommends that pregnant women consider postponing travel to all parts of Miami-Dade county, and to stay out of some areas of Miami altogether. Those with plans to get pregnant in the near future should also beware — if infected, the virus, which can be sexually transmitted, can linger for two months in women, and six months in men. Cause for concern, then, is very real among the family-inclined.

“However, some would rather not know the details. ‘In terms of the virus — if it’s considered a virus or infection, however they refer to it — I don’t know medically what a threat it is,’ said the blogger Colby Jordan, 23, who just married the collector and dealer Alberto ‘Tico’ Mugrabi in September. They will be in Miami this week. ‘My husband would have had to go anyway, so I figured I’d much rather be with him than be at home in New York.’

“Whether Jordan and her husband, one of the biggest collectors in the world, are thinking about family planning at this stage, she said, was too personal — a common and completely understandable reaction among many of those whom I approached for comment. When the threat was still a mosquito cloud hovering far away in Brazil in 2015, Zika felt like something of a jokey buzzword among removed New Yorkers — an attitude that’s darkened as the virus has spread into the U.S. over the last year. I first received notice of this growing concern in June, a month before Zika landed Stateside, when I asked Serena Williams during an interview whether she was worried about Zika at the Olympics later that summer. She’d been in a light mood, offering up athlete platitudes — her goal was simply to “go out there and have fun,” she said — until mention of the virus saw her suddenly turn serious. ‘Obviously,’ Williams replied, before listing off her detailed plans to protect herself.

“In conversation, Zika has been a prickly topic to introduce. Those willing to speak on the record are hard to come by, which is why I followed up an unrelated interview with the 28-year-old model Coco Rocha when I caught wind of her upcoming Miami vacation with her husband James Conran and their 19-month-old daughter. While they’ve ‘definitely’ been following the story, Conran said, after the recent birth of their daughter, Rocha no longer considers pregnancy one of her top concerns. ‘I feel like there’s so much in the world that you can worry about until it makes you sick,’ she said earnestly. ‘This is one thing, and we’re trying to live life.’

“New motherhood has also been a balm for Randolph, who had a baby nine months ago and will be present in her booth under the Art Basel tents. “I think I’m one of the few people who maybe is of a bit of a different mindset about this than most women my age,’ she said, adding that she’s talked with ’a lot” of women in the art world between the ages of 30 and 40 who are ‘really choosing not to go because of a fear of Zika.’ But Randolph isn’t planning on having another child immediately, and she’s come to regard the relatively small risk of contracting microcephaly as “totally fine” compared to the three to four percent chance of death her newborn faced due to other complications.

“For some, children aren’t even on the radar. ‘No one I know is trying to have kids,’ said the artist Chloe Wise, 25, who’ll be attending for the fifth year in a row. She’s even throwing her birthday party in Miami, and so far hasn’t seen any downtick in expected guests. ’There’s way crazier things in the world than the Zika thing, no offense to Zika,’ she said. She added, with a laugh, ‘The L train [shutdown] seemed like a big deal until Trump got elected. And now we’re all over the L train.’

“Wise’s young peers are not the only ones who seem to be immune to worry. ‘Men should be taking it just as seriously,’ Soboleva insisted, though few could point to any men who’ve decided to skip out on Basel, let alone even openly discuss the virus in the first place. And yet, as of the known cases in late June, men, not women, were responsible for all instances of the virus being sexually transmitted, and are recommended to wait six months — three times longer than women — after experiencing symptoms to have unprotected sex.

“’I feel like it’s as big of a threat for a man as it is for a woman, if you’re in a relationship and want to get pregnant,’ the newlywed Jordan said, explaining why she feels she might as well join her husband in Miami if his work already compels him to be there. And for men who aren’t committed to just one partner, the effects might be even greater, as they can contract the virus and pass it on without ever experiencing symptoms — or, if research rates are as low as they appear, without even realizing that’s within their capability. (As the CDC notes, aside from light fever and a few other irritations, ‘many people infected with Zika virus won’t have symptoms or will only have mild symptoms.’)

“Even if the attendance figures hold, there is anecdotal evidence that this year’s Art Basel Miami won’t be the beaming sun and fun of previous iterations. Whether it’s Zika or the election of Donald Trump, Wise admitted, “people seem to be less enthusiastic about their attendance this year.” Randolph has already observed “a mood change,” she said. "Any time you’ve got a group of people who are resisting — ‘Oh, I can’t believe you’re going with this scare’ — it just puts a pall over everything,” she said.

“’Certainly, these women of my age are a very important demographic to have at the fair, and that’s definitely going to be missed,’ Randolph went on. ‘It’s going to be a noticeable problem.’ Indeed, the Guggenheim postponed its Young Collectors Council lunch in Miami this year because the invite list was heavily skewed towards women of a childbearing age.

“Soboleva has been planning an Artsy event with Gucci, and while she hasn’t seen any drop-off in her RSVPs, she’s heard fretful whispers that collectors are skipping out this year for a few reasons, Zika among them. ‘Gallerists are worried about sales, and especially those doing it for the first or second time, for whom it’s a greater investment on their part,’ she said.

“The economics of fairs, Randolph pointed out, can put pressure on those who would rather stay out of Zika’s way. ‘If you’re working for a gallery, and you work on commission, you’re losing a lot of money if you’re not going to Miami,’ she said.

“Nevertheless, this week there will still be roughly 75,000 estimated visitors at the festivities in Miami Beach. They may have been encouraged by a Miami travel guide the New York Times published just two weeks ago, which relegated Zika to a brief mention consisting of a line or two before diving into backwater apéritifs. Perhaps after the election, the big Z might just be a distant concern B.

“As Chloe Wise put it, ‘Who’s trying to have kids right now, seriously? Those kids are going to have to deal with an apocalypse.’

Source: W Magazine

December 2, 2016: Brazilian Women with Zika-Infected Babies Pray For Cure

Miriam de Frana Araœjo with her son, Lucas Gabriel, during a routine checkup with an ear, nose and throat doctor in Campina Grande. Lucas, like many babies born with microcephaly, has auditory and vision problems.

“Miriam de França Araújo has had the same routine for the past year. On Wednesdays and Fridays, she wakes up before dawn, wraps her 1-year-old child, Lucas, in a thick blanket and gets into a white Volkswagen van that will rumble across dirt roads and a newly paved highway to a hospital nearly three hours away.

“Lucas was born in September 2015 with a small, misshapen head, quickly diagnosed as microcephaly, a birth defect rarely seen by the doctors who delivered him. Within months, doctors across Brazil’s impoverished northeast were growing increasingly alarmed by an unprecedented spike in microcephaly cases, which they eventually linked to the mosquito-borne Zika virus that had recently arrived in the country.

“’Nobody knew what Zika was,’ Araújo told USA TODAY. ‘Nobody even knew the word.’

“Araújo was among the first group of mothers and infants to be enrolled in a new microcephaly unit at a local hospital here, where a team of doctors and therapists treat children born with Zika-related disorders.

“The microcephaly unit has become a place of solidarity, where more than 100 women — many of them poor — lend each other support, share ideas and discuss ways to advocate on behalf of their children.

“’We formed a family, including with the doctors and nurses,’ Araújo explained. ‘We’ve developed an intimacy, learned each other’s stories and found a place to blow off steam.’

“On a recent day while waiting for appointments, the women discussed the difficulties they face. Araújo’s experience is typical: Lucas is the only baby with microcephaly in her small town, and prejudice from neighbors is a frequent topic. ‘Sometimes they don’t have to say anything, the look they give us says everything,’ said Adriana Ferreira Alves, as she bounced her baby, Maria Sophia, on her lap.

“Only one in six families lives in Campina Grande. The rest travel as much as four hours for appointments. Transportation is an ongoing source of anxiety, as van services provided by local municipalities are often late or canceled. ‘It is very humiliating,’ Araújo said.

“Concerns about access to benefits and medical costs are also prevalent. A lawyer has started to meet with the families to ensure they are receiving government services. Still, many of them struggle to pay for basic needs such as diapers and formula, to say nothing of advanced procedures and medicine.

One mother considered selling her cell phone to pay for the tiny prescription glasses that would help her baby see.

“’It never entered my mind that she could be born like this,’ said Ferreira Alves, who contracted Zika during the third month of her pregnancy. Maria Sophia, who was born last January, cannot hold her body upright and closes her eyes in the light.

“’At first, I blamed myself, thought that I hadn’t done things right. I cried a lot and became depressed,’ she said.

“Psychologist Jacqueline Loureiro leads group therapy sessions to help the women cope with wide-ranging emotional issues. ‘Every pregnant woman thinks, ‘I want my child to be born a certain way.’ When you discover a malformation, this idea is broken,’ she explained. ‘They need to experience mourning for this idealized child in order to accept the real child.’

“Adriana Melo, a fetal health specialist who first made the connection between Zika and microcephaly a year ago, is the public face of the program. She has traveled to conferences across Brazil and abroad, presenting the group’s research findings and lobbying for additional funding.

“’This first generation of mothers didn’t know about the mosquito, and they have provided all the answers to the world,’ she told USA TODAY. ‘They offered their amniotic fluid, they offered their babies’ blood, had their babies undergo scans and tests.’

“Melo and other doctors are raising funds to open a clinic where infected children receive treatment and mothers assist in groundbreaking research.

“Joelma dos Santos, 25, gave birth to her third child, Lorena Cecilia, last month, and while the baby’s head circumference is within the normal range, dos Santos had contracted Zika during pregnancy, and worrisome brain scans led doctors to flag her for additional testing after birth.

“She is an example of the new cases that Melo is concerned about: babies who outwardly appear healthy, but who may exhibit delayed developmental problems related to Zika. She hopes that by building a bigger clinic, doctors will be able to monitor children for three years.

“Dos Santos and her husband, José, expressed joy that their child was born without microcephaly. “I was so worried at first,” José said through tears of relief. “To have a daughter with microcephaly is so difficult these days, but thank God the latest ultrasound looked normal.”

“After spending the morning at a party hosted by the hospital to celebrate Lucas’ and other babies’ first birthdays, Araújo gathered him and her 7-year-old daughter, Maisa, for the long trip back to her family’s farm.

“Finally back at home, she organized Lucas’ seven medications and prepared for the next day’s journey back to Campina Grande for a monthly appointment with the ear, nose and throat doctor.

“’What matters most to me is his health. Every time he responds or gives me a smile, it is everything,’ she said.

“While Araújo and her mother prepared dinner, her father, Eluizo, sat on the porch with Lucas in his arms. He recalled a parable from the Bible’s Book of Revelation in which a dragon attacks a woman holding her newborn baby.

“’I thought, my God, that dragon must have been enormous,’ he said. ‘But as things often are in spiritual matters, the dragon that appeared to us is the tiny mosquito, causing so much destruction, attacking the brains of children.’

“He described how the earth saved the woman and her baby from the dragon at the end of the parable, offering a hopeful conclusion.

“’Who knows,’ he added, looking down at Lucas with a smile. ‘We are always searching for new discoveries. The whole world has already declared: we are going to fight this dragon.’"

Source: USA Today

December 1, 2016: Duke Researchers -- How Highly Potent Antibody Neutralizes Zika Infection Discovered

C10 antibody (purple) visualized to be interacting with the Zika virus coat (green). Image/Victor Kostyuchenko, Duke-NUS Medical School

“As Zika spreads throughout the world, the call for rapid development of therapeutics to treat Zika rings loud and clear. Taking a step further in identifying a possible therapeutic candidate, a team of researchers at Duke-NUS Medical School (Duke-NUS), in collaboration with scientists from the University of North Carolina, have discovered the mechanism by which C10, a human antibody previously identified to react with the Dengue virus, prevents Zika infection at a cellular level.

“Previously, C10 was identified as one of the most potent antibodies able to neutralise Zika infection. Now, Associate Prof Lok Shee-Mei and her team at the Emerging Infectious Disease Programme of Duke-NUS have taken it one step further by determining how C10 is able to prevent Zika infection.

“To infect a cell, virus particles usually undergo two main steps, docking and fusion, which are also common targets for disruption when developing viral therapeutics. During docking, the virus particle identifies specific sites on the cell and binds to them. With Zika infection, docking then initiates the cell to take the virus in via an endosome – a separate compartment within the cell body. Proteins within the virus coat undergo structural changes to fuse with the membrane of the endosome, thereby releasing the virus genome into the cell, and completing the fusion step of infection.

“Using a method called cryoelectron microscopy, which allows for the visualisation of extremely small particles and their interactions, the team visualised C10 interacting with the Zika virus under different pHs, so as to mimic the different environments both the antibody and virus will find themselves in throughout infection. They showed that C10 binds to the main protein that makes up the Zika virus coat, regardless of pH, and locks these proteins into place, preventing the structural changes required for the fusion step of infection. Without fusion of the virus to the endosome, viral DNA is prevented from entering the cell, and infection is thwarted.

“’Hopefully, these results will further accelerate the development of C10 as a Zika therapy to combat its effects of microcephaly and Guillain-Barré syndrome. This should emphasise the need for further studies of the effect of C10 on Zika infection in animal models,’ commented Dr Lok.

“’By defining the structural basis for neutralization, these studies provide further support for the idea that this antibody will protect against Zika infection, potentially leading to a new therapy to treat this dreaded disease,’ says Ralph Baric, PhD, professor in the Department of Epidemiology at UNC’s Gillings School of Global Public Health.

“These findings suggest that C10 may be developed as a therapy for Zika infection, and should be further explored. In addition, disrupting fusion with C10 may prove to be more effective in preventing Zika infection compared with therapies that attempt to disrupt docking. This is because the fusion step is critical for Zika infection, while the virus may develop other mechanisms to overcome disruptions to the docking step. With the call for rapid development of Zika therapies, C10 has emerged as a front runner to answer this call.”

Source: Outbreak News Today

Where Do Mosquitoes Go in Winter?

Believe it or not, the mosquitoes are out there, even in winter. They’re just hiding so we don’t notice them. Absent unseasonably warm weather, mosquitoes remain inactive through the winter months.

Some mosquitoes lay winter hardy eggs which lie dormant in the soil until spring. In late summer or fall, the female mosquito lays her eggs singly in areas where the ground is moist. The eggs hatch when conditions become favorable again, usually in the spring when temperatures begin to rise and sufficient rain falls.

Certain mosquitoes can survive winter in the larval stage. All mosquito larvae require water, even in winter. As the water temperature drops, it induces a state of diapause in the mosquito larvae, suspending further development and slowing metabolism.

Development resumes when the water warms again.

Many mosquito species live through the winter as adults. In fall, the mosquitoes mate and the males die. Only females spend the cold months hidden in protected places, such as hollow logs or animal burrows. When warm weather returns, the females must first find a bloodmeal to develop her eggs. Just when you’re outside enjoying the spring weather, the newly awakened mosquito moms are out in force, looking for blood. Once they’ve fed, the female mosquitoes lay their eggs in whatever standing water they can find.

Don't Be Fooled By Mosquito Control Gimmicks

When it comes to mosquito control devices, about the only thing that works is common sense, says an entomologist with Texas A&M University.

Meanwhile, many Texas citizens are using devices or controls costing hundreds or even thousands of dollars that may offer only marginal control or may actually draw more mosquitoes onto their property, said Dr. Jim Olson, professor of entomology with the Texas Agricultural Experiment Station in College Station, who passed last year.

Olson’s warning comes at a time when mosquito populations are on the rise due to warm, wet weather. It’s also a time when Texans need to heed the threat of mosquito-borne diseases such as West Nile Virus, Eastern Equine Encephalitis, and the Zika virus.

Fueled by fears of mosquito-borne diseases, the market is ripe for a host of dubious mosquito control devices.
“Often, the manufacturer’s game plan is to get in and make their profits and get out within two years, because it takes two years at least for the effectiveness of the devices to be researched,” Olson said.

First there are the sonic repellants. Whether wristband or tabletop model, these devices emit a high frequency sound, inaudible to humans, that mimics the sound that male mosquitoes make. Only female mosquitoes that have already mated with males bite humans and animals. By nature of their mated status, female mosquitoes tend to ignore male mosquitoes during this period of their life.
Good theory, Olson said, but unfortunately these devices just don’t work. The female’s lust for blood is more on her mind than avoiding males. Also female mosquitoes are only repelled by the sound of the male mosquito when they are already gorged with a blood meal. Consequently, the sonic repellant devices tend to only chase away females that aren’t prone to bite anyway.
The best thing about sonic repellants is they are generally inexpensive so buyers aren’t throwing that much money away, Olson noted.

Another type of sonic device supposedly attracts insects by imitating the sound of a human heartbeat. Unfortunately for the buyer – perhaps fortunately for the mosquito, the pest is not attracted by the sound of heartbeats but by the carbon dioxide and heat large mammals such as humans emit.

Some sonic devices also add heat to the attractant properties and draw mosquitoes into traps. If left on, they may actually trap hundreds of mosquitoes and that’s fine, but the problem is that in wet areas, the mosquito headcount may be as much as several million individuals per acre.

Another type of mosquito trap goes a step further. It uses propane to produce carbon dioxide and heat to draw the mosquitoes close enough to be sucked into a fan-driven trap. Though these propane-fueled devices may trap thousands of mosquitoes in a few days, there are again generally hundreds of thousands or even millions of mosquitoes an acre to deal with, thereby overwhelming the trap and its ability to effectively limit bites.

A warning flag on these devices is that they come with the caveat that they must be left on 24 hours a day, seven days a week, and then the owner will only realize a lowering of mosquito numbers in four to six weeks.

“With most mosquito species, weather conditions and the insect’s breeding patterns will result in a decline in four to six weeks without any intervention,” Olson said.

As with the bug zappers, the propane-fueled devices may actually draw more mosquitoes from long distances onto your property than can be controlled to prevent bites.
The question here is will these extra mosquitoes wait to be collected by the trap or take the opportunity to feed upon the trap’s owner?

“It’s probably a toss-up,” Olson said. “Plus, with the fact that running the propane burner 24/7 will draw more and more mosquitoes onto your property, you’re probably not going to lessen your chances of being bitten.”

What’s particularly disturbing to Olson are the pesticide misting devices now on the market. There are several models, but they generally work by emitting small puffs of the insecticides at timed intervals around a house’s perimeter. The devices are expensive, costing as much as $5,000, and their effectiveness is suspect. Worse is the amount of pesticide they release into the environment over time and the possibility of inhalation by residents and the drift of the pesticide to other properties.

“It’s about the most indiscriminate, irresponsible use of a chemical control that I’ve ever seen,” Olson said.
The best ways to avoid mosquito bites are the tried and true methods. As mosquitoes are most active at night, limit evening activities when possible. When you do go outside, cover up and use proven repellants.

“The DEET-containing repellants are still the most effective,” Olson said, “but other products and the organic repellants will work for awhile.”

Citronella candles repel mosquitoes but are most effective in enclosed patios and other confined spaces. The candles won’t work if conditions are windy.

People can take several preventative measures to reduce the mosquito population on their property.

“Dispose of prime breeding locations by getting rid of anything that will hold water,” Olson said. “Buckets and tin cans can fill with water and become breeding sites for mosquitoes.”

For areas that have standing water and can’t be drained, mosquito dunks are a good buy. The dunks, shaped like small donuts, use a bacterially derived pesticide called Bacillus thuringiensis israelensis (Bti).

Bti disrupts the life cycle of insects that lay their eggs in standing or running water. It is non-toxic to humans, amphibians, fish, crustaceans, adult insects, flatworms and mollusks. Neither is it toxic to insect predators of the black fly, such as dragonflies. The dunks are inexpensive, can be simply dropped into the breeding pools and generally last for months.

Olson has 40 years of experience researching and studying the biology, ecology, survey and management of mosquitoes and other biting insects. His career work has emphasized control of mosquitoes associated with agricultural and reclaimed wetland systems.

How to Avoid Mosquito Bites

This advice from Dr. Manny at FOX News.

“Mosquitoes are carriers for certain diseases, some of which can be deadly. In the United States, West Nile virus is the most common and dangerous mosquito-transmitted disease. Mosquitoes also transmit malaria, dengue fever and chikungunya.

“Common symptoms of these diseases include fever, body aches, dizziness and confusion.

“These symptoms can pop up two days to two weeks after a mosquito bite. If you get bitten and develop flu-like symptoms, see your doctor immediately.

“Your chances of being infected with a disease through a mosquito bite may be small, and there are steps you can take to reduce your risk of being bitten.

• Cover your skin as much as you can when you’re outside and mosquitoes are active.
• Use insect repellent on exposed skin.
• Make sure there are screens on all the windows and doors in your home and that you cover any rips or tears in them.
• Avoid having standing water around your home.

November 30, 2016: County Continues Vigilance Against Spread of Zika Virus

“As researchers learn more about the devastating health effects of Zika, county crews this past week continued an unprecedented effort to stop the virus from spreading locally.

“For the 10th time this year, San Diego County’s vector-control crews sprayed insecticide in a neighborhood known to have mosquitoes that can carry the virus. The latest spraying took place in the South County neighborhood of Nestor.

“As of Wednesday, 67 people in the county had tested positive for Zika this year after traveling abroad. But only 10 neighborhoods have been sprayed because in many cases, the targeted Aedes mosquitoes weren’t detected near the sickened residents’ homes.

“San Diego County hasn’t fielded any report of a locally acquired Zika case, while there have been 139 nationally this year.

“’It is encouraging,’ said Rebecca Lafreniere, deputy director of the county’s Environmental Health Department. ‘But we really emphasize our public-health message about preventing the breeding [of mosquitoes] in the first place.’

“She said the public can do its part by eliminating any pools of stagnant water — even small amounts.

“Other prevention tips include staying inside and bringing pets indoors, closing windows and doors, turning off fans that bring outdoor air inside and covering ornamental fishponds. The county also advises people to rinse fruits and vegetables from gardens before cooking or eating them, as well as wiping down or covering outdoor items such as toys and barbecue grills.

“San Diego County’s latest Zika-related spraying case arose amid what may be encouraging signs about the epidemic’s containment in the U.S. and internationally.

“A study released by the agency last week urged further caution for new mothers; it cited research showing that severe birth defects caused by Zika may not be apparent at birth but develop months afterward. The CDC now recommends long-term monitoring of babies born to Zika-infected women.

“Aedes mosquitoes didn’t gain public awareness in the U.S. until recent years, but they’ve long been a scourge in several other parts of the world. They can transmit not only Zika, but also yellow fever, dengue fever and chikungunya.

“In San Diego County, Lafreniere said the Aedes aegypti, also known as the yellow fever mosquito, and the Aedes albopictus, or the Asian tiger mosquito, were first reported in 2014 and 2015, respectively. Their appearance was a game-changer for the region’s vector control officials, who deal with most mosquito species by trying to kill larvae or reduce breeding areas.

“In the past, San Diegans who contracted mosquito-borne diseases while abroad weren’t a public-health threat once they returned home because those non-Zika viruses essentially had no way to spread here. Aedes mosquitoes are considered more invasive, and they’re adept at surviving and expanding their populations in urban areas.

“Vector-control crews must go after the adults, specifically the females that bite people and spread the Zika virus, Lafreniere said.

“She also said the county was prepared for responding to Zika because it has a plan for dealing with emerging vector-borne diseases. Likewise, the county has a reserve budget for an emergency public-health threat and follows an existing integrated pest-management approach that addresses public information and education, mosquito surveillance, biological control, physical control and microbial and chemical control.

“Fighting Aedes mosquitoes hasn’t been without its challenges, though. Lafreniere didn’t cite a dollar amount last week, but said the anti-Zika work has created a ripple effect on her department.

“’Because we’ve had these 10 (spraying) responses, it has shifted some of our operational needs,’ she said. For example, she said the county’s standard response time of one day for a vector-control issue has sometimes been stretched to two days because of the anti-Zika efforts.

“Besides working to combat the new invasive mosquitoes, the county is dealing with a longer mosquito season, which traditionally was during the warmer months of April through October.

“’What we’ve been experiencing in the last few years is very mild winters,’ Lafreniere said. “We’ve been seeing more mosquitoes in the winter, which is unusual."

Source: The San Diego Union-Tribune

November 29, 2016: Microcephaly Found in Babies of Zika-Infected Mothers Months After Birth

“It is the news that doctors and families in the heart of Zika territory had feared: Some babies not born with the unusually small heads that are the most severe hallmark of brain damage as a result of the virus have developed the condition, called microcephaly, as they have grown older.

“The findings were reported in a study of 13 babies in Brazil that was published Tuesday in Morbidity and Mortality Weekly Report. At birth, none of the babies had heads small enough to receive a diagnosis of microcephaly, but months later, 11 of them did.

“For most of those babies, brain scans soon after birth showed significant abnormalities, and researchers found that as the babies aged, their brains did not grow or develop enough for their age and body size. The new study echoes another published this fall, in which three babies were found to have microcephaly later in their first year.

“As they closed in on their first birthdays, many of the babies also had some of the other developmental and medical problems caused by Zika infection, a range of disabilities now being called congenital Zika syndrome. The impairments resemble characteristics of cerebral palsy and include epileptic seizures, muscle and joint problems and difficulties swallowing food.

“’There are some areas of great deficiency in the babies,’ said Dr. Cynthia Moore, the director of the division of congenital and developmental disorders for the Centers for Disease Control and Prevention and an author of the new study. ‘They certainly are going to have a lot of impairment.’

“Dr. Deborah Levine, a professor of radiology at Harvard Medical School who has studied Zika but was not involved in either study, said there would most likely be other waves of children whose brains were affected by the Zika infection, but not severely enough to be noticed in their first year.

“’A lot of the developmental abnormalities we’re not going to see until later,’ she said. ‘There’s going to be another group seen later in childhood, I’m afraid, and another group probably when they reach school age.’

“In the new study, doctors at two clinics in the northeastern Brazilian states of Pernambuco and Ceará described the cases of 13 infants who had tested positive for the Zika virus. In 11 of the babies, brain scans taken days or weeks after birth showed significant neurological damage, including improperly formed brain areas, excess fluid in some places and abnormal calcium deposits, or calcification, which probably resulted from brain cell death. But the size of their heads, though small, was not small enough to be considered microcephaly. So doctors monitored their progress as they grew.

“Dr. Vanessa van der Linden, another author of the study and a neuropediatrician at the Association for Assistance of Disabled Children in Recife, Brazil, where most of the babies in the study are patients, said the type of brain damage in the babies who later developed microcephaly “presented the same pattern, but less severe” than those with it at birth.

“The babies in the study published this fall also appeared to have a pattern of similar, but less severe, brain damage, said Dr. Antonio Augusto Moura da Silva, of the Federal University of Maranhão and an author of that study, which was published in Emerging Infectious Diseases. He and his colleagues studied 48 babies with brain abnormalities in the northeastern state of Maranhão, identified six babies who did not have microcephaly at birth, and found that three of them later developed it.

“’We were worried, but now that we’ve started following those cases, we are very sad,’ Dr. Silva said. ‘The picture is really terrible. At the least, if they have microcephaly, we expect them to have a very poor quality of life.’

“Experts and the authors of the studies said it was unclear why these infants’ brains did not develop enough to match their age and body size. Dr. Ernesto T. A. Marques Jr., an infectious disease specialist at the University of Pittsburgh and the Oswaldo Cruz Foundation in Recife, who was not involved in either study, said it could be that because of the initial fetal brain damage, “the necessary pathways and hormones that organize growth of the neonatal brain are not there anymore and the brain doesn’t grow.”

“It could also be the result of the immune system responding to the original Zika virus infection. Dr. Moore said that another possibility might be that there was still some infection that continued to damage the brain. But she said that seemed less likely, given that follow-up tests for Zika virus conducted on seven of the babies did not find evidence of active infection.

“The oldest babies in these studies are only just over a year old, too young for researchers to identify cognitive problems or delays in skills like speech. But some deficits are clear: Many of the babies had serious physical deficits tied to neurological damage, including overly tense muscles, muscle weakness and the inability to voluntarily move their hands.

“Still, unlike many babies born with microcephaly, most of the 13 in the new study had social interaction skills like smiling and making eye contact. And eight of them had good head control, an important skill for developing the ability to sit or walk.

“While cautioning that the study involved too few cases to make generalizations, Dr. van der Linden said that it appeared that most of these babies had good eye contact because the damage was less severe in brain areas involving vision than it was in areas involving motor skills.

“Dr. Marques said that head control, the ability to lift and support the head without help, in babies with microcephaly was “quite rare.” Having a social smile and eye contact is less rare, he said, depending on the type of visual damage and on whether they receive enough visual stimulation to strengthen their ability to use their eyes.

“’At this age, 80 percent of brain stimulus comes from the eyes,’ he said. ‘If you don’t have that working and you lose this window of opportunity, these babies cannot recover it.’

“One baby, a boy, had no anomalies at birth. His limbs looked normal and his head size was proportional to his body, Dr. Moore said. But brain scans soon after birth showed excess fluid and abnormalities in his cortex and corpus callosum, which separates the two hemispheres. At 11 months old, he had microcephaly, and also epilepsy, difficulty swallowing, involuntary muscle contractions, and muscles that were too stiff and restricted his movement, she said.

“Another baby had a sloping forehead and slight depressions in the front of his head at birth, as well as similar types of brain damage, apparent on scans, Dr. Moore said. By the time he was 1, he had developed microcephaly that was among the most severe of the babies in the study, and had muscular and swallowing problems. But he also had good eye contact, researchers reported.

“In six of the cases, the mothers reported having a symptom of Zika infection, a rash, between the second and fifth months of pregnancy. That supports other evidence suggesting that babies born to mothers who were infected late in the first trimester suffer the most serious effects. But since there are no symptoms in 80 percent of cases of Zika infection, it was unclear when most of the women were infected, and researchers are still unable to say whether the virus is more damaging to babies if their mothers experience symptoms.”

Source: The New York Times

November 28, 2016: Threat Posed by Zika Expected to Continue In Georgia In 2017

“Georgia so far has escaped the type of Zika threat faced by Florida, which has been the epicenter of the virus in the continental United States.

“However, public health officials say Zika will still pose problems in Georgia in coming years. And they note that some pregnant women in Georgia are infected with the virus, meaning they could give birth to babies with health problems.

“Georgia has seen 104 ‘travel-related’ cases of Zika since the first case was reported, The Atlanta Journal-Constitution reported. So far, not one infection has been caused by in-state mosquitoes, the newspaper reported.

“Though mosquito season may be over now, authorities say Zika will be a threat in 2017, and the virus could potentially be spread by local mosquitoes as it has spread in south Florida.

“In some ways 2016 was a dry run for what Georgia could face in 2017 if the virus spreads by local mosquitoes as it has in Miami, the Atlanta newspaper reported. Awareness campaigns launched during the past year in Georgia are lessons that will carry over if that happens, officials said.

“’This particular mosquito season, even though we’ve seen low numbers of mosquitoes that can carry the virus, it doesn’t mean that next season will be the same,’ said Chris Kumnick, interim director of environmental health for the Georgia Department of Public Health. ‘It doesn’t diminish the risk of managing that hazard.’

“The ongoing drought that’s spread across Georgia in the past eight months is one factor that helped the state avoid an outbreak like the one in south Florida, officials said. Another factor was a war for dominance between the two types of mosquitoes that carry the virus.

“By late spring, Georgia’s state health department had relaunched its Tip and Toss campaign, a mosquito control effort aimed at homeowners and businesses. People were told to remove all standing water from their bird baths, truck beds, patio furniture and any other outside containers bigger than a bottle cap. A teaspoon of water is enough for mosquitoes to successfully lay eggs, Georgians were warned.

But by the end of October, Georgia was well below its annual rainfall totals. Atlanta, Athens, Columbus and Macon all had below 33 inches of rain, anywhere from 12 to 16 inches below their respective 30 year averages. That, coupled with a cooler spring statewide and lower humidity levels in early summer, drove mosquito populations down.

Georgia monitors the insects’ population with light traps around the state. Epidemiologists extrapolate the potential number of the insects in the area based on the number of mosquitoes caught in the traps.

In particular, epidemiologists were looking for the Aedes aegypti and Aedes albopictus breeds, the primary carriers of the disease. For the last five to seven years, the Aedes aegypti population has been dwindling, said Kumnick. That mosquito is responsible for Miami’s Zika outbreak. It is the most efficient in spreading the virus because it only feeds on humans.

In Georgia, the only place the aegypti was found was in Muscogee County; until late September, only 14 of that type had been found. Along the Georgia coast, where some thought a local outbreak might originate, the last time the aegypti was found in traps was 2012 in Chatham County, Kumnick said.

Earlier this month, Georgia requested an additional $800,000 from the $1.1 billion federal Zika bill passed by Congress earlier this fall, said Nancy Nydam, spokeswoman for the state public health department.

That money will go toward preparedness for next year, officials said. Though the mosquitoes may be just about gone this season, their eggs are not. Those eggs over winter, wet or dry, and will be ready to hatch as soon as the weather warms next summer."

Source: The Associated Press

November 27, 2016: People Planning Winter Vacations Still Need to Worry About Zika Virus

According to the World Health Organization, the Zika virus is here to stay. And with people planning their winter vacations, travelers are being advised to pack bug spray and long sleeve clothing.

“Travelers are busy looking for last minute vacation plans.

“Deanna Sutherland Rigby from Vision Travel says warmer destinations are the most popular this time of year.

“’Dominican, Cuba, Mexico and other southern Caribbean Islands.’

“They’re also places with the highest risks of contracting Zika.

“Sutherland Rigby says while it is not top of mind for many vacationers it has been a topic of discussion this season.

“Cases of Zika have now been reported in over 50 countries.

“’You really can’t go anywhere now that there isn’t Zika virus.’

“Dr. Fiona Hunter is studying how the virus spreads to mosquitoes. She recently travelled to Brazil, another hot spot for the virus, and even plans on taking her family to the Dominican Republic this year.

“’This is the new normal- having Zika virus in the south and if you do choose to go somewhere you have to take care of yourself.’

“She advises vacationers to bring bug spray with them because some places don’t sell them.

“According to the Centres for Disease Control and Prevention mosquitoes that spread Zika don’t live at elevations above 2000 metres.

“Dr. Hunter says there is still a lot not known about Zika, which has been linked to severe birth defects.

“’Anybody out there who is either not pregnant or not planning on getting pregnant – Zika virus is really nothing to worry about.,’ said Dr. Brett Belchetz.

“Men and women are urged to practice safe sex for six months after travelling to Zika infected areas.

Source: CHCH

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