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Zika virus

WHO: Zika virus 'spreading explosively' in Americas

Doug Stanglin, and Liz Szabo
USA TODAY
Alice Vitoria Gomes Bezerra, 3 months old, who has microcephaly, is held by her father Joao Batista Bezerra as mother Nadja Cristina Gomes Bezerra sits nearby in Recife, Brazil. In the last four months, authorities have recorded close to 4,000 cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants.

The World Health Organization announced Thursday it will hold an emergency meeting next to week on how to confront the Zika virus, which it said is "spreading explosively" in the Americas.

It is “deeply concerning” the virus has now been detected in more than 20 countries and territories in the Americas since Brazil reported its first case in May, WHO director general Margaret Chan said. “The level of alarm is extremely high," she added.

The specialized U.N. agency was criticized for its slow response to the Ebola outbreak in 2013. Now, it could declare an international health emergency when a group of independent experts meet Monday in Geneva.

The virus, spread by Aedes mosquitoes, has been associated with a sharp jump in the birth of babies with abnormally small heads. It is also linked to increases in Guillain-Barre syndrome, in which the immune system attacks the nervous system, causing paralysis.

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

One purpose of the emergency meeting is to make sure nations don’t take inappropriate steps to limit travel or trade, said Bruce Aylward, assistant director-general of the WHO. During the Ebola outbreak, countries closed their borders, which harmed the fragile economies of West Africa.

Although 31 travelers have returned to the USA with Zika virus infections since 2015, the disease is not spreading locally in the continental USA, said Anne Schuchat, principal deputy director at the Centers for Disease Control and Prevention. Those travelers came from 11 states and Washington, D.C., Schuchat said.

Unlike the flu, Zika doesn't spread from person to person. Instead, it's spread by mosquitoes, like malaria and West Nile Virus. Mosquitoes that bite a person infected with Zika can then spread it to others.

Schuchat said the CDC expects to see additional Zika cases in travelers, but the continental USA is not included in the World Health Organization’s list of countries with Zika outbreaks.

The WHO includes Puerto Rico and the U.S. Virgin Islands in its list of places with Zika outbreaks because the virus appears to be spreading there in the native mosquito population. Nineteen "locally acquired" cases of Zika have been detected in Puerto Rico, along with one in the U.S. Virgin Islands, in people who did not travel outside of the area.

Experts: USA must prepare now for Zika virus

Testing for Zika is difficult. There are no commercial tests for the virus. Only a handful of labs in the USA can diagnose the infection, including one at the Centers for Disease Control and Infection, as well as facilities in California, Florida, New York, Puerto Rico and Hawaii.

There are also no vaccines or treatments for Zika. However, scientists are working on both, said Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases. Doctors plan to use vaccines already in development against the West Nile virus to develop one against Zika. The same mosquito spreads both diseases. Fauci said an early, phase 1 trial of that vaccine in humans could begin this year.

A phase 1 trial evaluates a vaccine's safety and ability to stimulate an immune response, Fauci said. A fully tested vaccine won't be available this year or even next, he added. However, pharmaceutical companies, who had never been interested in Zika vaccines in the past, are now showing interest, he said.

"We’re already talking to a few companies to be able to partner with us," Fauci said.

Scientists disagree about the threat Zika poses to the USA. Fauci has said that aggressive mosquito control efforts have controlled outbreaks of mosquito-borne diseases in the past, and it's likely that similar measures could control any Zika outbreak.

Schuchat noted the USA is less vulnerable to large mosquito-borne outbreaks than cities in Latin America, which are often much more densely populated, with much more trash on roads and in villages, less air conditioning and fewer window screens.

The Americas could see 3 million to 4 million Zika infections a year, said Sylvain Aldighieri, of the Pan American Health Organization. Aldighieri said that estimate is based on the fact that the Americas see 2 million cases a year of dengue fever, a virus spread by the same mosquito that spreads Zika virus.

The governments of several Latin American countries have advised women to postpone pregnancy. WHO officials said they would not be advising women on that issue.

“Decisions about pregnancy are very personal,” Aylward said. Pregnant women should take precautions to avoid mosquito bites, he added.

A Health Ministry employee fumigates a home against the Aedes aegypti mosquito to prevent the spread of the Zika virus, in Soyapango, El Salvador, on Jan. 27. Health authorities have issued a national alert against the Aedes aegypti mosquito, vector of the Zika virus which might cause microcephaly and Guillain-Barré syndrome.

The WHO announcement comes a day after doctors writing in The Journal of the American Medical Association criticized the organization's response to what it said was a disease with “explosive pandemic potential" with outbreaks in Africa, Southeast Asia, the Pacific Islands and the Americas.

The doctors said "the global dimensions of Zika are quite clear, with fresh urgency as the 2016 Olympics in Rio de Janeiro loom."

One of the authors of the JAMA editorial, Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown, praised the WHO's decision to schedule an emergency meeting, calling it "a critical first step in recognizing the seriousness of an emerging epidemic."

Gostin also called on the WHO to urgently mobilize international resources to curb the rapid spread of Zika worldwide, including aggressive mosquito control, active surveillance, accelerated vaccine research and travel advisories for pregnant women.

"It is far better to be over-prepared than to wait until a Zika epidemic spins out of control," Gostin said. "If the association between microcephaly and Zika virus is confirmed, there will be an ethical imperative to protect women of childbearing age from contracting the infection. The public will demand well-funded, proactive leadership from the World Health Organization.”

Chan had pledged sweeping reforms in the 68-year-old agency after its handling of the Ebola outbreak in West Africa three years ago. She admitted afterward WHO was unprepared for the epidemic.

WHO said it already supports increasing the surveillance systems in countries that have reported Zika and said that may be increased in the coming weeks. The organization said it will also focus on new vaccines and ways to control the mosquito population.

Tracking Zika virus infections is difficult, however. Unlike a virus such as measles, which produces clear signs of infection, many people with Zika never realize they're infected. About 80% of people infected by Zika have no symptoms. In others, symptoms may be too mild for people to even see a doctor. Common symptoms include a rash, low fever, mild headache, joint pain and pink eye, according to the WHO.

Scientists have a number of key questions about Zika and why its emergence in Brazil has coincided with the spike in microcephaly, or abnormal small head sizes, and why these birth defects have increased in Brazil but not in other countries.

Aylward, the WHO assistant director-general, noted Brazil is contending with multiple outbreaks of disease spread by Aedes mosquitoes, including dengue and chikungunya, which both cause fevers and joint pain. Aylward said doctors are looking into whether Zika becomes more dangerous if people are also infected with other mosquito-borne diseases, or if people have been infected with these diseases in the past.

The CDC has issued a travel alert, warning pregnant women to avoid traveling to places with Zika outbreaks.

After the latest reports of the virus, all three of the USA's biggest airlines are allowing some customers to cancel or postpone their trips if they’re flying to areas affected by Zika. American, United and Delta each made the move this week amid rising concerns about the mosquito-borne virus.

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