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U.S. government shifts $81 million to Zika vaccine research

By Julie Steenhuysen and Toni Clarke

CHICAGO/WASHINGTON (Reuters) – The U.S. Department of Health and Human Services has shifted $81 million in funds from other projects to continue work on developing vaccines to fight Zika in the absence of any funding from U.S. lawmakers.

In a letter addressed to Nancy Pelosi, a Democrat and minority leader of the U.S. House of Representatives, HHS Secretary Sylvia Burwell said she was allocating $34 million in funding to the National Institutes of Health and $47 million to the Biomedical Advanced Research and Development Authority (BARDA) to work on Zika vaccines.

Burwell said the funding was intended to keep Zika vaccine research going despite the lack of funding from U.S. lawmakers, who left for summer recess before allocating any funding to Zika research and preparedness.

The mosquito-borne Zika virus has spread to more than 50 countries and territories since the outbreak began last year in Brazil. On Thursday, Governor Rick Scott said state health officials have identified three additional people in the affected area with locally transmitted Zika, bringing the total to 25.

The Obama administration in February requested $1.9 billion to fight Zika, but congressional lawmakers have been considering a much smaller sum. A bill providing $1.1 billion was blocked by Democrats after Republicans attached language to stop abortion-provider Planned Parenthood from using that government funding for healthcare services, mainly in U.S. territories like Puerto Rico.

The Republican legislation also would siphon off unused money under President Barack Obama’s signature 2010 healthcare law to combat Zika. In addition, Democrats balked at a Republican provision that they said would gut clean water protections.

The new bolus of funds from HHS comes on top of the $589 million in repurposed funds previously allocated for Ebola efforts. HHS has said these funds will run out at the end of August.

At a press briefing in Washington, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said he needs $33 million to prepare to move the first potential Zika vaccine to the second phase of human clinical trials. The first phase of that testing is expected to end in late November or December.

Fauci said the health secretary has the authority to transfer 1 percent of NIH’s $33 billion budget per year from one Institute to the other. He said the director of the NIH, Dr. Francis Collins, will decide which existing programs the funds will be drawn from.

“He will probably do it on a prorated basis across the Institutes,” he said.

Fauci said the budget transfer will not fill the longer-term NIH funding needs to fight the virus and to develop a second or third potential vaccine candidate. Drugs frequently fail to realize the promise they show in early trials.

“We still need about $196 million more,” he said.

Fauci said the health secretary’s action was essentially one of desperation given the failure of Congress to authorize additional funding.

Taking money from other research programs “is extremely damaging to the biomedical research enterprise,” he said. “We’re taking money away from cancer, diabetes, all those things.”

Dr. LaMar Hasbrouck, executive director of the National Association of County and City Health Officials, said at the briefing that local health authorities are similarly siphoning off money from other programs.

“We’re robbing Peter to pay Paul,” he said.

In her letter, Burwell said the $47 million in funding for BARDA will allow the agency to enter into contracts with key partners to develop vaccines. But, she said BARDA will need an estimated $342 million in additional funding to continue its work with outside partners in the development of vaccines, diagnostics and pathogen inactivation technology used to protect the U.S. blood supply.

(Reporting by Julie Steenhuysen in Chicago and Toni Clarke in Washington; editing by Grant McCool and Bernard Orr)

Six innovations scientists hope will end Malaria

An Anopheles stephensi mosquito obtains a blood meal from a human host through its pointed proboscis in this handout photo

By Katy Migiro

ARUSHA, Tanzania (Thomson Reuters Foundation) – After being abandoned as too ambitious in 1969, global plans to eliminate malaria are back on the agenda, with financial backing from the world’s richest couple, Bill and Melinda Gates, and U.S. President Barack Obama.

The Gateses aim to eradicate malaria by 2040 by doubling funding over the next decade to support the roll out of new products to tackle rising drug resistance against the disease.

Their goal of permanently ending transmission of the disease between humans and mosquitoes is more ambitious than the Sustainable Development Goal of ending epidemic levels of malaria by 2030.

They are also supporting a push to create the world’s first vaccine against a parasite.

Six innovations scientists are working on are:

* New insecticides: Mosquitoes are becoming resistant to insecticides used to spray inside homes and in bed nets.

“There is no current insecticide that doesn’t show insect-resistance at the moment,” said Jed Stone, a spokesman for the UK-based Innovative Vector Control Consortium (IVCC).

Indoor spraying of walls with insecticide — which was used to wipe out malaria in the United States in the 1940s — has fallen by 40 percent since 2012 due to resistance to older products and the high cost of newer ones.

The IVCC is developing three new insecticides for use in indoor sprays and bed nets that kill insecticide-resistant mosquitoes.

“The insecticides are virtually ready but it will take about five years to finally develop them,” Stone said, adding that this largely involves registration with regulators.

* A single-dose cure: A pill that would wipe out all parasites in the body could be available by 2019, the Gates Foundation says.

Human trials of one candidate are planned following successful tests on mice, published in 2015.

Existing drugs have to be taken for three days with the risk that people do not finish their medication, contributing to the development of drug-resistant malaria.

They also only kill parasites at the asexual-stage where they cause fever but not at the sexual-stage where they are picked up by mosquitoes in blood.

* Insecticide-treated wall liners: Scientists hope insecticide-treated wall liners, which look like wallpaper, will be more effective than spraying people’s homes with insecticide every three to eight months. The wall liners kill mosquitoes that rest on them and can last for three years.

Tanzania’s National Institute for Medical Research is testing wall liners in 6,000 homes to see if they protect people from malaria. Results will be published in 2017.

* Insecticide-embedded clothing: American soldiers have been wearing combat uniforms treated with permethrin, a synthetic insecticide, since 2010 to protect them against insect-borne diseases.

The U.S. government’s Walter Reed Army Institute of Research will test the effectiveness of treated combat uniforms and repellent creams in July on Tanzanian soldiers who often catch malaria when working at night as peacekeepers.

* A vaccine: This is a big one, given vaccines success in eliminating smallpox, polio and measles in many countries.

More than 30 malaria vaccines are under development.

The Mosquirix vaccine, discovered in 1987, is a decade ahead of other candidates but, to date, it only halves the number of bouts of malaria young children suffer.

The World Health Organization is seeking funding for a pilot program to administer Mosquirix to 400,000 to 800,000 African children. The results will be used to make a decision on whether to use the vaccine more widely.

* GM mosquitoes: Scientists have genetically modified (GM) mosquitoes by adding genes that block the development of the malaria parasite inside the insect and prevent it from being transmitted to people.

Scientists have also genetically modified mosquitoes to make them infertile, so that they die out. But many are cautious about the unforeseen consequences of this.

“When people imagine a malaria end game scenario, GM mosquito technology would be incredibly powerful because it doesn’t rely on a robust health system in order to go in and disrupt transmission of the parasite,” said Martin Edlund, chief executive of Malaria No More, referring to war-torn countries like South Sudan.

The International Center for Journalists and Malaria No More provided a travel grant for this report

(Reporting by Katy Migiro; Editing by Katie Nguyen; Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women’s rights, trafficking, property rights and climate change. Visit http://news.trust.org to see more stories.)

Presidents, billionaires battle World’s deadliest creature

Workers look for holes in mosquito netting at the A to Z Textile Mills factory producing insecticide-treated bednets in Arusha, Tanzania

By Katy Migiro

ARUSHA, Tanzania (Thomson Reuters Foundation) – Jakaya Kikwete, the former president of Tanzania, recalled arriving at his cousin’s house to find the family arguing about taking their feverish teenage daughter to hospital.

“They were saying: ‘No, no, no, it’s not malaria’,” he said, describing how the family had sought advice from a traditional medicine man who said a jinni, or spirit, had invaded her body.

“They said: ‘If you take this girl to the hospital, if she gets an injection, then that jinni (spirit)… will… suck all her blood’,” Kikwete said.

Ignoring their protests, he took the girl to hospital but it was too late. She died from malaria.

Kikwete, who also lost his brother to malaria as a child, is committed to eradicating the disease, which killed an estimated 438,000 people globally in 2015 – making the mosquito, which transmits it, the world’s deadliest creature.

He and his wife even appear in television adverts, urging Tanzanians to prepare their bednets before they sleep.

“We are looking at 2040 as the most probable date for a malaria-free Africa,” Kikwete, who stepped down as president in November, told reporters at a recent dinner in Dar es Salaam.

“If we continue with the interventions that we have been doing here relentlessly, we should be able to get there.”

THE “E-WORD”

Global plans to eliminate malaria were abandoned in 1969 as the goal was seen as prohibitively complicated and expensive, despite success in eradicating the disease in the 1950s in parts of Europe, North America and the Caribbean.

The “e-word” has been revived in recent years, with support from the world’s richest couple Bill and Melinda Gates and U.S. President Barack Obama, who called malaria a “moral outrage”.

Bill Gates, who Kikwete describes as a “good friend”, aims to eradicate malaria by 2040 and has called for a doubling of funding by 2025.

His goal of permanently ending transmission of the disease between humans and mosquitoes is more ambitious than the Sustainable Development Goal of ending epidemic levels of malaria by 2030.

Spending on malaria, mostly by the United States, surged to $2.7 billion in 2015 from $130 million in 2000, while death rates in Africa have fallen by 66 per cent, according to the World Health Organization (WHO).

The most important investment was the roll out of one billion free bednets. Some 68 percent of malaria cases prevented since 2000 were stopped by these bednets, according to a study by the University of Oxford.

Money was also poured into improved diagnostic tests, better drugs, indoor spraying with insecticide and educating the public to use these tools – rather than blaming witchcraft or buying medication blindly over the counter every time they got a fever.

EVERYTHING IS FREE

In the Tanzanian town of Arusha, overlooked by the dormant volcano Mount Meru, donor-funded bednets and free tests and medicines have made a significant impact.

In a country with a powerful faith in witchcraft and traditional medicine, health officials have worked hard to persuade people to adopt proven methods of preventing and treating the disease.

“There are very few cases of malaria nowadays,” said Pius Dallos, the officer in charge of Kijenge Dispensary, where women sat on wooden benches, cradling their babies.

“Previously… if you didn’t have money, you could die from malaria. But nowadays, everything is free.”

But donors’ ability to maintain – and increase – funding is by no means certain given sluggish global growth and uncertainties over U.S. funding under a new administration.

“The political will to go that final mile may be hard to sustain because it will remain expensive until the end,” Dyann Wirth, a tropical disease expert at Harvard T.H. Chan School of Public Health, told the Thomson Reuters Foundation.

“It’s a question of priority.”

It is unlikely that Africa, which accounted for nine out of 10 of the 214 million cases of malaria in 2015, according to the WHO, could foot the bill itself.

On the edge of Arusha, Africa’s largest bednet manufacturer, A to Z Textile Mills, has been the main source of 50 million free bednets given to Tanzanians between 2009 to 2016.

Giant, noisy warehouses produce insecticide-treated fibres which are woven into round and square blue bednets. Women in green T-shirts work in fast-moving pairs, folding and cutting panels ready for stitching.

Donor funding drives production of the much-needed nets, as many ordinary Tanzanians cannot afford them.

“Demand is not driven by the need (but) by the funding,” said factory director Kalpesh Shah, sitting in front of framed photographs of visits by celebrity campaigners like Bono and Will Smith on the boardroom wall.

Commercial customers account for less than one percent of sales, he said. The Gates-funded Global Fund To Fight HIV, Tuberculosis and Malaria is their main buyer, followed by the U.S. President’s Malaria Initiative.

“The question of sustainability is on everyone’s mind,” said Daniel Moore, acting mission director for the U.S. Agency for International Development (USAID) in Tanzania.

“Right now, we are carrying the load.”

RISK

The failure of the global eradication programme that began in the 1950s casts a shadow over the latest campaign.

As mosquitoes and parasites developed resistance to insecticides and drugs in the 1960s, malaria rebounded in countries like Sri Lanka where once it had been virtually eliminated.

Resistance is becoming a major problem again. But greater efforts are being made to invest in new products that will keep humans one step ahead of evolution.

New tools are also required to eliminate the parasite from ‘asymptomatic carriers’ – people with a few parasites in their blood who don’t fall sick but can act as reservoir and spread the disease when they get bitten again by mosquitoes.

As the number of malaria cases falls, it will become harder to maintain the momentum among donors, governments and ordinary people in endemic regions.

“Without the long term investment of funds and the political commitment to continue the fight, we risk wasting the entire investment,” said Wirth.

“We are going to go back to the situation where we are losing one million children a year in Africa.”

The International Center for Journalists and Malaria No More provided a travel grant for this report

(Reporting by Katy Migiro; Editing by Ros Russell; Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women’s rights, trafficking, property rights and climate change. Visit http://news.trust.org to see more stories.)

Zika mystery deepens with evidence of nerve cell infections

By Julie Steenhuysen

CHICAGO (Reuters) – Top Zika investigators now believe that the birth defect microcephaly and the paralyzing Guillain-Barre syndrome may be just the most obvious maladies caused by the mosquito-borne virus.

Fueling that suspicion are recent discoveries of serious brain and spinal cord infections – including encephalitis, meningitis and myelitis – in people exposed to Zika.

Evidence that Zika’s damage may be more varied and widespread than initially believed adds pressure on affected countries to control mosquitoes and prepare to provide intensive – and, in some cases, lifelong – care to more patients. The newly suspected disorders can cause paralysis and permanent disability – a clinical outlook that adds urgency to vaccine development efforts.

Scientists are of two minds about why these new maladies have come into view. The first is that, as the virus is spreading through such large populations, it is revealing aspects of Zika that went unnoticed in earlier outbreaks in remote and sparsely populated areas. The second is that the newly detected disorders are more evidence that the virus has evolved.

“What we’re seeing are the consequences of this virus turning from the African strain to a pandemic strain,” said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.

The Zika outbreak was first detected in Brazil last year and is spreading through the Americas. It has been linked to thousands of suspected cases of microcephaly, a typically rare birth defect marked by unusually small head size, signaling a problem with brain development. Evidence linking Zika to microcephaly prompted the World Health Organization to declare a global health emergency in February.

The suspicion that Zika acts directly on nerve cells began with autopsies on aborted and stillborn fetuses showing the virus replicating in brain tissues. In addition to microcephaly, researchers reported finding other abnormalities linked with Zika including fetal deaths, placental insufficiency, fetal growth retardation and injury to the central nervous system.

Doctors also are worried that Zika exposure in utero may have hidden effects, such as behavioral problems or learning disabilities, that are not apparent at birth.

“If you have a virus that is toxic enough to produce microcephaly in someone, you could be sure that it will produce a whole series of conditions that we haven’t even begun to understand,” said Dr. Alberto de la Vega, an obstetrician at San Juan’s University Hospital in Puerto Rico.

First discovered in the Zika forest of Uganda in 1947, the virus circulated quietly in Africa and Asia, causing rare infections and producing mild symptoms. A 2013 outbreak in French Polynesia, the largest at that time, led researchers to make the Guillain-Barre link. Other neurological effects were noted but scientists made little of them at the time.

A rare and poorly understood condition, Guillain-Barre can weaken muscles and cause temporary paralysis, often requiring patients to need respirators to breathe.

An estimated 32,000 people in the French Polynesia Zika outbreak were infected, and 42 patients were confirmed to have Guillain-Barre, a 20-fold increase in incidence over the previous four years, the WHO reported. Another 32 patients had other neurological disorders, including encephalitis, meningoencephalitis, myelitis and facial paralysis.

Guillain-Barre is an autoimmune disorder, in which the body attacks itself in the aftermath of an infection. But the newly discovered brain and spinal cord infections are known to be caused by a different mechanism – a direct attack on nerve cells. That has prompted scientists to consider whether the Zika virus also may infect nerves directly in adults, as they already have suspected in fetuses.

In medical journals published last month, doctors described neurological syndromes in two patients that they attributed to Zika. Doctors in Paris diagnosed meningoencephalitis, an infection of both the brain and spinal cord, in an 81-year-old man who was hospitalized after being exposed to Zika on a cruise.

Another French team reported acute myelitis, a paralyzing infection of the spinal cord, in a 15-year-old girl who had been infected with Zika on the French Caribbean island of Guadeloupe.

In its latest surveillance report, the WHO said the two cases “highlight the need to better understand the range of neurological disorders associated with Zika-virus infection.”

Other mosquito-borne viruses – including dengue, Japanese encephalitis and West Nile – are known to directly infect nerve cells in the brain and spinal cord. But such viruses are seldom associated with Guillain-Barre, and never with microcephaly, said Baylor’s Hotez.

POSSIBLE EVOLUTION

In a recent paper, WHO researcher Mary Kay Kindhauser wrote that Zika “appears to have changed in character,” noting its transition from a mild infection to one causing “large outbreaks linked with neurological disorders.”

Scientists studying Zika in Brazil now are reporting the same neurological disorders seen in French Polynesia. From April through July 2015, doctors in Brazil identified a spike in Guillain-Barre cases.

In Salvador, there were roughly 50 reported cases of Guillain-Barre in July alone, far more than would typically be expected, Dr. Albert Ko, a tropical disease expert from Yale University who is studying Zika in the coastal city of Salvador, recently told a research symposium.

“Throughout Brazil, doctors have seen strange, atypical, neurological manifestations,” Ko said told the symposium.

Zika exposed patients have had other neurological problems as well, including acute disseminated encephalomyelitis, which causes inflammation of the myelin, the protective sheath covering nerve fibers in the brain and spinal cord. Other patients experienced tingling, prickling or burning sensations, which are often markers of peripheral nerve damage.

In addition to Brazil and French Polynesia, at least 11 more countries and territories have reported hundreds of cases of Guillain-Barre syndrome linked to Zika. In Brazil, Guillain-Barre cases jumped 19 percent to 1,708 last year.

El Salvador, a country that has an annual average of 196 cases of Guillain-Barre, reported 118 cases in six weeks in December and January.

Zika’s arrival in Colombia in October 2015 was associated with another increase in Guillain-Barre cases. The country typically reports 242 cases of the syndrome a year, or about five a week. But in the five weeks starting in mid-December, Colombia reported 86 cases of Guillain-Barre, or about 17 a week.

Dr. Carlos Pardo-Villamizar, a neurologist at Johns Hopkins University School of Medicine, is studying Zika complications with colleagues in five Colombian research centers. They have seen cases of encephalitis, myelitis and facial paralysis associated with Zika and want to understand what is triggering these complications.

They also want to study whether prior infection with dengue or chikungunya – two related viruses – are contributing to neurological disorders seen in patients with Zika.

Scientists are turning their attention next to Puerto Rico, where Zika is expected to infect hundreds of thousands of residents by year-end.

More cases hold the potential for “a better sense of the full spectrum of disease that Zika is capable of causing,” said Dr. Amesh Adalja of the Center for Health Security at the University of Pittsburgh Medical Center.

(Reporting by Julie Steenhuysen; additional reporting by Anthony Boadle in Brasilia, Brazil; Editing by Michele Gershberg and Lisa Girion)

WHO says Zika ‘spreading explosively,’ 4 million cases a possibility

GENEVA (Reuters) – The Zika virus, linked to severe birth defects in thousands of babies in Brazil, is “spreading explosively” and could infect as many as 4 million people in the Americas, the World Health Organization (WHO) said on Thursday.

Director-General Margaret Chan told members of the U.N. health agency’s executive board the spread of the mosquito-borne disease had gone from a mild threat to one of alarming proportions. The WHO would convene an emergency meeting on Monday to help determine its response, she said.

“The level of alarm is extremely high,” Chan told the Geneva gathering.

“Last year, the virus was detected in the Americas, where it is now spreading explosively. As of today, cases have been reported in 23 countries and territories in the region,” Chan said, promising quick action from the WHO.

The agency was criticized last year for reacting too slowly to West Africa’s Ebola epidemic, which killed more than 10,000 people, and it promised to cut its response time.

“We are not going to wait for the science to tell us there is a link (with birth defects). We need to take actions now,” Chan said, referring to the condition called microcephaly in which babies are born with abnormally small heads and brains that have not developed properly.

There is no vaccine or treatment for Zika, which is like dengue and causes mild fever, rash and red eyes. An estimated 80 percent of people infected have no symptoms. Much of the effort against the illness focuses on protecting people from mosquitoes and reducing mosquito populations.

Developing a safe and effective vaccine could take a year, WHO Assistant Director Bruce Aylward said, and it would take six to nine months just to confirm whether Zika is the actual cause of the birth defects, or if the two are just associated.

“In the area of vaccines, I do know that there has been some work done by some groups looking at the feasibility of a Zika virus vaccine. Now something like that, as people know, is going to be a 12-month-plus time frame,” he said.

U.S. health officials said the United States has two potential candidates for a Zika vaccine and may begin human clinical trials by the end of this year, but there will not be a widely available vaccine for several years.

Marcos Espinal, head of communicable diseases at the Pan American Health Organization, the WHO’s Americas arm, forecast 3 to 4 million Zika cases in the Americas.

As the virus spreads from Brazil, other countries in the Americas are likely to see cases of babies with Zika-linked birth defects, according to Carissa Etienne, regional director for the Pan American Health Organization.

Brazil has reported around 4,000 suspected cases of microcephaly, vastly more than in an average year and equivalent to 1 to 2 percent of all newborns in the state of Pernambuco, one of the worst-hit areas.

The WHO’s Chan said that while a direct causal relationship between Zika virus infection and birth malformations has not yet been established, it is strongly suspected.

“The possible links, only recently suspected, have rapidly changed the risk profile of Zika from a mild threat to one of alarming proportions,” she said.

Health and law expert Lawrence Gostin of Georgetown University in Washington, who had urged the WHO to act, welcomed Chan’s decision to convene an expert meeting, calling it “a critical first step in recognizing the seriousness of an emerging epidemic.”

OLYMPICS CONCERNS

With Rio de Janeiro set to host the Olympics from Aug. 5 to Aug. 21, International Olympic Committee President Thomas Bach said the IOC will issue guidelines this week concerning Zika.

“We will do everything to ensure the health of the athletes and all the visitors,” Bach told reporters in Athens.

Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention, said there have been 31 cases of Zika infection among U.S. citizens who traveled to areas affected by the virus.

“It’s possible and even likely that we will see limited outbreaks in the United States,” Schuchat said.

In Washington, U.S. Senator Edward Markey of Massachusetts called on the WHO and the U.S. Department of Health and Human Services to explain how they were tackling the virus because many Americans visit the affected region and more are expected to attend the Olympics.

White House spokesman Josh Earnest said President Barack Obama’s administration’s concern was focused mostly on pregnant women or women who could become pregnant, given the link to microcephaly.

Lufthansa, British Airways and JetBlue became the latest international carriers to offer rebookings or refunds for tickets to areas impacted by the virus.

Lufthansa and British Airways said they would offer pregnant women the opportunity to change their reservations to another destination or delay travel. They stopped short of offering complete refunds as several U.S. airlines have.

(Additional reporting by Kate Kelland in London; Additional reporting by Susan Heavey in Washington and Julie Steenhuysen in Chicago; Writing by Kate Kelland and Will Dunham; Editing by Mark Heinrich and Frances Kerry)

Zika reported in travelers who returned to California, Arkansas and Virginia

Travelers who recently returned to California, Arkansas and Virginia from foreign countries have tested positive for the Zika virus, health officials in those states announced Tuesday.

The Centers for Disease Control and Prevention (CDC) maintains that there haven’t been any people who have contracted the mosquito-borne virus in the United States, though there have been several cases where travelers got infected overseas and brought the virus back with them.

Zika is collecting the attention of public health officials because scientists are studying a possible link between the virus and a rare condition called microcephaly, in which children are born with smaller-than-usual heads. The birth defect can also be caused by other factors, the CDC says.

Still, the CDC has issued travel notices for 22 countries or territories where Zika is currently being spread, urging pregnant women to consider postponing any planned travel to those areas and asking all would-be travelers to “practice enhanced precautions” to prevent mosquito bites.

The three cases announced Tuesday all involved foreign travel.

In a statement, the Virginia Department of Health said the infection was confirmed in “an adult resident of Virginia who recently traveled to a country where Zika virus transmission is ongoing,” but did not elaborate. The infected individual was the state’s first imported Zika case, but isn’t at risk of transmitting the virus because it isn’t currently mosquito season in Virginia.

The Arkansas Department of Health said one of the state’s residents “recently traveled out of the country and had a mild case of Zika.” Officials confirmed the diagnosis late Monday afternoon.

“Arkansas has the kind of mosquitoes that carry Zika virus, so mosquitoes here in Arkansas can become infected with the virus if they bite someone who has Zika,” Dr. Nate Smith, the Arkansas Department of Health Director and State Health Officer, said in a statement. “For this reason, people traveling to countries with Zika should avoid mosquito bites for 10 days after they return.”

The Los Angeles County Department of Public Health said an adolescent girl who traveled to El Salvador last November was the county’s lone confirmed case of Zika, but she has recovered.

“At this time, local transmission is unlikely,” the department said in a statement. “It would require an Aedes mosquito biting a Zika infected person and then biting others.”

The CDC says only about 20 percent of people who are infected with Zika become ill and develop symptoms like fever, rash and joint pain. Most people fully recover from the illness in a week.

The possible link between Zika and microcephaly is a key component of the travel warnings.

The Brazilian Ministry of Health has investigated more than 4,100 microcephaly cases in the past 13 months, according to data released Wednesday. The ministry used to see fewer than 200 cases of the condition every year, though the numbers have surged since Zika arrived in May.

The Hawaii Department of Health has said a child who was recently born with microcephaly there had been infected with Zika, and his mother likely got the virus when she lived in Brazil.

The CDC says it will also be conducting a study to examine a possible link between Zika and Guillain-Barre Syndrome, a nerve disorder than can lead to muscle weakness and paralysis. Many fully recover from the syndrome, the CDC says, though it can be fatal in rare instances.

The World Health Organization is holding an information session on Zika tomorrow.

The organization says it’s possible the virus could cause epidemics in new areas it reaches because people don’t have immunity to it. There’s also currently no vaccine to prevent it.

U.S. boosts study of Zika, birth defect link as virus seen spreading

CHICAGO (Reuters) – U.S. health officials are stepping up efforts to study the link between Zika virus infections and birth defects in infants amid predictions for widespread circulation of the mosquito-borne virus within the United States during warmer months.

The U.S. Director of the National Institutes of Health on Tuesday called for intensified efforts to study the impact of Zika infections, citing a recent study estimating the virus could reach regions where 60 percent of the U.S. population lives.

The mosquito-borne virus has been linked to brain damage in thousands of babies in Brazil. There is no vaccine or treatment for Zika, a close cousin of dengue and chikungunya, which causes mild fever and rash. An estimated 80 percent of people infected have no symptoms, making it difficult for pregnant women to know whether they have been infected.

On Monday, the World Health Organization predicted the virus would spread to all countries across the Americas except for Canada and Chile.

In a blog post, NIH Director Dr. Francis Collins cited a Lancet study published Jan. 14 in which researchers predicted the Zika virus could be spread in areas along the East and West Coasts of the United States and much of the Midwest during warmer months, where about 200 million people live.

The study also showed that another 22.7 million people live in humid parts of the country where mosquitoes carrying the virus could live year round.

Given the threat, Collins said “it is now critically important to confirm, through careful epidemiological and animal studies, whether or not a causal link exists between Zika virus infections in pregnant women and microcephaly in their newborn babies.” Microcephaly results in babies being born with abnormally small heads.

Experts say there is still much to learn about Zika infections. For example, it is not clear how common Zika infections are in pregnant women, or when during a pregnancy a woman is most at risk of transmitting the virus to her fetus.

Collins said the National Institute of Allergy and Infectious Disease is conducting studies to more fully understand the effects of Zika in humans, and to develop better diagnostic tests to quickly determine if someone has been infected. The NIAID is also working on testing new drugs that might be effective against the virus.

The blog post was followed by the announcement on Tuesday of new guidelines from the U.S. Centers for Disease Control and Prevention providing instructions for pediatricians treating infants whose mothers may have been exposed to the virus during pregnancy.

In those guidelines, the CDC makes clear that Zika virus is considered a nationally notifiable condition, and instructs doctors to contact their state or territorial health departments to facilitate testing of potentially infected infants.

The guidelines for the care of infants affected by Zika infections follows CDC guidelines for caring for pregnant women exposed to Zika virus, which were first reported by Reuters. The CDC said last week it is trying to determine how many pregnant women may have traveled to affected regions in the past several months.

(Reporting by Julie Steenhuysen; Editing by James Dalgleish)

Hawaiian child born with birth defect was infected with Zika virus

A Hawaiian child who was recently born with a rare birth defect called microcephaly had been infected with the mosquito-borne Zika virus, the state Department of Health announced.

Officials made the announcement on Friday, the same day the Centers for Disease Control and Prevention (CDC) issued updated travel warnings for regions where Zika outbreaks are present.

The Zika virus usually only causes a mild illness and most people typically recover in a week, the CDC says, but the virus is collecting global attention because scientists are currently working to see if it is responsible for causing birth defects such as the one found in the Hawaiian child.

According to the CDC, children born with microcephaly have smaller-than-usual heads, and the defect may lead to other issues such as seizures, developmental delays and vision problems.

The Brazilian Ministry of Health reported a significant rise in the birth defect since the virus arrived in May. The country used to see fewer than 200 cases per year, but now has about 3,500.

The Hawaiian baby’s mother was living in Brazil last May, the state Department of Health said in a news release, and likely transmitted the virus to her child while he or she was in the womb.

Microcephaly can be caused by a variety of issues including genetic changes, malnutrition, alcohol exposure and certain kinds of infections, according to the CDC, but it’s still a relatively rare defect and only surfaces in about 2-12 babies out of every 10,000 born in the United States.

“We are saddened by the events that have affected this mother and her newborn,” Hawaii Department of Health State Epidemiologist Sarah Park said in a statement.

Hawaii health officials said neither the mother nor the child are currently at risk of transmitting Zika, nor were they ever at risk of spreading the virus throughout Hawaii. The country has yet to see a locally contracted case of Zika, the CDC has said.

However, the Hawaii Department of Health reported six people have gotten infected while visiting foreign countries and returned to the state.

The CDC on Friday sent out updated travel notices for Puerto Rico, Mexico, Central America, South America and the Caribbean, where Zika is found in local mosquitos, asking travelers — especially pregnant women — to “practice enhanced precautions” to prevent mosquito bites. Previously, the CDC had only been asking travelers to “practice usual precautions.”

There isn’t any vaccine against a Zika infection, the CDC says.

“The virus is spreading fairly rapidly throughout the Americas,” Dr. Lyle Petersen, the director of CDC’s division of vector-borne diseases, told reporters during a Friday evening news briefing, according to a transcript posted on the CDC’s website. “We know in populations that it does affect, a large percentage of the population may be become infected. And because of this growing risk of or growing evidence that there’s a link between Zika virus and microcephaly, which is a very severe and devastating outcome, it was important to warn people as soon as possible.”

Petersen told the news briefing that the CDC recently found its “strongest scientific evidence to date” of a link between Zika and “poor pregnancy outcomes” like microcephaly, but more tests and studies were needed to determine the risks the Zika virus may pose to pregnant women.

Common symptoms of Zika include fever, joint pain and rash, the CDC says. However, Petersen told the news briefing that only 1 in 5 people infected with the virus will display those symptoms.

Petersen also told reporters there have been at least eight United States travelers who tested positive for Zika after traveling overseas in the past 15 months, compared to just 12 who tested positive for the virus between 2007 and 2014. And the CDC is also still receiving samples from people displaying symptoms, so that number could increase as more test results come back.

While the specific kind of mosquito that transmit the virus are present in parts of the United States, Petersen told reporters that improvements in housing construction, air conditioning and mosquito control have helped prevent large outbreaks of other mosquito-borne illnesses.

He told the news briefing it would be difficult to determine exactly how Zika may spread in the coming months.

“I think we’re just going to have to wait to see how this all plays out,” he told reporters. “These viruses certainly can spread in populations for some time. But, again, this is new. This is a dynamic and changing situation. I think it’s really impossible for us to speculate what may happen in three or four or even next month for that matter.”

Separately, Hawaii is dealing with another outbreak of a mosquito-borne illness.

The state Department of Health says there have been 223 cases of dengue fever since Sept. 11. It’s the first locally-acquired outbreak of the disease since 2011.

The World Health Organization says dengue, which can cause fevers, headaches, muscle and joint pains and rashes, has become increasingly common in the past 50 years — spreading to more than 100 countries and placing about half the world’s population at risk of an infection.

CDC Issues Travel Notice After Zika Virus Arrives in Puerto Rico

Health officials are warning would-be travelers about the spread of a mosquito-borne illness that might be causing a growing number of children to be born with smaller-than-usual heads.

Late last week, the Centers for Disease Control and Prevention (CDC) issued a travel notice for Puerto Rico after the island reported its first locally contracted case of the virus. The advisory encourages travelers to take proactive steps to prevent mosquito bites, like wearing insect repellant and long clothing. The CDC has issued similar warnings for Mexico, Central America and South America, as several other countries have said the virus has sickened humans there.

Zika often causes people to experience fever, joint pain, rashes and red eyes for up to a week, the CDC says, but the illness seldom results in hospitalization. However, the Brazilian Ministry of Health recently said it was investigating about 3,000 cases of microcephaly, a neurological disorder in which children are born with unusually small heads and underdeveloped brains.

Before this year, the ministry said it usually saw about 150-170 annual cases of microcephaly. But since the Zika virus arrived in May, the ministry said the number of suspected cases have surged to 2,975. Authorities are currently examining if there’s a conclusive link between the two.

The CDC said test results have shown that some Brazilian babies with microcephaly were infected with Zika, but other babies developed microcephaly and tested negative for the virus. There are other possible causes for the defect, so it will take some time to determine the culprit. Still, the CDC says woman who are pregnant should be extra careful to prevent mosquito bites.

There isn’t any vaccine that can prevent the virus or any medicine that can treat it, according to the CDC. Because the mosquitos that transmit Zika live all across the planet, the organization says it’s likely that the virus could spread to new regions where illnesses have yet to be reported.

The virus can remain in the bloodstreams of infected individuals for about a week, according to the CDC, during which time it’s extra important to avoid mosquito bites to prevent transmission. While the organization reports no one has acquired Zika in the United States, there has been at least one instance where a traveler got sick while visiting a foreign country and returned home.

Hawaii Reports Additional Cases of Dengue Fever

The number of people infected with dengue fever in Hawaii is climbing, officials said Monday.

The Hawaii Department of Health reported that it was investigating 167 total cases of the mosquito-borne illness, which can lead to fatal consequences in extreme cases. There were 122 confirmed dengue cases as of Dec. 2, signifying 45 additional infections in about three weeks.

State health officials said only three of the 167 cases are currently infectious. The other people got sick between Sept. 11 and Dec. 10, so they are no longer at risk of transmitting the disease.

The health department also reported there were 659 additional potential dengue infections that had been ruled out, either through test results or the illnesses failing to meet the case criteria.

Dengue isn’t endemic (regularly found) in Hawaii, though health officials said it can occasionally be brought in from travelers who got infected in endemic regions. But this latest outbreak on the Big Island is unique because it’s the first cluster of locally acquired cases since 2011, when Centers for Disease Control and Prevention (CDC) records indicate five people got sick in Oahu.

According to the World Health Organization (WHO), an arm of the United Nations, dengue is transmitted when an infected mosquito bites a human. The infection generates a flu-like illness — from which most people usually recover within a week — though it sometimes progresses to severe dengue. In those instances, people can suffer organ impairment and severe bleeding.

The WHO estimates severe dengue hospitalizes about 500,000 people per year, and about 2.5 percent of them die. Dengue is much more common, with some estimates indicating as many as 136 million people falling ill every year, but non-severe cases of the disease are rarely ever fatal. Symptoms can include severe headaches, swollen glands, joint and muscle pain and a high fever.

The Hawaii outbreak reflects a global trend in which dengue is spreading to new locales.

The WHO reports the disease was traditionally found in the tropics and subtropics, but it’s now endemic in more than 100 countries and about half the world’s population is at risk of infection. Still, early detection and access to good medical care keeps the mortality rate below 1 percent. Without those, the WHO says severe dengue can be fatal in more than 20 percent of cases.

Hawaii health officials say it’s still safe to visit the island. The department encourages travelers to use insect repellant and wear long sleeves and pants to help prevent mosquitos from biting.

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