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CDC: Zika infections confirmed in 9 pregnant women in US

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rangerrebew:

CDC: Zika infections confirmed in 9 pregnant women in US

NEW YORK (AP) — Zika infections have been confirmed in nine pregnant women in the United States, including one who gave birth to a baby with a rare birth defect, health officials said Friday.

The Centers for Disease Control and Prevention said it's investigating 10 more reports of pregnant travelers with Zika. All got the virus while visiting or living in places with Zika outbreaks.

Also on Friday, the CDC issued a caution to people planning to attend the Olympics this summer in Rio de Janeiro.

The U.S. cases add to reports out of Brazil. Officials there are exploring a possible link to babies born with unusually small heads, a rare birth defect called microcephaly, which can signal underlying brain damage.

Zika has become epidemic in Latin America and the Caribbean since last fall. The virus, mainly spread through mosquito bites, causes mild illness or no symptoms in most people.

Since August, the CDC has tested 257 pregnant women for Zika; eight were positive, and a state lab confirmed a ninth.

— Three of the women have delivered babies; two of the newborns are apparently healthy, and one was born with microcephaly.

— Two had miscarriages, but it's unknown if the Zika infection was the cause.

— Two women had abortions, one after scans showed the fetus had an undeveloped brain. Details were not provided for the second case.

— Two pregnancies are continuing with no reported complications.

Five of the women had Zika symptoms in the first trimester, including the miscarriages, abortions and newborn with microcephaly.

In its report Friday, the CDC did not give the women's hometowns; state health officials have said there were two pregnant women with Zika in Illinois, three in Florida and one in Hawaii, who gave birth to a baby with microcephaly. That mother had lived in Brazil early in her pregnancy.

The CDC said all are U.S. residents, but it declined to answer a question on their citizenship.

The health agency said the nine women had been to places with Zika outbreaks — American Samoa, Brazil, El Salvador, Guatemala, Haiti, Honduras, Mexico, Puerto Rico and Samoa.

Those destinations are among the 30 places now on the CDC's travel alert. It recommends that pregnant women postpone trips to those areas.

While the link between Zika and the birth defect has not been confirmed, the possibility has prompted health officials to take cautionary steps to protect fetuses. That includes advice that Zika-infected men who have pregnant partners use condoms or abstain from sex.

In new guidance issued Friday night, the CDC addressed people planning to travel to Brazil for the 2016 Olympic Games in August and the 2016 Paralympic Games in September. The agency again advised that pregnant women consider not going and that their male sexual partners use condoms after the trip or abstain from sex during the pregnancy.

Women who are trying to become pregnant should talk to their doctors before making the trip, the CDC advised.

The CDC also recommends that all travelers use insect repellent while in Zika outbreak areas and continue to use it for three weeks after travel in case they might be infected but not sick. That's to prevent mosquitoes from biting them and possibly spreading Zika to others in the U.S. The type of mosquito that spreads Zika is in parts of the South.

The CDC has set up a voluntary registry to collect information about Zika-infected women and their babies. Officials also have made Zika a reportable disease.

Research also is underway into a possible link between Zika and a paralyzing condition in adults called Guillain-Barre.

The CDC on Friday also updated its investigation into 14 cases of possible sexual transmission of Zika from male travelers to their sex partners in the United States. Two cases have been confirmed, four more are probable and two have been dropped, the report said.

Zika is primarily spread by mosquito bites, and transmission through sex was thought to be extremely rare. It's been surprising that this many instances appear to have happened in the United States, CDC Director Dr. Tom Frieden noted during a call with reporters.

Similarly, the number of U.S. cases involving evidence of microcephaly or brain abnormalities "is greater than we would have expected," said the CDC's Dr. Denise Jamieson.

So far, 107 travel-related Zika infections have been diagnosed in 24 states and the District of Columbia, including the pregnant woman.

___

Online:

CDC Zika reports: http://www.cdc.gov/mmwr/index.html
Source URL: http://cnsnews.com/news/article/cdc-zika-infections-confirmed-9-pregnant-women-us

rangerrebew:
Nine isn't  enough for the Obama administration.  They need to recruit more people from heavily infected areas south of the border to come to the U.S. so they can infect Americans, mainly white women.

mountaineer:
A woman from my area (she lives in eastern Ohio) came back from a church mission trip to Haiti with Zika, apparently having received a skeeter bite there. She was sick for a couple of weeks but has fully recovered.

Meanwhile, news that Zika can lead to Guillen-Barre:
--- Quote ---New Study Links Zika Virus to Temporary Paralysis
By CATHERINE SAINT LOUIS
FEB. 29, 2016
NY Times


A new study of 42 cases of Guillain-Barré syndrome in French Polynesia offers the strongest evidence to date that the Zika virus can trigger temporary paralysis, researchers reported on Monday. But experts cautioned that more evidence from other locations was needed to be conclusive.

Since last year, doctors have noticed an unusual increase in Guillain-Barré cases in several countries with Zika outbreaks, including Brazil, El Salvador and Venezuela. But as the World Health Organization reported on Friday, a large number of those patients have not yet been confirmed through laboratory testing to have Zika.

Guillain-Barré leaves patients unable to move, in extreme cases forcing them to depend on life support. While most patients eventually regain full movement, the condition can be fatal. In the patients studied in French Polynesia, none died, but 38 percent went to an intensive care unit and

This study, published in The Lancet, used a number of tests to try to determine whether the group of 42 patients who contracted Guillain-Barré during a Zika outbreak in 2013 and 2014 also had the Zika virus.

“This is a compelling paper that provides a good deal of objective data to suggest an epidemiological link between recent Zika infection and increased risk of Guillain-Barré syndrome,” said Dr. Kenneth C. Gorson, professor of neurology at Tufts School of Medicine, who was not affiliated with the paper.

Thirty-seven, or almost 90 percent, of the patients in the study reported Zika-like symptoms four to 10 days before they started to notice neurological problems, like an inability to walk or general muscle weakness.

But determining whether the patients in fact had Zika was challenging. By the time they arrived at Centre Hospitalier de Polynésie Française in Tahiti during the 2013-2014 outbreak, none of them still had active Zika in their blood. The virus stays in the bloodstream for only about a week.

So researchers used a gold-standard test to look for Zika antibodies. It entailed adding serum from each patient to live Zika virus in a culture, and then seeing whether the patient had antibodies to destroy the virus.

All 42 patients had antibodies that killed the Zika virus. By contrast, only half of a control group of 98 people — matched for age, sex, and residence — had the antibodies.

“That’s huge, because it’s the first case-control study to establish a potential relationship between Zika virus infection and Guillain-Barré,” Dr. Gorson said.

Dr. David W. Smith, a professor of pathology and laboratory medicine at the University of Western Australia, cautioned that finding antibodies that neutralize Zika is not enough to prove an infection of Zika. To do that, the test also must show that the concentration of Zika antibodies was four times higher than for dengue, also known as dengue fever, which is common in Tahiti, said Dr. Smith, who was one of the authors of a commentary that accompanied the new study.

Only one of the 42 cases met that standard.

Dr. Arnaud Fontanet, one of three senior authors of the Guillain-Barré study, explained the results by pointing out that researchers had used blood samples taken in a three-month checkup, so the concentration of antibodies would have gone down.

The scientists also looked for another type of antibody, called IgM, to see if patients had recently been infected with Zika. Thirty one patients, nearly 74 percent, had IgM antibodies against Zika, but none against dengue. By contrast, only 11 percent of the control group had the dengue antibodies.

“If you put all this evidence together, for me, as an epidemiologist, I’m satisfied that Zika virus caused Guillain-Barré in those patients,” said Dr. Fontanet, head of the Epidemiology of Emerging Diseases Unit at the Institut Pasteur in Paris.

Other experts said the study fell short of proving causation. “More studies are needed to demonstrate if Zika virus can really cause Guillain-Barré syndrome,” said Dr. Bart C. Jacobs, a professor of immunology and neurology at Erasmus MC in the Netherlands. Still, Dr. Jacobs, who was not involved with the study, said it provided “convincing evidence for a link.”

The researchers were able to show that having had the dengue virus in the past did not enhance the severity of Guillain-Barré. A second control group of patients who had acute Zika in their blood, but no neurological complications, was recruited. When researchers compared the 42 paralyzed patients with both control groups, they found that pre-existing dengue immunity did not vary significantly between the three groups.

They found that roughly two out of 10,000 people infected with Zika virus developed Guillain-Barré in French Polynesia. Even though the condition is rare, Dr. Fontanet said, if two-thirds of a population is infected with Zika, as in French Polynesia, then a substantial number of patients may become paralyzed.

Patients in the study both deteriorated and recovered more quickly than typical patients with Guillain-Barré. It usually takes one to two weeks for a patient to progress from the first symptom to intensive care, but in these cases Dr. Fontanet said it was four days.

“That’s very short,” Dr. Fontanet said.

Doctors are now being asked to be aware of the quick progression, and to test for the Zika virus in addition to other pathogens. “The point is, you have to watch them much closer,” Dr. Gorson said.
--- End quote ---

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