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Blog | September 2016

September 30, 2016: Travelers Warned About Zika in St. Kitts and Nevis

The deadly Zika virus has been transmitted by mosquito in St. Kitts and Nevis, the Centers for Disease Control and Prevention reported Monday.

The development prompted the agency to urge travelers to the two-island nation to prevent themselves from getting mosquito bites. Mosquitoes in the area are spreading the disease to people, the CDC says.

Pregnant women are being advised not to travel to St. Kitts and Nevis because Zika can be spread from mother to fetus.

Three cases of the virus have been confirmed in St. Kitts and Nevis, the St. Kitts Nevis Observer reported, attributing the information to government officials.

Minister of Health Eugene Hamilton is calling on residents to make sure they do not have stagnant water or other potential breeding sites on their properties.

Cameron Wilkinson, medical chief of staff at JNF Hospital, told WINN FM radio that it should not be too much of a surprise that the disease has reached St. Kitts and Nevis because it has been found in neighboring countries.

“What is reassuring is the fact that for the majority of persons with the Zika virus, infections are very mild infections and there is no need for panic,” Wilkinson told the radio station.

Residents are not concerned because the ailment is under control, St. Kitts resident Saju Ng’alla told USA TODAY.

“Yes, so far we have had three cases, however, we are not worried it would be a problem,” said Ng’alla, who lives in Bird Rock on St. Kitts. “The government has taken steps to insure that residents are taking the necessary steps to contain it. People here are truly not worried about it.”

Travelers can prevent mosquito bites by:

• Covering exposed skin with clothing
Eliminating standing water around the home
• Using insect repellent registered with the Environmental Protection Agency
• Wearing clothing and using outdoor gear treated with permethrin
• Staying in places with air conditioning and window and door screens
• Sleeping under a mosquito bed net
• Using condoms

Symptoms of the Zika virus include fever, rash, joint pain and conjunctivitis, according to the CDC. The virus can be fatal.

As of Sept. 21, there have been 3,358 cases in the United States and 19,777 in U.S. territories, the CDC reports. As of Sept. 22, 47 countries in the Americas have reported the disease, according to the Pan American Health Organization.

Source: USA Today

September 29, 2016: Zika on the Rise

“The risk of Zika infection in the country is rising with the strong presence of its transmitter, Aedes mosquito, and its outbreak in Singapore and Malaysia where some eight lakh Bangladeshis work.

“The danger is more than what was conceived since 80 percent of Zika cases are asymptomatic, making it difficult for health officials to initiate checkups at ports, and also because the virus is transmitted through sexual intercourse, epidemiologists said.

“At least 19 were identified as Bangladeshi among the 369 Zika-infected people in the city state of Singapore until September 18. Six other cases have been found in Malaysia, according to media reports.

“Besides, Aedes mosquitoes that transmit dengue virus here are also responsible for the transmission of Zika.

“Some 2,757 Dengue cases were reported in Dhaka until September 22, which is the highest during this time since 2007, according to the Institute of Epidemiology, Disease Control and Research (IEDCR).

Medical experts earlier said it was mostly the South American countries like Brazil that had cases of Zika, and so Bangladesh had little risk with thin traffic from the region to Bangladesh. Now that the Asian countries having large numbers of Bangladeshi migrants face Zika outbreaks, some of them are much likely to carry the virus home, they said.

“The virus can be transmitted by Aedes mosquitoes after they bite someone carrying it from abroad or someone infected with it from the environment, said Professor Saif Ullah Munshi of the virology department at Bangabandhu Sheikh Mujib Medical University (BSMMU).

“’We have not conducted any survey to check if Zika virus is here in Bangladesh, but it was found in the environment in India. So, it is not unlikely that Zika virus is also here in Bangladesh,’ he told The Daily Star.

“Even if it is not found locally, the risk of its import has increased with the Zika outbreaks in Singapore and Malaysia, he said.

“There is no vaccine or treatment for Zika infection that causes mild fever, rash and red eyes.

“The recent-time Zika outbreak was first detected in Brazil last year and has since spread across America and the Caribbean.

“Pregnant women are considered to be at greatest risk because the virus can cause severe birth defects, including microcephaly marked by small head and underdeveloped brains.

“In Brazil, Zika has been linked to more than 1,800 cases of microcephaly.

“Prof AKM Shamsuzzaman, director (communicable disease control) of the Directorate General of Health Services (DGHS), said the government had ordered medical teams in all international air, sea and land ports to keep careful watch on incoming travellers from the affected countries.

“Thermal scanners are installed at the ports for health screening, he said.

“Cards are also given to passengers in planes to be filled up so that they can report the countries they are travelling from and if they have any symptom, Dr Shamsuzzaman added.

“Since 80 percent of the infected people are asymptotic, highest efforts should be put into preventing breeding of mosquitoes, said Prof Munshi of the BSMMU.

“Prof Meerjady Sabrina Flora, director at the IEDCR, said the authority had adequate surveillance and screening arrangements. There is nothing to be panicked but public awareness has to be built, she added.

“The health ministry has advised pregnant women not to travel to the Zika-affected countries.

“Measures to destroy mosquitoes are imperative, Sabrina said, adding that all should use mosquito repellents or nets to prevent mosquito biting.

“The World Health Organisation advised men and women returning from the Zika-affected countries to have safer sex or not have sex for six months, regardless of whether they are trying to conceive or showing symptoms.

“It said it had found evidence of Zika transmission from asymptomatic males to their female partners and a symptomatic female to her male partner, as well as evidence that Zika is present in semen for longer than thought.

“The authorities will arrange orientation for gynecologists so they screen pregnant women in case Zika infection is suspected, Dr Sabrina said.”

Source: The Daily Star

September 28, 2016: Mayors Say State Told Them to Keep Zika Mosquito Sites Secret

“The mayors of Miami-Dade County and Miami Beach on Sunday accused the Florida Department of Health of lying after the state agency said last week that it never told local officials to hide the locations in Miami Beach where mosquitoes carrying the Zika virus were captured.

“Florida’s health department strongly denied instructing local officials to keep the information confidential — and said the decision was entirely up to Miami-Dade — after the Miami Herald reported on Friday that a county attorney said the state agency had ordered them to keep it a secret.

“The statement was made during a court hearing for the Miami Herald’s lawsuit against Miami-Dade seeking the locations of traps in Miami Beach where mosquitoes carrying the Zika virus were captured this month. The suit seeks disclosure of the locations on grounds that the information would help the public make decisions about precautions to take if they live or work nearby, and also inform the community debate on the use of the controversial insecticide naled.

“On Sunday, Miami-Dade Mayor Carlos Gimenez, who is facing a runoff election in November, pushed back against the Florida health department’s denial with a written statement repeating that the agency had ordered secrecy in regards to the locations.

“’During multiple meetings, phone calls and conversations, officials from the Florida Department of Health explicitly stated to county officials that information identifying the addresses of traps containing mosquitoes positive for the Zika virus is confidential during active, ongoing epidemiological investigations,’ Gimenez said in the statement.

“’It is disturbing that the Florida Department of Health is denying previous directives to maintain confidentiality of the trap locations,’ Gimenez said in the statement. ‘At the end of the day, this is about the health and safety of our community, and we have been carrying out the express orders of the Florida Department of Health as it relates to disclosure of mosquito-trap information.’

Source: Miami Herald

September 27, 2016: Doctors Brace for Zika Babies

“This month, the first group of babies in Puerto Rico known to have been exposed to the Zika virus in their first trimester are being born. Pediatricians do not know what to expect.

“’This is not like any other outbreak or epidemic,’ said Dr. Fernando Ysern, a pediatrician in Caguas, Puerto Rico, who is the president of the Puerto Rico chapter of the American Academy of Pediatrics.

“In the pediatric field, Zika looms as a kind of developmental doomsday virus, attacking the vulnerability of early brain development, striking at the neurological basis of human potential. While Puerto Rico, a United States territory, will experience the first wave of children affected by Zika, the rest of the United States is bracing for the spread of the virus.

“As of Sept. 23, the Puerto Rico Department of Health reported 22,358 cases of Zika exposure, including 1,871 pregnant women. The Centers for Disease Control and Prevention’s latest statistics, as of Sept. 15, list 1,348 pregnant women with “any laboratory evidence of possible Zika virus infection” in United States territories and 749 in the United States.

“Exposure to Zika while pregnant does not mean a child definitely will be born with microcephaly, an unusually small brain and head, or have Zika-related health problems. But the risk is real, and pediatricians are trying to figure out how to follow these children, and how to take care of the ones who do have problems. While nobody knows the actual risk of Zika exposure to a fetus, studies have suggested that between 1 percent and 13 percent of pregnant women infected with Zika in the first trimester will have a child with microcephaly, but more could have children with more subtle developmental problems related to in utero exposure to the virus.

“Earlier this month, the American Academy of Pediatrics announced a $350,000 grant from the Department of Health and Human Services to create a network of pediatricians prepared to deal with a generation of children with Zika-related health problems. When babies are born with damaged brains because of Zika they will need medical care and their families will need support.

“But how do you prepare for a new and evolving and still poorly understood clinical challenge? Pediatric experts got together over the summer to talk about it. The meeting was convened by the Centers for Disease Control and Prevention in collaboration with the American Academy of Pediatrics, and it brought together a range of pediatric subspecialists, from neonatology and neurology, infectious diseases and developmental behavioral pediatrics, rehabilitation medicine, ophthalmology and orthopedics and more.

“There’s so much we don’t know. Dr. Peter Jay Hotez, the dean for the National School of Tropical Medicine at Baylor College of Medicine in Houston, said several big questions need to be answered. How does the virus do its damage? What is the full spectrum of damage, from the clearly visible microcephaly to less visible neurological changes? And what happens to babies exposed to Zika after birth, when the brain is still developing?

“The meeting yielded interim guidelines, published in the C.D.C. Morbidity and Mortality Weekly Report. ‘Initially at C.D.C., our biggest goal was to make sure pregnant women didn’t get Zika,’ said Dr. Sonja Rasmussen, a pediatrician and clinical geneticist who is the director of the Division of Public Health Information Dissemination at the C.D.C. ‘This meeting was really trying to make sure those babies have the best chance to reach their fullest potential.’

Source: The New York Times

September 26, 2016: What Does the Zika Rash Look Like?

This update from Naseem S. Miller.

“I came across one of the most precise descriptions of Zika infection symptoms in a recent New Yorker piece by the award-winning author and physician Dr. Siddhartha Mukherjee.

“In ‘The Race For A Zika Vaccine,’ Mukherjee follows the virus from one side of the globe to the other and into the laboratories of scientists who are racing to find a vaccine.

“The story starts with the case of a woman who walked into an E.R. in Melbourne, Australia, in April 2014 with symptoms that didn’t quite match anything the doctors had seen.

“The case is what we call today a travel-related case of Zika infection.

“The woman had just returned from the Cook Islands in the South Pacific. She first developed a fever, followed by a mild headache that turned into a persistent throb, Mukhrejee writes.

“’Migratory pains appeared in her joints, and an angry, blanching rash—the kind that pales when you press it—was now blooming across her torso,’ he writes.

“He then further describes the rash as ‘vivid raised red dots coalescing into islands—and the color of her eyes (pink, with streaks of vermillion), which was indicative of conjunctivitis, a symptom of certain viral infections.’

If you’re obsessed with learning about the Zika virus as I am, I highly recommend reading this piece.

Source: Orlando Sentinel

September 25, 2016: Sabah People May Have Inborn Zika Virus Antibodies

“People in Sabah may not need to be too worried about the Zika virus because they could have inborn antibodies since it is said to be endemic here.

“A Universiti Malaysia Sabah (UMS) Faculty of Medicine and Health Sciences (FMHS) professor said the virus has been found in apes and probably humans here as early as the 1960s.

“’From what scientists have researched and confirmed, we know that the orang utan are among apes or monkeys that carry the virus,’ molecular epidemiologist Prof Dr Kamruddin Ahmed said.

“However, due to deforestation and other factors forcing more animal-human contact, the Zika virus has been spread to humans, he said during an open forum on the virus at UMS on Tuesday.

“’It means that most of us probably have a natural anti-body against the virus,’ he said.

“’Therefore, it may mean that this Zika virus may not affect us the same way it is affecting other people in other parts of the world, especially Brazil where many babies born of Zika-infected mothers have microcephaly (small head) syndrome,’ Dr Kamruddin said, adding that the Zika virus strains in Malaysia and South America were different.

“He said there was also no concrete proof that microcephaly was caused by Zika virus but researchers are still trying to find answers to its cause and symptoms.

“He also said that international scientists are closer to finding a vaccine against the virus suitable for humans.

“Three experimental vaccines were reportedly developed by researchers at Harvard’s Beth Israel Hospital and the Walter Reed Army Institute of Research.

“The vaccines tested on monkeys were found to be safe and protected the animals against infection, according to the report published in Science magazine.

“Dr. Kamruddin advised people to be cautious but not panic, and to take measures to ensure they do not contract the virus.

“’There are still a lot of questions we cannot answer so it is best that we all take precautionary measures,” he said.

“Kota Kinabalu health office public health medicine consultant Dr. Jiloris @ Julian Dony urged the public to use mosquito nets at home, wear light and long-sleeved shirt and pants, as well as spray repellents when necessary to avoid being bitten by mosquitoes.

“’Everyone has a part in keeping their surroundings clean and to rid their areas of mosquito breeding grounds,’ he said, adding that there is no screening for Zika virus at public hospitals and clinics as of now.

“Also present at the forum were former Sabah Health Department director, who is now the public health medicine consultant for FMHS, Datuk Dr Mohd Yusof Ibrahim; FMHS entomologist Prof Dr Chua Tock Hing; Jesselton Medical Centre infectious disease consultant Dr Timothy William; and FMHS deputy dean of academic and student affairs Prof Dr Ahmad Faris Abdullah.”

Source: The Star

September 24, 2016: Quest Diagnostics Debuts New Test Service for Zika Virus

Quest Diagnostics on Wednesday unveiled a new antibody test service that helps medical professionals diagnose infection by the Zika virus.

“Quest is using a test developed by the Centers for Disease Control and Prevention (CDC).

“The test is authorized for emergency use by the U.S. Food and Drug Administration. The CDC has licensed the test to Quest Diagnostics and other select laboratories to aid the response to the Zika emergency in the United States.

“Quest operates about 2,300 patient service centers across the U.S., with approximately 260 of these centers located in Florida, the first state to document cases of local transmission.

“In addition, many health care providers can also collect patient specimens in their offices for testing by Quest Diagnostics, the company said in a statement. Quest Diagnostics serves half the physicians and hospitals in the United States each year.”

Source: CNBC

September 23, 2016: More Insurers Now Offering Coverage for Zika

At least five big players involved; protection provided in personal accident or travel plans

Janice Tai reports that "There is now “Zika insurance” for those afflicted with the mosquito-borne virus.

At least five major insurance firms here have started offering coverage for Zika in their personal accident or travel plans. This comes within a month of confirmation that it had spread within Singapore.

Great Eastern, for instance, extended coverage for Zika to all its existing and new personal accident policyholders last Friday. They can claim up to $300 for medical costs and $30,000 if death is due to the virus.

A pregnant woman diagnosed with Zika is entitled to twice the amount of medical reimbursement, and if her baby is born with Zika-related microcephaly, or abnormally small head, Great Eastern will pay a lump sum of $3,000.

Sompo Insurance Singapore has included Zika coverage for its home and selected personal accident insurance products from Sept 7.

“With an increasing number of Zika cases reported locally and worldwide, and feedback from our intermediaries and policyholders, we see a need to cover our existing and new policyholders against this virus,” said Ms Koh Yen Yen, its chief distribution officer.

NTUC Income was among the first to introduce such coverage back in April through the optional infectious disease cover under its Personal Accident Assurance policy.

“This could be extended to other products with infectious disease cover, said Ms Annie Chua, vice-president for personal lines at NTUC Income.

“Such coverage is similar to that for other infectious diseases such as dengue fever and hand, foot and mouth disease.

“Zika is also covered under some travel insurance plans, offered by Sompo and NTUC Income.

“The other insurers that provide Zika coverage are Prudential Singapore and AIA Singapore. So far, NTUC Income, Sompo and Prudential said they have not received any claims related to Zika.”

Source: The Straits Times

September 22, 2016: Predict Zika’s Spread? It’s Hard Enough to Count the Cases

How far will the Zika outbreak spread, and for how long?

“Predicting Zika’s course in the continental United States is difficult. Health experts have never confronted a virus quite like this one: a mild infection that can nonetheless devastate unborn infants, and that is transmitted by both mosquitoes and sex.

“Even tracking cases is hard because so few cause symptoms. ‘This is such a new thing entomologically that we’re all speaking above our pay grade,’ said Joseph M. Conlon, a technical adviser to the American Mosquito Control Association.

“Still, there is growing agreement among some experts that the virus may be, at best, slowed by aggressive mosquito control. Nothing short of winter will stop it, they said, and how many cases are mounting up is still hotly debated.

“Virtually no entomologists believe that the transmission of Zika is limited to a few square miles of downtown Miami and Miami Beach, no matter how vigorously state officials insist it is.

“’That’s just dreaming — it’s totally unrealistic,’ said Duane J. Gubler, a former director of the vector-borne diseases division of the Centers for Disease Control and Prevention. ‘Mosquitoes move around, people move around. Mosquitoes even move by car sometimes.’

“Nonetheless, the C.D.C. on Monday lifted its travel advisory for the Wynwood neighborhood of Miami, saying that no new locally transmitted cases had been detected there since early August and traps there had few mosquitoes since the spraying of two pesticides, naled and Bti, began.

“Elsewhere, Florida has been reporting new locally transmitted cases almost every day. There were 79 as of Sept. 16. As of Friday, it was investigating 17 infections to ascertain whether each was a lone case or part of a wider cluster.

“The state has refused to reveal the five places where it has trapped mosquitoes that tested positive for the virus, saying the information was “not necessary to public health.” Last week, arguing that it was, The Miami Herald sued Miami-Dade County to force it to name the sites. And it’s likely that some local transmission is not even known about yet. According to local doctors, hundreds of women are waiting weeks to get test results from overwhelmed state laboratories.”

“Experts have long predicted that other Gulf Coast cities might have outbreaks like Miami’s. Indeed, they may be having them now without realizing it because of the testing lags and asymptomatic cases.

“’Every week there’s another ‘Little Shop of Horrors,’ and everyone seems surprised,” said Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine. ‘But finding virus in both people and mosquitoes suggests intense transmission.’

“But a wildfirelike spread on the Gulf Coast, such as Puerto Rico is experiencing, is not expected, largely because air-conditioning and screens are more common.

“Also, Zika usually smolders for months before exploding. For example, Puerto Rico reported its first locally transmitted case in December, but did not have thousands each week until the summer. Florida’s first local case was in late July, so cold weather may break the cycle.

“Since January, the CDC has predicted that Zika would not spread faster on the American mainland than dengue and chikungunya, both of which are also carried by the Aedes aegypti mosquito.

“But some scientists argue that dengue and chikungunya are poor models for Zika. Lab animals with Zika develop more virus in their blood than they do when infected with the other viruses, said Rebecca C. Christofferson, a disease transmission specialist at Louisiana State University’s veterinary school. And, she said, Zika appears to be unusually quick to move from a mosquito’s gut to its salivary glands, where it is injected into the next victim.

“Dengue takes seven to 10 days to make that trip; chikungunya takes as few as five days, depending on temperature, mosquito size and other factors. ‘Zika is looking like chikungunya,’ Dr. Christofferson said.

“Also, Zika flies below the public health surveillance radar. Dengue’s nickname is “breakbone fever,” and chikungunya’s is “bending-up disease.” Both can be excruciatingly painful, so victims often see doctors quickly and their test results are reported to the state.”

“By contrast, 80 percent of Zika victims lack symptoms and may never see a doctor. ‘The symptoms are so diffuse that many, including many physicians, fail to recognize that a person has it,’ said Manuel F. Lluberas, a former Navy entomologist now in the private sector.

“As a result, a Zika cluster can grow without being noticed until someone infected, usually a pregnant woman, is tested.

“Also, the state’s biggest dengue outbreak began in 2009 in Key West, a tiny vacation island with a relatively rich and educated population of 25,000. It still took two years to contain, with 90 confirmed cases.

“The state’s first Zika outbreak is in Miami, an area of 5.5 million. Cities are more likely to have residents, some with guns or dogs, who refuse to open their doors to mosquito inspectors, said Mr. Conlon of the mosquito control association. One property’s pools and gutters can produce enough mosquitoes to blanket a neighborhood.

“’What’s getting to me is how complacent people in Miami are about this,”’he said. ‘That does not bode well for containment.’

“For example, he said, mosquitoes breed in flowering bromeliads. Yet despite threats of $1,000 fines, some Miami Beach residents resist ripping up their gardens.

“Half measures will not slow the virus. Aedes aegypti lay eggs that can cling to a dry surface until the rain they need arrives. It is not enough merely to empty the rows of conch shells, for instance, that decorate outdoor restaurants in Miami. ’”You have to scrub each one out":https://youtu.be/EacJsCirabE, Mr. Conlon said.

“Predictions of Zika’s course are also made difficult by a monumental wild card. Unlike other tropical viruses, it can be sexually transmitted.

“’That makes Zika a different breed of dog,’ Dr. Gubler said.

“If an infected person passes it to a household sexual partner, the virus will be in human blood for up to 20 days at that location for local mosquitoes to pick up and pass on.

“The long-term picture is even fuzzier. Experts are divided on whether the virus could become endemic, recurring summer after summer.

“The virus itself has two ways to survive winter. A recent laboratory experiment showed that about one mosquito in 300 passes it on to the next generation in her eggs. And Zika can last for six months in men’s semen.

“Either route could seed a new domestic outbreak next year — or the virus could be reimported from Latin America or the Caribbean.”

Source: The New York Times

September 21, 2016: Is Another Zika Brewing in the Caribbean?

Florida researchers have discovered a mosquito-borne virus called Mayaro in Haiti, where it had never been observed before.

“They found the virus in a blood sample taken in January 2015 from an 8-year-old boy who had tested negative for other mosquito-borne illnesses, including chikungunya and dengue. Researchers don’t know yet how widespread the infection could be or whether they will find it in other parts of the Caribbean, but the specific strain they identified is different from those previously seen in the Amazon, where most cases of Mayaro have historically been reported.

“Dr. Glenn Morris, director of the University of Florida’s Emerging Pathogens Institute, which identified the virus, says the findings underscore how additional viruses are ‘waiting in the wings’ and may pose future threats.

“Researchers who discovered Mayaro in Haiti had been studying the country’s chikungynya outbreak. When blood samples tested negative they aimed to discover whether other ailments were present. Their findings were published in the journal Emerging Infectious Diseases, which is run by the Centers for Disease Control and Prevention.

“Mayaro’s symptoms, which include fever and joint pain, are similar to chikunguya, but Dr. John Lednicky, a University of Florida associate professor in the environmental and global health department of the College of Public Health Professions, says joint pain from Mayaro can last for as long as year, and that people who are infected tend to have stomach problems.

“’The joint pain can be debilitating in day-to-day activities, even making walking around difficult,’ Lednicky says.

“The finding occurred as most attention has been centered on on Zika, a virus primarily spread through mosquitoes that is particularly dangerous to pregnant women, who risk giving birth to babies with the birth defect microcephaly, characterized by abnormally small heads.

As with Zika, little is known about Mayaro. It was first isolated in Trinidad and Tobago in 1954, and since then roughly 40 cases have been studied in South America by U.S. researchers. A couple of people have returned to the U.S. after traveling to parts of the world where the virus was circulating, including in eastern Peru. In 2011, a Swiss tourist who visited Peru was diagnosed with the virus after he returned home.

“Lednicky’s team was the first to identify the spread of Zika in Brazil, and later to discover its presence in spit and urine.

“It isn’t known yet whether – like Zika – Mayaro can be transmitted sexually. Researchers also don’t yet know whether the boy got Mayaro through the same type of mosquito, called Aedes aegypti, that has been linked to the Zika virus. Lednicky says studying Mayaro in Haiti will be difficult because it has only been discovered there once so far, but that lessons learned from Zika will help inform his team’s approach.

“He says that when he announced the discovery of Zika in Brazil, few were paying attention and he had difficulty getting funding for additional research.

“’Everyone was telling us we found an obscure virus that was of no interest to anybody,’ he says. ‘With Mayaro it’ll probably be the same thing.’

“Since then, Zika has spread rapidly, infecting more than 20,000 people in the U.S. and its territories. Congress has not allocated emergency funding to prevent and treat the Zika virus, though it is now working on doing so through a spending bill.

“‘We could have been so far ahead if we’d had access to research funds,’ Lednicky says.”

Source: US News

September 20, 2016: Thailand to Crack Down on Zika Breeding Spots

Authorities in Thailand seeking to curb the growing number of Zika cases say they will criminally charge homeowners who fail to remove mosquito breeding grounds on their property.

“The Public Health Ministry announced it will revive a 1992 law allowing officials to order the removal of decorative ponds or any areas with still water found to foster mosquitoes, which can transmit the Zika virus. Anyone failing to clean up or remove the mosquito breeding grounds can face a jail term of one month and a fine of 2,000-5,000 baht ($57-143).

Source: FOX News

September 19, 2016: Researchers Strengthen Link Between Zika and Microcephaly

This from Karen Kaplan from The Los Angeles Times.

“A first-of-its-kind study is strengthening the case that Zika is the culprit behind Brazil’s mysterious surge in babies born with microcephaly.

“Preliminary results from a study commissioned by the Brazilian Ministry of Health found that 13 out of 32 newborns with microcephaly tested positive for the Zika virus. Meanwhile, none of the 62 newborns in a comparison group who had normal-sized heads showed any sign of infection.

“The findings, reported Thursday in the journal Lancet Infectious Diseases, are the first to emerge from a longer-term effort to study 200 infants with microcephaly and compare each of them with two unaffected controls from the same region who were conceived at about the same time. Given the magnitude of the health crisis posed by Zika, the team decided to report interim results of babies who joined the study between mid-January and early May.

“The babies in the study were recruited from eight hospitals in and around Recife, a ‘hotspot of the microcephaly epidemic in Brazil,’ according to an editorial that accompanies the study. Each infant with microcephaly had a head circumference at least two standard deviations smaller than the average for his or her gestational age and gender. In fact, all but two of them had a head circumference that was three standard deviations smaller than average.

“In addition to measuring head size, the researchers took samples of umbilical cord blood, cerebrospinal fluid and sometimes peripheral blood from the microcephalic babies and ordered CT scans of their heads. Infants in the control group went through a similar procedure, except their heads were examined via ultrasound instead of CT and they were not subjected to a spinal tap.

“Mothers of babies in both groups provided blood samples and answered a questionnaire.

“Mothers in the microcephaly group had a higher rate of Zika infection than their counterparts in the control group — 80% versus 64% — but that difference was small enough that it could have been due to chance, according to the study. Likewise, more of the mothers in the microcephaly group reported having a rash during pregnancy — 41% versus 26% — but that difference was also too small to be statistically significant.

“The researchers noted that they had no way of determining when in their pregnancies the mothers had been infected.

“The babies in the microcephaly group had a range of health problems. For instance, 84% of them had a low birthweight for their gestational age (compared with only 6% of babies in the control group). Among the 27 who had a head CT, 11 had at least one abnormality, such as large ventricles, brain tissue that was smooth instead of folded, or calcifications that can be a sign of a past viral infection.

“One of the babies in the microcephaly group was stillborn and three others died in a hospital intensive care unit.

The most dramatic finding was that 41% of the microcephaly infants tested positive for Zika infection in their blood or cerebrospinal fluid, compared with 0% of the matched controls.

“In the editorial, infectious disease researchers Patricia Brasil of the Oswaldo Cruz Foundation in Rio de Janeiro and Dr. Karin Nielsen-Saines of UCLA called the association between Zika and microcephaly ‘striking.’

“The study authors saw the results as a wake-up call to the world.”

Source: Los Angeles Times

September 18, 2016: The American Zika Outbreak

The virus’s prevalence in Puerto Rico threatens disaster if Congress cannot pursue long-term action

“America is already experiencing a Zika outbreak. The disease has already infected almost 20,000 American citizens and more than 1,500 pregnant women — with some estimates reaching as high as over 10,000 infected pregnant women. There have been dozens of hospitalizations and dozens of cases of the immune disorder Guillain-Barré, including at least one fatal case. Thirteen Zika-infected mothers have either aborted or miscarried fetuses, many of which exhibited the brain damage often associated with the disease. This year’s cases are just the beginning, and it looks like the virus could become endemic on American soil in the near future.

“As Congress dithers over funding for Zika prevention on the mainland, the island commonwealth of Puerto Rico is at a stage well beyond the reach of a preemptive strike. As the virus still struggles to establish a beachhead among Aedes aegypti mosquitoes in southern Florida, it has found a home in the Caribbean heat and moisture of Puerto Rico. And that’s awful for an island still deep in the throes of an economic and humanitarian disaster, and for one that’s always struggled with an underfunded and undermanned health infrastructure. Though Puerto Rico’s unique tropical climate is an outlier compared with that of much of the continental United States, the underlying issues with its infrastructure provide examples of just how Zika could spread elsewhere in the country, too.

“It’s been less than a year since the first reported case of Zika in Puerto Rico, but doctors in the territory are “already at their breaking points”

Zika infections themselves are not terribly taxing to health-care systems—symptoms usually resemble those of a cold or flu, if patients exhibit them at all—but the potential complications can stagger even well-funded health systems. Treatment for microcephalic infants and adults that develop neurological complications can cost millions per patient. Evidence from Brazil presented in an upcoming Centers for Disease Control and Prevention study indicates that the true burden of neurological disorders from Zika is underreported, and that in addition to a well-reported link to Guillain-Barré, the disease is associated with a rise in expensive hospitalizations from other neurological conditions, including encephalitis, myelitis, and encephalomyelitis. Additional services for child and maternal health—including screening and access to abortions—and contraceptive services simply add to the price tag. And with so little information available about Zika’s long-term effects, it’s impossible to know if hidden symptoms and costs don’t lurk down the road."

Source: The Atlantic

September 17, 2016: Unique Utah Zika Case Remains Medical Mystery

“A case of the Zika virus in Utah is now the only one in the continental U.S. that’s still puzzling researchers on exactly how it spread, health officials said Tuesday.

“The man caught the illness after caring for his infected father, who had an extremely high level of the virus in his blood when he died in June, according to a report released by the U.S. Centers for Disease Control and Prevention. One possibility is that he transmitted the virus to his son through a bodily fluid in a way that hasn’t been recognized with Zika yet, officials said. The son kissed and hugged his dying father and helped care for him in a hospital, according to the report.

“Investigators couldn’t test the unidentified Salt Lake County man because he had already been cremated by the time he was diagnosed, said Angela Dunn with the Utah Department of Health. Signs of Zika have been found in blood, urine, semen and saliva, and the case could direct new research into whether it can also be carried in things like tears or stools, she said.

“No other cases have yet been found among the family or health workers. It’s unclear whether the case points to a potentially common mode of transmission, said Alex Kallen with the CDC. ‘I don’t think we know the answer to that right now,’ he said.

“The father caught the mosquito-borne virus abroad, but the son didn’t travel to an affected area or have sex with anyone who did, the report said.

“The son has since recovered. The virus causes only a mild illness in most people. But during recent outbreaks in Latin America, scientists discovered that infection during pregnancy has led to severe brain-related birth defects.

“Health officials also haven’t found any of the tropical mosquitoes that mainly spread the virus in the area or evidence that local mosquitoes are carrying the virus, according to the report released by the CDC.

“The son didn’t report touching any bodily fluids, and other family members had similar interactions with the father without getting sick, Dunn said. ‘We weren’t able to identify anything he did that was different,’ she said.

“It’s not uncommon to be unable to identify a key thing a patient did or didn’t do before catching an illness like Zika, Kallen said. Small, even unremembered, factors can often make a big difference, he said.

“The investigation is ongoing, and more information is expected later this year.

“More than 2,900 Zika illnesses have been reported in continental U.S. and Hawaii, including 13 in Utah, according to health officials.”

Source: CBS News

September 16, 2016: Florida Zika Count Hits 70 Local Cases

Florida health officials said Tuesday they found six new locally transmitted cases of Zika virus, bringing the state’s count to 70 cases.

“Florida Governor Rick Scott traveled to Washington D.C. Tuesday to lobby Congress for federal funding to fight the virus, and doctors repeated warnings that money’s running out, even as more and more pregnant women seek testing to see if they have Zika infections.

“’These are pregnant women who really want to know if their baby is at risk,’ said Dr. Beth Bell of the Centers for Disease Control and Prevention. ‘Tests take time.’ Bell said the CDC doesn’t have any more cash to work on faster and better tests so that women don’t have to wait for weeks to find out if they’ve been infected.

“The Zika virus causes catastrophic birth defects, as well as neurological conditions in adults.

“The Population Institute released a report Tuesday showing that the biggest threat of Zika is in states that provide the lowest levels of medical care to women who may become pregnant. ’It’s a cruel irony that the women most at risk of Zika are often the ones with the least access to reproductive health services,’ said Population Institute president Bob Walker.

“Congress has spent months dithering over Zika funding. President Barack Obama asked for $1.9 billion in emergency cash to fight the virus in February. Republicans who control both houses of Congress want to offer less, and Democrats have rejected bills that they say have unacceptable political extras written in.

“Senate Majority Leader Mitch McConnell now says Zika funding is likely to be included as part of a last-minute spending measure called a continuing resolution. The federal budget year runs out at the end of September.

“There’s no agreement on a final budget, but a CR, as the measure is called, would provide three months of funding so the federal government does not have to close — something that last happened in 2013.

“Federal health officials say three months worth of money is far from ideal.

“Bell said programs to develop better Zika tests, to monitor people for the virus and to study the damage that it can do to babies are all at risk.”

Source: NBC News

September 15, 2016: Miami's Beloved Bromeliad is a Zika Breeding Ground

“The battle of the bromeliads is underway in South Florida.

“As the region tries to contain the Zika virus, government officials have taken particular aim at the plants that are popular for their vibrant colors but can become breeding grounds for mosquitoes. Their hard leaves grow in tight, cylindrical formations, which allows water to pool inside and provide a perfect mosquito incubator.

“Miami-Dade County and Miami Beach have ordered bromeliads removed from all government property and are encouraging residents to do the same in their homes and businesses. The city of Miami has removed hundreds of plants along the central US-1 corridor. Those who fight mosquitoes every day have applauded those decisions to eliminate the plants that serve as incubators for mosquitoes that spread Zika.

“But some in South Florida feel the bromeliad is being unfairly targeted.

“Leo Castro, a nursery owner in the Redlands agricultural area south of Miami, said he has 100,000 bromeliads in his nursery but doesn’t have mosquito problems because he regularly flushes the water from the plants to make sure mosquito larvae don’t have time to grow. He said he’s lost big contracts recently – from government buildings to commercial complexes to hospitals – that have heeded government warnings and decided to rip out their bromeliads.

“Castro, who owns Country Garden Bromeliads, said that’s unfair to the plants – and his business – considering that South Florida was built on a swamp and has dozens of other trees and plants that pool water.

“’The bromeliads are getting a bad rap,’ he said. “Even if you got rid of every single bromeliad in South Florida, the mosquitoes wouldn’t go away.”

“Sandy Shapiro is so concerned about the plight of the bromeliad that she’s hosting a community forum next week to talk about the impact Zika is having on the region’s horticultural industry. Shapiro is the executive director of the Miami Beach Botanical Garden, which was closed down for a week after Florida health officials captured mosquitoes with the Zika virus in the garden.

“Shapiro said her staff has been closely monitoring the garden’s 2,000 bromeliads since Zika was first detected in South Florida. She said they followed the standard protocol for the plants – flushing the water regularly to remove mosquito larvae, spraying the plants with non-chemical larvicides and trimming dying leaves.

“Despite those efforts, she said Miami Beach officials came in and removed all the plants, filling three dump trucks.

“’Public health is the most important thing,’ she said. ‘But…that was a regrettably extreme measure. It has ripple effects, and we don’t realize how it spills over into the broader community.’

“To date, more than 600 people, including more than 80 pregnant women, have tested positive for the Zika virus in Florida – all contracting the virus while traveling abroad. The state Department of Health says 56 people contracted the virus locally. Miami-Dade County began aerial mosquito spraying last week and will continue through the month to lower the mosquito population on Miami Beach.”

Source: USA Today

September 14, 2016: Recent Studies Show the Zika Virus is Detectable in Semen for Up to 6 Months After Infection

Kelly McBride Folkers, Arthur L. Caplan, and Lee Igel on how officials skirt addressing Zika as an STD.

“Zika is working its way around the United States. It’s spreading across Florida, and is before long expected to reach Texas, Louisiana and other Southern states. It is a dizzying trip, and one that isn’t going to end anytime soon.

“The virus spreads from a type of mosquito that has now officially been confirmed to carry Zika in Miami Beach.

“But while mosquitoes are a key menace when it comes to Zika, the media and public officials are too focused on them. They also need to pay attention to sex: If we are going to stop the spread of this disease, we are going to need better access to Zika testing for anyone who is sexually active in a Zika zone.

“At the moment, the Centers for Disease Control and Prevention recommends testing for pregnant women at risk of Zika transmission, people who exhibit symptoms of being infected with Zika, and people who have had sex with a partner who might have been exposed to the virus.

The CDC explicitly states that men, women who are not pregnant and children who are not symptomatic do not need to be tested. That, however, is not the best way to manage Zika.

“Zika testing isn’t being offered as an essential preventive health service to every American right now. Nor should it be, at least not yet. It would be a waste of medical resources to include a Zika test with every sexually transmitted disease panel, especially for people outside areas of active transmission.

But it seems like more than just an oversight that the CDC is not yet recommending that sexually active men seek out testing in areas where active Zika transmission is confirmed. Recent studies show the Zika virus is detectable in semen for up to six months after infection.

“Zika isn’t the only virus that can be found in semen for months after infection: Another recent study of 429 men infected with Ebola in Liberia showed that 38 of them tested positively for it more than one year after having symptoms of the disease. Primary literature on this study: And, of course, we have known for some time that men can transmit HIV and HPV to a male or female partner.

“If men can be carriers of Zika, why aren’t they being recommended for testing in active Zika zones, too? Despite the fact that Zika is becoming a public health crisis for the general population, pregnant women and their doctors are being asked to bear the burden of preventing its spread. And if we are going to prevent the outbreak from spreading further, shouldn’t testing and counseling be offered to anyone who might be at risk as part of a panel of tests for sexually transmitted infections?

“US government agencies at both local and federal levels are recommending more precautions, but skirt around addressing Zika as an STD.

“The Food and Drug Administration recently called for universal testing for Zika in blood donations. The CDC continues to issue advisories for pregnant women not to travel to places with established, active Zika transmission. The FDA knows that testing is important. The agency continues to grant emergency use authorizations, or EUA, to various Zika diagnostic tests, with the provision that the permission can be revoked if the emergency subsides. So far, none of these tests has been granted FDA approval for standard use in clinical care anywhere.

“Another problem with testing is that not all brands of tests are created equal, which makes it difficult for patients to know if they even have Zika. While some use a well-established technique, the same one used for a rapid HIV test, some on the EUA list use newer technologies. For those tests, only labs with the equipment manufactured by the company marketing the test can get accurate results. So, without a standard test being offered in Zika zones, combined with the fact that we know a person with Zika is able to infect another person for at least six months, we are creating a perfect storm for the spread to continue.

“This information is clear if you read the EUA authorization information — and here’s the link to Roche’s press release that says you have to have their analyzer for their test, which was recently granted an EUA.

“But a lack of accurate testing isn’t the only issue preventing easy access to testing. A lack of money to pay for testing is also problematic.

“Who is footing the bill for Zika infection tests, which run an average of $500 apiece?

“It is unclear whether most private insurance companies cover the cost of testing.

“The bottom line is that we need a Zika policy for the current outbreak and for the long run. Zika virus infection isn’t always a mild illness that will go away on its own. It can cause serious neurological problems in adults, like Guillain-Barré syndrome, a severe condition in which the immune system destroys nerve cells that control movement.

“Zika isn’t the first STD that we’ve been squeamish around, and our puritanical history makes it likely that it won’t be the last. STDs and their resulting epidemics make for tumultuous and often ineffective public health policy in the United States.”

Source: CNN

September 13, 2016: Zika Doubled Birth Defects in Brazil

Northeast region of Brazil considered epicenter of outbreak

“The pictures from Brazil are heartbreaking: baby after baby born with a small head and damaged brain after an attack by the Zika virus during pregnancy. The official numbers are equally disturbing: The rate of birth defects involving the nervous system nearly doubled across Brazil after Zika arrived.

“This stark statistical reality was discovered by a team of researchers from Brazil’s Oswaldo Cruz Foundation, which analyzed hospital records across Brazil from 2008, well before Zika arrived, until the end of February 2016.

“The researchers also looked for data on rare, potentially deadly inflammations of the brain and spinal cord such as encephalitis, myelitis, and encephalomyelitis, as well as Guillain-Barré syndrome, a disorder where the body’s immune system attacks its own nerve cells, causing pain, paralysis and even death.

“The results, published in the Centers for Disease Control and Prevention journal Emerging Infectious Diseases, found ‘an unprecedented and significant rise in the hospitalization rate for congenital malformations of the nervous system, Guillain-Barré syndrome, encephalitis, myelitis and encephalomyelitis’ beginning in mid-2014.

“That’s more than a year before the world became aware of the outbreak in October 2015, and stories of Zika’s terrible consequences began to appear in the news.

“The numbers show the northeast region of Brazil, often considered the epicenter of the Zika outbreak, was indeed the hardest hit. Historical averages of congenital malformations were stable at about 40/100,000 live births until November of 2015. Then the number jumped to 170/100,000 births, four times higher.

“Then, in the four months between November 2015 and February 2016, “a total of 1,027 hospitalizations for congenital malformations of the nervous system were recorded nationwide,” the researchers said. Almost half, 448, occurred in the Northeast.

“Rates of Guillain-Barré and encephalitis, myelitis and encephalomyelitis showed a similar increase in the Northeast. Hospitalizations for Guillain-Barré increased by nearly 3% until the outbreak peaked in July of last year, while the Northeast was the only area of the country to see an increase in CNS.”

Source: “WCVB TV ABC News” – Source No Longer Available Online

September 12, 2016: Zika May Spread from Infected Eyes

Zika virus is capable of infecting the eye, according to a new study. The study, in mice, helps explain why some people with Zika virus develop eye disease, and suggests that contact with infected eyes may play a role in spreading the disease.

“Researchers have found that Zika virus can live in eyes and have identified genetic material from the virus in tears, according to a study from Washington University School of Medicine in St. Louis. The study, in mice, helps explain why some Zika patients develop eye disease including a condition known as uveitis which can lead to permanent vision loss.

“The study, published Sept. 6 in Cell Reports, describes the effect of Zika virus infection in the eyes of mouse fetuses, newborns and adults. The researchers now are planning complementary studies in human patients infected with the virus.

“’Our study suggests that the eye could be a reservoir for Zika virus,” said Michael S. Diamond, MD, PhD, the Herbert S. Gasser Professor of Medicine and one of the study’s senior authors. "We need to consider whether people with Zika have infectious virus in their eyes and how long it actually persists.’

“Zika virus causes mild disease in most adults but can cause brain damage and death in fetuses. About a third of all babies infected in utero with Zika show eye disease such as inflammation of the optic nerve, retinal damage or blindness after birth. In adults, Zika can cause conjunctivitis — redness and itchiness of the eyes — and, in rare cases, uveitis.

“To determine what effect Zika infection has on the eye, the researchers infected adult mice under the skin — similar to the way humans are infected by mosquitoes — and found live virus in the eyes seven days later. These observations confirm that Zika is able to travel to the eye. It is not yet known whether the virus typically makes that trip by crossing the blood-retina barrier that separates the eye from the bloodstream, traveling along the optic nerve that connects the brain and the eye, or some other route.

“Eye infection raises the possibility that people could acquire Zika infection through contact with tears from infected people. The researchers found that the tears of infected mice contained Zika’s RNA — the genetic material from the virus — but not infectious virus when tested 28 days after infection.

“‘Even though we didn’t find live virus in mouse tears, that doesn’t mean that it couldn’t be infectious in humans,” said Jonathan J. Miner, MD, PhD, an instructor in medicine and the study’s lead author. "There could be a window of time when tears are highly infectious and people are coming in contact with it and able to spread it.’

“The eye is an immune privileged site, meaning the immune system is less active there, to avoid accidentally damaging sensitive tissues responsible for vision in the process of fighting infection. Consequently, infections sometimes persist in the eye after they have been cleared from the rest of the body.”

Source: Washington University School of Medicine

September 11, 2016: Miami Beach Issues Thousands of Dollars in Zika Fines

The City of Miami Beach is aggressively enforcing a code that prohibits standing water in response to the recent Zika cases

“The effort to control breeding grounds for mosquitoes that could carry Zika is stinging property owners with some stiff fines.

“Since the city launched its war on mosquitoes on August 19, it has issued $72,000 in fines against properties where stagnant water is pooling, according to figures provided to NBC 6 Investigators by the city.

“Small, shaded pools of stagnant water are where the mosquito that carries Zika thrives.

“’It’s really about trying to get the Zika under control,” said city manager Jimmy Morales. "During this crisis period, we have gone to businesses that have such obvious violations that we do hit them with an immediate fine to try to get immediate compliance.’

Source: NBC News Miami

September 10, 2016: Miami Beach Mayor Says 'Zika Threat Continues to Grow,' as More Mosquitoes With Zika Found

“The Zika virus has been detected in a new mosquito sample taken in Miami Beach, the Florida Department of Agriculture and Consumer Services announced Friday.

“State officials said the new sample is from the same small Miami Beach neighborhood where three other samples tested positive for Zika on Sept. 1.

“’This new discovery shows that the Zika threat continues to grow,’ Miami Beach mayor Philip Levine said in a statement.

“But in a statement, the Department of Agriculture and Consumer Services reminded concerned residents that the state ‘has tested more than 2,900 mosquito samples, consisting of nearly 48,000 mosquitoes, since May, and these four total samples from a small area in Miami Beach are the only samples to test positive.’

“Florida’s commissioner of agriculture, Adam H. Putnam, said, ‘This find underscores the continued need already underway in Miami-Dade to employ an aggressive and comprehensive mosquito control strategy. Only with a multi-faceted approach to controlling the Zika-carrying mosquito will we be able to protect Floridians and visitors.’

“And Miami-Dade County mayor Carlos A. Gimenez added, ‘The fact that we have identified a fourth Zika-positive mosquito pool in Miami Beach serves as further confirmation that we must continue our proactive and aggressive approach to controlling the mosquito population, including our recent decision to begin aerial spraying in combination with larvicide treatment by truck.’

“Aerial insecticide spraying occurred Friday in Miami Beach, with a plane carrying the insecticide naled releasing the spray over the Atlantic Ocean before dawn.

“The next round is scheduled for 6 a.m. Sunday.”

Source: ABC News

September 9, 2016: Will The Aftershocks of Zika Ever End?

Hearing loss is associated with in-utero Zika infection. All babies exposed to Zika should have hearing tested, says CDC.

“Any infant exposed to the Zika virus in utero should have their hearing tested after birth, no matter how normal they may appear, the Centers for Disease Control and Prevention announced last week..

“The recommendation follows a study of 69 Brazilian infants up to 10 months old who were born with both microcephaly and laboratory-confirmed evidence of Zika infection.

“The study showed that 16 failed the first screening test in at least one ear; follow-up tests of these same babies showed that eight continued to experience hearing loss. By the end of the study, four of the babies had permanent sensorineural hearing loss, which cannot be medically or surgically corrected.

“Sensorineural hearing loss occurs after damage to the inner ear, called the cochlea, or the nerve pathways from the inner ear to the brain. It’s the most common type of permanent hearing loss and reduces the ability to hear faint sounds. Even when loud, sound is often muffled or unclear.

“Hearing loss is a well-established side effect of several other congenital infections, such as herpes simplex, syphilis, rubella, toxoplasmosis and cytomegalovirus. Because babies with those infections can appear to have normal hearing at first but show evidence of progressive hearing loss in later checkups, the CDC recommends that babies exposed to Zika have also have regular follow-ups to rule out future hearing decline.

“Brain scans of babies born with microcephaly show scientists where the damage is occurring. Calcifications are common in the parts of the brain associated with visual and auditory processing, along with lesions that cause both hearing and vision loss. The obvious damage has lead some researchers to recommend vision exams for all babies exposed to the virus as well as hearing tests.”

Source: CNN#

September 8, 2016: Zika Mosquitoes Can Infect Their Eggs, Too

Here’s another reason it will be hard to get rid of Zika: Mosquitoes can pass the virus to their offspring in their eggs

“It’s not a surprising finding. Mosquitoes infect their larvae with other viruses, too, including Zika’s close relative the dengue virus.

“But it’s another obstacle for people trying to get rid of Zika and the mosquitoes that spread it.

""It makes control harder,’ said Dr. Robert Tesh of the University of Texas Medical Branch in Galveston. ’Spraying affects adults, but it does not usually kill the immature forms — the eggs and larvae. Spraying will reduce transmission, but it may not eliminate the virus.

“Usually, it takes people plus mosquitoes to spread a virus. The mosquitoes bite actively infected people, incubate the virus for a while, and then bite other people to spread it. If no people in an area are infected, no virus spreads. Sometimes an animal can act as a reservoir — birds can keep West Nile Virus spreading, for instance.

“So-called vertical transmission allows the virus to spread even if all the adult mosquitoes in an area die out.

“Tesh and colleagues infected Aedes aegypti and Aedes albopictus mosquitoes with Zika and then tested the eggs they laid.

“The Aedes aegypti mosquitoes — the main carrier of Zika — did occasionally pass the virus to their eggs, they reported in the American Journal of Tropical Medicine and Hygiene. But it wasn’t most or even much of the time, about one in every 290 times.

That means it’s probably not a major way Zika sticks around, Tesh said.

""I think it just another survival mechanism for the virus to make it through the season," Tesh told NBC News.

“Zika has spread explosively across Latin America and the Caribbean over the past year. It’s caused two small outbreaks in Florida and is expected to lead to more.

“Once thought to be a benign virus, it’s now been shown to cause horrendous birth defects if a pregnant woman gets it, and can cause a paralyzing condition called Guillain-Barré syndrome.

“There’s no drug to treat it and no vaccine to prevent it. The World Health Organization and the Centers for Disease Control and Prevention say the best way to fight Zika is to fight the Aedes mosquitoes that carry it.

“But that’s not easy. Aedes are container breeders, they can lay their eggs in small containers and need just a tiny bit of water to hatch.

“They live in and around houses and like crowded urban areas where spraying is difficult.

“Spraying insecticides to kill adult mosquitoes cannot wipe out Aedes, Tesh and other experts said. They lay their eggs right above the water line in a small container, a discarded tire or some trash, Tesh explained.

""So when that container is filled and the water covers the eggs, the eggs hatch," he said.

“The eggs can survive being dried out, and they stick really well. They’re impervious to insecticides or other chemicals, he added. So simply emptying containers regularly does not necessarily get rid of the mosquitoes.

You have to scrub the inside of the container. That is the way to get rid of the eggs, he said

“Dr. Peter Hotez, who heads the tropical medicine program at Baylor College of Medicine in Houston, said the trade in used tires probably helped spread Aedes mosquitoes back into countries such as Brazil, which had eradicated them decades ago with heavy insecticide use.

“There was some good news in the study: Aedes albopictus, the so-called Asian tiger mosquito that has a much broader ranges than Aedes aegypti, did not transmit Zika to its eggs. Researchers still are not clear whether tiger mosquitoes can infect people with Zika, although they can carry the virus.”

Source: NBC News

September 7, 2016: Globally, Where Do We Stand with Zika

“Moving from Africa to French Polynesia to Central and South America, the disease is now active in the US and Asia, and is likely to continue to spread.

“Zika arrives in a country via the bloodstream of hundreds of globe-trotting vacationers and business people, all returning home from areas where Zika is actively circulating. It’s not like you can stop it — four out of five people with Zika have no symptoms, so most of those passengers are unaware they carry the virus in their blood.

No country is immune from a potential outbreak, as long as the mosquitoes capable of spreading the virus, Aedes aegypti and the Aedes albopictus, live there

“To make matters worse, Zika can also be transmitted by blood transfusions and through sexual contact, particularly oral, anal and vaginal sex, and even by secretions left on sex toys.

Some have called Zika the world’s newest STD

“Scientists have learned a lot about Zika in the last year. For one, the virus appears to have mutated as it has spread across the world.

“When it first emerged, inconspicuously, from Uganda’s Zika forest in 1947, the effects of infection were mild, nothing worse than a mild cold or flu. While that’s still true for many today, for others, the consequences of Zika are devastating. Babies are being born with life-altering brain damage to women infected with Zika during their pregnancies; immune-compromised adults are dying of complications, and a Zika-triggered auto-immune disorder called Guillain-Barré attacks the nervous system, causing temporary paralysis, and even death.

“Several countries in Central and South America are asking the women in their countries to delay pregnancy if they possibly can and the Centers for Disease Control in the United States has told American women to stay away from areas where Zika is active. CDC sexual guidance is strict as well: no intercourse during the entire pregnancy unless the couple can carefully and correctly practice safe sex. Similar recommendations apply to couples who are trying to conceive.

""If you’re pregnant, you’re in a very delicate situation," says medical epidemiologist Dr. John Brooks, head of the CDC’s National Center for HIV/AIDS and STD Prevention. “You want to do everything you can to protect that baby. So our recommendation is to defer unprotected sexual contact for the entire pregnancy to protect against an outcome that could last a lifetime.’”

Source: CNN

September 6, 2016: Singapore's Zika Cases Send Warning Signal to Asia

In just one week, Zika cases in Singapore have gone from zero to 258, raising concerns about a potential rapid surge in cases across Asia

“A recent study estimates that roughly 2.6 billion people in the region and Africa could be at risk of contracting the virus, which has been linked to the neurological disorder microcephaly in unborn babies.

“It’s not yet clear why Zika has spread so suddenly in Singapore. Many of the cases are thought to be locally-transmitted by the Aedes aegypti mosquito.

“On Saturday, Singapore’s Ministry of Health said analysis of two cases found they had likely evolved from a strain of Zika that was already circulating in Southeast Asia. Malaysia confirmed its first case of Zika infection in a 58-year-old woman — who had visited her daughter in Singapore — on September 1. The country reported its first locally-transmitted case on September 3, with authorities expecting more to come.”

Source: CNN

September 5, 2016: The FDA Has Issued Emergency Authorization for Roche's Zika Test

“The U.S. Food and Drug Administration on Monday issued emergency authorization for a Zika diagnostics test from Swiss drugmaker Roche, skirting normal approval channels as the regulator moves to fight the disease’s spread.

“Zika virus, detected in Brazil and elsewhere last year before spreading to the Americas, is associated with microcephaly, a birth defect characterized by an unusually small head and potential developmental problems.

“Through last week, the United States reported 2,517 Zika cases, 29 of which were likely acquired locally in Florida through mosquito bites and the rest brought in by travellers, the U.S. Centers for Disease Control and Prevention (CDC) said.

“Some 9,000 additional cases have been reported in U.S. territories, including Puerto Rico.

“With FDA approval, Roche’s test now can be used to screen patients exhibiting Zika symptoms that meet CDC criteria, including fever, rash, joint pain and red eyes. Samples will be sent for analysis to specially-certified U.S. laboratories with the appropriate equipment, a Roche spokesman said.

“’The LightMix Zika test is an easy-to-use molecular diagnostic test that enables healthcare professionals to quickly detect the virus,’ said Uwe Oberlaender, the head of molecular diagnostics at Basel-based Roche.

“The FDA issues such Emergency Use Authorization during public health emergencies, to quickly deploy unapproved medical products for as long as they are needed.”

Source: Fortune

September 4, 2016: Amid Zika Fears, Florida Theme Parks Offer Mosquito Repellent

Walt Disney World, SeaWorld and Universal Orlando are giving away repellent

“It probably was only a matter of time, but mosquito repellent has joined hand sanitizer as a must-have health accessory at Florida theme parks.

“Walt Disney World, Sea World and Universal Orlando are spearheading the movement in hope of sidelining any fears tourists may have of being exposed to Zika-carrying mosquitoes.

“So far, no case of the dangerous Zika virus has been found that far north — Orlando is 228 miles on the Florida Turnpike from Miami. But experts say it’s only a matter of time before the bug reaches the Magic Kingdom.

“So Disney is getting set to reassure a key targeted demographic, women in child-bearing years and their partners, that it will have repellent on hand to fend off any of the critters, disease-ridden or not.

“‘In an abundance of caution, we are accelerating preventative efforts throughout our property, including providing complimentary insect repellent to our guests along with helpful guidelines from the Centers for Disease Control and Prevention,’ Disney said in a statement. ‘We have an extensive mosquito-prevention and monitoring program in place, and we continue to work closely with local, state and federal experts on this topic.’”

Source: CNN

September 3, 2016: Singapore Confirms 41 Cases of Locally-Transmitted Zika Virus

“Singapore authorities have confirmed 41 cases of locally-transmitted Zika virus, which in Brazil has been linked to a rare birth defect, and said more cases were expected to be identified.

“Those infected include 36 foreign construction workers employed at a site near Aljunied in the southeast of the island, the health ministry and the National Environment Agency (NEA) said in a joint statement on Sunday.

“On Saturday, authorities had confirmed Singapore’s first case of a local transmission of the virus, to a 47-year-old Malaysian woman, also from the Aljunied area.

“’MOH (the ministry of health) cannot rule out further community transmission in Singapore since some of those tested positive also live or work in other parts of Singapore,’ the statement said. ‘We expect to identify more positive cases.’

“The authorities said they have tested 124 people, primarily construction workers. Seventy-eight tested negative and five cases were pending. Thirty-four patients have fully recovered. It was not immediately clear where the foreign workers were from, but Singapore hosts a large contingent of workers from the Asian sub-continent.”

“All the cases are residents or workers in the Aljunied Crescent/Sims Drive area. They are not known to have traveled to Zika-affected areas recently, and are thus likely to have been infected in Singapore. This confirms that local transmission of Zika virus infection has taken place,” the statement said.

“Dozens of NEA staff cleaned drains and sprayed insecticide in the mainly residential area early on Sunday, and volunteers and contractors handed out leaflets and insect repellent. The NEA workers had accessed more than 1,800 premises of a total of 6,000 in the area to check for mosquito breeding.”

Source: Fortune

September 2, 2016: FDA Recommends Zika Testing for All Blood Donated in U.S.

“The U.S. Food and Drug Administration recommended on Friday that all blood donated in the United States and its territories be tested for Zika virus, as it moves to prevent transmission of the virus through the blood supply.

“The agency said its decision to expand blood screening in the United States was based on concerns about more cases of local transmission in Florida, the growing number of travel-related infections and concerns that Zika-tainted blood could unwittingly be given to a pregnant woman, putting her unborn baby at risk of severe birth defects.

The transfusion of a pregnant woman with blood infected with the Zika virus could have terrible consequences, Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said during a conference call with reporters.

“The current Zika outbreak was first detected in Brazil last year and has since spread across the Americas. In Brazil, Zika has been linked to more than 1,800 cases of microcephaly, and U.S. officials expect as many as 270 cases in Puerto Rico, where local transmission of the virus is widespread.

“’Over 8,000 travel associated and over 2,000 non-travel associated cases of Zika have been reported in the United States and U.S. territories,’ Marks told reporters.

“Given frequency of travel of individuals within the United States, he said there was a risk that people without symptoms of Zika could donate blood and transmit the virus.”

Source: Reuters

September 1, 2016: Tropical Storm Would Worsen Florida's Zika Outbreak

“Florida braced for a double whammy from Mother Nature on Thursday, with a tropical wave in the Caribbean potentially threatening to balloon into a tropical storm or hurricane just as the region fights outbreaks of the mosquito-borne Zika virus.

“While the unnamed storm could still bring rain to Florida over the next few days, by Friday the threat of it developing into a tropical storm or hurricane largely subsided. But this year’s hurricane season is only in its infancy, meaning a major tropical storm or hurricane could still spin up and threaten the region in the coming months.

“Such a storm would make it harder to control the Zika outbreak, which has grown to 43 cases in Miami-Dade and Palm Beach counties. Zika poses the greatest threat to pregnant women and their fetuses, who can develop devastating birth defects if infected by the virus, according to the Centers for Disease Control and Prevention.

“Florida Gov. Rick Scott said state emergency officials were monitoring the Caribbean storm, but didn’t activate the state’s emergency operations center.

“’Our goal is to protect the pregnant women in our state and all developing babies,’ Scott told USA TODAY. ‘What we can do everyday is to get rid of standing water, wear bug repellent and make sure we have aggressive mosquito control.’

“While a tropical storm or hurricane would initially blow mosquitoes out of the sky, it could also leave behind standing water that allows the insects to breed, said Joseph Conlon, technical adviser to the American Mosquito Control Association.

“An increase in mosquitoes doesn’t necessarily lead to a spike in disease, said Jerome Goddard, an extension professor of medical entomology at Mississippi State University. That’s because the ‘nuisance’ mosquitoes that live in flooded salt marshes don’t tend to spread disease, no matter how annoying they may be.

“The mosquito species that primarily transmits Zika, the Aedes aegypti, prefers to live near people and lay eggs in man-made containers, such as bird baths, flower pots and discarded tires.

“’Lots of rain from a hurricane wouldn’t make much difference for Aedes aegypti, since they are so specialized in where they breed,’ Goddard said. ’They’re not going to breed out in the yard in a pool of water or in receding floodwaters.’

“Yet the devastation caused by a major storm could increase the risk of Zika in other ways, such as by blowing off window and door screens, Goddard said.

“A hurricane would also likely divert resources from fighting Zika, as officials focus on clearing storm damage, restoring power and helping displaced residents, Beck-Sagué said. Public health staff would have less time to diagnose Zika cases and track the source of infections.

“State and county officials would likely have to put their Zika education efforts on hold, said Sandra Whitehead, director of program and partnership development at the National Environmental Health Association.

“The system could still strengthen as it spins into the Gulf of Mexico early next week, possibly impacting the Gulf Coast.”

Source: USA Today

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