The Jim Bakker Show

Infant mortality and malaria soar in Venezuela, according to government data

Pregnant women lay on beds without sheets during their labour at a maternity hospital in Maracaibo, Venezuela June 19, 2015. REUTERS/Isaac Urrutia

By Alexandra Ulmer

CARACAS (Reuters) – Venezuela’s infant mortality rose 30 percent last year, maternal mortality shot up 65 percent and cases of malaria jumped 76 percent, according to government data, sharp increases reflecting how the country’s deep economic crisis has hammered at citizens’ health.

The statistics, issued on the ministry’s website after nearly two years of data silence from President Nicolas Maduro’s leftist government, also showed a jump in illnesses such as diphtheria and Zika. It was not immediately clear when the ministry posted the data, although local media reported on the statistics on Tuesday.

Recession and currency controls in the oil-exporting South American nation have slashed both local production and imports of foreign goods, and Venezuelans are facing shortages of everything from rice to vaccines. The opposition has organized weeks of protests against Maduro, accusing him of dictatorial rule and calling for elections.

In the health sector, doctors have emigrated in droves and patients have to settle for second-rate treatment or none at all. A leading pharmaceutical association has said roughly 85 percent of medicines are running short. Venezuelans often barter medicine, post pleas on social media, travel to neighboring countries if they can afford it, or line up for hours at pharmacies.

The Health Ministry had stopped releasing figures after July 2015, amid a wider data blackout. It was not clear why it published this latest batch of data.

Its statistics for 2016 showed infant mortality, or death of children aged 0-1, climbed 30.12 percent to 11,466 cases last year. The report cited neonatal sepsis, pneumonia, respiratory distress syndrome, and prematurity as the main causes.

Hospitals often lack basic equipment like incubators, and pregnant women are struggling to eat well, including taking folic acid, factors that can affect a baby’s health.

(To read the story on Venezuelan women seeking sterilizations as crisis sours child-rearing, click http://www.reuters.com/article/us-venezuela-sterilizations-idUSKCN10E1NK)

Maternal mortality, or death while pregnant or within 42 days of the end of a pregnancy, was also up, rising 65.79 percent to 756 deaths, the report said.

The Health Ministry did not respond to a request for further information. Maduro’s government says a coup-mongering elite is hoarding medicines to stoke unrest.

‘TURMOIL’

While Venezuelans are acutely aware of the country’s health issues, the ministry’s statistics bulletin shocked some in the medical community.

“The striking part is turmoil in almost all the categories that this bulletin addresses, with particularly significant increases in the infant and maternal health categories,” said Dr. Julio Castro, an infectious disease specialist and an outspoken critic of the government’s health policies.

Doctors say the health bulletins, meant to be released weekly, should be published in a timely fashion to alert medical practitioners to national trends and threats.

Venezuela, for instance, had controlled diphtheria, a bacterial infection that is fatal in 5 to 10 percent of cases, in the 1990s. Doctors last year sounded the alarm that it had returned, but the government initially said there were no proven cases and admonished those seeking to spread “panic.”

The data now shows diphtheria affected 324 people – up from no cases the previous year.

Diphtheria was once a major global cause of child death but is now increasingly rare thanks to immunizations, and its return showed how vulnerable the country is to health risks.

Reuters documented the case of a 9-year-old girl, Eliannys Vivas, who died of diphtheria earlier this year after being misdiagnosed with asthma, in part because there were no instruments to examine her throat, and shuttled around several run-down hospitals.

(For a story on “Venezuelan girl’s diphtheria death highlights country’s health crisis”, click http://www.reuters.com/article/us-venezuela-health-idUSKBN15P1DA)

There were also 240,613 cases of malaria last year, up 76.4 percent compared with 2015, with most cases of the mosquito-borne disease reported in the rough-and-tumble Bolivar state.

Cases of Zika rose to 59,348 from 71 in 2015, reflecting the spread of the mosquito-borne virus around Latin America last year. There was no data for likely Zika-linked microcephaly, where babies are born with small heads, although doctors say there have been at least several dozen cases.

(To read the story on “Amid government silence, Venezuela’s microcephaly babies struggle”, click http://www.reuters.com/article/us-health-zika-venezuela-idUSKBN12H1NY)

(Reporting by Alexandra Ulmer; Editing by Girish Gupta and Frances Kerry)

Top U.S. chicken producing state suffers first case of bird flu

quarantine researcher checking chickens on poultry farm for bird flu

By Tom Polansek

CHICAGO (Reuters) – Georgia has confirmed its first-ever case of bird flu in commercial poultry, its agriculture department said on Monday, widening an outbreak of the disease into the United States’ biggest chicken meat-producing state.

A flock of 18,000 chickens used for breeding was culled after testing positive for H7 bird flu, according to the agriculture department. It said the birds in far northwestern Georgia were likely infected with a form of the virus that is not highly lethal because the flock did not show signs of illness.

The discovery came after officials in Alabama, Kentucky and Tennessee confirmed cases of highly pathogenic, or lethal, and low pathogenic H7N9 bird flu in breeding operations this month. U.S. officials have said the risk of the disease spreading to people from poultry or making food unsafe is low.

But the spread of highly pathogenic bird flu to poultry in new states would represent a financial risk for meat companies because it could kill more birds or require flocks to be culled. It could also trigger more import bans from other countries after South Korea and other buyers limited U.S. poultry shipments following highly pathogenic cases in Tennessee.

The worst-ever U.S. outbreak of highly pathogenic bird flu in poultry in 2014 and 2015 killed about 50 million birds, most of which were egg-laying hens in Iowa.

More than 200,000 breeding chickens in Georgia, Alabama, Tennessee and Kentucky have been killed in recent weeks by high and low pathogenic bird flu or culled to contain the virus, according to state officials. U.S. poultry producers had about 55.1 million breeder hens on hand as of March 1, according to the USDA.

In 2015, Georgia produced 7.9 billion pounds of chicken meat valued at $4.2 billion, the agency said.

“Poultry is the top sector of our number one industry, agriculture, and we are committed to protecting the livelihoods of the many farm families that are dependent on it,” Gary Black, Georgia’s agriculture commissioner, said in a statement.

Some companies are still feeling pressure related to the 2015 losses.

On Monday, Cal-Maine Foods, the biggest U.S. egg producer, said its quarterly sales fell about 32 percent from a year ago because prices were under pressure after farmers increased production in response to an outbreak two years ago.

(Reporting by Tom Polansek; Editing by Andrew Hay)

U.S. reports low pathogenic bird flu outbreak in Wisconsin: OIE

PARIS (Reuters) – The United States reported an outbreak of avian flu on a farm in Wisconsin, the second in the country in less than a week although the virus found this time is considered less virulent, the World Organisation for Animal Health (OIE) said on Tuesday.

A strain of low pathogenic H5N2 avian flu has been discovered in a flock of 84,000 turkeys in Barron County, Wisconsin, the U.S. Department of Agriculture (USDA) said in a report posted on the website of the Paris-based OIE.

The USDA said the turkey flock was tested after birds showed signs of depression and the infected premises were quarantined.

The new outbreak comes after the detection of highly pathogenic H7 bird flu last week in a chicken breeder flock in Tennessee farm contracted by U.S. food giant Tyson Foods Inc.

As opposed to highly pathogenic strains which can cause high mortality rates among poultry, low pathogenic ones typically cause few or no clinical signs in birds.

In 2014 and 2015, during a widespread outbreak of highly pathogenic avian flu, primarily of the H5N2 strain, the United States killed nearly 50 million birds, mostly egg-laying hens. The losses pushed U.S. egg prices to record highs.

The USDA said tests had shown that the H5N2 virus detected in Wisconsin was of North American wild bird origin and distinct from the H5N2 viruses found in 2015.

The risk of human infection in poultry outbreaks is low, although in China more than 110 people died this winter amid an outbreak of the H7N9 virus in birds.

The detection of a first case of bird flu in the United States this year prompted several Asian countries, including South Korea, Japan, Taiwan and Hong Kong, to limit imports of U.S. poultry.

(Reporting by Sybille de La Hamaide and Gus Trompiz, editing by David Evans)

Hard to detect, China bird flu virus may be more widespread

By Dominique Patton

BEIJING (Reuters) – Bird flu infection rates on Chinese poultry farm

BEIJING (Reuters) – Bird flu infection rates on Chinese poultry farms may be far higher than previously thought, because the strain of the deadly virus that has killed more than 100 people this winter is hard to detect in chickens and geese, animal health experts say.

s may be far higher than previously thought, because the strain of the deadly virus that has killed more than 100 people this winter is hard to detect in chickens and geese, animal health experts say.

Poultry that have contracted the H7N9 strain of the avian flu virus show little or no sign of symptoms. That means any infection is only likely to be detected if farmers or health authorities carry out random tests on a flock, the experts said.

But in humans, it can be deadly.

That’s different to other strains, such as the highly pathogenic H5N6 that struck South Korean farms in December, prompting the government to call in the army to help cull some 26 million birds.

But that strain didn’t kill any people.

There have been multiple outbreaks of bird flu around the world in recent months, with at least half a dozen different strains circulating. The scale of the outbreaks and range of viral strains increases the chances of viruses mixing and mutating, with new versions that can spread more easily between people, experts say.

For now, H7N9 is thought to be relatively difficult to spread between people. China’s Center for Disease Control and Prevention has said the vast majority of people infected by H7N9 reported exposure to poultry, especially at live markets.

“There are very few, if any, clinical signs when this (H7N9) virus infects birds, and that’s the main reason we’re not seeing reporting coming from poultry farms in China,” said Matthew Stone, deputy director general for International Standards and Science at the World Organisation for Animal Health (OIE).

INTENSIVE OUTBREAK

As many as 79 people died from H7N9 bird flu in China in January alone, up to four times higher than the same month in past years.

While spikes in contamination rates are normal in January – the main influenza season – the high level of human infections has prompted fears the spread of the virus among people could be the highest on record – especially as the number of bird flu cases reported by farmers has been conspicuously low.

The high number of human infections points to a significant outbreak in the poultry population that is not being detected, says Guan Yi, director of the State Key Laboratory of Emerging Infectious Diseases and the Center of Influenza Research at the University of Hong Kong.

“If we have so many human infections, naturally it reflects activity, an intensive outbreak in chickens. They are highly associated,” he said.

China has the world’s largest flock of chickens, ducks and geese, and slaughtered more than 11 billion birds for meat in 2014, according to the United Nations’ Food and Agriculture Organisation (FAO).

The last major bird flu outbreak in China, in 2013, killed 36 people and cost the farming industry around $6.5 billion.

CONTROL CHALLENGE

The experts’ assessment underscores the challenge for China’s government and health ministry in monitoring and controlling the H7N9 outbreak in both people and poultry.

While, with few visible signs of infection in birds, it’s easier for farmers to flout the reporting rules and continue selling poultry at market, Stone at the OIE said China has a “very significant” surveillance program at live markets.

The government promised on Thursday to tighten controls on markets and poultry transport to help battle the virus.

The agriculture ministry last month collected more than 102,000 serum samples and 55,000 virological samples from birds in 26 provinces. Of the latter samples, only 26 tested positive for the virus, according to data on the ministry’s website.

But the rapid rise in human infections and spread to a wider geographic area is likely to increase pressure on Beijing to do more poultry testing at markets and on farms.

The ministry did not respond to faxed questions on its surveillance efforts.

The National Health and Family Planning Commission said on Thursday the spread of H7N9 among people was slowing.

Some Chinese netizens have called for more timely reports on infections, and some experts have said China has been slow to respond to the human outbreak. The authorities have warned the public to stay alert for the virus, cautioning against panic.

Others played down the threat to humans, as long as they stay away from live markets.

“As scientists, we should be watching this outbreak and the effectiveness of any control measures,” said Ian Mackay, a virologist and associate professor at the University of Queensland in Australia. “We don’t have a vaccine available for H7N9 in humans, but we do have effective antivirals.”

“So far, the virus does not spread well between humans,” he added. “As members of the public, who do not seek out live poultry from markets in China, we have almost nothing to worry about from H7N9 right now.”

(Reporting by Dominique Patton in BEIJING, with additional reporting by Ben Hirschler in LONDON; Editing by Josephine Mason and Ian Geoghegan)

Yellow fever kills 600 monkeys in Brazil’s Atlantic rainforest

By Anthony Boadle

BRASILIA (Reuters) – An outbreak of yellow fever has claimed the lives of more than 600 monkeys and dozens of humans in Brazil’s Atlantic rainforest region, threatening the survival of rare South American primates, a zoologist said on Wednesday.

The monkeys, mostly brown howlers and masked titis, are falling out of trees and dying on the ground in the forests of Espirito Santo state in Brazil’s southeast.

“The number of dead monkeys increases every day,” said Sergio Lucena, he said of the impact of the disease’s spread in his state, “We now know that the rare buffy-headed marmoset is also threatened by the yellow fever virus and dying.”

The howler’s sounds closely resemble grunts or barks. It was the silence that fell on the forests that first alerted farmers that something was amiss, sparking specialists to investigate.

The masked titi is considered as “vulnerable” by the Swiss-based International Union for Conservation of Nature, which has placed it on its Red List of Threatened Species.

No evidence has so far surfaced of the affliction felling woolly spider monkeys, considered one of the world’s most endangered by the IUCN.

WORST YELLOW FEVER OUTBREAK IN DECADES

Brazil is suffering the worst yellow fever outbreak in decades that has killed at least 69 humans, nearly all in central state of Minas Gerais, where the problems began.

Most people recover from yellow fever after the first phase of infection, which usually involves fever, headache, shivers, loss of appetite and nausea or vomiting, according to the World Health Organization.

Millions of Brazilians have been vaccinated as health authorities scramble to prevent the outbreak from turning into an epidemic. There is no such protection available for monkeys.

Yellow fever is a viral disease found in tropical regions of Africa and the Americas that mainly affects humans and monkeys and is transmitted by the same type of mosquito that spreads dengue and the Zika virus.

Hundreds of thousands of people died from it in the Americas before a vaccine was developed in 1938.

Brazil’s federal health officials are investigating if the latest outbreak is linked to a tailings dam collapse last year in Minas Gerais at the Samarco iron ore mine co-owned by BHP
Billiton and Vale SA.

The dam accident, which polluted the Rio Doce river, is regarded as the country’s worst environmental disaster.

Some scientists have said that calamity may have made the monkeys more susceptible to contracting yellow fever by decimating their habitat and food supplies.

Proliferation of bird flu outbreaks raises risk of human pandemic

wokers gather ducks that may have bird flu

By Kate Kelland

LONDON (Reuters) – The global spread of bird flu and the number of viral strains currently circulating and causing infections have reached unprecedented levels, raising the risk of a potential human outbreak, according to disease experts.

Multiple outbreaks have been reported in poultry farms and wild flocks across Europe, Africa and Asia in the past three months. While most involve strains that are currently low risk for human health, the sheer number of different types, and their presence in so many parts of the world at the same time, increases the risk of viruses mixing and mutating – and possibly jumping to people.

“This is a fundamental change in the natural history of influenza viruses,” Michael Osterholm, an infectious disease specialist at University of Minnesota, said of the proliferation of bird flu in terms of geography and strains – a situation he described as “unprecedented”.

Global health officials are worried another strain could make a jump into humans, like H5N1 did in the late 1990s. It has since caused hundreds of human infections and deaths, but has not acquired the ability to transmit easily from person to person.

The greatest fear is that a deadly strain of avian flu could then mutate into a pandemic form that can be passed easily between people – something that has not yet been seen.

While avian flu has been a prominent public health issue since the 1990s, ongoing outbreaks have never been so widely spread around the world – something infectious disease experts put down to greater resilience of strains currently circulating, rather than improved detection or reporting.

While there would normally be around two or three bird flu strains recorded in birds at any one time, now there are at least half a dozen, including H5N1, H5N2, H5N8 and H7N8.

The Organization for Animal Health (OIE) says the concurrent outbreaks in birds in recent months are “a global public health concern”, and the World Health Organization’s director-general warned this week the world “cannot afford to miss the early signals” of a possible human flu pandemic.

The precise reasons for the unusually large number and sustained nature of bird outbreaks in recent months, and the proliferation of strains, is unclear – although such developments compound the global spreading process.

Bird flu is usually spread through flocks through direct contact with an infected bird. But Osterholm said wild birds could be “shedding” more of the virus in droppings and other secretions, increasing infection risks. He added that there now appears to be “aerosol transmission from one infected barn to others, in some cases many miles away”.

Ian MacKay, a virologist at Australia’s University of Queensland, said the current proliferation of strains means that “by definition, there is an increased risk” to humans.

“You’ve got more exposures, to more farmers, more often, and in greater numbers, in more parts of the world – so there has to be an increased risk of spillover human cases,” he told Reuters.

BRITAIN TO BANGLADESH

Nearly 40 countries have reported new outbreaks of highly pathogenic avian influenza in poultry or wild birds since November, according to the WHO.

In China, H7N9 strains of bird flu have been infecting both birds and people, with the of human cases rising in recent weeks due to the peak of the flu season there. According to the WHO, more than 900 people have been infected with H7N9 bird flu since it emerged in early 2013.

In birds, latest data from the OIE should that outbreaks of highly pathogenic avian flu have been detected in Britain, Italy, Kuwait and Bangladesh in the last few days alone.

Russia’s agriculture watchdog issued a statement describing the situation as “extremely tense” as it reported H5N8 flu outbreaks in another four regions. Hungarian farmers have had to cull 3 million birds, mostly geese and ducks.

These come on top of epidemics across Europe and Asia which have been ongoing since late last year, leading to mass culling of poultry in many countries.

Strains currently documented as circulating in birds include H5N8 in many parts of Europe as well as in Kuwait, Egypt and elsewhere, and H5N1 in Bangladesh and India.

In Africa – which experts say is especially vulnerable to missing flu outbreak warning signs due to limited local government capacities and weak animal and human health services – H5N1 outbreaks have been reported in birds in Burkina Faso, Cameroon, Ghana, Niger, Nigeria and Togo. H5N8 has been detected in Tunisia and Egypt, and H7N1 in Algeria.

The United States has, so far this year, largely escaped bird flu, but is on high alert after outbreaks of H5N2, a highly pathogenic bird flu, hit farms in 15 states in 2015 and led to the culling of more than 43 million poultry.

David Nabarro, a former senior WHO official who has also served as U.N. system senior coordinator for avian and human influenza, says the situation is worrying. “For me the threat from avian influenza is the most serious (to public health), because you never know when,” he told Reuters in Geneva.

HIGHLY PATHOGENIC H5N1

H5N1 is under close surveillance by health authorities around the world. It has long been seen as one to watch, feared by infectious disease experts because of its pandemic potential if it were to mutate an acquire human-to-human transmission capability.

A highly pathogenic virus, it jumped into humans in Hong Kong in 1997 and then re-emerged in 2003/2004, spreading from Asia to Europe and Africa. It has caused hundreds of infections and deaths in people and prompted the culling of hundreds of millions of poultry.

Osterholm noted that some currently circulating H5 strains – including distant relatives of H5N1 – are showing significant capabilities for sustaining their spread between wild flocks and poultry, from region to region and farm to farm.

“What we’re learning about H5 is, that whether its H5N6, H5N8, H5N2 or H5N5, this is a very dangerous bird virus.”

Against that background, global health authorities and infectious disease experts want awareness, surveillance and vigilance stepped up.

Wherever wild birds are found to be infected, they say, and wherever there are farms or smallholdings with affected poultry or aquatic bird flocks, regular, repeated and consistent testing of everyone and anyone who comes into contact is vital.

“Influenza is a very tough beast because it changes all the time, so the ones we’re tracking may not include one that suddenly emerges and takes hold,” said MacKay.

“Right now, it’s hard to say whether we’re doing enough (to keep on top of the threat). I guess that while it isn’t taking off, we seem to be doing enough.”

(Additional reporting by Ed Stoddard in Johannesburg, Stephanie Nebehay in Geneva, Polina Devitt in Moscow and Sybille de La Hamaide in Paris; Editing by Pravin Char)

Yemen’s suspected cholera cases soar to 1,410 within weeks

A nurse checks a boy at a hospital intensive care unit in Sanaa, Yemen

GENEVA (Reuters) – The number of suspected cholera cases in Yemen has ballooned to 1,410 within three weeks of the outbreak being declared, the World Health Organization said on Friday, as 18 months of war has destroyed most health facilities and clean water supplies.

Yemen’s Health Ministry announced the outbreak on Oct. 6 in Sanaa city, and by Oct. 10 the WHO said there were 24 suspected cases. The following day, a WHO official in Yemen said there was “no spread of the disease”.

But on Friday, WHO spokesman Tarik Jasarevic told a Geneva news briefing that as of Thursday there were 1,410 suspected cholera cases in 10 out of Yemen’s 23 governorates – mostly in Taiz, Aden, Lahj, Hodeida and Sanaa.

The conflict between a Saudi Arabia-led coalition and the Iran-aligned Houthi group which controls much of northern Yemen, including Sanaa, has destroyed much of Yemen’s infrastructure, killed more than 10,000 people and displaced millions.

A girl holds her sister outside their family’s hut at the Shawqaba camp for internally displaced people who were forced to leave their villages by the war in Yemen’s northwestern province of Hajjah March 12, 2016. REUTERS/Abduljabbar Zeyad

Cholera is only one risk in Yemen’s war but a rapid advance of the disease would add a new dimension to the humanitarian disaster which UNICEF says has left 7.4 million children in need of medical help and 370,000 at risk of severe acute malnutrition.

WHO said on Wednesday that only 47 of the suspected cases had tested positive for cholera and the outbreak had spread beyond the capital to nine other governorates.

Children under 10 accounted for half of the cases with six deaths from cholera and 36 associated deaths from acute watery diarrhea, the WHO said in the Oct. 26 report.

Although most suffers have no symptoms or mild symptoms that can be treated with oral rehydration solution, in more severe cases the disease can kill within hours if not treated with intravenous fluids and antibiotics.

(Reporting by Tom Miles and Stephanie Nebehay; Editing by Louise Ireland)

Florida declares new area of Zika transmission in Miami

By Julie Steenhuysen

(Reuters) – Florida officials on Thursday announced a new area of Zika transmission in the Miami region and have called on the federal government for funding to help fight the outbreak.

Florida Governor Rick Scott said state health officials have confirmed that local transmission of the mosquito-borne Zika virus is occurring in a new small area in Miami-Dade County, where the state believes two women and three men have been infected by the virus.

The governor said the state’s health department believes Zika transmission is only occurring in Miami-Beach and in the new area, which covers about 1 square mile (2.6 square km).

Zika, which is spread primarily by mosquitoes but also sexually, is a concern for pregnant women and their partners because the virus has been liked with a series of birth defects including microcephaly, marked by small head size and underdeveloped brains that can lead to severe developmental problems in babies.

Last month, U.S. health officials urged pregnant women to consider putting off all nonessential travel to Miami due to the Zika virus even as the state lifted a travel warning for the Wynwood, the Miami neighborhood which was the first site of local Zika transmission in the continental United States.

Florida has reported a total of 164 cases of Zika caused by local mosquito transmission, including 19 people who were infected in the state but live elsewhere. There are also five cases in which it was not clear whether transmission occurred in Florida or elsewhere.

In a statement released on Thursday, Scott said the announcement of the new area of transmission underscores the “urgent need” for federal funding to fight the virus, adding that the state still has not received any of the funding that was approved by Congress and signed by President Barack Obama two weeks ago.

Scott said he has asked the U.S. Centers for Disease Control and Prevention to work directly with the Miami-Dade Mosquito Control District to identify best practices for defeating Zika in the new area.

Florida officials had already reported four of the five cases of Zika that occurred in the new area of transmission in Miami-Dade County. “With the confirmation of today’s case, this area now meets the CDC’s criteria for a new zone,” officials said in a statement.

The Zika virus was first detected in Brazil last year and has since spread across the Americas. It has been linked to more than 1,800 cases of microcephaly in Brazil.

(Reporting by Julie Steenhuysen in Chicago; Editing by Lisa Shumaker)

Doctors say Haiti ripe for large Zika outbreak, virus under: reported

By Makini Brice

PORT-AU-PRINCE (Reuters) – Posters warning of the dangers of Zika only reached Haiti’s health ministry in August, six months after the country reported an outbreak, in one example of delayed prevention efforts that have health experts worried a “large epidemic” is looming.

Gabriel Thimothe, a senior health ministry official, said the public service posters would be distributed to hospitals and airports shortly, but that health funding had been cut this year and foreign aid was sparse to fight the mosquito-borne virus that can cause severe birth defects.

Zika infections in pregnant women have been shown to cause microcephaly – a defect in which babies’ heads and brains are undersized – as well as other brain abnormalities.

Widespread fumigation that has limited the virus’ spread in other Caribbean nations such as Cuba only began in Haiti last month. Publicity campaigns have been all but invisible and hospital workers were on strike for much of the year.

“We’re expecting a large epidemic but we don’t know when it will occur,” said Jean-Luc Poncelet, the World Health Organization’s representative in Haiti. “There is under-reporting.”

Such an epidemic could severely strain Haiti’s fragile healthcare system, battered by an earthquake in 2010 that killed 300,000, and still struggling with a cholera epidemic that has sickened nearly 800,000 people.

WHO data show 5,000 suspected cases have been reported in more prosperous neighbor Dominican Republic, which shares the island of Hispaniola with Haiti and has a similar population and climate. Haiti by contrast, has reported 3,000 suspected cases, according to numbers shared by the U.S. Centers for Disease Control and Prevention.

That makes Haiti’s Zika infection rate about 30 per 100,000 people, compared to 82 per 100,000 in Brazil, where the connection between Zika and microcephaly was first detected, and 50 per 100,000 in Dominican Republic

The connection between Zika and microcephaly first came to light last fall in Brazil, which has since confirmed more than 1,800 cases of microcephaly.

RAINY SEASON

In the Dominican Republic there were spikes in infections in March and May, broadly coinciding with rainy seasons on both sides of the island, a time when mosquitoes and diseases they carry normally flourish. In Haiti, the number of cases reported each week generally dropped from February through the rains.

A long strike by medical residents at most public hospitals coincided with that decline, raising the question of whether there were fewer infections or a lack of health workers available to register cases.

A Zika task force, which includes the government and non-governmental organizations, was formed in May, Thimothe said. Several U.S. health officials in Haiti told Reuters that the United States provided $3 million in August to combat Zika in the country, money that was initially intended to be deployed against Ebola in West Africa.

Thimothe said the impact of an explosion of microcephaly cases would be devastating, but denied the condition was more widespread than thought, even though many Haitian women give birth at home rather than in clinics.

His position is supported by WHO data through June, which did not show an uptick in microcephaly or Guillain-Barre syndrome, a neurological disorder that can cause temporary paralysis and has also been linked to Zika.

But Louise Ivers, the senior health and policy advisor for Partners in Health, which along with Haitian organization Zanmi Lasante runs a hospital in the central town of Mirebalais, said she had seen at least 12 cases this year of Guillain-Barre, normally a rare condition.

The same hospital registered two microcephaly cases, including one confirmed to be linked to Zika, this summer.

“Maybe we are too late for prevention. Maybe we just have to manage the consequences,” Ivers said. “This could just be the tip of the iceberg.”

(Additional reporting by Joseph Guyler Delva; Editing by Frank Jack Daniel and Alistair Bell)

Health official warns Zika virus could spread across U.S. Gulf

The New York State Department of Health unveiled a Zika Prevention Kit for pregnant women during the rollout of a Zika Information hotline and

By Chris Prentice

(Reuters) – One of the top U.S. public health officials on Sunday warned that the mosquito-borne Zika virus could extend its reach across the U.S. Gulf Coast after officials last week confirmed it as active in the popular tourist destination of Miami Beach.

The possibility of transmission in Gulf States such as Louisiana and Texas will likely fuel concerns that the virus, which has been shown to cause the severe birth defect known as microcephaly, could spread across the continental United States, even though officials have played down such an outcome.

Concern has mounted since confirmation that Zika has expanded into a second region of the tourist hub of Miami-Dade County in Florida. Miami’s Wynwood arts neighborhood last month became the site of the first locally transmitted cases of Zika in the continental United States.

“It would not be surprising we would see additional cases perhaps in other Gulf Coast states,” Dr. Anthony Fauci, director of the allergy and infectious diseases unit of the National Institutes of Health (NIH), said in an interview on Sunday morning with ABC News.

Fauci noted that record flooding this month in Louisiana – which has killed at least 13 people and damaged some 60,000 homes damaged – has boosted the likelihood Zika will spread into that state.

“There’s going to be a lot of problems getting rid of standing water” that could stymie the mosquito control efforts that are the best way to control Zika’s spread, he said.

U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly, a birth defect marked by small head size that can lead to severe developmental problems in babies. The connection between Zika and microcephaly first came to light last fall in Brazil, which has now confirmed 1,835 cases of microcephaly that it considers to be related to Zika infections in the mothers.

On Friday, Florida Governor Rick Scott confirmed that state health officials had identified five cases of Zika believed to be contracted in Miami Beach.

The U.S. Centers for Disease Control and Prevention told pregnant women they should avoid the trendy area and suggested those especially worried about exposure might consider avoiding all of Miami-Dade County.

NIH’s Fauci on Sunday said the conditions of most of the country make it unlikely there would be a “diffuse, broad outbreak,” even though officials need to prepare for that possibility.

He compared it with diseases such as Dengue, which is endemic in certain tropical and subtropical regions of the world but rarely occurs in the continental United States. In Miami’s Wynwood area, experts have seen “substantial” knockdowns of mosquito populations.

Still, its containment is more complicated because Zika can be sexually transmitted, Fauci said.

“This is something that could hang around for a year or two,” he said.

The World Health Organization has said there is strong scientific consensus that Zika can also cause Guillain-Barre, a rare neurological syndrome that causes temporary paralysis in adults.

(Reporting by Chris Prentice in New York; Editing by Alan Crosby)

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