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August 31, 2016: Do Vacant Properties Explain Miami's Zika Outbreak?

Tangential to Mosquito Squad’s mantra of reducing water collection sources to reduce the mosquito population is this interesting view from Jonathan May, Harvard

“For months, experts predicted that local Zika transmission would hit the U.S. When mosquitos began transmitting the virus from infected to uninfected people, the threat of a major epidemic would rise significantly.

“Then it happened. The first cases were detected in Miami, with a large cluster found in a one-square-mile patch on the north side of the city, in a hip, artsy neighborhood called Wynwood.

“As expected, Zika appeared in a major city along the Gulf Coast, where the Aedes aegypti mosquito thrives. But why Wynwood?

“The neighborhood, long known as ‘Little San Juan’ for its large Puerto Rican community, has been quickly gentrifying over the last ten years (according to Wikipedia). Now it’s also known for its street art, including the Wynwood Walls, which has driven a hipster feel and growing fashion scene.

“But, as the New York Times reported, while bustling and visually appealing, Wynwood includes a ‘still-tattered section of run-down buildings where residents struggle in poverty.’ The Times noted that the mix of housing, businesses and warehouses made fighting mosquitos particularly tough.

“I ran my own analysis on data collected by the U.S. Postal Service to assess a possible link with vacant housing. Vacant and foreclosed homes have been identified as major potential breeding sites for mosquitos: as Sonia Shah wrote recently for the Washington Post, swimming pools in foreclosed homes were implicated in Florida’s 2009 dengue outbreak and Bakersfield, California’s 2007 West Nile virus outbreak.

“I found a strong link. Out of Miami-Dade County’s 517 census tracts (geographical groupings of roughly 1,200-8,000 people) the three highest rates of residential vacancy are tracts 28, 31 and 22.02. One of these tracts represents Wynwood’s southern half; the others lie directly adjacent to Wynwood’s north and south limits.

“In each of these areas, around 10% of homes (as represented by a USPS mailing address) had been vacant for at least 90 days, as of June 30. That’s far higher than the county average of 2.1% and median of 1.4%. These census tracts aren’t the biggest in Miami-Dade County, nor have they got the most vacancies, but they’ve got the steepest concentration of vacant homes:

“Each area has also got a business vacancy rate over 10%, placing them in the top quintile of Miami-Dade census tracts. On a quick look at Google Street View, you can hardly miss all the available commercial spaces, like this one:

“When nobody’s using a property, it’s a lot less likely to stay clean. That could mean more debris and standing water, where Ae. aegypti mosquitos like to breed. As health officials scramble to prepare cities all along the Gulf Coast, residential vacancy rates could prove a useful statistic for predicting neighborhood-level risk.”

Since the mosquitos don’t fly far—WHO says they travel about 400 meters in their lifetimes—and take 90% of their meals from human hosts, they also need environments with plenty of access to human residents and/or passersby. Wynwood’s active street life might have added fuel to the mix, especially since Ae. aegypti likes to bite during daylight hours.

Source: Harvard University

August 30, 2016: Johns Hopkins Opens World's First Zika Virus Center

Researchers and healthcare providers from Johns Hopkins will work with medical experts from Brazil to treat patients and conduct research to better understand the disease. Meanwhile, the virus has spread to Palm Beach.

“Johns Hopkins Medicine has launched the Johns Hopkins Wilmer Zika Center, where medical professionals focus on caring for patients with the Zika virus. The center is touted as the first multidisciplinary Zika center in the world.

“The center’s staff, providers and members are from Johns Hopkins Medicine, the Johns Hopkins School of Public Health and medical experts from Brazil. These experts focus on infectious diseases, maternal-fetal medicine, ophthalmology, epidemiology, pediatrics, physiotherapy, psychiatry and social work.

“’Patients will no longer be required to travel to multiple centers for care relating to Zika virus,’ said William May, MD, associate professor of ophthalmology, Johns Hopkins Wilmer Eye Institute, in a statement. ‘Physicians and staff members in various departments at Johns Hopkins will be available to provide comprehensive care to patients within one institution.’

“While the virus is most commonly known to cause microcephaly, a birth defect affecting the brain, the virus also causes eye abnormalities, like cataracts, in over half of the babies infected with Zika. The Wilmer Eye Institute led the Zika center’s development, which will be able address these concerns.

“Both adults and pediatric patients from around the world can be referred to the center by outside physicians or through Johns Hopkins. Patients may also call the center to make an appointment. The Zika center will also conduct research to further understand the virus.

“’Our No. 1 priority will be focused on our patients, but our hope is that our care will also lead to many new developments in the effort to fight this potentially devastating disease,’ said May.

“The center’s opening comes on the heels of Florida Governor Rick Scott’s announcement on Wednesday of a new case of locally-contracted Zika in Palm Beach. To date, the virus had been contained to a small Wynwood neighborhood and neighboring Miami Beach.

“To date, there are 43 non-travel related cases in these areas and 523 travel-related cases throughout the state.

Further, the Governor expressed frustration with the Centers for Disease Control and Prevention for failing to provide enough support to the state. Last week Scott requested 5,000 antibody tests, but Florida has only received 1,200. He also requested more lab support and personnel to expedite testing and an additional 10,000 Zika prevention kits, but the requests haven’t been answered.

“’This is unacceptable,’ said Scott in a statement. ’It’s disappointing that these requests have not been fulfilled. Florida now has 43 cases of locally acquired Zika and the Obama Administration must quickly fulfill our entire request so that we can continue to provide the resources our state needs to combat this virus.’

“I’ve also repeatedly called on the Obama Administration to provide a detailed plan on how Florida should work with FEMA on how federal resources will be allocated to combat this virus,” he added. “I expect the Obama Administration to be a good partner and work quickly to fulfill these requests.”

Source: Healthcare IT News

August 29, 2016: OraSure Gets U.S. Contract to Hurry Development of Zika Test

Funding will speed development of oral test kits for the virus

OraSure Technologies Inc. said Tuesday that it had been awarded a U.S. government contract to speed the development of its oral test kits for the Zika virus.

“The Bethlehem, Pa., maker of oral tests for HIV and Ebola said the six-year contract was for upward of $16.6 million with a biomedical research agency attached to the U.S. Department of Health and Human Services.

“The initial commitment is for $7 million with options of up to $9.6 million to finance evaluation of further product enhancements, and clinical and regulatory services, OraSure said.

“’We believe the availability of an accurate rapid Zika antibody test will be a valuable tool to address current and potential future outbreaks,’ said Douglas A. Michels, OraSure’s chief executive. ‘[The funding] will enable us to complete clinical and other activities required to obtain regulatory approvals for this product.’

“OraSure said it would provide an update on guidance and timing during its November earnings call. Shares of the company rose 9.3% in after-hours trading.

“The company’s test kits for HIV and Ebola use mouth swabs to collect saliva. Orasure claimed its tests for Zika will be of greater use than the examination of tissue or blood samples because the virus can be detected earlier with its technique.

“The Zika virus, identified in Uganda in 1947, has spread in Latin America since its 2014 arrival in Brazil before making its way north. The virus has been spreading in Florida.

“According to the U.S. Centers for Disease Control and Prevention, as of Aug. 11 there were 529 cases of pregnant women possibly infected with the Zika virus, which can infect a fetus, possibly causing birth defects including microcephaly, an abnormally small head associated with improper brain development.:

Source: The Wall Street Journal

August 28, 2016: Brain Scan of Brazilian Baby Shows Array of Zika Effects

The Zika virus not only causes smaller heads and brains — the signature microcephaly — but disrupts development, scans show

“The image tells a heartbreaking story: Zika’s calamitous attack on the brains of babies — as seen from the inside.

“A study of brain scans and ultrasound pictures of 45 Brazilian babies whose mothers were infected with Zika in pregnancy shows that the virus can inflict serious damage to many different parts of the fetal brain beyond microcephaly, the condition of unusually small heads that has become the sinister signature of Zika.

“The image, published Tuesday in the journal Radiology, also suggest a grim possibility: Because some of the damage was seen in brain areas that continue to develop after birth, it may be that babies born without obvious impairment will experience problems as they grow.

“’It really brings to the forefront the importance of truly understanding the impact of Zika virus and the fact that we need to follow children who not only are exposed to Zika in pregnancy, but even those who don’t appear to have any complications at birth,’ said Dr. Catherine Y. Spong, acting director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, who was not involved in the study.

“Most of the babies in the study were born with microcephaly, although three were not. Each also suffered other impairments, almost all of which emerge earlier than microcephaly because a smaller head is really a consequence of a brain that has failed to develop fully or has been damaged along the way, experts said.

“’The brain that should be there is not there, said Dr. Deborah Levine, an author of the study and a professor of radiology at Harvard Medical School. ‘The abnormalities that we see in the brain suggest a very early disruption of the brain development process.’

“The scans show the range of Zika’s brain targets, some of which experts knew about, including the corpus callosum, which facilitates communication between the two hemispheres; the cerebellum, which plays a significant role in movement, balance and speech; and the basal ganglia, which are involved in thinking and emotion.

“’I think we were all aware that Zika causes brain abnormalities, but it’s been more generic,’ said Dr. Rita Driggers, an associate professor of gynecology and obstetrics at Johns Hopkins University School of Medicine, who was not involved in the study. ‘Now we know more specifically what we’re looking for in terms of brain abnormalities before the microcephaly occurs.’”

Source: The New York Times

August 27, 2016: South Florida Doctors Treat Baby Girl Born with Zika Virus

A baby girl who tested positive for the Zika virus is being treated by doctors in South Florida.

“The baby’s mother contracted the Zika virus while traveling while pregnant off the coast of Venezuela.

“The baby has not been diagnosed with microcephaly, but doctors said the child is suffering from other Zika-related side effects.

“Photos taken inside the baby girl’s eyes at the Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine help give doctors a clearer vision of how to treat the baby.

“The baby’s mother contracted the virus at the end of her first trimester, while on a family Christmas vacation on the island of Margarita off the coast of Venezuela. The island is about 290 miles east of Caracas.

“’They thought it was the sun,’ the mother said in Spanish about the rashes she started getting followed by red eyes and stomach issues.

“She said she felt terrible to hear the news and then her ‘world collapsed.’

“The mom, who is from Venezuela, but now lives in Doral, said she saw three doctors and then waited for the results.

“She said the past months have been filled with anxiety, not knowing the fate of her baby, Micaela, who is now nearly two months old.

“So far, Micaela does have some calcifications in her brain left behind by the virus.

“’It just tells us that there was a bacteria or a virus in the brain and that virus has left us with some calcifications,’ Dr. Audina Berrocal said. ‘Babies with early intervention and the right support, sometimes they compensate for those changes that we find early.’

“Berrocal recently spent time in Brazil working with 25 other babies who have severe microcephaly.

“The scars in those babies’ retinas are larger and closer to the center than Micaela’s, evidence of what is likely long-term damage.

“’Finding changes in the eyes indicates that we must have something in the brain of that child,’ Berrocal said.

“Still, Berrocal said Micaela will likely have ‘almost normal visual development.’

“The mom is thankful that her daughter’s condition is not worse, and gave her the middle name Milagros (Miracle), because she believes her daughter is a miracle child.

“’Don’t go to places where there is Zika,’ the mom warned other mothers, saying sometimes she hasn’t been able to sleep, worrying about her young daughter’s future.

Source: WPLG News Miami

August 26, 2016: West Side of New York Gets Zika Smart and Ready

“The city has unveiled a snazzy new website that goes through the prevention measures that officials are taking to prevent an outbreak of Zika. It’s got some important neighborhood-level information.

“The kinds of mosquitoes that can spread Zika are called Aedes aegypti. Those are not known to live in New York. But a cousin, called Aedes albopictus, does live in the city and could potentially become a transmitter of Zika, so health officials have been tracking their whereabouts. The city has put out traps to catch mosquitoes and examine whether they’re part of the potentially problematic species.

“A map that goes along with the city’s presentation shows how many mosquitoes were captured in local traps per week this year. On the UWS, one cluster of traps shows 2 mosquitoes were caught per week, and the other shows 0.3 were caught. That’s far below other areas of the city, such as the Lower East Side, where an average of 16 were caught. None of the mosquitoes caught in the city so far have tested positive for Zika. Another local trap showed that an average of 5 Culex pipiens and/or Culex restuans mosquitoes were caught per week — those can carry West Nile Virus.

“The site also shows where the city has sprayed to kill mosquitoes, and where they have issued notices of violation for leaving standing water. None of those have been issued on the UWS. To report standing water, which can be a breeding ground for mosquitoes, fill out the form here.

“See the whole site here. And be aware that you can also get Zika from sex.”

Source: West Side Rag

August 25, 2016: Zika Virus in School: Miami Officials Make Tough Decisions

“With school starting across Miami – where there are growing concerns about the Zika virus.

“Health officials are monitoring two so-called Zika zones.

“In Miami Beach, at least five people have apparently beeninfected by local mosquitoes.

“The original Zika zone is just across Biscayne Bay. So far, at least 36 people in the area have been infected. The virus can cause severe birth defects.

“The Florida Department of Health handed out free bug repellent at Miami Beach Senior High. Students from here and one other school in the newest Zika zone were encouraged to spray themselves before class.

“Melanie Fishman, principal at South Pointe Elementary in Miami, said they don’t want students to spray themselves at school because “some kids might have asthma.”

“The Miami-Dade school district handed out protective clothing – long sleeves and pants for students that needed it.

“The proactive efforts taken by the school district have impressed Carol Karp, whose son Adam is entering high school.

“’I commend their efforts, fantastic,’ Karp said. ‘It’s what we should do to protect children and community.’

“Nearly 3,300 will now be attending school in the 1.5-mile area where local Zika transmission has been confirmed on Miami Beach.

“Ashley Beauegard, a yoga teacher who is 6 months pregnant, canceled her baby shower in Miami Beach, and worries, her home, 15 minutes north of the Zika zone, may also be a vulnerable area.

“’I mean I just feel like it spread from Wynwood to Miami Beach, cases that we know of,’ Beauegard said. ‘So how many cases that we don’t know of could’ve spread further already?’

“Starting last Monday, 7,600 kids in Miami-Dade County will be attending school inside of one of the Zika zones – there are now two in the county. The superintendent of schools originally considered relocating the students, but decided not to.”

Source: CBS News

August 24, 2016: Gulf States Next at Risk for Zika Outbreak, NIH Official Says

“Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), warned that Gulf Coast states are the most susceptible to a new Zika outbreak.

“’Well, the ones that are most at risk, George, are those along the Gulf Coast. I would not be surprised if we see cases in Texas, in Louisiana, particularly now where you have a situation with flooding in Louisiana,’ Fauci told ABC’s George Stephanopoulos on ‘This Week.’

“’When you have a sub-tropical, or semi-tropical region with the right mosquitoes, and individuals who have travel-related cases that are in the environment, it would not be surprising that we will see additional cases, not only in Florida, but perhaps in other of the Gulf Coast states,’ he said.

’On Friday, the Centers for Disease Control and Prevention (CDC) issued a travel warning after five Zika infections were confirmed in Miami-Dade County.

“The CDC recommended that those living or traveling to the area increase their efforts to prevent mosquito bites and advised pregnant women and their partners to postpone ‘nonessential travel to all parts of Miami-Dade County.’

“The head of the NIAID said Americans should take the threat of Zika seriously, although he does not believe there will be a widespread outbreak across the continental United States.

“’I do not think, although we need to be prepared for it, that we’re going to see a diffuse, broad outbreak in the United States because of a number of issues, particularly the conditions in our country … would not really make that a very likely happening,’ Fauci said.

“He added that he anticipates Zika to stick around for ‘a year or two.’

“’Hopefully, we get to a point to where we could suppress it so that we won’t have any risk of it,’ he noted.

“Fauci overseas research to prevent, diagnose and treat established infectious diseases, as well as emerging diseases like Ebola and Zika.”

Source: ABC News

August 23, 2016: Zika Might Affect Adult Brains, Too, Study Finds

“The Zika virus, previously thought only to be a big threat to developing babies, might also affect adult brains, researchers reported Thursday.

“Tests in mice suggest the virus can get to and damage immature brain cells in adults — something that indicates Zika infection may not be as harmless for grown-ups as doctors have believed.

“It will take much more study to know if human beings infected by Zika are at risk, but the report, published in the journal Cell Stem Cell, adds another disturbing twist to the Zika saga.

“Zika is known to home straight in on developing nerve cells, especially brain cells, when it infects a fetus. The result is devastating birth defects — a small head, known as microcephaly, profound brain destruction, and sometimes less obvious brain damage.

“Babies often miscarry and if they survive, they have permanent brain damage. There’s no cure.

“Other viruses are known to prefer brain cells and nerve cells — herpes viruses are a well known example — but Zika is surprising scientists more the more they study it. “There’s a lot we don’t know about Zika,” Centers for Disease Control and Prevention director Dr. Thomas Frieden said Thursday.

“Hongda Li of the Howard Hughes Medical Institute and The Rockefeller University in New York and colleagues used an experimental strain of mice for their tests.

“They knew Zika preferred immature brain cells called stem cells and they were working on recent discoveries that adult brains also carry these immature brain cells.

“’Two areas in the adult mouse brain contain neural stem cells: the subventricular zone of the anterior forebrain and the subgranular zone of the hippocampus,’ they wrote in their report.

“And sure enough, Zika got into those brain regions when the mice were infected and appeared to kill some of the stem cells in there.

“’Our data therefore suggest that adult as well as fetal neural stem cells are vulnerable to Zika virus neuropathology,” they wrote. "Thus, although Zika virus is considered a transient infection in adult humans without marked long-term effects, there may in fact be consequences of exposure in the adult brain.’

“It’s not clear what that might mean to people affected by Zika. Researchers are only beginning to study it and its long-term effects.

“Adult brains are less vulnerable to damage than those of developing babies, but brain damage can cause epilepsy, personality changes, depression and dementia.

“Zika’s not necessarily believed harmless to adults. The evidence suggests that 75 to 80 percent of those infected never know it, suffering mild symptoms at most. The worst affected usually have had muscle aches, headaches, a rash and red eyes.

“It can also cause Guillain-Barre syndrome – a paralyzing disorder that a few people suffer after a variety of infections. Puerto Rico reported Thursday that 30 people had suffered Guillain-Barre in the Zika epidemic there so far.

“Li’s team said their findings may help explain cases of Guillain-Barre.

“‘Infection of neural progenitor cells in stem cell niches may relate to the emergent cases of Zika-linked Guillain-Barre syndrome (GBS),’ they wrote.”

Source: NBC News

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