Reacting to ZIKA without overreacting ~ Outbreak of DENGUE in HAWAII now largest since statehood.

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Reacting to ZIKA without overreacting ~ Outbreak of DENGUE in HAWAII now largest since statehood.

Global 02/04/16 clarke.com: posted by Rajeev Vaidyanathan –  Excellent blog article addressing

  • What we know about Zika Virus
  • How it is spreading
  • Comparing Zika to Dengue
  • Lessons from Dengue
  • What now? What’s Next?

See http://www.clarke.com/blog/zika-react/?sthash.Xnn1prqN.mjjo

Author’s Note: Who is Rajeev Vaidyanathan and what is Clarke? – Dr. Vaidyanathan is the Director of Environmental Science  at Clarke, a global environmental products and services company based in St. Charles, Illinois. Their mission is to make communities around the world more livable, safe and comfortable. They do this.by pioneering, developing and delivering environmentally responsible mosquito control and aquatic services to help prevent disease, control nuisances and create healthy waterways,

Dengue:

hotspotHawaii 02/04/16 hawaiinewsnow.com: Health officials identified one new case of dengue fever on Thursday, bringing the total number of cases to 249. Three cases are potentially infectious to mosquitoes. All others are no longer infectious. Of the total confirmed cases, 225 are Hawaii Island residents and 24 are visitors; 45 have been children. As of Monday, a total of 1,100 reported potential cases have been excluded based on test results or because they didn’t meet case criteria. The outbreak, which started Sept. 11, is now the largest since statehood. – For complete article see http://www.hawaiinewsnow.com/story/30671944/new-cases-of-dengue-fever-on-hawaii-island-bring-total-to-248

WHO expects ZIKA VIRUS to reach most countries of the AMERICAS ~ CDC expands ZIKA VIRUS TRAVEL WARNING ~ CDC officials says big ZIKA VIRUS outbreak unlikely in US ~ ARIZONA officials confirm HANTAVIRUS fatality ~ ARIZONA scientist says DEER are developing genetic resistance to CHRONIC WASTING DISEASE.

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South, Central and North America 01/25/16 wcvb.com: by Emily Smith – The World Health Organization anticipates that the Zika virus will spread to all but two countries in South, Central and North America. The mosquito-borne disease has raged in South America and other regions for several months. Twenty-one countries and territories of the Americas have reported cases of the virus since Brazil reported the first cases of local transmission in May 2015, WHO’s regional office for the Americas said in a statement. “Aedes mosquitoes — the main vector for Zika transmission — are present in all the region’s countries except Canada and continental Chile,” the statement said. The Centers for Disease Control and Prevention urged pregnant women to postpone travel to Bolivia, Brazil, Cape Verde, Colombia, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Saint Martin, Suriname, Samoa, Venezuela and Puerto Rico. The CDC also recommended that women who have recently traveled to these places during their pregnancy be screened and monitored for the virus. – For complete article see http://www.wcvb.com/health/who-expects-zika-virus-to-spread/37620996

Caribbean 01/26/16 cdc.gov: Media Release – Today, CDC added the following destinations to the Zika virus travel alertsUnited States Virgin Islands and Dominican Republic.  Previously, CDC issued a travel alert (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing: the Commonwealth of Puerto Rico, a U.S. territory; Barbados; Bolivia; Brazil; Cape Verde; Colombia; Ecuador; El Salvador; French Guiana; Guadeloupe; Guatemala; Guyana; Haiti; Honduras; Martinique; Mexico; Panama; Paraguay; Saint Martin; Samoa; Suriname; and Venezuela.  Specific areas where Zika virus transmission is ongoing are often difficult to determine and are likely to continue to change over time. As more information becomes available, CDC travel alerts will be updated. – For complete release see http://www.cdc.gov/media/releases/2016/s0126-zika-travel-guidance.html

National 01/27/16 npr.org: by Rob Stein – The outbreak of Zika virus in Brazil and other countries has raised concern that the pathogen could start spreading widely in the United States, as well. But federal health officials and other infectious disease specialists say so far that seems unlikely. “Based on what we know right now, we don’t think that widespread transmission in the United States is likely,” says Dr. Beth Bell, director of the National Center for Emerging and Zoonotic Infectious Diseases at the Centers for Disease Control and Prevention. There are several reasons for Bell’s cautious optimism that isolated cases that show up in the U.S. could be contained. The first is that the two species of mosquitoes that could be capable of transmitting the virus, Aedes aegypti and Aedes albopictus, live mostly in the southern, more tropical parts of the U.S. That makes it likely that transmission would be limited primarily to these areas. And for various reasons, the chain of events and conditions the virus needs in order to spread is more easily disrupted in the U.S. than elsewhere. For example, many people in the U.S. have air conditioning in the summer, so aren’t as likely to leave windows open at the times of day when mosquitoes are especially active. Open windows also tend to have screens. And many counties and other municipalities spray to kill mosquitoes and are vigilant in trying to eliminate pools of standing water where the insects can breed. “These are all conditions that make it less likely for ongoing, large-scale spread to occur,” Bell says. – For complete article see http://www.npr.org/sections/health-shots/2016/01/26/464459350/big-zika-virus-outbreak-unlikely-in-the-u-s-officials-say

Hantavirus:
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Arizona 01/25/16 lakepowelllife.com: by John Christian Hopkins – A 17-year-old Cameron girl is the first victim of the Hantavirus on the Navajo Nation in 2016. The death was confirmed by the Navajo Department of Health and the Navajo Epidemiology Center on January 19. . . . The girl was active in her community and had a 4.0 GPA. She had Hantavirus symptoms when she visited the Tuba City Hospital, and died en route to the University of New Mexico Hospital in Albuquerque. – For complete article see http://www.lakepowelllife.com/navajo-girl-dies-from-hantavirus/

Chronic Wasting Disease (CWD):

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National 01/22/16 greatfallstribune.com: by Nicholas Haley, DVM, PhD – Perhaps no issue is as controversial in the hunting community right now as Chronic Wasting Disease. There’s constant finger-pointing and a lot of theories about how it will change hunting forever for the worse. But fortunately, emerging scientific research suggests that CWD doesn’t have to be the scourge that many fear. Last year, a herd at an Iowa ranch was depopulated after one of the animals tested positive for CWD, as is standard U.S. Department of Agriculture protocol. However, the situation took years to resolve as the ranch owner fought for a more equitable solution. As such, CWD naturally spread among the animals. This provided a unique opportunity for testing of the animals, since depopulation normally occurs relatively quickly. After testing and euthanizing the entire herd, sadly a large percentage were identified as CWD positive. The silver lining was that 20 percent were negative, and we are currently looking at a genetic link to resistance in these animals. If we can further characterize this resistance in deer, that’s very promising. As CWD spreads — and it will, since you can’t stop free-ranging deer from moving around — then the deer that are more genetically susceptible to the disease will die off at higher rates than those that are less genetically susceptible. The net result will be a hardier population of deer that is more resistant to CWD. With farmed deer, there’s the potential to select for this resistance faster than nature herself could. – For complete article see http://www.greatfallstribune.com/story/opinion/guest-opinions/2016/01/22/chronic-wasting-disease-prognosis/79199086/

CDC expands ZIKA VIRUS TRAVEL ALERT adding 8 more locations and reporting suspected link between ZIKA VIRUS and GUILLAIN-BARRÈ syndrome

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National 01/22/16 medscape.com: by Robert Lowes – The Centers for Disease Control and Prevention (CDC) announced today that it has added eight more countries and territories — some outside the Americas — to the list that pregnant women should avoid on account of the mosquito-borne Zika virus, which is strongly suspected of causing microcephaly.

microcephaly-comparison-500pxIn addition, the agency is conducting research with hard-hit Brazil into a possible link between the virus and Guillain-Barré syndrome (GBS), which has been reported in patients with probable Zika infections.

K_guillianBarre1Last week, the CDC advised pregnant women to consider postponing trips to 14 countries and territories in Central and South America and the Caribbean where mosquitos have spread the Zika virus. It also suggested that women trying to become pregnant should first consult their physician before traveling to those areas, and if they do, to apply insect repellent and take other measures to avoid mosquito bites. These 14 countries and territories are Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto Rico. Of the eight countries and territories added to the list of Zika hot spots, six are in the Caribbean and South America: Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin, and Guyana. The two others, Cape Verde and Samoa, break the geographic pattern. Cape Verde is off the coast of Africa while Samoa is in Polynesia. – For complete article see http://www.medscape.com/viewarticle/857693?nlid=98072_3901&src=wnl_newsalrt_160122_MSCPEDIT&uac=218349HV&impID=965828&faf=1

CDC issues ZIKA TRAVEL ALERT ~ HAWAIIAN baby’s brain damage tied to ZIKA VIRUS ~ ZIKA VIRUS confirmed in TEXAS traveler – DENGUE FEVER outrbreak prompts HAWAII officials to close recreational area ~ ARIZONA officials confirm HANTAVIRUS death

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National 01/15/16 medscape.com: by Robert Lowes – Pregnant women in any trimester should consider postponing travel to 14 countries and territories in South and Central America and the Caribbean where mosquitos are spreading the Zika virus, the Centers for Disease Control and Prevention (CDC) announced tonight. Viral infection in pregnant women has been associated with microcephaly in infants. In what it calls a level 2 travel alert, the CDC also advises women who are thinking about becoming pregnant to consult with their physician before traveling to these areas, and if they do, follow strict precautions to avoid mosquito bites. Safeguards include wearing long-sleeve shirts and long pants and using insect repellent. The 14 countries and territories covered by the travel alert are Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto Rico. – For complete article see http://www.medscape.com/viewarticle/857389?nlid=97363_3901&src=wnl_newsalrt_160115_MSCPEDIT&uac=218349HV&impID=957011&faf=1

Author’s Note: For “Short Answers to Hard Questions About Zika Virus” see http://www.nytimes.com/interactive/2016/01/16/health/what-is-zika-virus.html?emc=edit_tnt_20160117&nlid=57949252&tntemail0=y

Hawaii 01/18/16 cbsnews.com: Health officials say a baby born in a Hawaii hospital is the zikavirus.symptom77884first in the United States born with Zika virus.  The U.S. Centers for Disease Control and Prevention said Sunday it’s also the first infant born in the country with microcephaly associated with Zika virus, a birth defect where a baby’s head is smaller than expected. Babies with the condition often have smaller brains that might not have developed properly, often resulting in mental retardation. The virus, which is transmitted through mosquito bites, has affected between 440,000 and 1.3 million people in Brazil since last May, officials estimate. Researchers say they’ve found strong evidence that a recent surge in microcephaly in the country — 3,530 babies have been born with the condition since October, up from fewer than 150 in 2014 — is linked to Zika virus. – For complete article see http://www.cbsnews.com/news/hawaii-baby-born-with-brain-damage-linked-to-zika-virus/

National 01/11/16 medscape.com: by Janis C. Kelly – Zika virus, a mosquito-borne infection believed to cause microcephaly in infants born to infected mothers, has crossed from Latin America into Texas, experts reported today. The case of Zika in a traveler recently returned from El Salvador was confirmed through investigations by Harris County, Texas, health officials and the Centers for Disease Control and Prevention (CDC). The case is expected to result in major new surveillance and vector-control initiatives. Peter Hotez, MD, dean of the National School of Tropical Medicine at Baylor College of Medicine, president of the Sabin Vaccine Institute, and Texas Children’s Hospital Endowed Chair of Tropical Pediatrics, Houston, told  Medscape Medical News, “There is a perfect storm brewing for Zika virus in the US. I was never worried that Ebola would take off here, but I am worried about Zika. We have 2 species of Aedes mosquitoes that can transmit Zika in our area. We also have high levels of poverty, resulting in people living without window screens and near discarded tires and other water-catching containers where the mosquitoes can breed.” Dr Hotez said that Zika infection usually produces nonspecific, influenza-like symptoms Zika-Virus-2.rashin pregnant women, with the associated birth defects becoming apparent only 9 months later. “By that time, it is too late,” Dr Hotez said. “This first case of Zika infection in Harris County is a wake-up call, a warning that we should immediately start implementing programs of active surveillance. As we move into the spring and summer months, if we start seeing cases among people who have never traveled outside of the country, we need to implement aggressive mosquito control measures as well as health advisories for people to implement personal protection measures.” – For complete article see http://www.medscape.com/viewarticle/857072?nlid=96603_3901&src=wnl_newsalrt_160112_MSCPEDIT&uac=218349HV&impID=953397&faf=1

Author’s Note: According to numerous reports, the infected traveler is a resident of the City of Houston, Texas.

Dengue Fever:

Hawaii 01/15/16 abcnews.go.com: by Marina Riker – Hawaii officials closed a Big Island a_48road, campground and hiking trail in an effort to stop the spread of a  dengue fever outbreak that has sickened 223 residents and visitors as of Friday. Five of those cases could be potentially infectious, according to the Hawaii Department of Health. The Hawaii Department of Land and Natural Resources closed the Muliwai hiking trail on the far cliff side of Waipio Valley and its Waimanu Valley campground on Friday. Hawaii County’s Civil Defense Agency blocked all traffic to Waipio Valley Access Road on Thursday and limited access to residents. The road closure comes three weeks after health officials closed access to state lands near Milolii and Honomalino Bay, which were “hotspots” for the mosquito-borne virus. – For complete article see http://abcnews.go.com/Health/wireStory/dengue-fever-prompts-hawaii-campground-trail-road-closures-36327566

Hantavirus:

Arizona 01/13/16 azdailysun.com: A resident of the Navajo Nation who lived in the east central part of Coconino County has died of complications of Hantavirus Pulmonary imagesCAULAVUQSyndrome. The rare but potentially fatal disease, which has no vaccine or cure, is spread by infected rodent droppings. It is the fourth confirmed case of hantavirus reported in Coconino County since 2006. Two of those cases resulted in death. It is not known at this time where the recently deceased individual contracted hantavirus. Studies show that wild mice throughout Arizona have been infected with hantavirus. It is transmitted to humans when they breathe air contaminated with the virus. If fresh rodent droppings, urine or nesting materials from infected animals are stirred up, tiny droplets containing the virus get into the air. Exposure to mouse droppings in enclosed areas such as cabins, sheds and outbuildings poses the greatest potential risk for contracting hantavirus. – For complete article including symptoms and recommendations see http://azdailysun.com/news/local/officials-confirm-hantavirus-death/article_9542f93e-6fb6-57c5-a401-6a19dfe9b1c1.html

ZIKA VIRUS confirmed in TEXAS traveler

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National 01/11/16 medscape.com: by Janis C. Kelly – Zika virus, a mosquito-borne infection believed to cause microcephaly in infants born to infected mothers, has crossed from Latin America into Texas, experts reported today. The case of Zika in a traveler recently returned from El Salvador was confirmed through investigations by Harris County, Texas, health officials and the Centers for Disease Control and Prevention (CDC). The case is expected to result in major new surveillance and vector-control initiatives. Peter Hotez, MD, dean of the National School of Tropical Medicine at Baylor College of Medicine, president of the Sabin Vaccine Institute, and Texas Children’s Hospital Endowed Chair of Tropical Pediatrics, Houston, told  Medscape Medical News, “There is a perfect storm brewing for Zika virus in the US. I was never worried that Ebola would take off here, but I am worried about Zika. We have 2 species of Aedes mosquitoes that can transmit Zika in our area. We also have high levels of poverty, resulting in people living without window screens and near discarded tires and other water-catching containers where the mosquitoes can breed.” Dr Hotez said that Zika infection usually produces nonspecific, influenza-like symptoms in pregnant women, with the associated birth defects becoming apparent only 9 months later. “By that time, it is too late,” Dr Hotez said. “This first case of Zika infection in Harris County is a wake-up call, a warning that we should immediately start implementing programs of active surveillance. As we move into the spring and summer months, if we start seeing cases among people who have never traveled outside of the country, we need to implement aggressive mosquito control measures as well as health advisories for people to implement personal protection measures.” – For complete article see http://www.medscape.com/viewarticle/857072?nlid=96603_3901&src=wnl_newsalrt_160112_MSCPEDIT&uac=218349HV&impID=953397&faf=1

Author’s Note: According to numerous reports, the infected traveler is a resident of the City of Houston, Texas.

CDC warns tourists of PUERTO RICO’s first locally acquired case of ZIKA VIRUS ~ HAWAII reports largest outbreak of DENGUE FEVER since statehood

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Puerto Rico 01/02/16 wdsu.com: by Sandee LaMotte – Health officials in Puerto Rico reported the island’s first case of Zika, a mosquito-borne virus recently linked to the rise of a serious neurological disorder among newborns in Brazil. “There is no reason for alarm, and the public should continue to take commonsense steps to avoid mosquito bites,” Puerto Rican Congressman Pedro Pierluisi said in a statement on Thursday. He added that he expects experts from the Centers for Disease Control and Prevention to visit the island in early January to educate local physicians to “properly diagnose and treat the virus.” The CDC has issued a warning to tourists traveling to Puerto Rico and other affected areas, asking them to protect themselves from the mosquitoes that spread the virus — especially pregnant women. The Aedes aegypti mosquito thrives in tropical climates and typically lives around buildings in urban areas. It is known to bite aggressively during the day, but can also attack at night, both indoors and out. It’s the same mosquito that can carry yellow fever, dengue fever and chikungunya. There is no vaccine to prevent Zika, and once infected there is no medicine to treat the virus. Symptoms typically include fever, rash, joint pain, and the red eyes of conjunctivitis. They’re usually mild, and can last up to a week. Other symptoms can include muscle pain, headache, pain behind the eyes and vomiting. Symptoms typically begin three to seven days after being bitten by an infected mosquito. – for complete article see http://www.wdsu.com/health/zika-virus-reported-in-puerto-rico/37225934

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Hawaii 01/01/16 hawaiinewsnow.com: Health officials identified seven new cases of dengue fever on Friday, bringing the total number of cases to 202. As many as 13 of the confirmed cases are potentially infectious to mosquitoes. All others are no longer infectious. Of the total confirmed cases, 182 are Hawaii Island residents and 20 are visitors; 38 have been children. As of Friday, a total of 765 reported potential cases have been excluded based on test results and/or not meeting case criteria. The outbreak, which started Sept. 11, is now the largest since statehood. The second-largest outbreak was in 2001, and included 122 confirmed cases were reported. Dengue fever is transmitted to humans when they are bit by infected mosquitoes. The symptoms usually include a sudden onset of fever, severe headaches, rash and eye, joint and muscle pain.  No other locally-acquired dengue fever cases have been reported on any other islands. – See http://www.hawaiinewsnow.com/story/30671944/new-cases-of-dengue-fever-on-hawaii-island-bring-total-to-195

TRAVEL WARNING: Outbreak of CHIKUNGUNYA FEVER in LATIN AMERICA and the CARIBBEAN ~ TRAVEL WARNING: Outbreak of DENGUE FEVER in HAWAII ~ MAINE reports first ever human death due to EASTERN EQUINE ENCEPHALITIS (EEE) ~ Emerging ZIKA VIRUS may cause severe birth defects.

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Western Hemisphere 11/30/15 travelpulse.com: by Donald Wood – For those traveling to Latin America or the Caribbean in the coming month, be aware of an outbreak of Chikungunya, a mosquito-borne virus impacting an average of one million people per year. According to Maggie Fox of NBCNews.com, researchers have discovered that the Chikungunya virus can cause brain inflammation called encephalitis more often than previously reported, and while not usually fatal, it is known to cause intense headaches, joint pain, rashes and fever.

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Chikungunya arrived in the in the Western Hemisphere when it was first discovered on St. Martin island in December 2013. Since its discovery, the virus has spread as far north as Florida and throughout Central and South America. The doctor who led the study, Dr. Patrick Gérardin of Central University Hospital in Saint Pierre, Reunion Island, released a warning for travelers, saying, “Since there is no vaccine to prevent Chikungunya and no medicine to treat it, people who are traveling to these areas should be aware of this infection and take steps to avoid mosquito bites, such as wearing repellent and long sleeves and pants if possible.” In a report from the Pan American Health Organization, over 600,000 cases of the Chikungunya virus have been diagnosed this year alone, with 76 deaths attributed to the illness. Over the last two years, more than 1.1 million cases were reported, including 194 fatalities. – For complete article see http://www.travelpulse.com/news/impacting-travel/what-travelers-should-know-about-chikungunya-virus.html

DENGUE:

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Hawaii 12/02/15 wcvb.com: by Debra Goldschmidt – Health officials in Hawaii are getting help from the CDC to control the ongoing outbreak of dengue fever on the Big Island. Dr. Lyle Petersen — director of the Centers for Disease Control and Prevention’s division of vector borne infectious diseases — and two colleagues traveled to Hawaii and met with state health officials Tuesday. They plan to travel to the Big Island on Wednesday. Along with their expertise, they brought tools including special mosquito traps that are easier to use and not widely available but work well with the specific type of mosquitoes that transmit dengue fever. Since September there have been 117 confirmed cases of the mosquito-borne disease, according to the state department of health. Twenty-nine of those sick are children under the age 18. The majority of the ill patients, 103, are local residents. Dengue fever is transmitted to humans when they are bit by infected mosquitoes. There are two types of mosquitoes — Aedes aegypto and Aedes albopictus — that can transmit the virus, and both types are found in Hawaii. This is the first locally transmitted outbreak of the viral illness on the Big Island and the first outbreak in the state since five people were infected on the island of Oahu in 2011. – For complete article see http://www.wcvb.com/health/cdc-joins-probe-of-hawaiian-dengue-fever-cases/36752062

EASTERN EQUINE ENCEPHALITIS (EEE):

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Maine 12/02/15 fosters.com: by Ellen W. Todd – The Maine Center for Disease Control and Prevention recently acknowledged the state’s first-ever human death caused by Eastern Equine Encephalitis (EEE). The Maine CDC announced in a Nov. 24 news release that an adult in York County who died Oct. 17 was confirmed to have had the mosquito-borne illness. The individual, described as a mature adult (age 65 or above), became ill with encephalitis in late September and was hospitalized in New Hampshire on Sept. 30, according to the news release. Preliminary testing by New Hampshire’s public health laboratory in early October was inconclusive, according to the Maine CDC, and the sample was sent to the federal CDC in Fort Collins, Colorado, for confirmation. Maine CDC received the positive results Nov. 19 or 20. John Martins, a spokesperson for the Maine CDC, could not say what town the individual was from or give further information due to privacy laws. Although several horses have died from EEE in Maine over the last decade, and a visitor to the state died from the illness in 2008, this is the first time a Maine resident has succumbed to the illness. – For complete article see http://www.fosters.com/article/20151202/NEWS/151209858

ZIKA ( aka ZICA) VIRUS:

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Global 12/03/15 sciencemag.org: by Gretchen Vogel – An emerging virus that is causing an unprecedented epidemic in Brazil and is quickly spreading through Latin America may be responsible for a spike in severe birth defects. The Zika virus, a little-known pathogen that until 2007 hadn’t been seen outside of Africa and Asia, spread earlier this year to South America and has infected more than 84,000 people in Brazil. Zika usually causes relatively mild symptoms, including fever and rashes. Many infected people do not get sick at all. But the Brazilian government is now warning that the virus may be responsible for a dramatic increase 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. The connection is not yet proven, but if Zika virus is causing birth defects, it would be a serious public health issue. Transmitted by mosquitoes, the pathogen is rapidly expanding its range. In October and November, cases were identified in Colombia, Suriname, Guatemala, El Salvador, and Mexico. There is no vaccine or treatment for the little-studied virus, and its mosquito hosts are common as far north as the southern United States. – For complete article see http://news.sciencemag.org/health/2015/12/fast-spreading-virus-may-cause-severe-birth-defects