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Zika Virus moves towards a Pandemic 2016

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Potential Sexual Transmission of Zika Virus
Didier Musso , Claudine Roche, Emilie Robin, Tuxuan Nhan, Anita Teissier, and Van-Mai Cao-Lormeau

Abstract

In December 2013, during a Zika virus (ZIKV) outbreak in French Polynesia, a patient in Tahiti sought treatment for hematospermia, and ZIKV was isolated from his semen. ZIKV transmission by sexual intercourse has been previously suspected. This observation supports the
possibility that ZIKV could be transmitted sexually.


The Study

In early December 2013, during the ZIKV outbreak, a 44-year-old man in Tahiti had symptoms of ZIKV infection: asthenia, low grade fever (temperature from 37.5°C to 38°C) and arthralgia. Symptoms lasted 3 days. Eight weeks later, he described a second episode of symptoms compatible with ZIKV infection: temperature from 37.5°C to 38°C, headache on days 1–3, and wrist arthralgia on days 5–7. The patient did not seek treatment, thus biological samples were not collected during the first 2 periods of illness. The patient fully recovered from the second episode, but 2 weeks later he noted signs of hematospermia and sought treatment. Because the patient had experienced symptoms of ZIKV infection some weeks before, he was referred to our laboratory in the Institut Louis Malardé, Papeete, Tahiti for ZIKV infection diagnostic testing. The medical questionnaire revealed no signs of urinary tract infection, prostatitis, urethritis, or cystitis, and the patient stated that he did not had any recent physical contact with persons who had acute ZIKV infection. We collected blood and semen samples. Direct and macroscopic examinations of the semen confirmed hematospermia. We extracted RNA using the NucliSENS easyMAG system (bioMérieux, Marcy l’Etoile, France) from 200 μL of blood and from 500 μL of semen and urine; both were eluted by 50 μL of elution buffer. We used 5 μL of RNA extracted for amplification. We tested blood and semen RNA extracts using real-time reverse transcription PCR (rRT-PCR) as described using 2 primers/probe amplification sets specific for ZIKV (3). The rRT-PCR results were positive for ZIKV in semen and negative in blood, and confirmed by sequencing of the genomic position 858–1138 encompassing the prM/E protein coding regions of ZIKV. The generated sequence (GenBank accession no. KM014700) was identical to those previously reported at the beginning of the ZIKV outbreak (3). Three days later, we collected a urine sample, then a second set of blood and semen samples. Semen and urine from this second collection were not found to contain traces of blood by both direct and macroscopic examinations. rRT-PCR detected ZIKV RNA in the semen and urine, but not in the blood sample.

We quantified ZIKV RNA loads using an RNA synthetic transcript standard that covers the region targeted by the 2 primers/probe sets. RNA loads were: 2.9 × 107 copies/mL and 1.1 × 107 copies/mL in the first and second semen samples, respectively, and 3.8 × 103 copies/mL in the urine sample.

We cultured semen and urine as described for dengue virus cultured from urine (6). Briefly, 200 μL of each sample diluted in 200 μL of 1% fetal calf serum (FCS) minimum essential medium (MEM) were inoculated onto Vero cells and incubated for 1 h at 37°C; inoculum was then removed and replaced by 1 mL of culture medium. We also inoculated a negative control (200 μL of 1% FCS-MEM) and a positive control (5 μL of a ZIKV-positive serum diluted in 200 μL of 1% FCS-MEM). The cells were then incubated at 37°C in 5% CO2 for 6 days. The presence of ZIKV in the culture fluids was detected by rRT-PCR as described.

Replicative ZIKV particles were found in the 2 semen samples but none were detected in the urine sample. This finding does not exclude the possibility that ZIKV particles were present in urine. Positive samples were not titered.

Conclusions

The ZIKV natural transmission cycle involves mosquitoes, especially Aedes spp. (7), but perinatal transmission (8) and potential risk for transfusion-transmitted ZIKV infections has also been demonstrated (9). Moreover, ZIKV transmission by sexual intercourse has been suggested by Foy et al. (10), who described a patient who was infected with ZIKV in southeastern Senegal in 2008. After returning to his home in Colorado, United States, he experienced common symptoms of ZIKV infection and symptoms of prostatitis. Four days later, he observed signs of hematospermia, and on the same day, his wife had symptoms of ZIKV infection. Because the wife of the patient had not traveled out of the United States during the previous year and had sexual intercourse with him 1 day after he returned home, transmission by semen was suggested. ZIKV infection of the patient and his wife was confirmed by serologic testing, but the presence of ZIKV in the semen of the patient was not investigated.

Infectious organisms, especially sexually transmitted microorganisms including viruses (human papillomavirus or herpes simplex virus), are known to be etiologic agents of hematospermia (11). To our knowledge, before the report of Foy et al. (10) and this study, arbovirus infections in humans had not been reported to be associated with hematospermia, and no arboviruses had been isolated from human semen.

We detected a high ZIKV RNA load and replicative ZIKV in semen samples, but ZIKV remained undetectable by rRT-PCR in the blood sample collected at the same time. These results suggest that viral replication may have occurred in the genital tract, but we do not know when this replication started and how long it lasted. The fact that the patient had no common symptoms of ZIKV acute infection concomitantly to hematospermia suggests that the viremic phase occurred upstream, probably during the first or second episode of mild fever, headache, and arthralgia.

The detection of ZIKV in both urine and semen is consistent with the results obtained in a study of effects of Japanese encephalitis virus, another flavivirus, on boars. The virus was isolated from urine and semen of experimentally infected animals, and viremia developed in female boars that artificially inseminated with the infectious semen (12).

Flaviviruses have also been detected in urine of persons infected with West Nile virus (WNV). WNV RNA was detected in urine for a longer time and with higher RNA load than in plasma (13). WNV antigens were detected in renal tubular epithelial cells, vascular endothelial cells, and macrophages of kidneys from infected hamsters (14), suggesting that persistent shedding of WNV in urine was caused by viral replication in renal tissue. Dengue virus (DENV) RNA and DENV nonstructural protein 1 antigen were also detected in urine samples for a longer time than in blood, but infectious DENV has not been isolated in culture. Hirayama et al. concluded that the detection of DENV by rRT-PCR was useful to confirm DENV infections after the viremic phase (6). Also, yellow fever virus RNA was isolated from the urine of vaccinated persons (15), and Saint Louis encephalitis viral antigens, but not infective virus, have been detected in urine samples from infected patients (10).

Our findings support the hypothesis that ZIKV can be transmitted by sexual intercourse. Furthermore, the observation that ZIKV RNA was detectable in urine after viremia clearance in blood suggests that, as found for DENV and WNV infections, urine samples can yield evidence of ZIKV for late diagnosis, but more investigation is needed.

Dr. Musso is a medical doctor and director of the Diagnosis Medical Laboratory and the Unit of Emerging Infectious Diseases of the Institut Louis Malardé, Papeete, Tahiti, French Polynesia. His research programs target endemic infectious diseases, especially arbovirus infections, leptospirosis, tuberculosis, and lymphatic filariasis.
Acknowledgment

We obtained written informed consent from the patient for publication of this report, and publication of data related to ZIKV infections have been approved by the Ethics Committee of French Polynesia under reference 66/CEPF.

See the Whole CDC Report Here
http://wwwnc.cdc.gov/eid/article/21/2/14-1363_article
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: January 29 2016 at 8:42am
It's a shame abortion is illegal in Brazil.  

We hear a lot about malformed babies, but the majority if not all are also suffering from bran damage as well. 

Our next generation is going to be handicapped mutants at this rate.   This could be going on for a decade until there's a vaccine.   An avian flu pandemic would have almost been a better choice. 

Sugar coating is not my gig.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: January 29 2016 at 10:27am
I could not agree more, Boss. 

This will not only destroy those directly damaged, but the lives of their nearest relatives too.  I speak from personal experience, yet my son was far less damaged than those poor babies.  I am lucky enough to live in a country with a good welfare system to support me with his care as well.  

What those mothers, fathers and siblings face does not bare thinking about.  The ramifications spread out to grandparents, aunts, uncles and the employment prospects of the carers.  Eventually the health of the carers suffers, until finally care ceases to be an option.  What then for the children?  Who cares when the carers no longer can?  Even here where there is a care system I did not surrender my son until I could no longer walk.  No one abandons their children without a colossal fight.  Two years later, I can hobble again and my son is happy and cared for.  But this is a rich country.  In poorer areas, with less available options the future is horribly bleak.

So I applaud your honesty!  Hiding unpleasant truths, behind closed doors or political correctness does no favors for anyone.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: January 30 2016 at 4:34am
Although I still feel they are not ready yet to declare a Pandemic from Zika,

http://wwntradio.com/2016/01/30/mosquito-borne-zika-virus-spreading-explosively.html

The WHO will have an emergency committee on Monday to decide if the Zika virus outbreak should be declared in worldwide health emergency.

The Zika virus is spread through mosquito bites. Instead, all have recently traveled to countries where Zika is circulating.

But if a woman is infected during pregnancy, it can trigger birth defects.

Earlier Thursday, the head of the World Health Organization, Dr. Margaret Chan, said the virus has escalated from being "a mild threat to one of alarming proportions", NPR reported.

"Health experts and researchers are working to strengthen the connection between the Zika virus in the mother and any potential connection to this poor health outcome", says Tompkins. "There is a need for greater awareness amongst community", the health minister said. The particular mosquito to blame for the Zika virus is the female Aedes Aegypti mosquito, a common mosquito in the warmer Gulf coast states.

Zika is spread by mosquitoes. Dr K K Agarwal, honorary general secretary of IMA, said though the chances of the virus spreading are slim, the possibility can't be ruled out either.

comment: They are getting rather verbal in many locations saying it is not going to spread - especially to Northern California. 

http://www.sacbee.com/news/local/health-and-medicine/healthy-choices/article56963613.html

While a case of Zika virus was reported in California this week, health officials say the state’s dry Mediterranean climate and pest control efforts make it an unlikely home for the mosquitoes that carry the tropical disease.

Two species of Aedes mosquito can transmit the virus, but neither is found in high concentrations in California. Some mosquitoes, however, have been detected as far north as Hayward and Menlo Park in the Bay Area and in Central Valley cities such as Madera, Fresno and Clovis. The mosquitoes have been found in the greatest numbers in Southern California, particularly near the U.S.-Mexico border, said local mosquito control officials.

comment: referring to another recent post, if it can be transmitted sexually or by other means this throws all the reassurances we won't have a more serious problem out the window.

I have been stressing the fact that the criteria for WHO to declare this a Pandemic is rather specific. It is my thinking on this that at a time of world financial instability, they are going to really be hesitant to declare a Pandemic. Yet the alert level will likely be raised and Monday is a date this could happen.

One recent statement which I feel is pretty accurate is that there is "no way" we are going to have a vaccine for this "for years".  Given the necessary steps to test a vaccine for public use we can for the present assume we may not see anything like it until this disease spreads a great deal.

The problem is, it is likely it may have other routes to spread besides mosquitoes, and if so, in all the countries and states which keep stressing they are safe, they aren't.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: January 30 2016 at 4:49am
Originally posted by wrote:

Potential Sexual Transmission of Zika Virus
Didier Musso , Claudine Roche, Emilie Robin, Tuxuan Nhan, Anita Teissier, and Van-Mai Cao-Lormeau

Abstract

In December 2013, during a Zika virus (ZIKV) outbreak in French Polynesia, a patient in Tahiti sought treatment for hematospermia, and ZIKV was isolated from his semen. ZIKV transmission by sexual intercourse has been previously suspected. This observation supports the
possibility that ZIKV could be transmitted sexually.

See the Whole CDC Report Here
http://wwwnc.cdc.gov/eid/article/21/2/14-1363_article


This disturbs me a lot. What does CDC say about this?

http://www.cdc.gov/zika/transmission/index.html

Through infected blood or sexual contact

  • Spread of the virus through blood transfusion and sexual contact have been reported.

This means that we could be looking at an HIV scenario globally which could result in a Pandemic.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: January 30 2016 at 4:50am
http://patients.about.com/od/yourdiagnosis/a/pandemic.htm

Phases of a Pandemic

WHO keeps track of all identified viruses, animal or human, through a set of phases or stages.

  • Phase 1: Viruses are circulating within animals only. No human infection has resulted from the animal virus.
  • Phase 2: An animal virus has caused an infection in a human being. At this point there is a basic level of pandemic threat because the virus strain has mutated to make that transfer to a human.
  • Phase 3: Small clusters of human beings have contracted the virus in one community. There is potential for spread of the virus if others outside that community come into contact with those humans who are infected. At this point, the illness may be epidemic in that community, but it is not pandemic.
  • Phase 4: Human-to-human and animal-to-human virus transmission is causing outbreaks in many communities and more people are getting sick in those communities. More communities report outbreaks and pandemic is more likely, although, according to WHO, a pandemic is not a forgone conclusion.
  • Phase 5: Human-to-human transmission is taking place in at least two countries in one WHO region. WHO has a network of 120 National Influenza Centers in 90 different countries. At phase 5, most countries are not affected (yet) but a pandemic is considered imminent. This phase is the signal that governments and health officials must be ready to implement their pandemic mitigation plans.
  • Phase 6: A global pandemic is underway. Illness is widespread and governments and health officials are actively working to curtail spread of the disease, and help their populations deal with it using preventive and stop-gap measures.

comment: We have not reached this level yet as per definition. While millions of infections have been predicted we are not there yet.

  • Post-pandemic: After the increase in activity, the disease-spreading activity will begin to wane. The key at this point is to be prepared to try to prevent a second wave.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: January 31 2016 at 3:18am
Not yet a Pandemic, Zika continues to spread.  Sunday Editorial

As we approached February 2016 the world is filled with speculation and alarm.
http://www.who.int/mediacentre/news/statements/2016/emergency-committee-zika/en/

Tomorrow WHO Director-General, Margaret Chan, will convene an International Health Regulations Emergency Committee on Zika virus and observed increase in neurological disorders and neonatal malformations.

The Committee will meet on Monday 1 February in Geneva to ascertain whether the outbreak constitutes a Public Health Emergency of International Concern.

comment: The meeting is not to declare a Pandemic. WHO will begin the following courses of action.

The World Health Organization is supporting countries to control the Zika virus disease through the following steps:

  • Strengthen surveillance
  • Build the capacity of laboratories to detect the Zika virus
  • Work with countries to eliminate mosquito populations
  • Prepare recommendations for the clinical care and monitoring of people diagnosed with the Zika virus infection
  • Define and support priority areas of research into the Zika virus disease and possible complications emanating from it

Most of all in all effected areas, we must continue to respond with a calm focused effort to limit the spread of this disease and continue to be precise and realistic about how much it can spread and ways it will.

Countries and Territories with Active Zika Virus Transmission

The virus can be expected to spread further, as the mosquitoes which carry it can be found across the following countries and territories with active Zika virus transmission:

  • Barbados
  • Bolivia
  • Brazil
  • Cape Verde
  • Colombia
  • Dominican Republic
  • Ecuador
  • El Salvador
  • French Guiana
  • Guadeloupe
  • Guatemala
  • Guyana
  • Haiti
  • Honduras
  • Martinique
  • Mexico
  • Panama
  • Paraguay
  • Puerto Rico
  • Saint Martin
  • Samoa
  • Suriname
  • United States Virgin Islands
  • Venezuela


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: January 31 2016 at 3:39am
Common sense protection against Zika.  Although there may be other ways it can spread than mosquitoes, most houses and apartments in the more developed countries have screens in their windows. Make sure yours are in good condition and replace those that are not.

Realistically, Zika may infect more than pregnant women.

http://www.nytimes.com/2016/01/22/world/americas/zika-virus-may-be-linked-to-surge-in-rare-syndrome-in-brazil.html


But disease specialists in Brazil say that the virus may also be causing a surge in another rare condition, the potentially life-threatening Guillain-Barré syndrome, in which a person’s immune system attacks part of the nervous system, leaving some patients unable to move and dependent on life support.


“Guillain-Barré can be a nightmare for those who have it,” said Dr. Wellington Galvão, a hematologist in the city of Maceió in northeast Brazil who treated 43 patients with Guillain-Barré in 2015, up from an average of 10 to 15 cases in previous years. “I estimate that Zika increases by about 20 times the probability that an individual can get Guillain-Barré.”

Is it possible for airlines to shut down entry from infected countries? 

There is very little chance a vaccine could be developed in less than a year. While many areas in the Northern Hemisphere are reasonable safe from mosquitoes since we are the dead of Winter, Spring and Summer are coming.

In conclusion, for now, there seems to be a great resistance by WHO to declaring a Pandemic as per the wording implemented since the 2009 Pandemic. Basically, it boils down to they will not declare one unless people are literally dying in the streets. That is my take on this.

Also, the mobilization needed can be initiated without demonizing countries that are infected. This spreading disease could hurt the global economy in a big way. No one wants that.

Perhaps a key phrase is "active transmission". What does that mean?

Bogota, Columbia - January 30, 2016

There are 20,297 confirmed cases of the virus in Colombia, the national health institute said in a epidemiology bulletin, and among them are 2,116 pregnant women.

Pandemic? Not yet. Outbreak. Definitely.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 01 2016 at 7:26am
Situation moves to worldwide health emergency as Zika spreads.

http://www.newsmax.com/Newsfront/Health-Zika-WHO-Margaret-Chan/2016/01/28/id/711573/

Margaret Chan, head of The World Health Organization (WHO) cited four main reasons why WHO is "deeply concerned" about Zika: The possible link to birth defects and brain syndromes, the prospect of further spread, a lack of immunity in populations in the newly affected areas and the absence of vaccines, treatments or quick diagnostic tests for the virus.

Still, convening an emergency committee does not guarantee that a global emergency will be declared — WHO has held 10 such meetings to assess the Middle Eastern respiratory syndrome coronavirus and no emergency has been announced.

Declaring a global emergency is akin to an international SOS signal and usually brings more money and action to address an outbreak. The last such emergency was announced over the 2014 devastating Ebola outbreak in West Africa; polio was declared a similar emergency the year before.

She also noted a possible relationship between Zika infection and Guillain-Barre syndrome, which can cause temporary paralysis.

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

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 01 2016 at 3:31pm
Margaret Chan - head of WHO - declares an International Public Health Emergency
February 1, 2016


 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 01 2016 at 3:34pm
Now they have declared an emergency, what will they do?

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Diligent Quote  Post ReplyReply Direct Link To This Post Posted: February 01 2016 at 5:04pm
Hello Forum, Can you help me, please ? Has anyone information that the Zika virus { zvirus } can be spread through saliva ?

Appreciate any help or input, for sure.

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Hi Diligent, long time no see.  A few of us here think that it may possibly transmit by saliva, although no proof at this time.    I personally think it's possible.    We're tracking possible bodily fluid / saliva transmission here. 

I think it personally transmits similar to Ebola via bodily fluids, with the help of the mosquito, but not a lot of info on it, yet.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Diligent Quote  Post ReplyReply Direct Link To This Post Posted: February 01 2016 at 7:03pm
Thank-you, Albert.

I appreciate the feedback.

Watching carefully.

Sincerely,

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 02 2016 at 6:59am
Zika has reached Australia as well as confirmation of the mosquitoes that carry it.

http://www.dailytelegraph.com.au/news/nsw/zika-virus-mosquitoes-found-in-sydney-airport-increases-insecticide-spraying-of-incoming-passengers/news-story/997365490643371ee6cea1578e0522d5

MOSQUITOES capable of spreading the deadly zika virus have been detected at Sydney’s international airport, prompting increased insecticide spraying of passengers arriving from infected regions.


A potential outbreak of the Zika virus is more likely to occur in far north Queensland than anywhere else in Australia, according to public health experts who believe Sydney will be spared from the worldwide spread of the disease.

http://www.gippslandtimes.com.au/story/3701933/two-confirmed-cases-of-zika-virus-in-australia-researchers-warn-after-who-emergency-declaration/


The NSW Health department has confirmed two cases of Zika virus in Australia from passengers travelling from the Caribbean back to Sydney.


comment: With the large numbers of cases in Latin American, and its likely spread, it is hard to believe that with things a lot warmer now in the Land Down Under, there is not a possible spread via mosquitoes. Even the declaration of an international emergency does not seem enough to really paint a realistic picture of a disease that still could become Pandemic.  Just because people are not coming down with soaring fevers and covered with spots does not mean that the neurological component is not highly significant.

A disease that could paralyze you and require intervention so you can breathe is dangerous. Also if it impairs mental function or attacks the brain, we already have enough brilliant foreign policy decisions and wars, without our leaders having any more reality issues. It has been a characteristic pattern to start downplaying the seriousness of outbreaks and the numbers of people infected. There are tens of thousands already infected and although one in five may be symptomatic, that still could be a lot of people. Also over time, symptomatic or not, this could be a killer.

I have always said, and you can read back over my posts for the last 3 years, that the next Pandemic will have a nuero component. We started seeing that in the past with other viruses with people jumping out of windows and other serious issues. It still would be wise to prepare, store food, keep some of your money in cash and gold, and know there are some bad times coming. Any disease like Zika could hit our medical system hard as well as really cause some real pain and suffering to our Latin American brothers and sisters. Just because it isn't here yet - doesn't mean it isn't  coming... not if, but when.

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Post Options Post Options   Thanks (2) Thanks(2)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 02 2016 at 6:49pm
Having started tracking this early on I should continue onward if it becomes Pandemic.  Guess it is time to get that book out which has been on the burners for a long time. 

http://www.boston.com/news/nation/2016/02/02/case-zika-infection-transmitted-sex-reported-texas/zrEQtAsqQoEpfv6WK32i1H/story.html

I do see and appreciate a lot more people are posting here on Zika, especially Albert and it all helps. I had to take a break with my lady and listen to some good rock music and take a few hours off.

If it can be transmitted sexually, I would say we may well be about to have a Pandemic - declared or not. A lot of traffic must be going through here- because I am getting a lot of lag and having trouble posting.

It is ironic. We have evolved an now have a very permissive society with people having multiple sex partners.  Not going to get Biblical but common sense is those married or with someone in a monogamous relationship will not have to worry about a sexually transmitted disease. Life styles that are open will have to start taking precautions. This is only the tip of the iceberg really.

If this disease can be spread by droplets then this will be even more serious.

Thanks again to all the posters here over the years - my AFT family. People are reading AFT. It is coming up #1 in many searches.  One of the few places on the net we post 24/7 - the real news.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote CRS, DrPH Quote  Post ReplyReply Direct Link To This Post Posted: February 03 2016 at 9:42am
Is the Zika outbreak a pandemic yet? 

It is moving in that direction.  A viral pandemic would require sustained transmission of the pathogen in more than one country - that is the simple definition of "pandemic."   There is nothing sinister about the term, it is an epidemiological statement of a viral natural history.  


The key is "sustained."  HIV AIDS is a pandemic, H1N1 swine flu is a pandemic etc.  We still do not know enough about Zika to formally declare a pandemic.  Rather, there seem to be regional outbreaks without sustained transmission (thus far). 

The fact that WHO has declared a "global emergency" is noteworthy, as they dragged their feet on this during the Ebola outbreak (which did not rise to pandemic criteria).  





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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 03 2016 at 10:23pm
Originally posted by CRS, DrPH CRS, DrPH wrote:

Is the Zika outbreak a pandemic yet? 

It is moving in that direction.  A viral pandemic would require sustained transmission of the pathogen in more than one country - that is the simple definition of "pandemic."   There is nothing sinister about the term, it is an epidemiological statement of a viral natural history.  


The key is "sustained."  HIV AIDS is a pandemic, H1N1 swine flu is a pandemic etc.  We still do not know enough about Zika to formally declare a pandemic.  Rather, there seem to be regional outbreaks without sustained transmission (thus far).





Thanks for posting this. I have been looking for days to try and figure out where exactly they are in terms of what is a "Pandemic"?

I also agree with you they definitely don't know much about Zika in terms of how it can spread or if it has mutated.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 03 2016 at 10:23pm
Have posted this in the news as well - but the governor in Florida has declared a Zika emergency.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 04 2016 at 4:22am
Did not see this before. Not sure if this is a delayed release of information or what, but Zika is in New York.

http://oracleherald.com/2016/01/25/3-test-positive-for-zika-virus-in-ny.html

3 test positive for Zika virus in NY


"The mayor's office will be intensifying inspections for the Olympics in August, despite this being a period with lower numbers of mosquitoes", City Hall said in a statement today.

The Zika outbreak also comes as Rio prepares for its annual carnival celebrations which begin on February 5.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Satori Quote  Post ReplyReply Direct Link To This Post Posted: February 04 2016 at 7:40am

Brazil confirms Zika infection from a blood transfusion


http://www.reuters.com/article/us-health-zika-brazil-blood-idUSKCN0VD22N

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I read that the organizers of the carnival in Rio are advising people to wear long sleeves and pants. Because the carnival is all about sensible clothing...


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"Any community that fails to prepare, with the expectation that the federal government will come to the rescue, will be tragically wrong." Michael Leavitt, HHS Secretary.
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I'm a mosquito magnet. I always have been. My husband doesn't worry when there's a mosquito in our room at night because he knows it'll be busy feasting on me and leave him well alone. At BBQ's I'm always the one in jeans, socks and sturdy shoes.
Those who got it wrong, for whatever reason, may feel defensive and retrench into a position that doesn’t accord with the facts.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: February 04 2016 at 11:49am
Me too - I spent the last part of the summer with bites all over me working on my truck at my in laws, even with long pants and bug spray. Couldn't work out where they where coming from because the neighbors on either side said they has no mosquitoes - until I discovered the unused hot tub in the back yard still had water in it. It had so many larvae in it, I swear they were swimming in shoals. A gallon of bleach and an hour with the jets running at 104 degrees fixed them, but they were back less than a week later. Most of them were Asian Tiger mosquitoes, and it turns out they were in the house too - and they feed all day instead of just dusk and dawn like most species.
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Well it sure does seem to be spreading - 6 cases in Canada as of Feb.2 according to this... interesting quoete from article... “I was on TV a lot, and explained why Ebola will never gain a foothold here,” says Hotez. “I’m not saying that now. I’m very concerned.”


[URL= ][/URL]http://www.msn.com/en-ca/health/medical/zika-the-new-global-health-terror/ar-BBp5LZs?li=AAggNb9&ocid=iehp[URL= ][/URL]

In the Zika forest of Uganda, in April 1947, a rhesus monkey developed a fever. The monkey was caged on a tree platform, part of a U.S. research program investigating tropical diseases. Two days later, the feverish monkey was brought to a lab in the town of Entebbe, where its blood serum was injected into mice. After 10 days, all the mice were sick too. This was the first recorded appearance of the Zika virus, which was later found in mosquitoes trapped in the same forest, according to a 2009 article in the journal Emerging Infectious Diseases. Scientists learned that these mosquitoes could spread the virus to humans, but the symptoms are generally mild, and last only up to a week: they include fever, rash, joint pain and red eyes. In fact, only one in five infected people show any symptoms at all. For the next 60 years or so, the Zika virus was more or less forgotten.

Less than a year ago, Zika was reported in Brazil. As more people were infected, evidence began to emerge that this virus might not be so harmless at all. Officials started to suspect that pregnant women who are bitten by an infected mosquito might be more likely to give birth to infants with brain damage and abnormally small heads, a condition called microcephaly. Other people are apparently at risk of developing Guillain-Barré syndrome, which can cause temporary paralysis and, in rare instances, death. Scientists have yet to definitively link either condition to Zika infection, but such a link looks increasingly likely. Before they had a chance to fully understand the virus’s impact, the number of cases started growing out of control.

In recent months, the Zika virus has ripped through the Americas like wildfire, sparking a pandemic that nobody saw coming. Zika has gone “from a mild threat to one of alarming proportions,” says World Health Organization director-general Margaret Chan, who warned that it is spreading “explosively” through the region. With up to 1.5 million cases in Brazil alone, the WHO predicts there could soon be up to four million people infected across the Americas. (By contrast, a total of 8,098 people worldwide became sick during the 2003 outbreak of severe acute respiratory syndrome, or SARS.)

Aedes aegypti mosquitos are seen in containers at a lab of the Institute of Biomedical Sciences of the Sao Paulo University, on January 8, 2016 in Sao Paulo, Brazil. Researchers at the Pasteur Institute in Dakar, Senegal are in Brazil to train local researchers to combat the Zika virus epidemic. / AFP / NELSON ALMEIDA (Photo credit should read NELSON ALMEIDA/AFP/Getty Images)© Used with permission of / © Rogers Media Inc. 2016. Aedes aegypti mosquitos are seen in containers at a lab of the Institute of Biomedical Sciences of the Sao Paulo University, on January…
As of Feb. 2, Zika was transmitting locally in 26 countries and regions in Central and South America and the Caribbean, including Mexico, Barbados and Puerto Rico—places where, a year ago, it had never been seen. The WHO predicts that it will spread to all regions in the Americas, except for Canada and continental Chile, where the type of mosquito that carries it can’t survive. They say it might also reach areas in Africa, Asia and southern Europe. There’s currently no Zika vaccine, no treatment, no cure.

There’s new evidence that mosquitoes might not be the only ones responsible for its spread. On Feb. 2, health officials in Dallas County, Texas, reported the first locally acquired case of the Zika virus on U.S. soil in the current outbreak—a person who was infected sexually, by someone who was sick with Zika after a trip to Venezuela. So far, there’s only been limited evidence that Zika could be transmitted sexually. If more cases like this are reported, that will change the nature of the threat once more.

Public health officials’ mounting panic was evident in the wave of warnings issued shortly after the new year, each more tensely worded than the last. On Jan. 15, the U.S. Centers for Disease Control (CDC) issued an unprecedented advisory, instructing pregnant women not to travel, if at all possible, to 14 Zika-affected countries and regions. Days later, they added eight more to the list, like Ecuador; Cape Verde, off the coast of Africa; and Samoa, in the South Pacific. Nigeria has issued a travel restriction to Latin America, aimed at pregnant women. In the U.K., authorities told couples returning from these areas to avoid getting pregnant for at least a month, while they might unknowingly be infected. And Canadians coming home from the region have been told not to donate blood for one month, in case they’re carrying the virus.

On Feb. 1, the WHO took the rare step of naming Zika a “public health emergency of international concern.” A political manoeuvre intended to direct money and resources—and especially attention—at the crisis, it should spur efforts to halt the virus’s spread. In declaring the public health emergency, the WHO cited “the recent cluster of microcephaly cases,” and advised pregnant women to consider delaying travel to affected areas. It stopped short of making any travel or trade restrictions, although some critics attacked the agency for not warning pregnant women off visiting affected countries.

Still, a growing number of would-be travellers are changing plans. Air Canada and other airlines recently said they’d allow passengers to change or cancel bookings to regions where Zika is spreading. The pandemic sprang to life so quickly that others have been caught off-guard. Travellers returning to Australia, Denmark, Israel and the U.S. have since been diagnosed with Zika. Here in Canada, as of Feb. 2, six cases of infection had been reported: two in B.C., one in Alberta, and three in Quebec. All six had recently visited either Brazil, El Salvador, Colombia or Haiti, according to the Public Health Agency of Canada. At least one baby in the U.S. has been born with microcephaly. The child’s mother was in Brazil early in her pregnancy.

For those who live where the Zika virus is circulating, the situation looks even more stark. The fear of birth defects is so great that authorities in Colombia, El Salvador, Jamaica and Ecuador have reportedly urged women not to get pregnant for now. With no treatments that stop the virus, doctors’ best advice is to avoid mosquito bites, to use bug repellent and to stay indoors. For now, there is no end in sight. “It is a pandemic,” says Brian Ward, a professor of medicine and microbiology at McGill University, and an expert in tropical diseases. “We are on the upslope.”

More clouds are gathering on the horizon. In August, Brazil hosts the Summer Olympics, and half a million tourists are expected to visit. The country plans to deploy 220,000 military troops to go door-to-door and speed eradication efforts. Incredibly, Brazil is warning pregnant women not to attend. “The risk, which I would say is serious, is for pregnant women. It is clearly not advisable for you [to travel to Brazil for the Games] because you don’t want to take that risk,” said Jaques Wagner, President Dilma Rousseff’s chief of staff. But the risk to others is not so serious, he continued, and insisted that the Olympics will not be cancelled.

In the southern U.S., where no local transmission by mosquito has been reported to date, people are bracing for springtime, when the bugs become more active. The Aedes aegypti species, which carries Zika, can be found in Florida and along the Gulf Coast. “If you have a generation of pregnant women terrified of going outside,” says Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, “that’s going to be a game-changer.”

Zika is spreading so rapidly—and seems to have such devastating effects—that experts speculate the virus may have mutated, and taken on a far more dangerous form.

DAILY_ZIKA_VIDEO_POST01© Used with permission of / © Rogers Media Inc. 2016. DAILY_ZIKA_VIDEO_POST01
Scientists don’t know how Zika made its way to the Americas, halfway around the world from where it was discovered. It seems to have hopped eastwards along islands that dot the Pacific. An isolated outbreak was reported on the tiny South Pacific island of Yap, in 2007, and another in French Polynesia in 2013. There, 11 per cent of the population was affected. But not many people live on those islands, and Zika’s effects—which are mild in most people—didn’t raise flags.

The virus arrived in Easter Island, off the coast of South America, and then came to Brazil. That country has plenty of disease-carrying mosquitoes, and a massive population of 200 million—the vast majority with little or no immunity to Zika, like almost everyone else in the Americas. Brazilian public officials first reported local transmission of the virus in May 2015. “There wasn’t very much concern about it,” Ward says. “Compared to dengue and chikungunya,” two other mosquito-borne illnesses in the area, he says, “Zika is a weenie.” At least, that’s what authorities believed at the time.

As the number of infections grew, officials noticed something chilling: a twentyfold increase in babies born with microcephaly, a rare and devastating birth defect. “Microcephaly is not subtle. It’s very severe,” says Kellie Murphy, a maternal-fetal medicine specialist at Toronto’s Mount Sinai Hospital. The outcomes of these babies vary widely. Some will struggle to feed themselves, and have a shortened lifespan. (No Canadian cases of Zika-linked microcephaly have been reported. Maternal infections with viruses like rubella, or chromosomal disorders, can also cause the condition.)

On Jan. 27, health authorities in Brazil said that, since Oct. 4, 180 cases of suspected microcephaly had been reported. (Brazil typically sees about 150 cases per year.) After over 700 reports were examined, microcephaly was confirmed in 270 of them—and in six of those, there was evidence of Zika. Researchers discovered the virus in the amniotic fluid of two pregnant women, whose fetuses were diagnosed with microcephaly via ultrasound. The CDC found traces in the brains of two newborns with microcephaly who died, and in the placentas of two women who miscarried fetuses with the condition.

“Retrospectively, in French Polynesia, we’re seeing evidence that [microcephaly] may have been happening there, too,” says Scott Weaver, director of the Institute for Human Infections and Immunity at the University of Texas Medical Branch. But the population there is so much smaller, it was harder to notice. Weaver and his team are trying to develop a lab animal that can be used as a research model of Zika infection, to understand how the virus might contribute to microcephaly. It could take several more months of work, WHO officials say, before a link between Zika and microcephaly is confirmed.

At this time of year, Canadians would typically be flocking south. Spooked travellers are starting to reconsider. “I certainly can’t recall another situation where airlines were so willing to offer a refund due to an outbreak,” travel blogger Chris Myden says in an email. “They’re generally reluctant to give refunds for any reason.”

In late January, Myden started to notice some chatter about Zika on his Facebook pages, which feature deals on flights and travel packages from Canada. On the Edmonton page, one woman wrote: “Any thoughts on the Zika virus?” She’d planned to visit the Bahamas (which is not currently on the list of affected regions) with a pregnant friend. Confusion reigned. One poster accused the media of “massively overblowing” the Zika pandemic. Another poster told her she should go, but not let her friend outside. Others suggested wearing lots of bug spray, but one woman wrote: “Diligence with repellent is not enough. I was eaten alive in Australia a few weeks ago despite using 80 per cent DEET religiously—they’ll find a spot.” Said another: “Have a great time, drink too much, get lots of sunshine and don’t worry about it.”

If would-be travellers are confused, imagine those who’ve recently visited a place where Zika is spreading. They have to cope with a frustrating lack of information. There is no commercially available test for Zika. Canada’s Public Health Agency has a test that can detect the virus in a patient’s blood up to two weeks after infection. If a pregnant woman travelled earlier on, that test won’t be of much use. (The agency, which is working to build testing capacity, says it can send away for further tests to the CDC if necessary.) “Ideally, it would be great to check [a patient’s] blood and say, ‘You’re not at risk,’ ” says Murphy, the Mount Sinai obstetrician. “But we’re not there yet.”

Canadian doctors are following the CDC’s advice to pregnant women, but it’s vague. If the woman has no symptoms, but has visited an area where Zika is circulating, the CDC says that her doctor should follow the fetus regularly via ultrasound to look for signs of microcephaly. The condition is best diagnosed late in the second trimester and beyond; but the accuracy of this method in detecting microcephaly related to Zika “is not known,” the CDC says, adding that better guidelines will be drafted when we know more. Women with symptoms of Zika should be tested, the CDC says, but that doesn’t address the four-in-five who won’t show any. Doctors can’t say for sure if their fetuses will be affected. Neither Canada nor the U.S. currently has the capacity for general screening. “You’d be scaring a huge number of people unnecessarily,” Ward says. “If there were something we could do about it, maybe I’d feel differently.”

Many women who have contracted Zika seem to have healthy babies. For a person who tests positive, health authorities’ best recommendations are rest, drink fluids and take acetaminophen to reduce pain and fever.

Those early in their pregnancies, especially in the first trimester, are probably most vulnerable, but even that’s not definitive—which is why Lyle Petersen, the CDC’s director of vector-borne diseases, said that pregnant women “in any trimester” should avoid visiting a region where Zika is transmitting. “We do not know exactly what is the biggest period of risk during a woman’s pregnancy,” he said. “This is a new situation. It’s a dynamic situation. I think we’re just going to have to wait and see how this all plays out.”

The CDC guidelines are “confusing,” says Hotez. “Too much is left for the layperson to interpret.” And they’re cold comfort to people living in Brazil, El Salvador, Colombia and other areas where the virus has taken hold. They face the harrowing prospect of putting off pregnancy, or having a child with a lifelong disability. Some countries in the region ban abortion outright. In El Salvador, women suspected of having an abortion can face criminal charges and jail time.

Brazil’s health minister, Marcelo Castro, has said that his country is “badly losing” the battle against disease-spreading mosquitoes, and that the Zika outbreak is probably worse than it looks because so many infected people don’t exhibit symptoms. As part of its efforts, Brazil plans to distribute mosquito repellent to some 400,000 pregnant women.

The link to Guillain-Barré syndrome is just as mysterious and fear-inducing, although scientists can say even less about it than the suspected link to microcephaly, not even who might be at risk. Brazil’s health ministry and others have reported a worrying increase in cases of Guillain-Barré, which arises when the body’s immune system attacks the nervous system. It was called “more terrifying than any horror movie” by one young Brazilian woman, who spoke to the New York Times. Infected with Zika by a mosquito bite, she was paralyzed and had to be put on a ventilator in the intensive care unit.

The scariest part is how little we understand the virus. “Nothing about this epidemic has been published. Nothing has been peer reviewed,” says Hotez. “It’s all coming through WHO alerts and anecdote.”

TOPSHOT - A municipal agent sprays anti Zika mosquitos chimical product at the sambadrome in Rio de Janeiro, on January 26, 2016. Brazil is mobilizing more than 200,000 troops to go "house to house" in the battle against Zika-carrying mosquitoes, blamed for causing horrific birth defects in a major regional health scare, a report said Monday. (CHRISTOPHE SIMON/AFP/Getty Images)© Used with permission of / © Rogers Media Inc. 2016. TOPSHOT - A municipal agent sprays anti Zika mosquitos chimical product at the sambadrome in Rio de Janeiro, on January 26, 2016. Brazil…
TOPSHOT – A municipal agent sprays anti Zika mosquitos chimical product at the sambadrome in Rio de Janeiro, on January 26, 2016.

Brazil is mobilizing more than 200,000 troops to go “house to house” in the battle against Zika-carrying mosquitoes, blamed for causing horrific birth defects in a major regional health scare, a report said Monday. (CHRISTOPHE SIMON/AFP/Getty Images)

One of the most perplexing questions is—why has this “weenie” of a virus, as Ward calls it, started to flex its muscle? Zika has circulated in parts of Africa and Asia for decades at least. If there was any chance it could lead to such disastrous outcomes, even in just a small number of people who are infected, why wouldn’t we know about it?

For now, scientists can only speculate. It could be that people in parts of Africa and Asia have been exposed to Zika and other viruses like it from childhood on, so they’ve built up an immunity, and consequently, infection rates stay low. “Zika is there, but it’s not causing pandemics,” Ward says. “It’s part of the background noise.” (In the 1950s, researchers tested people in India for the Zika virus, and found that many had antibodies in their blood, suggesting they’d previously been infected and recovered.) Another possibility is that Zika’s more serious side effects have always existed, but health officials didn’t notice because they occurred at regular intervals, not in the sudden burst we’ve seen in the Western hemisphere. Once the virus hit the Americas, where millions had never been exposed to Zika before, so many were infected so rapidly that previously rare events were starkly obvious.

Weaver, who’s studied mosquito-borne viruses his entire career, is considering another explanation. “It’s possible the Zika virus has mutated,” Weaver says. “That’s what we’ve seen in chikungunya,” another mosquito-borne virus that recently spread from Africa to Europe and the Americas. Chikungunya causes fever and joint pain, and “makes you feel absolutely miserable,” says Ward. “Some people get permanent arthritis,” and can’t work or function normally. About one in 1,000 cases is fatal.

Chikungunya—like Zika, dengue and yellow fever—is transmitted by the Aedes aegypti mosquito, which is notorious to public health authorities. A small, dark insect, it feeds on humans (it will sometimes bite animals), and strikes mostly in the day. It lays eggs in standing water, so it’s found near human settlements, and likes to come indoors.

According to the CDC, this species of mosquito sneaks up on its victims, approaching from behind, and biting ankles and elbows: people sometimes won’t even realize they’ve been bitten. The Aedes aegypti mosquito lives across Central and South America and the Caribbean, all the way up into Florida and the U.S. Gulf Coast. It doesn’t come as far north as Canada, although its relative, Aedes albopictus, ranges to Chicago and New York in the summertime. (There is some evidence that Aedes albopictus might transmit Zika, but less effectively.) According to Weaver, the chikungunya virus mutated to be carried by Aedes albopictus more efficiently, and has spread more rapidly through the Americas as a result.

Zika might have undergone a similar transformation. “Maybe somewhere along the way, it became more efficient at infecting mosquitoes. Or maybe it adapted for more efficient replication in humans,” Weaver says. That could explain why it might be causing such alarming new effects—and why it’s tearing through the Americas. “It’s also possible the virus became better capable of crossing the placenta, into the fetus.”

Patient Sandra Milena Ovallos, 20 years old and 25 weeks pregnant, attends a medical examination after suffering from fever and skin rash at the Hospital Universitario Erazmo Meoz in Cucuta, Colombia. (Schneyder Mendoza/EPA/CP)© Used with permission of / © Rogers Media Inc. 2016. Patient Sandra Milena Ovallos, 20 years old and 25 weeks pregnant, attends a medical examination after suffering from fever and skin rash at the Hospital…
Kamran Khan, of St. Michael’s Hospital in Toronto, studies the spread of infectious disease as it relates to globalization. He became interested during the SARS epidemic of 2003. SARS was first diagnosed in a Toronto woman who’d returned from Hong Kong. A total of 44 people in Canada died in that outbreak, and an astounding 25,000 were placed under quarantine. “The world has become so much smaller,” Khan says. “Clinicians have to think about diseases that occur not just in our backyard, but anywhere in the world.”

We’re far more interconnected now, only a decade after SARS. According to Khan, 3.5 billion trips are made on commercial flights every year. A virus like Zika could travel with an infected passenger on any one of those flights, landing in a new location. Once home, if an infected person is bitten by an uninfected mosquito that can carry the virus, that bug can become infected, and spread it to another person—and the virus moves on and on. For that reason, the CDC says that any infected person should be careful not to get any additional mosquito bites for at least a week, to avoid infecting more mosquitoes.

Now, with the new report that a person in Texas has acquired the virus sexually, public health officials will be focused on another way it can spread. There’s only been limited evidence that Zika was transmissible by sex, amounting to two case studies. During the 2013 outbreak in French Polynesia, a man in Tahiti fell ill, and the virus was isolated from his semen. The other case, reported in 2008, was a U.S. researcher, infected with Zika while on a trip to Senegal. He returned to Colorado, and experienced the symptoms associated with Zika infection. So did his wife, but she had not been to Senegal, or anywhere outside of the U.S., although they had sex a day after he came home.

“There’s very little information right now [on possible sexual transmission],” says Teresa Tam, Canada’s deputy chief public health officer. The agency is working to develop some kind of guidelines, she explains. Until then, “precautionary measures might be appropriate.” (Dallas County health officials now recommend condoms, in addition to mosquito protection.) As for whether it can be transmitted by blood transfusion, that, too, isn’t totally clear. According to Tam, in another study in French Polynesia, three per cent of asymptomatic blood donors were carrying the Zika virus in their blood, which is why restrictions were placed on blood donors here.

As scientists work to untangle all this, Zika moves further afield. Khan is the author of a paper in The Lancet that examines how Zika could spread even further. He and his team mapped the final destinations of international travellers leaving airports in Brazil, from September 2014 to August 2015. Of 9.9 million travellers, they found, 65 per cent were going to the Americas, 27 per cent to Europe, and five per cent to Asia. (The greatest number were headed to the U.S.) A team from Oxford University mapped the global spread of the Aedes mosquito, and modelled climate conditions that allow the virus to spread from mosquito to human. More than 60 per cent of the U.S. population, they found, live in areas where seasonal transmission is possible. Almost 23 million Americans are in climate zones where Zika can be transmitted year-round.

Hotez remembers the Ebola scare in 2014, and panic after a health care worker in his state was diagnosed with the virus. (Ebola, which is transmitted through contact with bodily fluids, infected just a handful of Americans, although it ravaged West Africa.) At the time, he was a voice of reassurance to Texans who feared that Ebola would spread there. “I was on TV a lot, and explained why Ebola will never gain a foothold here,” says Hotez. “I’m not saying that now. I’m very concerned.”

Municipal agents spray anti Zika mosquitos chimical product at the sambadrome in Rio de Janeiro, on January 26, 2016. Brazil is mobilizing more than 200,000 troops to go "house to house" in the battle against Zika-carrying mosquitoes, blamed for causing horrific birth defects in a major regional health scare, a report said Monday. (Christophe Simon/AFP/Getty Images): Municipal agents spray anti Zika mosquitos chimical product at the sambadrome in Rio de Janeiro, on January 26, 2016. (Christophe Simon/AFP/Getty Images)© Used with permission of / © Rogers Media Inc. 2016. Municipal agents spray anti Zika mosquitos chimical product at the sambadrome in Rio de Janeiro, on January 26, 2016. (Christophe Simon/AFP/Getty…
Staring down a pandemic expected to hit the U.S., Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, recently told Time he wants a “full-court press” for a Zika vaccine. “I’m saying, ‘Folks, this is it, all hands on deck for Zika, this is really important.’ ”

The tone of public health officials is much different than it was in the early days of Ebola. Then, the WHO was criticized for dragging its feet: it didn’t declare Ebola a global public health emergency until months after alarms had been sounded, and nearly 1,000 people in West Africa had died. Drug makers were chastized for not more aggressively pursuing a vaccine. “The technology to make an Ebola vaccine was published in 2003,” says Hotez, president of the non-profit Sabin Vaccine Institute. “It sat on the shelf for more than a decade, because the model says, you wait for big pharma to license it and turn it from a discovery into a product.” Taking a drug to market can cost hundreds of millions of dollars, which is beyond the reach of research labs. In 2014, Margaret Chan of the WHO castigated the pharmaceutical industry for ignoring the plight of Africans who suffered from Ebola. “A profit-driven industry does not invest in products for markets that cannot pay,” she said.

Weaver believes that experimental Zika vaccines will begin to roll out in short order. “The challenge is, will there be enough commercial interest for a company to invest in one?” he wonders, especially as more people develop immunity to Zika, and the pandemic ebbs. He does believe there will be a market for a vaccine, “because microcephaly is such a frightening outcome.” Not to mention that Zika is sweeping through the Americas, close to home.

Screen Shot 2016-02-03 at 5.50.15 PM© Used with permission of / © Rogers Media Inc. 2016. Screen Shot 2016-02-03 at 5.50.15 PM Scientists are racing to make a vaccine, and an early front-runner has a Canadian connection. Gary Kobinger, head of special pathogens at the Public Health Agency’s National Microbiology Lab in Winnipeg (who was also behind an Ebola vaccine and the Ebola drug ZMapp), believes their Zika vaccine could be ready for human clinical trials as early as this summer. Even so, “it could be years before there’s widespread access,” he says.

Doctors also need a better test for the virus, to identify who’s been infected. Tom Hobman, a professor in the department of cell biology at the University of Alberta, is working on a version that’s cheap and effective, to be deployed in Central and South America. The one used today is “very sensitive, and highly specific, but more expensive and needs specialized equipment,” he explains. “If you’re looking at millions of infections, that’s not the best way to go.” His test will be designed to provide results for Zika within a couple of hours, based on a blood sample.

Curbing the spread of this virus means getting rid of mosquitoes, which has been done before. In the 20th century, as dengue swept South America, governments made it a priority to eliminate Aedes aegypti, fumigating and destroying habitats, says a paper in The American Journal of Tropical Medicine and Hygiene. In 1962, 18 continental countries and many Caribbean islands announced they’d wiped out the Aedes, but measures must be kept up to stay effective, which takes money and political will. From the 1970s to the 1990s, Aedes aegypti returned, as did dengue fever and other mosquito-borne diseases—with consequences that are now all too apparent.

Scientists have begun toying with more high-tech solutions. A British company, Oxitec, has experimented with genetically modified mosquitoes whose offspring die before they reach adulthood, causing populations to crash. In the U.S., researchers have made “malaria-proof” mosquitoes, which pass along a malaria-blocking gene to nearly all their offspring. Some suggest these techniques could be used to stop bugs from transmitting viruses like Zika, or even to wipe out the Aedes aegypti for good. But once the genie is out of the bottle and these mutant mosquitoes begin to spread, there’s no taking it back. Even in the face of a global pandemic, scientists are right to be cautious.

Over the last weekend of January, as many as 300,000 people gathered in the streets of Rio de Janeiro to celebrate Carnival, which was then still days away. Officials were busy fumigating the city stadium, where tourists and locals were expected to gather. In anticipation of the Olympics, authorities say they’ll perform inspections of facilities, and destroy mosquito breeding grounds. It’s too early to tell what sort of chilling effect Zika will have on tourism there, not to mention Mexico and the Caribbean, although we know that SARS cost Ontario hoteliers $60 million in the month of April 2013 alone.

Screen Shot 2016-02-03 at 5.50.26 PM© Used with permission of / © Rogers Media Inc. 2016. Screen Shot 2016-02-03 at 5.50.26 PM
As for the U.S., “if Zika is going to hit the Gulf Coast,” Hotez predicts, “it will be around April.” Those who live in poor communities will be hardest-hit. Dengue, a major cause of illness and death in the tropics, has shown up in economically depressed parts of Houston. “You have dilapidated housing, ripped screens or no screens at all, and environmental degradation around the house, garbage piled up, standing water,” Hotez says.

In Canada, it’s easy to feel complacent. Health officials emphasize that our risk is low, and that’s true: even if a handful of travellers bring Zika home, it can’t be transmitted without lots of Aedes mosquitoes to spread it around. But the climate is changing, and bugs are ranging farther north—the Aedes albopictus, which might be able to transmit Zika, can already make it to Chicago in the summertime, so it’s hard to believe it’s not here, at least in extremely limited numbers. “The problem of climate change is very much related to Zika,” Khan says. “Many of these diseases originate in animals, whether it’s HIV, SARS, Ebola”—or Zika.

One of the most frightening aspects of the Zika pandemic is how unprepared we’ve been. Yet we’ve known about this virus for 60 years, because of a research program in the forests of Uganda. According to Weaver, money for that type of work has mostly dried up. Until recently, it would have been “very difficult” to get funding to study Zika, he says.

The simplest way to stop a pandemic is to do so before it catches fire. “We need to invest in the surveillance and discovery of new viruses,” Weaver emphasizes, “to know what the next threat might be.” Experts worry that, even in the midst of this global Zika panic, that’s unlikely to change.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 04 2016 at 2:51pm
Basically, as I have posted over and over, after 2009 they redefined Pandemic so that unless people were dying in the streets, they would not declare one. We have a basically mosquito transmitted disease which by definition should not spread from the tropics to the rest of the world and CAN NEVER BECOME A PANDEMIC  UNLESS it meets some very basic criteria.

1) It can be spread in other ways. It can. HIV was by blood and sexually. Is AIDS a Pandemic?

Okay, I have been having a real problem with find WHO declaring this a Pandemic but not CDC.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5531a1.htm

Let's get basic.

http://www.merriam-webster.com/dictionary/pandemic

occurring over a wide geographic area and affecting an exceptionally high proportion of the population <pandemic malaria>

2) Will WHO move away from declaring a Pandemic until it is bodies in the streets? (BITS)? Pandemic Now
Yes, they probably will. When I was at the cyber conference in 2009 online Margaret Chan met with a group of people. They were not representatives by country. They were a group of people who she asked if it would be more damaging to the economy and welfare of nations versus the number of deaths. Obviously, it was decided that despite the repercussions so many people had Swine Flu which was spread like the common cold, they would call it.

Not any more. Just like the forces behind the scenes in America are vast and powerful, so the economic and money people do not want to see their areas suffer. Already billions will be lost in tourism to Latin America countries and Brazil because of this.

It is much like the Vulcan Spock collapsing while looking in Captain's Kirk's eyes and saying

(In The Wrath of Khan (1982))“Logic clearly dictates that the needs of the many outweigh the needs of the few.”

Captain Kirk answers, “Or the one.”  

3) Does the issue of creating a panic where people will freak out and there will be anarchy justify withholding real numbers and body counts versus one and twos that are reported?

Some believe it does. Especially in the U.S. and at the highest levels in security and government.

Assessment:  What is the positive reason to declare a Pandemic and if we are up against a virus there is no treatment for and no vaccine for more than a year - what will be the effect of doing so?  I would say. Perhaps, panic.

Have we ever seen the countries of the world recently be able to unite (i.e. Ebola) and beyond self-interest and cooperate to mobile to face a worldwide disease? 

Conclusion: I would ask the readers here and members of AFT to find a place since 2009 where WHO has declared a Pandemic of any sort besides Flu. I can't find it. There may be those who can add to this thread with posts showing they have done so.

.gov has stood their ground in declaring Flu Pandemics.

http://www.flu.gov/pandemic/history/index.html

Malaria is called an epidemic by CDC

http://wwwnc.cdc.gov/eid/article/13/5/06-1333_article

Zika is not currently a Pandemic. It neither has the death count, the area coverage, or the consistency to be called one. For now.

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February 4, 2016 - Today - United States

http://www.flu.gov/pandemic/about/index.html

A pandemic is a global disease outbreak. It is determined by how the disease spreads, not how many deaths it causes.

When a new influenza A virus emerges, a flu pandemic can occur. Because the virus is new, the human population has little to no immunity against it. The virus spreads quickly from person-to-person worldwide.

The United States is not currently experiencing a flu pandemic. If a pandemic occurs, the federal government will work to identify the cause and create a vaccine. Flu.gov will provide updates on the steps the federal government is taking to address the pandemic.

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http://www.npr.org/sections/health-shots/2016/02/03/465339603/what-we-know-so-far-about-sexual-transmission-of-zika-virus

This is not the first time that the virus has been sexually transmitted, and it most likely isn't the first time it's been sexually transmitted in the U.S.

In 2008, two scientists returned to Colorado after months of field work in Senegal, where they'd been bitten by Aedes aegypti, the species of mosquito that transmits Zika virus.

One of them ended up passing the virus to his wife, most likely during intercourse. The couple noticed that the husband's semen had been bloody for a few days before the wife felt sick. She later tested positive for Zika, even though she had not left the U.S. in years. The pair co-authored a paper on their case, which has been called the first documented case of sexual transmission of an insect-borne disease.

During a Zika virus outbreak in French Polynesia in 2013, the virus was isolated from the bloody semen of a man in Tahiti. This was a few weeks after he had symptoms, and while his blood no longer contained traces of the virus, his urine did, and his semen contained live virus capable of replicating. The authors speculate that the virus may have replicated in the man's genital tract.

Similarly, Japanese researchers studying boars infected with a virus in the same family as Zika isolated virus from the urine and semen of boars that was capable of infecting a female through artificial insemination.

Is sexual transmission definitely possible? "Well, it sounds like it," says Dr. Robert Tesh, a professor at the University of Texas Medical Branch who studies emerging infectious diseases. But if it is, it's probably quite rare.

"I know it's sexy, talking about sexual transmission, but it's still the mosquito that's the important vector," says Tesh, who co-authored the case report from Colorado.

comment: Well, it remains to be seen if it will remain quite rare. I am no stranger to posting about lack of reporting of cases. I was nearly banned in 2009 for posting 500,000 case in New York versus less than 10,000 formally reported by CDC. Later the real numbers were released and during the worst outbreaks, sometimes we get really low numbers when actual infections are more than 10x what is reported.

As I have commented privately to users here, this is going to force the U.S. to take a very serious look at its immigration policies if this continues and can be spread primarily from Latin America. Yet, as far as the Pandemic goes - until it is widespread globally and continues in countries infected, it will not be a Pandemic.

No one wants a Pandemic. No one will make money from one even the drug companies really because it will take a long time to do a vaccine.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: February 05 2016 at 8:16am
It isn't news that traces of the Zika virus can be found in urine or saliva, as viral RNA has been detected using RT-PCR testing since 2014 http://www.ncbi.nlm.nih.gov/pubmed/26071336 - What hasn't been demonstrated - until now - is the presence of live Zika virus in these bodily fluids.
 
The news hitting the AP and Reuters this morning has been the confirmation of live virus detection in saliva and urine by FIOCRUZ, Brazil's leading scientific research institute. 

While the implications of this finding are not yet clear, this will raise new questions about the routes of transmission of the virus from human-to-human.

*****WARNING POSSIBLE BIOHAZARD*****
At this point I would assume that H2H transmission of Zika via Aerosol distance close contact eg 3feet same as Ebola

THIS IS WHOLLY PRECAUTIONARY AT THIS TIME

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Originally posted by wrote:

It isn't news that traces of the Zika virus can be found in urine or saliva, as viral RNA has been detected using RT-PCR testing since 2014 http://www.ncbi.nlm.nih.gov/pubmed/26071336 - What hasn't been demonstrated - until now - is the presence of live Zika virus in these bodily fluids.
 
The news hitting the AP and Reuters this morning has been the confirmation of live virus detection in saliva and urine by FIOCRUZ, Brazil's leading scientific research institute. 

While the implications of this finding are not yet clear, this will raise new questions about the routes of transmission of the virus from human-to-human.

*****WARNING POSSIBLE BIOHAZARD*****
At this point I would assume that H2H transmission of Zika via Aerosol distance close contact eg 3feet same as Ebola

THIS IS WHOLLY PRECAUTIONARY AT THIS TIME



We may soon see this spread by droplets through the air. Perhaps not appropriately called airborne, but similar to the ability of Ebola to spread.

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There are currently not enough cases in the U.S. to even rate an epidemic or enough in the world to call it a Zika Pandemic.  I have seen this over and over with alerts from countries with one, two, and three cases which finally never became serious epidemics. Ebola flared up in West Africa and while it was bad in the substandard areas with people personally burying their dead and with few doctors, it did not spread to the U.S hardly at all.

The smell of panic is in the air as well as a real effort to scare people as companies move to develop a vaccine before the Olympics go to Brazil. It is terribly ironic to me as I have aged and become much more grounded and less reactive, as I see so many people losing it.  Marvel not if drug companies scramble to make a vaccine and it ready by the Olympics and they make billions on it.

It is bad in Brazil and it is spreading throughout Latin America. It probably has mutated and you are going to see some sexual transmission as it moves from infected areas to the U.S. It is the dead of winter here and the mosquitoes in many areas are buried by snow or it is freezing.

It took HIV ten years or more to reach its current level and we still aren't seeing bodies in the streets or a large part of our population unlike where it is much worse in non-third-world countries with many people dying from AIDS.

Zika is not a new virus. The fact that it has moved from Africa to the Americas is new. Whether all the numbers are being put out there, someone is counting and you can be sure, for national defense, trying to deal with it.

People should prepare anyway. Our economy may be far worse a threat than any virus and our terrible foreign policy in U.S. may get us in a World War and shut our grid down before Zika is a real problem in the U.S.. You need to stock up on food, batteries, blankets so if the power goes out or we have weather from hell, which we may, you are ready.

I continue to hope that our serious concerns about Zika will, as with Ebola, be a lot of hype and the disease will not spread  "explosively" in the U.S.

Will say once more here "It is hard to be the voice of reason in the middle of chaos".
"Do not panic. Prepare."   Med

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The reason there are not more cases confirmed in the U.S. and other locations is that there is no commercial test available to clinics and all samples must be sent to CDC.

comment: Is this correct?  So far everywhere I have searched comes up with this.

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The other side of the story - take a deep breath.  Comments on this?  Is most of the outbreak hype?

The real news?




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What's the latest - Interview by phone with Henry Niman - 2/6/2016 8:00 a.m. PST

It's been awhile since I talked to Henry. I posted my last interview here
http://www.avianflutalk.com/a-conversation-with-henry-niman_topic30673.html

He and I talked a lot during the Pandemic of 2009 as well as during the SARS problem in China. He is a man who knows his gene sequences.

Recombinomics, Inc. Founder and President, Henry L Niman earned a PhD at the University of Southern California in 1978. He took a postdoctoral position at Scripps Clinic and Research Foundation where he developed monoclonal antibody technology. In 1982, he developed the flu monoclonal antibody, which is widely used throughout the pharmaceutical, biotech, and research industries. Some of his monoclonal antibodies were distributed worldwide to researchers by the National Cancer Institute.

The last YouTube video I posted was disturbing. After watching it I felt I needed to call Dr. Niman and ask him about it and what is happening with Zika. What is the real story in all of this? I know when we were tracking Avian Flu as well as Swine Flu I got a lot of sequences from Henry as well as data that few in the world had. I wanted to know - what is happening with Zika - are we going to have another Pandemic?

It was good to hear him again and he called me after I had left him a message. He knew about the 4,000 or so cases in Brazil and I asked him - my latest data showed on 400 or so of those were confirmed. What happened?

Dr Niman:  They had changed the measurement rules for Micro-cephalic babies to less than 23 cm. Then they started getting even the babies who just had small heads. They raised the level to less than 32 cm and many of the cases were no longer included in the new criteria.

Medclinician: So how many then?

Dr Niman: Well then they were down to 1000 or so and finally 500.

Medclinician: So what about this "scientist" who is an "expert" and saying there is no confirmed virus in the children. Maybe on 17 cases.

Dr Niman: The embryos are infected in the first two trimesters. There may not be any live virus after they are born and the damage has already been done. 

Medclinician: How long have we had Zika Virus?

Dr Niman: Well it was confirmed in Uganda in 1947 but that was in a monkey and they named it after the area in which it was found.

Medclinician: Is this sexually transmitted and how long have we known about that? 

Dr Niman: We knew about it in 2008 in Puerto Rico.

Medclinician: I just got a report in that they have declared an emergency in Puerto Rico from Zika.
http://abcnews.go.com/Health/zika-virus-outbreak-updates-pregnant-woman-puerto-rico/story?id=36737501 

What are your current numbers for cases in the U.S.?

Dr Niman: I have 11 in New York - 14 in Florida - 11 in Texas

Medclinician: I am being told that there is no commercial test available and all samples are being sent to CDC.

Dr Niman: Well that is partially true. New York and Texas either have applied for certification or will have it soon.

Medclinician: I have also been told that it takes 2 weeks for the results to come back. Is that true?

Dr Niman: No. We can get results from a PCR test in a few hours. The other is a problem because it has to be drawn several days after the person is symptomatic and has a higher level of virus to trip the titer level. Also we have to watch out for other similar infections like Dengue Fever which could give us a positive.
 
http://www.can.org.au/Pages/Hepatitis_C/Testing/PCR_Testing.aspx

Medclinician: Well I know you are very busy so let's cut to the chase. I have two last important questions. First - has the virus mutated recently?

Dr Niman: No.  The last mutations were probably in 2004 or 2007. Haiti and Easter Island.  I just went over the new sequences they just released yesterday from over 7 countries. Seems like there is a big rush for sequencing. - Columbia - Brazil - Haiti - Puerto Rico - none of them is much different than what we saw in 2007.

Medclinician: Last question. Henry, are we going to have a Zika Pandemic?

Dr Niman: It is not likely for several reasons. But we will see a lot more cases in the United States and other places as we approach Summer. There are areas in Latin America and even the South in the U.S. which have mosquitoes year round. We are seeing outbreaks in Central America and other places because they have accumulated a reservoir of the virus to infect people. You must look at how this disease spreads. Sexual spread is very limited and we are seeing people coming back from Christmas vacations and a lot of travel. If you have active mosquito activity in an area and an infected person gets bit, that mosquito will likely carry it to others and you will develop a reservoir of infected insects which will spread it. Yet however the great the spread in areas with mosquitoes, it is unlikely there will be a large outbreak to Northern areas. You cannot have a Pandemic when the disease cannot maintain itself for any constant duration in the North.

Medclinician: Henry, it was good to talk to you and I feel lucky to have survived this long to do so.

Dr Niman: Med, I want to add one more thing. You know even if New York and Florida are certified there are a limited number of test kits and a shortage. Florida only has 475 of them last count and so the number of confirmed cases will be limited by the kits they have. Also most of the cases are asymptomatic. Many of them recover and do not go in to see a doctor so there is no record and there is likely far more cases considering both of these factors.

Medclinician: Thank you, Henry.  I personally don't think this will become Pandemic either but I am sure we will have not one, but maybe several coming... not if but when.

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Zika in Washington D.C.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: February 07 2016 at 12:03pm
Good interview, Med Thumbs Up
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Wow. niman is really off with his case count on this.   There are 51 cases.   
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He's also off about test kits.  Florida has them, and I believe they have nearly 500.

niman is good with flu, but not sure about this one, or he's not keep close tabs. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 07 2016 at 1:11pm
Originally posted by Albert Albert wrote:

Wow. niman is really off with his case count on this.   There are 51 cases.   
Those aren't all the cases he told me about. That was just in 3 states.  Also the difference between 475 test kits and 500 - not that much.  Niman is still amazing on his sequences and I found the press later taking our lead on this as they are reporting there has been no recent mutation.  What do you think about the mosquitoes in the snow, Albert?  I have never seen that before. And in Washington D.C.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 07 2016 at 1:14pm
Originally posted by jacksdad jacksdad wrote:

Good interview, Med Thumbs Up


Thanks Jacksdad. I felt like I got a lot of information and most of it I had not seen before. Albert has a lot of good ideas on this and also other members here are posting some great data and news on Zika. The question is, can we have a Pandemic without any place cold getting infected - or being part of it. It was chilling this morning as I posted that clip from New York with Mosquitoes surviving year round with snow in the background. It has been real cold up there at times and just had a pretty serious storm.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: February 07 2016 at 1:29pm
Originally posted by Medclinician Medclinician wrote:


Medclinician: I am being told that there is no commercial test available and all samples are being sent to CDC.

Dr Niman: Well that is partially true. New York and Texas either have applied for certification or will have it soon.



Was a good interview.  I just thought he would have mentioned the 475 test kits instead of zero.

He's definitely a flu expert and no doubt about that. 



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Originally posted by Medclinician Medclinician wrote:

What's the latest - Interview by phone with Henry Niman - 2/6/2016 8:00 a.m.

Dr Niman: I have 11 in New York - 14 in Florida - 11 in Texas




He gave this answer yesterday?  There are 51 cases in 9 states.   He is way off his game with this one.

He is also claiming no mutation without doing sequencing.   No samples are available. 

He also needs to understand that a pandemic is not solely based on the number of cases in the U.S., but on worldwide scale.  So although we could have a pandemic by definition, it does not necessarily  mean an event that hits the U.S. hard.   

Like I said, with influenza he's the best, at times.  He's big into vaccines on a business level, and recombination.  If the the virus can't recombine or no reasortment, or if there is no vaccine in play, he probably has no interest.  His answers and lack of knowledge in the interview shows it in my opinion..



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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: February 07 2016 at 1:47pm
Originally posted by Albert Albert wrote:

Originally posted by Medclinician Medclinician wrote:

What's the latest - Interview by phone with Henry Niman - 2/6/2016 8:00 a.m.

Dr Niman: I have 11 in New York - 14 in Florida - 11 in Texas




He gave this answer yesterday?  There are 51 cases in 9 states.   He is way off his game with this one.

He is also claiming no mutation without doing sequencing.   No samples are available. 

He also needs to understand that a pandemic is not solely based on the number of cases in the U.S., but on worldwide scale.  So although we could have a pandemic by definition, it does not necessarily  mean an event that hits the U.S. hard.   

Like I said, with influenza he's the best, at times.  He's big into vaccines on a business level, and recombination.  If the the virus can't recombine or no reasortment, or if there is no vaccine in play, he probably has no interest.  His answers and lack of knowledge in the interview shows it in my opinion.



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Post Options Post Options   Thanks (0) Thanks(0)   Quote Medclinician Quote  Post ReplyReply Direct Link To This Post Posted: February 07 2016 at 3:09pm
Originally posted by Albert Albert wrote:

Originally posted by Albert Albert wrote:

[QUOTE=Medclinician]What's the latest - Interview by phone with Henry Niman - 2/6/2016 8:00 a.m.

Dr Niman: I have 11 in New York - 14 in Florida - 11 in Texas




He gave this answer yesterday?  There are 51 cases in 9 states.   He is way off his game with this one.

He is also claiming no mutation without doing sequencing.   No samples are available. 

He also needs to understand that a pandemic is not solely based on the number of cases in the U.S., but on worldwide scale.  So although we could have a pandemic by definition, it does not necessarily  mean an event that hits the U.S. hard.   

Like I said, with influenza he's the best, at times.  He's big into vaccines on a business level, and recombination.  If the the virus can't recombine or no reasortment, or if there is no vaccine in play, he probably has no interest.  His answers and lack of knowledge in the interview shows it in my opinion.





No, you need to reread my interview. They received a ton of samples a few days ago and he was looking them over.  He is just as sharp on Zika as Flu.  4 countries samples matched with the 2004 or 2007 mutations - one was in Easter Islands the other in Puerto Rico.  Even though we are not seeing a recent mutation, we are seeing a mutation.

Also, a lot of the confirmed cases were because they recently changed the size for micro-cephalic.  The first lower size had to be replaced because some babies are just small and also have small heads without an abnormality. So then they raised the size and this really took a lot of cases in Brazil off the list. Finally there were only 17 cases with virus in the specimen.

Dr Niman: No. We can get results from a PCR test in a few hours. The other is a problem because it has to be drawn several days after the person is symptomatic and has a higher level of virus to trip the titer level. Also we have to watch out for other similar infections like Dengue Fever which could give us a positive.
 
http://www.can.org.au/Pages/Hepatitis_C/Testing/PCR_Testing.aspx

As for virus kits he said

Florida are certified there are a limited number of test kits and a shortage. Florida only has 475 of them last count

The gist of all this was even if a state is certified and has a limited supply of test kits you aren't going to get large numbers like 4,000 cases when you can't test people.  Some or many of the cases will be negative - so if you have 475 kits not so many cases.

Another point was the reservoir. There are reservoirs developing in the U.S. over the last 5 years which could have the virus.  This would eliminate the traveler situation and mosquitoes would bite an infected person and spread it.

You have admit that "widespread" infection is a rather non-specific term. How widespread? 20 countries - is that a Pandemic? or even 30?  

There are 195 sovereign states in the world as of 2015.
http://www.polgeonow.com/2011/04/how-many-countries-are-there-in-world.html

CDC on February 2, 2016 reported the spread of Zika to more than 30 countries.

http://www.ripcordtravelprotection.com/zika-outbreak-update/

Now if we can take "confirmed cases" in Brazil and go from more than 4,000 to less than 500 - some of the blockbuster numbers being put out from let's say... Columbia may not be all that accurate. You think the Swine Flu tests would miss some... the Zika tests being used may not be all that accurate and you may be getting Dengue Fever - which is pretty widespread mixed in.

They released sequence information a few days ago. There is a lot of data and so far none of it points to a recent mutation.

Medclinician

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: February 07 2016 at 7:14pm
niman was correct about no mutation.    Batting 1 out of 5 isn't bad.  Big smile

First complete genome sequence of the Zika virus released

Date:  January 11, 2016
Having confirmed the first cases of infection in Suriname then in French Guiana, the Institut Pasteur in French Guiana has sequenced the complete genome of the Zika virus, which is responsible for an unprecedented epidemic currently sweeping through the tropical regions of the Americas. Published in The Lancet medical journal, the analysis of this sequence shows almost complete homology with the strains responsible for the epidemic that occurred in the Pacific in 2013 and 2014.

Last November, following a request by colleagues in Suriname, the team from the Virology Laboratory at the Institut Pasteur in French Guiana -- a National Reference Center for Arboviruses for the Antilles-French Guiana region -- confirmed the first five indigenous cases of infection by the Zika virus in Suriname. Researchers from the Institut Pasteur in French Guiana have just mapped the complete genome sequence of this viral strain using one of these five samples. The analysis of this genome, which features in The Lancet today, shows that it belongs to the Asian lineage and presents over 99% homology with the strain responsible for the epidemic in French Polynesia in 2013. "Until now few complete sequences of this virus and none of the strains currently circulating in South and Central America were available. This complete sequence of the virus is a major starting point for shedding light on how its behavior develops," points out Dominique Rousset, Head of the Virology Laboratory and National Reference Center for Arboviruses at the Institut Pasteur in French Guiana.

The first cases were confirmed in Brazil in May 2015 and the country is currently experiencing the largest epidemic ever recorded with 440,000 to 1,300,000 suspected cases reported by the Brazilian health authorities. The Zika virus has spread quickly, affecting 10 countries in the tropical regions of the Americas as well as the Caribbean so far. While until recently the infection was considered harmless, the Zika virus epidemic which raged in French Polynesia and the Pacific in 2013-2014 was accompanied by an increase in serious neurological complications, such as Guillain-Barre syndrome and congenital neurological defects. In Brazil, the very significant increase in the number of microcephaly cases in fetuses whose mothers were infected during pregnancy forced the government to declare a state of emergency in December 2015. "Are these defects caused by the Zika virus alone, the co-circulation of other infectious agents or other factors? Multidisciplinary research projects will need to be set up to answer these questions. We are already trying to improve our knowledge of this virus and understand its development, primarily by building on diagnostic tools" explains Dominique Rousset.

In addition, a team of four researchers from the Institut Pasteur in Dakar arrived in Sao Paulo on January 5th, to help Brazilian scientists deal with the Zika epidemic.

To date, 17 cases have been confirmed in French Guiana and three in Martinique. Given the very rapid spread of the Zika virus, the Institut Pasteur in French Guiana remains actively involved in epidemiological monitoring, alongside the health authorities and the Institut Pasteur International Network. "We are committed to supporting vector control by monitoring resistance to insecticides, as part of an agreement with the Regional Health Agency. Research into the impact of this resistance on the vectorial competence of Aedes aegypti populations for various arboviruses, including the Zika virus, is also being conducted at the Vectopole," adds Isabelle Dusfour, entomologist at the Institut Pasteur in French Guiana.

Described for the first time in Uganda in 1947, Zika is an arbovirus belonging to the same family as the dengue virus and is spread by the same vector, the Aedes aegypti mosquito.

It can also be spread by the tiger mosquito, Aedes albopictus, which is present in some regions in mainland France. Under the supervision of entomologist Anna-Bella Failloux, responsible for the Arboviruses and Insect Vectors Unit, the Institut Pasteur is currently conducting research in Paris to assess the vectorial competence of Aedes aegypti and Aedes albopictus, and ascertain the role of these two species in the dynamics of the Zika epidemic. This work will help to better assess the risk of the virus being introduced to France.

http://www.sciencedaily.com/releases/2016/01/160111152815.htm
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