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Posts Tagged ‘Microcephaly’

Corporate Wealth Trumps Public Health

Posted by feww on May 28, 2016

Submitted by a reader

WHO rejects call for Rio Olympic Games to be moved or postponed, despite outbreak of Zika virus in Brazil

The World Health Organization (WHO) has rejected a call for the Rio Olympic Games to be moved or postponed despite the threat posed by the outbreak of Zika virus in Brazil.

WHO public health advice regarding the Olympics and Zika virus: News Release

Based on current assessment, cancelling or changing the location of the 2016 Olympics will not significantly alter the international spread of Zika virus. Brazil is 1 of almost 60 countries and territories which to date report continuing transmission of Zika by mosquitoes. People continue to travel between these countries and territories for a variety of reasons. The best way to reduce risk of disease is to follow public health travel advice.

Based on the current assessment of Zika virus circulating in almost 60 countries globally and 39 in the Americas, there is no public health justification for postponing or cancelling the games,” the WHO said in a statement.

The statement is in response to a letter signed by a group of at least 152 doctors, researchers, and health professionals to the United Nations health agency calling for the Rio Olympics to be postponed or moved because of concerns of the spread of the Zika virus.

“Our greater concern is for global health. The Brazilian strain of Zika virus harms health in ways that science has not observed before,” states the letter, signed by experts in the United States, India, Canada, Britain, Australia, Norway, the Philippines, Russia, South Africa, Switzerland, Taiwan and Brazil, among others.

“An unnecessary risk is posed when 500,000 foreign tourists from all countries attend the Games, potentially acquire that strain, and return home to places where it can become endemic,” it said.

“Should that happen to poor, as-yet unaffected places (e.g., most of South Asia and Africa) the suffering can be great.”

“… the Brazilian viral strain causes microcephaly and probably Guillain-Barré syndrome. Further, because human, animal and in vitro studies demonstrate that the virus is neurotrophic and causes cell death, it is biologically plausible that there are other as yet undiscovered neurological injuries, as exist for similar viruses (e.g. dengue). [… ] That while Zika’s risk to any single individual is low, the risk to a population is undeniably high. Currently, Brazil’s government reports 120,000 probable Zika cases,9 and 1,300 confirmed cases of microcephaly (with another 3,300 under investigation)10, which is above the historical level of microcephaly. […] Rio de Janeiro is highly affected by Zika. Brazil’s government reports Rio de Janeiro state has the second-highest number of probable Zika cases in the country (32,000)… and the fourth-highest incidence rate (195 per 100,000), demonstrating active transmission. […] despite Rio’s new mosquito-killing program, the transmission of mosquito-borne disease has gone up rather than down. While Zika is a new epidemic and lacks historical data, using dengue fever as a proxy, cases in Rio from January thru April 2016 are up 320% and 1150% over the same periods in 2015 and 2014, respectively.”

“It is indisputable that option (a) of holding the Games as scheduled has a greater risk of accelerating the spread of the Brazilian viral strain than the alternatives. Postponing and/or moving the Games also mitigates other risks brought on by historic turbulence in Brazil’s economy, governance, and society at large—which are not isolated problems, but context that makes the Zika problem all but impossible to solve with the Games fast approaching.”

The Letter questions whether the UN health agency can give a non-biased view of the situation because of its “secret” high – level partnership with the International Olympic Committee.

WHO and IOC in Partnership

WHO has a decades – long, high – level partnership with the International Olympic Committee. That partnership was last affirmed in 2010 at an event where the Director General of WHO and President of the IOC signed a Memorandum of Understanding, which is secret because neither has disclosed it.

Inappropriately, WHO sees its role as not just providing public health advice. It established a “Virtual Interdisciplinary Advisory Group”, whose “ important promotional point,” according to WHO is “that the Group can help in bidding for major events (like the Olympic Games)”.  That is a clear conflict of interest, when WHO must also evaluate and make recommendations about Olympic travel during a Public Health Emergency of International Concern (PHEIC).

The overly close relationship between WHO and the IOC is apparent in the comments of WHO’s Executive Director responsible for Zika, just days after it was declared a PHIEC:

“Brazil is going to have a fantastic Olympics and it’s going to be a successful Olympics and the world is going to go there. I just wish I was going there, but there’s not going to be a lot of problems there by then. ”

With respect, this is a troubling statement. WHO cannot credibly assess the public health risks of Zika and the Olympics when it sets neutrality aside. Declaring that “it’s going to be a successful Olympics and the world is going to be there” implies that WHO has given the Olympics an unconditional green light, without regard to rapidly emerging medical, entomological, and epidemiological evidence — all of which must be considered in assessing whether this mass gathering could accelerate the global spread of the Brazilian strain of Zika virus. To prejudge that “there’s not going to be a lot of problems” before reviewing this evidence is extremely inappropriate of WHO, and suggests that a change in leadership may be required to restore WHO’s credibility.

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ZIKV Transmission Documented in 55 Countries and Territories

Posted by feww on March 9, 2016

Geographical distribution of Zika virus steadily widening

A total of 55 countries and territories have documented Zika virus transmission between 1 January 2007 and 3 March 2016.

  • Colombia reported 42,706 suspected cases of ZIKV btween  1 October 2015 and 20 February 2016, with 1,612 cases confirmed.
  • Starting 2007, locally acquired Zika cases have been reported in 15 countries and territories in the Western Pacific Region.
    • Four Pacific Island countries and areas (American Samoa, Marshall Islands, Samoa and Tonga) have reported Zika infections in 2016.
    • Nauru has declared Zika virus as a national emergency of concern for purposes of preparedness, but to date no Zika virus cases have been reported.
  • Between 1 October 2015 and 7 February 2016, Cabo Verde (African region), reported 7,325 suspected cases of Zika virus disease (two cases have been confirmed, so far).
    • The outbreak peaked during the week of 22 November 2015 and has been in decline since then; 44 cases were reported in the week up to 21 February 2016. The number of suspected cases of Zika virus disease reported each week in Praia (light blue) and other municipalities (dark blue) of Cabo Verde (Fi g. 4).
    • The outbreak appears to have begun in Praia and then spread to other municipalities. Preliminary information, subject to confirmation, indicates that this outbreak has been caused by an African strain of Zika virus.
    • No neurological abnormalities have been reported.

Incidence of microcephaly

  • Between 22 October 2015 and 27 February 2016 a total of 5,909 cases of microcephaly and/or central nervous system (CNS) malformation were reported by Brazil including 139 deaths including miscarriage or stillbirth. [Previously an average of 163 microcephaly cases was recorded nationwide.]
    • 31 of these were confirmed as having microcephaly and/or CNS malformation potentially linked to congenital Zika virus infection, 96 remain under investigation and 12 were discarded.
    • The reported increase in microcephaly incidence in Brazil is concentrated in the Northeast Region.
  • An outbreak of Zika virus in French Polynesia was followed by an increase in the number of CNS malformations in children born between March 2014 and May 2015. A total of 19 cases were reported including eight microcephaly cases compared to the national average of 0 – 2 cases per year.
  • Zika virus is not yet proven to be a cause of the increased incidence of microcephaly in Brazil. However, (i) given the temporal and geographical associations between Zika virus infections and microcephaly, (ii) the repeated discovery of virus in fetal brain tissue, and (iii) in the absence of a compelling alternative hypothesis, a causal role for Zika virus is a strong possibility that is under active investigation, says WHO.

Incidence of Guillain – Barré syndrome (GBS)

In the context of Zika virus circulation, nine countries or territories have reported increased GBS incidence and/or laboratory confirmation of a Zika virus infection among GBS cases.

  • Reported increase in incidence of GBS cases, with no GBS cases biologically documented of Zika virus infection: El Salvador and Colombia.
  • Reported increase in incidence of GBS cases, with at least one GBS case confirmed with previous Zika virus infection: Brazil, French Polynesia, Suriname and Venezuela.
  • No increase in GBS incidence reported but at least one GBS case confirmed with previous Zika virus infection: Martinique, Panama and Puerto Rico.

Between October 2013 and April 2014, French Polynesia experienced the first Zika virus outbreak ever recorded in the country. During the outbreak, 42 patients were admitted to hospital with GBS. This represents a 20 – fold increase in incidence of GBS in French Polynesia compared with the previous four years.

  • Of the 42 patients, 16 (38%) required admission to an intensive care unit and 12 (29%) received mechanical ventilation. No deaths were reported.
  • The majority of these cases (88%) reported symptomatic Zika virus infection in the days that preceded the onset of neurological symptoms. A recently published formal analysis of these data (case – control study) showed a strong association between Zika infection and GBS .
  • This study is the first large observational study to compare exposure to Zika virus among people with and without GBS and provides important information about the causal role of Zika infection.
  • In 2015 in the state of Bahia in Brazil, 42 GBS cases were reported, among which 26 (62%) had a history of symptoms consistent with Zika virus infection. A total of 1,708 cases of GBS were registered nationwide, representing a 19% increase from the previous year (1,439 cases of GBS in 2014), though not all states reported an increase in incidence.
  • In Colombia, 201 GBS cases with a history of suspected Zika virus infection were reported in the nine weeks to 14 February 2016. Most of the cases are from Norte de Santander and Barranquilla – areas where many of the Zika virus cases have been registered.
  • To date, none of the cases of GBS have been laboratory confirmed for Zika virus infection, or other possible causes, and the patterns of infection and disease by age and sex need confirmation.

Additional information [sourced from who]

Zika Virus

Zika virus disease is caused by a virus transmitted by Aedes mosquitoes. Other transmission modes are still under investigation. People with Zika virus disease usually have a mild fever, skin rash (exanthema), and conjunctivitis. These symptoms normally last f or 2 – 7 days. At present there is no specific treatment or vaccine currently available. The best form of prevention is protection against mosquito bites. Zika virus is known to circulate in Africa, the Americas, Asia, and the Pacific region. Zika virus had only been known to cause sporadic infections in humans until 2007, when an outbreak in Micronesia infected 31 people.

Microcephaly

Microcephaly is an uncommon condition where a baby’s head circumference is less than expected based on the average for their age and sex. The condition is usually a result of the failure of the brain to develop properly, and can be caused by genetic or environmental factors such as exposure to toxicins, radiation, or infection during development in the womb. Microcephaly can be present as an isolated condition or may be associated with other symptoms such as convulsions, developmental delays, or feeding difficulties.

Guillain – Barré syndrome

Guillain – Barré syndrome in its typical form is an acute illness of the nerves that produces a lower, bilateral, and symmetrical sensorimotor development deficit. In many cases there is a history of infection prior to the development of the Guillain – Barré syndrome. The a nnual incidence of GBS is estimated to be between 0.4 and 4.0 cases per 100,000 inhabitants per year. In North America and Europe GBS is more common in adults and increases steadily with age. Several studies indicate that men tend to be more affected than women.

Resources from WHO

Zika virus http://www.who.int/mediacentre/factsheets/zika

Microcephaly http://www.who.int/emergencies/zi ka – virus/microcephaly/en/

Guillain – Barré syndrome http://www.who.int/mediacentre/factsheets/guillain – barre – syndrome/en/

Infants with microcephaly http://www.who.int/csr/resources/publications/zika/assessment – infants/en/

Guillain – Barré syndrome http://www.who.int/csr/resources/publications/zika/guillain – barre – syndrome/en/

Breastfeeding http://www.who.int/csr/resources/publications/zika/breastfeeding/en/

Sexual transmission http://who.int/csr/resources/publications/zika/sexual – transmission – prevention/en/

Vector control http://www.who.int/emergencies/zika – virus/articles/mosquito – control/en/

Blood safety http://who.int/csr/resources/publica tions/zika/safe – blood/en/index.html

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ZIKV Infection: Local Transmission in United States

Posted by feww on February 13, 2016

ZIKV infection: Increased risk of fetal microcephaly, Guillain-Barré syndrome —CDC

Aedes aegypti, the most common mosquito vector of ZIKV globally, is present in Puerto Rico. Therefore, the virus is expected to continue to spread throughout Puerto Rico, posing risk of infection to 3.5 million residents, including about 43,000 pregnant women per year.

The first locally acquired case of Zika virus disease in Puerto Rico was identified in early December 2015, and 29 additional laboratory-confirmed cases have been detected since, including in one pregnant woman and in a man with Guillain-Barré syndrome.

Zika virus, a mosquito-borne flavivirus, spread to the Region of the Americas (Americas) in mid-2015, and appears to be related to congenital microcephaly and Guillain-Barré syndrome (1,2). On February 1, 2016, the World Health Organization (WHO) declared the occurrence of microcephaly cases in association with Zika virus infection to be a Public Health Emergency of International Concern. On December 31, 2015, Puerto Rico Department of Health (PRDH) reported the first locally acquired (index) case of Zika virus disease in a jurisdiction of the United States in a patient from southeastern Puerto Rico. During November 23, 2015–January 28, 2016, passive and enhanced surveillance for Zika virus disease identified 30 laboratory-confirmed cases. Most (93%) patients resided in eastern Puerto Rico or the San Juan metropolitan area. The most frequently reported signs and symptoms were rash (77%), myalgia (77%), arthralgia (73%), and fever (73%). Three (10%) patients were hospitalized. One case occurred in a patient hospitalized for Guillain-Barré syndrome, and one occurred in a pregnant woman. [CDC]

Clinicians in Puerto Rico are now required to report all cases of microcephaly, Guillain-Barré syndrome, and suspected Zika virus infection to PRDH. “Other adverse reproductive outcomes, including fetal demise associated with Zika virus infection, should be reported to PRDH.”

Index case. The first case of Zika virus disease identified in Puerto Rico occurred in a man aged 80 years with multiple chronic medical conditions, who reported onset of symptoms on November 23, 2015.

Eight days after illness onset, he was evaluated in a hospital emergency department for progressive weakness after several days of watery, nonbloody diarrhea, recent episodes of falling, shoulder pain, chills, malaise, and abdominal pain. He did not report myalgia, headache, or retro-orbital pain. He was febrile, tachycardic, tachypneic, and hypotensive, with bilateral erythematous sclera. Laboratory results revealed leukocytosis with a predominance of neutrophils; hemoconcentration; thrombocytopenia; elevated serum transaminases, blood urea nitrogen, and creatinine; hyponatremia; and hypoglycemia. He received a diagnosis of sepsis, was admitted to the intensive care unit for fluid resuscitation and monitoring, and was treated with broad spectrum antibiotics. Diagnostic considerations included leptospirosis and dengue. He experienced respiratory decompensation requiring intubation and 5 days of mechanical ventilation. He was hospitalized for 2 weeks, during which time he underwent an extensive evaluation. Blood and stool cultures were negative, as were serologic tests for human immunodeficiency virus, Leptospira, and Strongyloides. Schistosoma immunoglobulin G titers were elevated, for which praziquantel was administered. On December 2, serum was collected for dengue and chikungunya diagnostic testing, and was positive for anti-dengue virus IgM, negative for anti-chikungunya virus IgM, and negative for detection of dengue virus and chikungunya virus RNA. Because a hospital-based enhanced surveillance protocol was in place for detection of Zika virus, the same serum specimen was tested for Zika virus infection by RT-PCR with a positive result. Confirmatory molecular diagnostic testing was performed at CDC. Detection of anti-dengue virus IgM antibody likely was a result of cross-reactive anti-Zika virus IgM antibody. Although no pathogen other than Zika virus was identified, the patient’s clinical course suggests that he also had an occult bacterial infection. Read more…

Suggested citation: Thomas DL, Sharp TM, Torres J, et al. Local Transmission of Zika Virus — Puerto Rico, November 23, 2015–January 28, 2016. MMWR Morb Mortal Wkly Rep 2016;65(Early Release):1–6. DOI: http://dx.doi.org/10.15585/mmwr.mm6506e2er

Disease Outbreak News – 12 February 2016  – Mirrored from WHO

Sexually transmitted ZIKV infection in Dallas, Texas

On 5 February 2016, the National IHR Focal Point for the United States of America notified PAHO/WHO of a probable case of sexual transmission of Zika virus.

Person A, a resident of Dallas, Texas, travelled to Venezuela for one week between late December and the beginning of January. Several days after returning to the United States, Person A developed symptoms consistent with Zika virus infection, including fever, rash, conjunctivitis, and malaise. One day prior to symptom onset and once during the symptomatic period, Person A had sex with Person B (non-traveller). Approximately one week after the onset of illness in Person A, Person B developed symptoms consistent with Zika virus disease, including fever, pruritic rash, conjunctivitis, small joint arthralgia and malaise.

Laboratory tests confirmed Zika virus infection in both Person A and Person B. Samples collected from Person A at 14 days after symptom onset and from Person B at 4 and 7 days after illness onset had evidence of Zika virus IgM and neutralizing antibodies. Additional tests are being carried out. Local meteorological conditions at the time would not have supported mosquito activity; furthermore, entomological sampling that was conducted in the concerned area yielded no mosquitoes. Read more…

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‘Evidence of Zika Virus Infection in Brain and Placental Tissues’

Posted by feww on February 11, 2016

Morbidity and Mortality Weekly Report (MMWR)

Evidence of Zika Virus Infection in Brain and Placental Tissues from Two Congenitally Infected Newborns and Two Fetal Losses — Brazil, 2015

The following are field notes from Brazil on ZIKV infection posted in the latest issue of CDC’s Morbidity and Mortality Weekly Report

Zika virus is a mosquito-borne flavivirus that is related to dengue virus and transmitted primarily by Aedes aegypti mosquitoes, with humans acting as the principal amplifying host during outbreaks. Zika virus was first reported in Brazil in May 2015 (1). By February 9, 2016, local transmission of infection had been reported in 26 countries or territories in the Americas.* Infection is usually asymptomatic, and, when symptoms are present, typically results in mild and self-limited illness with symptoms including fever, rash, arthralgia, and conjunctivitis. However, a surge in the number of children born with microcephaly was noted in regions of Brazil with a high prevalence of suspected Zika virus disease cases. More than 4,700 suspected cases of microcephaly were reported from mid-2015 through January 2016, although additional investigations might eventually result in a revised lower number (2). In response, the Brazil Ministry of Health established a task force to further investigate possible connections between the virus and brain anomalies in infants (3).

Since November 2015, CDC has been developing assays for Zika virus testing in formalin-fixed, paraffin-embedded (FFPE) tissue samples. In December 2015, FFPE tissues samples from two newborns (born at 36 and 38 weeks gestation) with microcephaly who died within 20 hours of birth and two miscarriages (fetal losses at 11 and 13 weeks) were submitted to CDC, from the state of Rio Grande do Norte in Brazil, for histopathologic evaluation and laboratory testing for suspected Zika virus infection. All four mothers had clinical signs of Zika virus infection, including fever and rash, during the first trimester of pregnancy, but did not have clinical signs of active infection at the time of delivery or miscarriage. The mothers were not tested for antibodies to Zika virus. Samples included brain and other autopsy tissues from the two newborns, a placenta from one of the newborns, and products of conception from the two miscarriages.

FFPE tissues were tested by Zika virus reverse transcription-polymerase chain reaction (RT-PCR) targeting the nonstructural protein 5 and envelope genes using general methods for RT-PCR (4), and by immunohistochemistry using a mouse polyclonal anti-Zika virus antibody, using methods previously described (5). Specific specimens from all four cases were positive by RT-PCR, and sequence analysis provided further evidence of Zika virus infection, revealing highest identities with Zika virus strains isolated from Brazil during 2015. In the newborns, only brain tissue was positive by RT-PCR assays. Specimens from two of the four cases were positive by immunohistochemistry: viral antigen was noted in mononuclear cells (presumed to be glial cells and neurons within the brain) of one newborn, and within the chorionic villi from one of the miscarriages. Testing for dengue virus was negative by RT-PCR in specimens from all cases.

For both newborns, significant histopathologic changes were limited to the brain, and included parenchymal calcification, microglial nodules, gliosis, and cell degeneration and necrosis. Other autopsy tissues and placenta had no significant findings. Tests for toxoplasmosis, rubella, cytomegalovirus, herpes simplex, and HIV were negative in the two mothers who experienced miscarriages. Placental tissue from one miscarriage showed heterogeneous chorionic villi with calcification, fibrosis, perivillous fibrin deposition, and patchy intervillositis and focal villitis, while tissue from the other miscarriage had sparsely sampled normal-appearing chorionic villi.

This report describes evidence of a link between Zika virus infection and microcephaly and fetal demise through detection of viral RNA and antigens in brain tissues from infants with microcephaly and placental tissues from early miscarriages. Histopathologic findings indicate the presence of Zika virus in fetal tissues. These findings also suggest brain and early gestational placental tissue might be the preferred tissues for postmortem viral diagnosis. Nonfrozen, formalin-fixed specimens or FFPE blocks are the preferred sample type for histopathologic evaluation and immunohistochemistry, and RT-PCR can be performed on either fresh frozen or formalin-fixed specimens. To better understand the pathogenesis of Zika virus infection and associated congenital anomalies and fetal death, it is necessary to evaluate autopsy and placental tissues from additional cases, and to determine the effect of gestational age during maternal illness on fetal outcomes.

Suggested citation for this article: Martines RB, Bhatnagar J, Keating MK, et al. Notes from the Field: Evidence of Zika Virus Infection in Brain and Placental Tissues from Two Congenitally Infected Newborns and Two Fetal Losses — Brazil, 2015. MMWR Morb Mortal Wkly Rep 2016;65(Early Release):1–2. DOI: http://dx.doi.org/10.15585/mmwr.mm6506e1er

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ZIKV

DENGUE

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ZIKV: Health Emergency Declared in 4 Florida Counties

Posted by feww on February 4, 2016

Florida Governor Declares Health Emergency in Four Counties

Gov. Scott has signed Executive Order 16-29 directing Florida State Surgeon General Dr. John Armstrong to declare a public health emergency in the four counties which have the Zika virus, according to the governor’s website.

The Executive Order follows the discovery of a total of nine travel-associated cases (defined as disease believed to be contracted outside of the state) of the Zika virus across Miami-Dade, Hillsborough, Lee and Santa Rosa Counties.

“Today I am directing Surgeon General Dr. John Armstrong to declare a public health emergency in the four counties that have individuals with the Zika virus.  Although Florida’s current nine Zika cases were travel-related, we have to ensure Florida is prepared and stays ahead of the spread of the Zika virus in our state.  Our Department of Health will continue to be in constant communication with all county health offices, hospitals and the Federal Centers for Disease Control and Prevention (CDC).  We know that we must be prepared for the worst even as we hope for the best,” said Scott on Wednesday.

To view the Executive Order, click HERE.

Link to Microcephaly

Researchers suspect a possible link between Zika virus infection and microcephaly, a severe birth defect where a baby’s head is smaller than expected when compared to babies of the same sex and age. Babies with microcephaly often have smaller brains that might not have developed properly.

Microcephaly can occur as a result of changes in babies genes, as well as other causes that can include the following exposures during pregnancy:

Microcephaly is a birth defect where a baby’s head is smaller than expected when compared to babies of the same sex and age. Babies with microcephaly often have smaller brains that might not have developed properly. Microcephaly is not a common condition. State birth defects tracking systems have estimated that microcephaly ranges from 2 babies per 10,000 live births to about 12 babies per 10,000 live births in the Unites States.

Ae. aegypti Mosquitoes: The Principal Vectors of ZIKV

Ae. aegypti and Ae. albopictus are the principal vectors of dengue (DENV-1, DENV-2, DENV-3, DENV-4), chikungunya (CHIKV), yellow fever (YFV), and Zika (ZIKV) viruses. Of these seven arboviruses, DENV, YFV and CHIKV have caused outbreaks within the United States and its territories in the past 110 years.

With a newly-obtained fiery red blood meal visible through her transparent abdomen, the now heavy female Aedes aegypti mosquito took flight as she left her host’s skin surface. Photo Credit: James Gathany/ CDC

Approximate distribution of Ae. aegypti and Ae. albopictus mosquitoes in the United States. -CDC-

ZIKV in Brief [CDC]

Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon.

Outbreaks of Zika have occurred in areas of Africa, Southeast Asia, the Pacific Islands, and the Americas. Because the Aedes species mosquitoes that spread Zika virus are found throughout the world, it is likely that outbreaks will spread to new countries. In December 2015, Puerto Rico reported its first confirmed Zika virus case. Locally transmitted Zika has not been reported elsewhere in the United States, but cases of Zika have been reported in returning travelers.

There is no vaccine to prevent or medicine to treat Zika. Travelers can protect themselves from this disease by taking steps to prevent mosquito bites. When traveling to countries where Zika virus (see map) or other viruses spread by mosquitoes have been reported, use insect repellent, wear long sleeves and pants, and stay in places with air conditioning or that use window and door screens.

Zika and pregnancy

Zika Travel Notices

Latest Health Warnings

Authorities in four countries—Colombia, Ecuador, El Salvador and Jamaica—have warned women to avoid pregnancy as cases of microcephaly, believed to be caused by Zika virus (ZIKV), continue to multiply.

Brazil. Authorities say the number of babies born with suspected microcephaly has now reached about 4,000 since October, 2015.

Colombia. Health Minister has urged women to delay pregnancies for about eight months.

Ecuador, El Salvador and Jamaica. Authorities have told women to delay pregnancies by up to two years.

U.S. In January, explosive outbreaks of ZIKV, a dangerous tropical disease linked to birth defects, prompted the  U.S. health officials to issue a travel alert for people traveling to regions and countries where the virus transmission is spreading: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto Rico.

Countries that have past or current evidence of Zika virus transmission

AFRICA: Angola*, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Cote d’Ivoire, Egypt*, Ethiopia*, Gabon, Gambia*, Kenya*, Nigeria, Senegal, Sierra Leone*, Somalia*, Tanzania*, Uganda and Zambia*.

AMERICAS: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Suriname and Venezuela.

OCEANIA/PACIFIC ISLANDS: Cook Islands, Easter Island, Federated States of Micronesia, French Polynesia, New Caledonia, Samoa, Solomon Islands and Vanuatu.

ASIA: Cambodia, India*, Indonesia, Malaysia, Pakistan*, Philippines, Thailand and Vietnam*.

[*For these countries, the only evidence of Zika virus transmission is from studies that detected Zika virus antibodies in healthy people.  These studies cannot determine where the people were infected or if they were infected with Zika virus because the antibodies may have resulted from infections with other closely related viruses, such a; s dengue virus.]

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ZIKV

DENGUE

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ZIKV Update – Feb. 3, 2016

Posted by feww on February 3, 2016

Zika virus acquired through sexual transmission —Texas Officials

Health officials have confirmed that a person in Dallas County, Texas, contracted the Zika virus through sexual contact, the first such case reported in the continental United States.

The patient in Texas was infected after having sex with their partner who had returned from Venezuela, according to reports.

The Centers for Disease Control and Prevention (CDC) earlier released the following statement:

CDC has confirmed through laboratory testing the first U.S. case of Zika virus infection in a non-traveler in the continental United States. According to a Dallas County Health Department investigation, a person who recently traveled to an area with Zika virus transmission returned to the United States and developed Zika-like symptoms. The person later tested positive for Zika, along with their sexual partner, who had not traveled to the area. In this instance there was no risk to a developing fetus.

“Based on what we know now, the best way to avoid Zika virus infection is to prevent mosquito bites. We do not have definitive information on the infectious time period, and will provide more guidance for individuals and clinicians as we learn more. Sexual partners can protect themselves by using condoms to prevent spreading sexually transmitted infections. People who have Zika virus infection can protect others by preventing additional mosquito bites.

Two confirmed cases of Zika virus reported in Ireland

Meanwhile, two cases of ZIKV infection have been reported in Ireland, which are being investigated by The Health Service Executive (HSE), said a report.

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WHO Declares Microcephaly Cluster a ‘Public Health Emergency of International Concern’

Posted by feww on February 2, 2016

Experts ‘strongly suspect’ causal relationship between Zika infection during pregnancy and microcephaly

WHO convened an Emergency Committee, under the International Health Regulations, to gather advice on the severity of the health threat associated with the continuing spread of Zika virus disease in Latin America and the Caribbean.

Some 18 experts and advisers assessed “the strong association, in time and place, between infection with the Zika virus and a rise in detected cases of congenital malformations and neurological complications,” and agreed that a causal relationship between Zika infection during pregnancy and microcephaly is strongly suspected, though not yet scientifically proven, said WHO in a statement posted online.

After a review of the evidence, the Committee advised that the recent cluster of microcephaly cases and other neurological disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes an “extraordinary event” and a public health threat to other parts of the world.

Members of the Committee agreed that “a coordinated international response was needed to minimize the threat in affected countries and reduce the risk of further international spread,” and that the “situation meets the conditions for a Public Health Emergency of International Concern,” said WHO.

“I am now declaring that the recent cluster of microcephaly cases and other neurological disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes a Public Health Emergency of International Concern,” said WHO Director-General.

WHO did not elaborate as to why the Committee had “found no public health justification for restrictions on travel or trade to prevent the spread of Zika virus.”

Countries that have past or current evidence of Zika virus transmission

AFRICA: Angola*, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Cote d’Ivoire, Egypt*, Ethiopia*, Gabon, Gambia*, Kenya*, Nigeria, Senegal, Sierra Leone*, Somalia*, Tanzania*, Uganda and Zambia*.

AMERICAS: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Suriname and Venezuela.

OCEANIA/PACIFIC ISLANDS: Cook Islands, Easter Island, Federated States of Micronesia, French Polynesia, New Caledonia, Samoa, Solomon Islands and Vanuatu.

ASIA: Cambodia, India*, Indonesia, Malaysia, Pakistan*, Philippines, Thailand and Vietnam*.

[*For these countries, the only evidence of Zika virus transmission is from studies that detected Zika virus antibodies in healthy people.  These studies cannot determine where the people were infected or if they were infected with Zika virus because the antibodies may have resulted from infections with other closely related viruses, such as dengue virus.]

Related  Links

Additional Links

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ZIKV: Additional Information on Transmission

Posted by feww on January 29, 2016

 Microcephaly:  Zika virus or Guillain-Barré syndrome?

ZIKV is transmitted primarily by Aedes aegypti mosquitoes (1,7). Aedes albopictus mosquitoes also might transmit the virus. Aedes aegypti and Ae. albopictus mosquitoes are found throughout much of the Americas, including parts of the United States, and also transmit dengue and chikungunya viruses.

In addition to mosquito-to-human transmission, Zika virus infections have been documented through:

  • Intrauterine [in mother’s womb, or uterus] transmission resulting in congenital infection
  • Intrapartum [during the act of birth] transmission from a viremic mother to her newborn
  • Sexual transmission
  • Blood transfusion
  • Laboratory exposure

There is a theoretical concern that transmission could occur through organ or tissue transplantation, and although Zika virus RNA has been detected in breast milk, transmission through breastfeeding has not been documented.

The Brazil Ministry of Health has reported a marked increase in the number of infants born with microcephaly in 2015, although it is not known how many of these cases are associated with Zika virus infection. Guillain-Barré syndrome also has been reported in patients following suspected Zika virus infection. Studies are under way to evaluate the risks for Zika virus transmission during pregnancy, the spectrum of outcomes associated with congenital infection, and the possible association between Zika virus infection and Guillain-Barré syndrome.

There is no commercially available test for ZIKV. The virus testing is performed in the United States at CDC and four state health department laboratories.

Source: Hennessey M, Fischer M, Staples JE. Zika Virus Spreads to New Areas — Region of the Americas, May 2015–January 2016. MMWR Morb Mortal Wkly Rep 2016;65:55–58. DOI: http://dx.doi.org/10.15585/mmwr.mm6503e1

What is Guillain-Barré syndrome (GBS)?

Guillain-Barré syndrome (GBS) is a rare disorder in which a person’s own immune system damages their nerve cells, causing muscle weakness and sometimes paralysis. GBS can cause symptoms that usually last for a few weeks. Most people recover fully from GBS, but some people have long-term nerve damage. In very rare cases, people have died of GBS, usually from difficulty breathing.

  • The background rate for GBS in the U.S. is about 80 to 160 cases of GBS each week, regardless of vaccination.

What causes GBS?

Many things can cause GBS; about two-thirds of people who develop GBS symptoms do so several days or weeks after they have been sick with diarrhea or a respiratory illness. Infection with the bacterium Campylobacter jejuni is one of the most common risk factors for GBS. People also can develop GBS after having the flu or other infections (such as cytomegalovirus and Epstein Barr virus). On very rare occasions, they may develop GBS in the days or weeks after getting a vaccination.

 

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ZIKV: Media Sensationalism Forcing WHO to Overreact?

Posted by feww on January 28, 2016

If WHO believes ZIKV outbreak is that serious, WHY wait until WHEN?

The WHO announced today it will convene Emergency Committee on Zika virus (ZIKV) and observed increase in neurological disorders and neonatal malformations on February 1, 2016.

Statement by WHO:

WHO Director-General, Margaret Chan, will convene an International Health Regulations Emergency Committee on Zika virus and observed increase in neurological disorders and neonatal malformations.

The Committee will meet on Monday 1 February in Geneva to ascertain whether the outbreak constitutes a Public Health Emergency of International Concern.

Decisions concerning the Committee’s membership and advice will be made public on WHO’s website.

Outbreak in the Americas

In May 2015, Brazil reported its first case of Zika virus disease. Since then, the disease has spread within Brazil and to 22 other countries and territories in the region.

Arrival of the virus in some countries of the Americas, notably Brazil, has been associated with a steep increase in the birth of babies with abnormally small heads and in cases of Guillain-Barré syndrome, a poorly understood condition in which the immune system attacks the nervous system, sometimes resulting in paralysis.

A causal relationship between Zika virus infection and birth defects and neurological syndromes has not been established, but is strongly suspected.

WHO action

WHO’s Regional Office for the Americas (PAHO) has been working closely with affected countries since May 2015. PAHO has mobilized staff and members of the Global Outbreak and Response Network (GOARN) to assist ministries of health in strengthening their abilities to detect the arrival and circulation of Zika virus through laboratory testing and rapid reporting. The aim has been to ensure accurate clinical diagnosis and treatment for patients, to track the spread of the virus and the mosquito that carries it, and to promote prevention, especially through mosquito control.

The Organization is supporting the scaling up and strengthening of surveillance systems in countries that have reported cases of Zika and of microcephaly and other neurological conditions that may be associated with the virus. Surveillance is also being heightened in countries to which the virus may spread. In the coming weeks, the Organization will convene experts to address critical gaps in scientific knowledge about the virus and its potential effects on fetuses, children and adults.

WHO will also prioritize the development of vaccines and new tools to control mosquito populations, as well as improving diagnostic tests.

A “news” outlet said:

Three to four million people will be infected with Zika in the Americas this year, the World Health Organization says.” [They have provided NO link to the person saying this.]

“Most cases result in no symptoms and it is hard to test for, but WHO officials said an estimated 1.5 million people had been infected in the country.” [Again, no one in WHO is aware of any source for this statement.]

The only statement made in this regard is the following:

FIRE-EARTH Models show more than one million incidences of ZIKV infections may have occurred worldwide since October 2015.

Neither WHO (PAHO), nor CDC currently has a working model for predicting the “explosive” growth of ZIKV.

“Zika virus spreading in Europe”

Earlier this week, another “news” outlet predicted that the virus would be spreading in Europe rapidly because a Danish traveler had been found infected with the disease.

The idiots who make up such silly stories about the virus outbreaks have ZERO to NO idea how the disease is transmitted, or how fast it could spread.

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ZIKV Found in Australian Travelers Returning from S. America

Posted by feww on January 26, 2016

Submitted by a reader – Edited by FEWW

Australians authorities echo warning to travelers planing to visit 22 countries affected by ZIKV

Australian health experts report mosquito-borne Zika virus (ZIKV), linked to brain damage in thousands of babies in Brazil, has already been discovered in Australia in travelers returning from South America, said a report.

For the virus to spread, however, it would require specific species of mosquitoes to act as a vector. The Aedes aegypti mosquito, one such vector, is currently found only in far north Queensland.

The Department of Foreign Affairs and Trade has issued new advice warning Australians, particularly pregnant women, to reconsider plans to travel to 22 countries affected by the virus, including many in South and Central America, and the Pacific island nation Samoa.

[FIRE-EARTH Models show more than one million incidences of ZIKV infections may have occurred worldwide since October 2015. —Editor]

The new travel advice comes in response to a warning by the World Health Organisation that Zika virus is now likely to spread to all countries in South, Central and North America except Canada and Chile. [Blog Moderators have not found any evidence to confirm either PAHO or WHO has issued a warning to this effect. This appears to be media sensationalism at best, or a desperate ruse designed for phishing more information from independent sources. —Editor]

At least 3,893 suspected cases of microcephaly had occurred in Brazil as of January 22, 2016, or over 30 times more than in any year since 2010 and equivalent to 1 to 2 per cent of all newborns in the state of Pernambuco, one of the worst-hit areas, said WHO.

ZIKV was first detected in a monkey in Zika forest near Lake Victoria, Uganda, in 1947.

Microcephaly is a birth defect where a baby’s head is smaller than expected when compared to babies of the same sex and age. Babies with microcephaly often have smaller brains that might not have developed properly. Microcephaly is not a common condition. State birth defects tracking systems have estimated that microcephaly ranges from 2 babies per 10,000 live births to about 12 babies per 10,000 live births in the Unites States.

Countries that have past or current evidence of Zika virus transmission

AFRICA: Angola*, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Cote d’Ivoire, Egypt*, Ethiopia*, Gabon, Gambia*, Kenya*, Nigeria, Senegal, Sierra Leone*, Somalia*, Tanzania*, Uganda and Zambia*.

AMERICAS: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Suriname and Venezuela.

OCEANIA/PACIFIC ISLANDS: Cook Islands, Easter Island, Federated States of Micronesia, French Polynesia, New Caledonia, Samoa, Solomon Islands and Vanuatu.

ASIA: Cambodia, India*, Indonesia, Malaysia, Pakistan*, Philippines, Thailand and Vietnam*.

[*For these countries, the only evidence of Zika virus transmission is from studies that detected Zika virus antibodies in healthy people.  These studies cannot determine where the people were infected or if they were infected with Zika virus because the antibodies may have resulted from infections with other closely related viruses, such as dengue virus.]

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ZIKV Emergency: New Warnings Issued by Colombia, Ecuador, El Salvador & Jamaica

Posted by feww on January 23, 2016

One million cases of ZIKV infections worldwide: FIRE-EARTH Models

FIRE-EARTH Models show more than one million incidences of ZIKV infections may have occurred worldwide since October 2015.

Link to Microcephaly

Researchers suspect a possible link between Zika virus infection and microcephaly, a severe birth defect where a baby’s head is smaller than expected when compared to babies of the same sex and age. Babies with microcephaly often have smaller brains that might not have developed properly.

Microcephaly can occur as a result of changes in babies genes, as well as other causes that can include the following exposures during pregnancy:

Microcephaly is a birth defect where a baby’s head is smaller than expected when compared to babies of the same sex and age. Babies with microcephaly often have smaller brains that might not have developed properly. Microcephaly is not a common condition. State birth defects tracking systems have estimated that microcephaly ranges from 2 babies per 10,000 live births to about 12 babies per 10,000 live births in the Unites States.

Latest Health Warnings

Authorities in four countries—Colombia, Ecuador, El Salvador and Jamaica—have warned women to avoid pregnancy as cases of microcephaly, believed to be caused by Zika virus (ZIKV), continue to multiply.

Brazil. Authorities say the number of babies born with suspected microcephaly has now reached about 4,000 since October, 2015.

Colombia. Health Minister has urged women to delay pregnancies for about eight months.

Ecuador, El Salvador and Jamaica. Authorities have told women to delay pregnancies by up to two years.

U.S. Last week, explosive outbreaks of ZIKV, a dangerous tropical disease linked to birth defects, prompted the  U.S. health officials to issue a travel alert for people traveling to regions and countries where the virus transmission is spreading: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto Rico.

Countries that have past or current evidence of Zika virus transmission

AFRICA: Angola*, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Cote d’Ivoire, Egypt*, Ethiopia*, Gabon, Gambia*, Kenya*, Nigeria, Senegal, Sierra Leone*, Somalia*, Tanzania*, Uganda and Zambia*.

AMERICAS: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Suriname and Venezuela.

OCEANIA/PACIFIC ISLANDS: Cook Islands, Easter Island, Federated States of Micronesia, French Polynesia, New Caledonia, Samoa, Solomon Islands and Vanuatu.

ASIA: Cambodia, India*, Indonesia, Malaysia, Pakistan*, Philippines, Thailand and Vietnam*.

[*For these countries, the only evidence of Zika virus transmission is from studies that detected Zika virus antibodies in healthy people.  These studies cannot determine where the people were infected or if they were infected with Zika virus because the antibodies may have resulted from infections with other closely related viruses, such a; s dengue virus.]

Ae. aegypti Mosquitoes: The Principal Vectors of ZIKV

Ae. aegypti and Ae. albopictus are the principal vectors of dengue (DENV-1, DENV-2, DENV-3, DENV-4), chikungunya (CHIKV), yellow fever (YFV), and Zika (ZIKV) viruses. Of these seven arboviruses, DENV, YFV and CHIKV have caused outbreaks within the United States and its territories in the past 110 years.

With a newly-obtained fiery red blood meal visible through her transparent abdomen, the now heavy female Aedes aegypti mosquito took flight as she left her host’s skin surface. Photo Credit: James Gathany/ CDC

Approximate distribution of Ae. aegypti and Ae. albopictus mosquitoes in the United States. -CDC-

ZIKV in Brief [CDC]

Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon.

Outbreaks of Zika have occurred in areas of Africa, Southeast Asia, the Pacific Islands, and the Americas. Because the Aedes species mosquitoes that spread Zika virus are found throughout the world, it is likely that outbreaks will spread to new countries. In December 2015, Puerto Rico reported its first confirmed Zika virus case. Locally transmitted Zika has not been reported elsewhere in the United States, but cases of Zika have been reported in returning travelers.

There is no vaccine to prevent or medicine to treat Zika. Travelers can protect themselves from this disease by taking steps to prevent mosquito bites. When traveling to countries where Zika virus (see map) or other viruses spread by mosquitoes have been reported, use insect repellent, wear long sleeves and pants, and stay in places with air conditioning or that use window and door screens.

Zika and pregnancy

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ZIKV Infection Cases Reported in Illinois

Posted by feww on January 20, 2016

Two pregnant Illinois women test positive for the Zika virus

Two pregnant Illinois residents, who recently traveled to countries where Zika virus is spreading, have tested positive for the virus, said the Illinois Department of Public Health. 

The latest development follows the case of a ZIKV infected infant in Hawaii who was born with microcephaly, on January 17, 2016.

The following statement was issued by the Illinois Health Department:

Two Illinois Residents Test Positive For Zika Virus

SPRINGFIELD (January 19, 2016). The Illinois Department of Public Health (IDPH) is alerting the public of the potential of contracting Zika virus while traveling abroad.  Zika virus is spread to people through mosquito bites, similar to West Nile virus or dengue fever.  While illness is usually mild and severe disease requiring hospitalization is uncommon, there is a possible link between Zika virus infection in pregnant women and subsequent birth defects.

Two pregnant Illinois residents who recently traveled to countries where Zika virus is found have tested positive for the virus.  Physicians are monitoring their health and pregnancies.

“There is virtually no risk to Illinois residents since you cannot contract Zika virus from another person, but only through the bite of an infected mosquito,” said IDPH Director Nirav D. Shah, M.D., J.D.  “But since this is a time of year when people travel to warmer climates and countries where Zika virus is found, we are urging residents, especially pregnant women, to take preventive measures when traveling in affected countries and check health travel advisories.”

The Centers for Disease Control and Prevention (CDC) issued a travel alert (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing, including:

Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto Rico. [See below for the full list.]

This alert follows reports in Brazil of microcephaly and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant.  However, additional studies are needed to further characterize this relationship.

Until more is known, CDC recommends that pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing.  Pregnant women, women trying to become pregnant, or women who are thinking about becoming pregnant and must travel to one of these areas should talk with their doctor or other health care provider first and strictly follow steps to avoid mosquito bites during the trip.

The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes).  Symptoms can last from several days to weeks.  There is no vaccine to prevent or medicine to treat Zika virus infection.

When traveling to countries where Zika virus has been reported, all travelers should take steps to prevent mosquito bites, such as using use insect repellent, wearing long sleeves and pants, and staying in places with air conditioning or that use window and door screens.  More information about Zika virus can be found on the CDC website.  CDC has also developed interim Zika virus guidelines for health care providers in the United State caring for pregnant women.

Countries with past or current evidence of Zika virus transmission


Countries that have past or current evidence of Zika virus transmission —CDC

Countries that have past or current evidence of Zika virus transmission

AFRICA: Angola*, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Cote d’Ivoire, Egypt*, Ethiopia*, Gabon, Gambia*, Kenya*, Nigeria, Senegal, Sierra Leone*, Somalia*, Tanzania*, Uganda and Zambia*.
AMERICAS: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Suriname and Venezuela.

OCEANIA/PACIFIC ISLANDS: Cook Islands, Easter Island, Federated States of Micronesia, French Polynesia, New Caledonia, Samoa, Solomon Islands and Vanuatu.

ASIA: Cambodia, India*, Indonesia, Malaysia, Pakistan*, Philippines, Thailand and Vietnam*.

[*For these countries, the only evidence of Zika virus transmission is from studies that detected Zika virus antibodies in healthy people.  These studies cannot determine where the people were infected or if they were infected with Zika virus because the antibodies may have resulted from infections with other closely related viruses, such as dengue virus.]

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CDC Issues Travel Warning as Zika Virus Epidemic Continues to Spread

Posted by feww on January 16, 2016

U.S. health officials warn pregnant women against traveling to Latin America, Caribbean countries

Explosive outbreaks of Zika, a dangerous tropical disease linked to birth defects, have prompted the  U.S. health officials to issue a travel alert for people traveling to regions and countries where Zika virus (ZIKV) transmission is ongoing: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto Rico.

CDC has issued a travel alert (Level 2-Practice Enhanced Precautions) for the above-listed areas.

This alert follows reports in Brazil of microcephaly and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant. However, additional studies are needed to further characterize this relationship. More studies are planned to learn more about the risks of Zika virus infection during pregnancy.

CDC recommends special precautions, out of an abundance of caution, for pregnant women and women trying to become pregnant:

  • Pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who must travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow steps to avoid mosquito bites during the trip.
  • Women trying to become pregnant who are thinking about becoming pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip.

Because specific areas where Zika virus transmission is ongoing are difficult to determine and likely to change over time, CDC will update this travel notice as information becomes available. Check the CDC travel website frequently for the most up-to-date recommendations.

Currently, there is no vaccine to prevent or medicine to treat Zika. Four in five people who acquire Zika infection may have no symptoms. Illness from Zika is usually mild and does not require hospitalization. Travelers are strongly urged to protect themselves by preventing mosquito bites:

  • Wear long-sleeved shirts and long pants
  • Use EPA-registered insect repellents containing DEET, picaridin, oil of lemon eucalyptus (OLE), or IR3535. Always use as directed.
    • Insect repellents containing DEET, picaridin, and IR3535 are safe for pregnant and nursing women and children older than 2 months when used according to the product label. Oil of lemon eucalyptus products should not be used on children under 3 years of age.
  • Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents).
  • Stay and sleep in screened-in or air-conditioned rooms.

In addition to the steps announced today, CDC is working with public health experts across the U.S. Department of Health and Human Services (HHS) to take additional steps related to Zika. CDC is developing interim guidance for pregnant women as well as sharing additional information about Zika with public health officials, clinicians and the public.  In addition, efforts are underway across HHS to develop vaccines, improved diagnostics and other countermeasures for Zika.

Countries with past or current evidence of Zika virus transmission


Countries that have past or current evidence of Zika virus transmission (See below for list)

Background:

CDC scientists tested samples provided by Brazilian health authorities from two pregnancies that ended in miscarriage and from two infants with diagnosed microcephaly who died shortly after birth. For the two full-term infants, tests showed that Zika virus was present in the brain. Genetic sequence analysis showed that the virus in the four cases was the same as the Zika virus strain currently circulating in Brazil.  All four mothers reported having experienced a fever and rash illness consistent with Zika virus disease (Zika) during their pregnancies.

Locally acquired Zika was reported for the first time in Brazil in May 2015, and the virus has since been reported in 14 countries and territories in Latin America and the Caribbean:  Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and Commonwealth of Puerto Rico.

According to Brazilian health authorities, more than 3,500 microcephaly cases were reported in Brazil between October 2015 and January 2016.  Some of the affected infants have had a severe type of microcephaly and some have died.  The full spectrum of outcomes that might be associated with infection during pregnancy and the factors that might increase risk to the fetus are not yet fully understood. Health authorities in Brazil, with assistance from the Pan American Health Organization, CDC, and other agencies, have been investigating the possible association between Zika virus infection and microcephaly in infants. However, additional studies are needed to further characterize this relationship. More studies are planned to learn more about the risks of Zika virus infection during pregnancy.

In the past, outbreaks of Zika virus infection have occurred in Africa, Southeast Asia, and the Pacific Islands.  Zika virus is transmitted to people primarily through the bite of an infected Aedes species mosquito.  About one in five people infected with Zika virus will develop symptoms, which include fever, rash, joint pain, and conjunctivitis (pink eye). Other commonly reported symptoms include myalgia, headache, and pain behind the eyes. The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon and case fatality is low. Guillain-Barré syndrome has been reported in patients with probable Zika virus infection in French Polynesia and Brazil . Research efforts will also examine the link between Zika and GBS.

Countries that have past or current evidence of Zika virus transmission

AFRICA: Angola*, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Cote d’Ivoire, Egypt*, Ethiopia*, Gabon, Gambia*, Kenya*, Nigeria, Senegal, Sierra Leone*, Somalia*, Tanzania*, Uganda and Zambia*.

AMERICAS: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Suriname and Venezuela.

OCEANIA/PACIFIC ISLANDS: Cook Islands, Easter Island, Federated States of Micronesia, French Polynesia, New Caledonia, Samoa, Solomon Islands and Vanuatu.

ASIA: Cambodia, India*, Indonesia, Malaysia, Pakistan*, Philippines, Thailand and Vietnam*.

[*For these countries, the only evidence of Zika virus transmission is from studies that detected Zika virus antibodies in healthy people.  These studies cannot determine where the people were infected or if they were infected with Zika virus because the antibodies may have resulted from infections with other closely related viruses, such as dengue virus.]

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Zika Virus: Coming to a Place Near You…

Posted by feww on January 5, 2016

ZIKV spreading in Brazil, reported in 19 countries as of January 4 —ECDC

At least 19 countries are reporting local transmission of confirmed Zika virus infections (ZIKV) in the nine months to 4 Jan 2016, reported the European Center for Disease Prevention and Control (ECDC).

​Those countries are

​Brazil, Cape Verde, Colombia, El Salvador, Fiji, French Guiana, Guatemala​, Honduras, Martinique, Mexico, New Caledonia, Puerto Rico, Panama, Paraguay, Samoa, Solomon Islands, Suriname, Vanuatu and Venezuela.

ZIKV in Brazil
The Ministry of Health (MOH) of Brazil is concerned about a possible association between the Zika virus outbreak and increased numbers of babies born with microcephaly (smaller than expected head size).

Brazil reported its first case of ZIKV in May 2015. The virus has since spread rapidly, causing infections in many Brazilian states and other countries in Latin America. The association of Zika virus infection and microcephaly and is still under investigation, said MOH.

Microcephaly in Brazil
Starting in October 2015, the Brazilian MOH received reports of an increase in the number of babies being born with microcephaly. The number of microcephaly cases are roughly 10 times higher than what the country normally sees in a year.

There are no published reports of increased numbers of microcephaly associated with other similar viral (i.e. flaviviral) diseases transmitted by mosquitoes.

ZIKV in Puerto Rico
On December 31, the Puerto Rico Department of Health reported the first locally acquired case of Zika virus infection in Puerto Rico.  Zika was confirmed in a resident of Puerto Rico with no known travel history.  Health officials in Puerto Rico are monitoring for other cases of Zika virus infection, said CDC.

 Zika: Coming To America Through Mosquitoes, Travel, and Sex —Forbes
“…The latest two [viruses] that hit the U.S., chikungunya and dengue, are painful and bad enough — and dengue can kill people who are infected more than once. Zika adds an added nasty punch of perhaps causing microcephaly, a birth defect where babies are born with abnormally small skulls and brains, and often have developmental abnormalities…” (Stone, 1/4).

On Dec. 10, officials in Panama announced the country’s first case of locally acquired ZIKV , which raised the number of countries in the Americas with reported cases of the infections to at least 10

On Dec. 1, the Pan American Health Organization (PAHO) issued an alert concerning the Yellow Fever. Cases had already been reported in Brazil, Chile (on Easter Island), Colombia, El Salvador, Guatemala, Mexico, Paraguay, Suriname and Venezuela.

In light of the circulation of yellow fever in several areas of the Region, and in the context of the ongoing El Niño Southern Oscillation (ENSO) the Pan American Health Organization/World Health Organization ( PAHO/WHO) advises Member States to establish and maintain the capacity to detect and confirm cases of yellow f ever and keep health professionals up to date to enable them to identify suspected cases and manage cases properly, especially in areas at risk for yellow fever. In addition, M ember States are advised to maintain high vaccination coverage in at risk populations.

INTRODUCTION [ECDC]

Zika virus disease is a mosquito-borne disease caused by Zika virus (ZIKV) which causes in general a mild febrile illness with maculo-papular rash. Aedes mosquitoes are considered as main vectors. Before 2007, viral circulation and a few outbreaks were documented in tropical Africa and in some areas in Southeast Asia. Since 2007, several islands of the Pacific region have experienced outbreaks. In 2015, ZIKV disease outbreaks were reported in South America for the first time. ZIKV disease is now considered as an emerging infectious disease.

A significant increase of patients with Guillain–Barré syndrome (GBS) was reported during the 2014 outbreak in French Polynesia. A similar increase along with an unusual increase of congenital microcephaly was observed in some regions in north eastern Brazil in 2015. Causal relationships are currently under investigation.

There is no prophylaxis, treatment or vaccine to protect against ZIKV infection. Therefore, preventive personal measures are recommended to avoid mosquito bites during the daytime. http://ecdc.europa.eu/en/healthtopics/zika_virus_infection/factsheet-health-professionals/Pages/factsheet_health_professionals.aspx#sthash.2cnQku6v.dpuf

THE PATHOGEN

  • Zika virus (ZIKV) disease is caused by a virus from the Flavivirus genus, Flaviviridae family, from the Spondweni group.
  • It was first isolated in 1947 from a monkey in the Zika forest, Uganda, then in mosquitoes (Aedes africanus) in the same forest in 1948, and in a human in Nigeria in 1952. There are two ZIKV lineages: the African lineage and the Asian lineage which has recently emerged in the Pacific and the Americas. [1,2]

CLINICAL FEATURES AND SEQUELAE

  • The incubation period ranges between approximately three to 12 days after the bite of an infected mosquito.
  • Most of the infections remain asymptomatic (between 60 to 80%).
  • Disease symptoms are usually mild and the disease in usually characterised by a short-lasting self-limiting febrile illness of 4–7 days duration without severe complications, with no associated fatalities and a low hospitalisation rate.
  • The main symptoms are macular or papular rash, fever, arthralgia, non-purulent conjunctivitis/conjunctival hyperaemia, myalgia and headache. The maculo-papular rash often starts on the face and then spreads throughout the body. Less frequently, retro-orbital pain and gastro-intestinal signs are present.

Auto-immune, neurological and neurodevelopmental conditions such as Guillain-Barré syndrome and microcephaly in foetuses and newborns from mothers possibly exposed to ZIKV in the two first trimesters of the pregnancy were notified during recent Zika disease outbreaks (French Polynesia and Brazil). Further evidence is needed to establish a causal link between these neurological/neurodevelopmental impairments and infections with ZIKV.

EPIDEMIOLOGY

  • Serological surveys in Africa and Asia indicate a most likely silent ZIKV circulation with detection of specific antibodies in various animal species (large mammals such as orangutans, zebra, elephants, water buffaloes) and rodents.
  • The knowledge of geographical distribution of ZIKV is based on results of serosurveys and viral isolation in mosquitoes and humans, and with reports of travel-associated cases and very few published outbreaks. Before 2007, the areas with reported ZIKV circulation included tropical Africa and Southeast Asia.
  • An outbreak was reported on Yap Island, Federated States of Micronesia (FSM) from April to July 2007 [3]. This was the first outbreak of ZIKV identified outside of Africa and Asia. Between 2013 and 2015, several significant outbreaks were notified on islands and archipelagos from the Pacific region including a large outbreak in French Polynesia. In 2015, ZIKV emerged in South America with widespread outbreaks reported in Brazil and Columbia [1,4,5].

TRANSMISSION

  • Zika virus is transmitted by mosquitoes. It has been isolated from Aedes aegypti mosquitoes and experimental infections show that this species is capable of transmitting ZIKV.
  • Other Aedes mosquito species (notably Ae. africanus, Ae. albopictus, Ae. polynesiensis, Ae. unilineatus, Ae. vittatus and Ae. hensilli) are considered as potential vectors of ZIKV. These species bite during the day (especially in mid-morning and between late afternoon and twilight).
  • Additional modes of transmission have been identified. Perinatal transmission can occur most probably by trans-placental transmission or during delivery when the mother is infected. Sexual transmission was reported in two case reports.
  • There is a potential risk of ZIKV transfusion-derived transmission.
  • More information on mosquitoes can be found here: Aedes albopictus and Aedes aegypti. [1,6-8]

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Disasters/ Significant Events – Dec 25, 2015

Posted by feww on December 25, 2015

Brazil warns against pregnancy amid surge in ZIKV birth defects

States of Emergency have been declared in six  Brazilian states after a surge in the number of suspected microcephaly among the newborn linked to Zika virus (ZIKV).

In Pernambuco State, about 1,000 cases have been reported. In Rio de Janeiro, about 400 pregnant women are suspected of having Zika infection. About 3 dozen related infant deaths are being investigated. 

Brazilian health authorities are advising would-be parents not to get pregnant, especially in the country’s northeast. The advice follows research that have linked the potentially deadly virus Zika, a mosquito-borne infection, to newborn microcephaly—a neurological disorder that can result in a severe birth defect in which the brain fails to develop properly and the head is much smaller than normal.

Microcephaly can be caused by genetic factors, infections, or injuries. In recent years, there have been between 150 and 200 cases in Brazil per year. As of 30 November, more than 1,200 cases had been reported in 10 states, all of which have also reported Zika virus infections, says Ana Maria Bispo de Filippis, head of the flavivirus laboratory at the Oswaldo Cruz Institute in Rio de Janeiro, Brazil.”

However, the number of suspected infections have now doubled to more than 2,400  cases and spared to 20 Brazilian states (compared with 147 cases last year).

 

Storms kill at least a dozen, injure dozens more, leave trails of destruction across the U.S. South

Gov. Haslam approved the Tennessee Emergency Management Agency’s recommendation to go to a Level III State of Emergency, after storms moved across the state Wednesday night, killing at least two people.

Gov. Deal declared a state of emergency in Georgia for Fannin, Gilmer and Pickens counties through January.

“Following severe weather that resulted in flooding, damage to roads and properties and downed trees, the state is working to ensure the affected counties have access to the resources necessary for response efforts,” said Deal.

Gov. Bryant has declared a State of Emergency in seven Mississippi counties after storms pummeled the state late Wednesday..

Benton, Coahoma, Marshall, Panola, Quitman, Prentiss and Tippah counties have all reported damage,  at least six dead and more than 40 injuried.

  • Macon County North Carolina issued a state of emergency after the storm caused severe flooding across the area.
  • An unknown number of people were injured after the storm overturned planes at a local airport northwest of the state, said reports.

A large tornado, one of at least 3 dozens, landed in Mississippi and raked along a 240-km trail to Tennessee.

spc reports 23-12-15
SPC received hundreds of severe weather reports including 39 tornadoes, as of posting. Tornadoes left trails of destruction across multiple states: Alabama, Mississippi, Arkansas, Tennessee, and Illinois.

 

Beijing air pollution worsens significantly

Air pollution index (AQI) in China hit a high of 592 on Friday and persisted at 562, as of posting.

[The EPA’s revised breakpoints for the upper end of the hazardous air pollution band, AQI of 401 – 500, is equivalent to PM2.5 concentration of 350.5 – 500 μgm−³ averaged over a 24-hour period.  —Editor]

There’s apparent confusion among officials concerning the severity and duration of the smog events, on the one hand, and the extent of willpower exercised by government to shoo away the potentially deadly pollution, on the other. The official news agency, Xinhua, wrote:

Even though Beijing has lifted the red alert for severe pollution, the capital city will remain in haze for a few more days. [How dare smog worsens “even though” the authorities have downgraded the pollution warning to the lowest level. Ed.]

The Beijing municipal heavy pollution emergency response headquarters issued a blue alert for heavy pollution in the city on Thursday afternoon, saying smog will hit central Beijing and southern suburbs on Thursday night. It called on residents in these areas to take protective measures.

“Red” represents the most severe warning level on China’s four-tier warning system,  followed by orange, yellow and blue.

In addition to Beijing, at least 50 other cities in northern and eastern China have issued air pollution alerts for potentially deadly smog this week.

 

 

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ZIKV – Emerging Virus May Cause Severe Birth Defects

Posted by feww on December 4, 2015

Brazil records six fold increase in microcephaly: Report

Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease (Zika) are fever, rash, joint pain, and red eye. The illness is usually mild with symptoms lasting from several days to a week, according to CDC.

Zika virus (ZIKV) is a flavivirus related to yellow fever, dengue, West Nile, and Japanese encephalitis viruses. In 2007 ZIKV caused an outbreak of relatively mild disease characterized by rash, arthralgia, and conjunctivitis on Yap Island in the southwestern Pacific Ocean. This was the first time that ZIKV was detected outside of Africa and Asia. The history, transmission dynamics, virology, and clinical manifestations of ZIKV disease are discussed, along with the possibility for diagnostic confusion between ZIKV illness and dengue. The emergence of ZIKV outside of its previously known geographic range should prompt awareness of the potential for ZIKV to spread to other Pacific islands and the Americas. [Edward B. Hayes/CDC]

Zika may be responsible for an “unprecedented epidemic in Brazil and is quickly spreading through Latin America may be responsible for a spike in severe birth defects,” said a report.

Brazilian government has warned that the virus could be responsible for a dramatic rise “in cases of microcephaly, a severe birth defect in which the brain fails to develop properly and the head is much smaller than normal. Children with microcephaly frequently have developmental delays, learning disabilities, impaired motor function, and seizures.”  However, the connection remains to be proven.

“Microcephaly can be caused by genetic factors, infections, or injuries. In recent years, there have been between 150 and 200 cases in Brazil per year. As of 30 November, more than 1200 cases had been reported in 10 states, all of which have also reported Zika virus infections, says Ana Maria Bispo de Filippis, head of the flavivirus laboratory at the Oswaldo Cruz Institute in Rio de Janeiro, Brazil.”

Brazil’s northeastern state of  Pernambuco has recorded at least 487 microcephaly cases so far this year, compared with an average of 10 cases per year between 2010 and 2014, said the report.

“The virus has been found in the amniotic fluid of two fetuses diagnosed with microcephaly via ultrasound. It has also been found in tissues of a baby with microcephaly that died shortly after birth. It seems that in some cases the virus can cross the placenta and infect the fetus directly, says Patricia Garcez, a neurodevelopment expert at the Federal University of Rio de Janeiro in Brazil. It’s possible that the virus then attacks brain cells, she says. If that happens during the key phases of brain development in the first 3 to 4 months of pregnancy, the overall size of the brain would be dramatically reduced, leading to microcephaly.”

Additionally, health authorities in French Polynesia reported “17 cases of unusual central nervous system birth defects following a Zika outbreak there in 2013 and 2014.”

Unpreventable and Untreatable!

There is no vaccine to prevent or medicine to treat Zika. When traveling to countries where Zika virus or other viruses spread by mosquitoes have been reported, travelers should protect themselves from this disease by taking steps to prevent mosquito bites.

Geographic Distribution

Outbreaks of Zika virus disease (or Zika) previously have been reported in tropical Africa, Southeast Asia, and the Pacific Islands. Zika virus likely will continue to spread to new areas. In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infections in Brazil. [CDC]

Countries that have past or current evidence of Zika virus transmission (as of December 2015)

Source: CDC

Countries that have past or current evidence of Zika virus transmission

AFRICA:  Angola*, Burkina Faso, Cameroon, Central African Republic, Cote d’Ivoire, Egypt*, Ethiopia*, Gabon, Gambia*, Kenya*, Nigeria, Senegal, Sierra Leone*, Somalia*, Tanzania*, Uganda and Zambia*

ASIA: Cambodia, India*, Indonesia, Malaysia, Pakistan*, Philippines, Thailand and Vietnam*

AMERICAS: Brazil, Colombia, El Salvador, Guatemala, Mexico, Paraguay and Suriname

OCEANIA/PACIFIC ISLANDS: Cook Islands, Easter Island, Federated States of Micronesia, French Polynesia, New Caledonia, Solomon Islands and Vanuatu

*For these countries, the only evidence of Zika virus transmission is from studies that detected Zika virus antibodies in healthy people.  These studies cannot determine where the people were infected or if they were infected with Zika virus because the antibodies may have resulted from infections with other closely related viruses, such as dengue virus.

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