Emerging Infections

A group of 68 organizations, including a number of medical societies, have called on Congress to pass an emergency spending bill requested by President Obama to fund activities to combat the spread of Zika virus.

In letters sent to House and Senate leaders, the groups called on Congress to “provide new funding rather than repurpose money from other high-priority programs at the Centers for Disease Control and Prevention and other federal agencies to ensure our health security and public health preparedness.”

James Gathany/CDC

On Feb. 22, President Obama asked Congress to consider $1.9 billion in supplemental spending related to the Zika virus. Congress has not acted on the request.

“According to the World Health Organization, the virus is spreading explosively, and scientists predict there will be $3 million to $4 million new infections in the Americas this year,” Dr. Hal C. Lawrence III, executive vice president and CEO of the American Congress of Obstetricians and Gynecologists, said during an April 5 press conference. “Zika is expected to infect 1 in 5 – 20% – of Puerto Ricans by the end of 2016 and as summer draws near, it may spread to the continental United States.”

There is “great concern” among ob.gyns. who may treat pregnant women exposed to Zika virus, Dr. Lawrence said. “These physicians strive to provide the best possible care for their patients. However, as health care providers, we just don’t have enough information at this time, nor enough treatment options.”

He emphasized that there are no treatment options or preventions guidelines “other than avoid being bitten by mosquitoes and using contraception if you don’t want to get pregnant.”

The lack of information and uncertainty makes it difficult for women “to make decisions about planning their pregnancies and causes pregnant women to suffer anxiety and distress,” he said. “In order to do more, we must know more. That’s why we are pleading with Congress to pass the emergency supplemental spending bill that President Obama has requested.”

Joining ACOG on the letter are American Academy of Family Physicians, American Academy of Pediatrics, American Medical Association, Infectious Diseases Society of America, HIV Medicine Association, March of Dimes, and others. Pharmaceutical manufacturers Johnson & Johnson and Novavax are signatories as well.

“If we take immediate action, we may be able to dramatically slow the spread of Zika, giving scientists time to develop and test a vaccine,” according to the letter. “Without action, we fear the number of newborns born with debilitating birth defects will only continue to rise.”

[email protected]

A group of 68 organizations, including a number of medical societies, have called on Congress to pass an emergency spending bill requested by President Obama to fund activities to combat the spread of Zika virus.

In letters sent to House and Senate leaders, the groups called on Congress to “provide new funding rather than repurpose money from other high-priority programs at the Centers for Disease Control and Prevention and other federal agencies to ensure our health security and public health preparedness.”

James Gathany/CDC

On Feb. 22, President Obama asked Congress to consider $1.9 billion in supplemental spending related to the Zika virus. Congress has not acted on the request.

“According to the World Health Organization, the virus is spreading explosively, and scientists predict there will be $3 million to $4 million new infections in the Americas this year,” Dr. Hal C. Lawrence III, executive vice president and CEO of the American Congress of Obstetricians and Gynecologists, said during an April 5 press conference. “Zika is expected to infect 1 in 5 – 20% – of Puerto Ricans by the end of 2016 and as summer draws near, it may spread to the continental United States.”

There is “great concern” among ob.gyns. who may treat pregnant women exposed to Zika virus, Dr. Lawrence said. “These physicians strive to provide the best possible care for their patients. However, as health care providers, we just don’t have enough information at this time, nor enough treatment options.”

He emphasized that there are no treatment options or preventions guidelines “other than avoid being bitten by mosquitoes and using contraception if you don’t want to get pregnant.”

The lack of information and uncertainty makes it difficult for women “to make decisions about planning their pregnancies and causes pregnant women to suffer anxiety and distress,” he said. “In order to do more, we must know more. That’s why we are pleading with Congress to pass the emergency supplemental spending bill that President Obama has requested.”

Joining ACOG on the letter are American Academy of Family Physicians, American Academy of Pediatrics, American Medical Association, Infectious Diseases Society of America, HIV Medicine Association, March of Dimes, and others. Pharmaceutical manufacturers Johnson & Johnson and Novavax are signatories as well.

“If we take immediate action, we may be able to dramatically slow the spread of Zika, giving scientists time to develop and test a vaccine,” according to the letter. “Without action, we fear the number of newborns born with debilitating birth defects will only continue to rise.”

[email protected]

A group of 68 organizations, including a number of medical societies, have called on Congress to pass an emergency spending bill requested by President Obama to fund activities to combat the spread of Zika virus.

In letters sent to House and Senate leaders, the groups called on Congress to “provide new funding rather than repurpose money from other high-priority programs at the Centers for Disease Control and Prevention and other federal agencies to ensure our health security and public health preparedness.”

James Gathany/CDC

On Feb. 22, President Obama asked Congress to consider $1.9 billion in supplemental spending related to the Zika virus. Congress has not acted on the request.

“According to the World Health Organization, the virus is spreading explosively, and scientists predict there will be $3 million to $4 million new infections in the Americas this year,” Dr. Hal C. Lawrence III, executive vice president and CEO of the American Congress of Obstetricians and Gynecologists, said during an April 5 press conference. “Zika is expected to infect 1 in 5 – 20% – of Puerto Ricans by the end of 2016 and as summer draws near, it may spread to the continental United States.”

There is “great concern” among ob.gyns. who may treat pregnant women exposed to Zika virus, Dr. Lawrence said. “These physicians strive to provide the best possible care for their patients. However, as health care providers, we just don’t have enough information at this time, nor enough treatment options.”

He emphasized that there are no treatment options or preventions guidelines “other than avoid being bitten by mosquitoes and using contraception if you don’t want to get pregnant.”

The lack of information and uncertainty makes it difficult for women “to make decisions about planning their pregnancies and causes pregnant women to suffer anxiety and distress,” he said. “In order to do more, we must know more. That’s why we are pleading with Congress to pass the emergency supplemental spending bill that President Obama has requested.”

Joining ACOG on the letter are American Academy of Family Physicians, American Academy of Pediatrics, American Medical Association, Infectious Diseases Society of America, HIV Medicine Association, March of Dimes, and others. Pharmaceutical manufacturers Johnson & Johnson and Novavax are signatories as well.

“If we take immediate action, we may be able to dramatically slow the spread of Zika, giving scientists time to develop and test a vaccine,” according to the letter. “Without action, we fear the number of newborns born with debilitating birth defects will only continue to rise.”

[email protected]

As warmer weather raises the possibility of local Zika virus transmission in the continental United States, federal health officials are pushing state and local governments to devise plans aimed at protecting pregnant women from infection, to increase access to contraception, and to ensure better coordination by mosquito control districts.

On April 1, the U.S. Centers for Disease Prevention and Control hosted a day-long seminar on Zika attended by some 300 state and local public health professionals. Zika virus, which is increasingly linked to adverse fetal outcomes including microcephaly, is now spreading in Puerto Rico, the U.S. Virgin Islands, and American Samoa.

Though most of the U.S. response effort is currently concentrated in Puerto Rico, and no local transmission has yet been reported in the continental U.S., a CDC report issued concurrently with the conference highlighted the potential for Zika transmission within the U.S. The entire southern half of the continental U.S., and much of its east coast, is home to the Aedes aegypti mosquitoes that can carry Zika virus.

In the same report, CDC also stressed that pregnant women should avoid travel to areas where Zika is being rapidly transmitted, and avoid sexual contact or consistently use condoms with partners who “reside in or have traveled to areas with active Zika virus transmission.”

© CDC

“The key here is to reduce the risk to pregnant women,” Dr. Tom Frieden, CDC director, said at a news conference during the meeting. “There is an urgent need for all of us to learn more and do more,” he noted, acknowledging that officials had concerns about securing sufficient federal funding, getting rapid screening tools commercially developed in the absence of such funding, and improving the capabilities of U.S. mosquito control districts in the states most likely to be affected.

As local clusters of dengue virus disease have occurred in Florida, Texas, and Hawaii, Dr. Frieden said these states need to be particularly responsive to the Zika threat. However, Zika transmission could follow a different pattern, he said.

While Dr. Frieden described some local mosquito control districts and their capabilities as robust, others are considerably less so. Many districts in vulnerable states are not contiguous, leading to potential gaps in vector control. Dr. Frieden noted that even where control is most intensive, such as in Puerto Rico, vector resistance to common pesticides is a problem.

Dr. Frieden also stressed the importance of widening local access to contraception. He clarified that the CDC was not advising couples to avoid or delay pregnancy, even in Puerto Rico. However, he said, “if a woman and her partner choose not to become pregnant [there should be] ready access to effective contraception,” particularly the long-term reversible methods likely to be most effective.

Amy Pope, deputy homeland security advisor in the Obama administration, underscored the concern about Zika-specific funding. In February, the administration requested some $1.9 billion from Congress to combat Zika, including by improving access to contraception, developing vaccines and diagnostics, and other efforts. This funding has yet to be approved, Ms. Pope noted, adding that some members of Congress proposed redirecting funding that had been earmarked to combat Ebola.

“Congress is asking the American people to choose which disease it wants the most protection from,” Ms. Pope said, and Dr. Frieden reminded the conference that the Ebola crisis was not over. A new case from Liberia was announced April 1, he noted, and an ongoing cluster of transmission is occurring in Guinea.

As warmer weather raises the possibility of local Zika virus transmission in the continental United States, federal health officials are pushing state and local governments to devise plans aimed at protecting pregnant women from infection, to increase access to contraception, and to ensure better coordination by mosquito control districts.

On April 1, the U.S. Centers for Disease Prevention and Control hosted a day-long seminar on Zika attended by some 300 state and local public health professionals. Zika virus, which is increasingly linked to adverse fetal outcomes including microcephaly, is now spreading in Puerto Rico, the U.S. Virgin Islands, and American Samoa.

Though most of the U.S. response effort is currently concentrated in Puerto Rico, and no local transmission has yet been reported in the continental U.S., a CDC report issued concurrently with the conference highlighted the potential for Zika transmission within the U.S. The entire southern half of the continental U.S., and much of its east coast, is home to the Aedes aegypti mosquitoes that can carry Zika virus.

In the same report, CDC also stressed that pregnant women should avoid travel to areas where Zika is being rapidly transmitted, and avoid sexual contact or consistently use condoms with partners who “reside in or have traveled to areas with active Zika virus transmission.”

© CDC

“The key here is to reduce the risk to pregnant women,” Dr. Tom Frieden, CDC director, said at a news conference during the meeting. “There is an urgent need for all of us to learn more and do more,” he noted, acknowledging that officials had concerns about securing sufficient federal funding, getting rapid screening tools commercially developed in the absence of such funding, and improving the capabilities of U.S. mosquito control districts in the states most likely to be affected.

As local clusters of dengue virus disease have occurred in Florida, Texas, and Hawaii, Dr. Frieden said these states need to be particularly responsive to the Zika threat. However, Zika transmission could follow a different pattern, he said.

While Dr. Frieden described some local mosquito control districts and their capabilities as robust, others are considerably less so. Many districts in vulnerable states are not contiguous, leading to potential gaps in vector control. Dr. Frieden noted that even where control is most intensive, such as in Puerto Rico, vector resistance to common pesticides is a problem.

Dr. Frieden also stressed the importance of widening local access to contraception. He clarified that the CDC was not advising couples to avoid or delay pregnancy, even in Puerto Rico. However, he said, “if a woman and her partner choose not to become pregnant [there should be] ready access to effective contraception,” particularly the long-term reversible methods likely to be most effective.

Amy Pope, deputy homeland security advisor in the Obama administration, underscored the concern about Zika-specific funding. In February, the administration requested some $1.9 billion from Congress to combat Zika, including by improving access to contraception, developing vaccines and diagnostics, and other efforts. This funding has yet to be approved, Ms. Pope noted, adding that some members of Congress proposed redirecting funding that had been earmarked to combat Ebola.

“Congress is asking the American people to choose which disease it wants the most protection from,” Ms. Pope said, and Dr. Frieden reminded the conference that the Ebola crisis was not over. A new case from Liberia was announced April 1, he noted, and an ongoing cluster of transmission is occurring in Guinea.

As warmer weather raises the possibility of local Zika virus transmission in the continental United States, federal health officials are pushing state and local governments to devise plans aimed at protecting pregnant women from infection, to increase access to contraception, and to ensure better coordination by mosquito control districts.

On April 1, the U.S. Centers for Disease Prevention and Control hosted a day-long seminar on Zika attended by some 300 state and local public health professionals. Zika virus, which is increasingly linked to adverse fetal outcomes including microcephaly, is now spreading in Puerto Rico, the U.S. Virgin Islands, and American Samoa.

Though most of the U.S. response effort is currently concentrated in Puerto Rico, and no local transmission has yet been reported in the continental U.S., a CDC report issued concurrently with the conference highlighted the potential for Zika transmission within the U.S. The entire southern half of the continental U.S., and much of its east coast, is home to the Aedes aegypti mosquitoes that can carry Zika virus.

In the same report, CDC also stressed that pregnant women should avoid travel to areas where Zika is being rapidly transmitted, and avoid sexual contact or consistently use condoms with partners who “reside in or have traveled to areas with active Zika virus transmission.”

© CDC

“The key here is to reduce the risk to pregnant women,” Dr. Tom Frieden, CDC director, said at a news conference during the meeting. “There is an urgent need for all of us to learn more and do more,” he noted, acknowledging that officials had concerns about securing sufficient federal funding, getting rapid screening tools commercially developed in the absence of such funding, and improving the capabilities of U.S. mosquito control districts in the states most likely to be affected.

As local clusters of dengue virus disease have occurred in Florida, Texas, and Hawaii, Dr. Frieden said these states need to be particularly responsive to the Zika threat. However, Zika transmission could follow a different pattern, he said.

While Dr. Frieden described some local mosquito control districts and their capabilities as robust, others are considerably less so. Many districts in vulnerable states are not contiguous, leading to potential gaps in vector control. Dr. Frieden noted that even where control is most intensive, such as in Puerto Rico, vector resistance to common pesticides is a problem.

Dr. Frieden also stressed the importance of widening local access to contraception. He clarified that the CDC was not advising couples to avoid or delay pregnancy, even in Puerto Rico. However, he said, “if a woman and her partner choose not to become pregnant [there should be] ready access to effective contraception,” particularly the long-term reversible methods likely to be most effective.

Amy Pope, deputy homeland security advisor in the Obama administration, underscored the concern about Zika-specific funding. In February, the administration requested some $1.9 billion from Congress to combat Zika, including by improving access to contraception, developing vaccines and diagnostics, and other efforts. This funding has yet to be approved, Ms. Pope noted, adding that some members of Congress proposed redirecting funding that had been earmarked to combat Ebola.

“Congress is asking the American people to choose which disease it wants the most protection from,” Ms. Pope said, and Dr. Frieden reminded the conference that the Ebola crisis was not over. A new case from Liberia was announced April 1, he noted, and an ongoing cluster of transmission is occurring in Guinea.

A new case study adds yet more evidence to the link between congenital Zika virus infection and fetal brain damage while offering insights into how the virus affects brain development at different stages.

“Our study highlights the possible importance of [Zika virus] RNA testing of serum obtained from pregnant women beyond the first week after symptom onset, as well as a more detailed evaluation of the fetal intracranial anatomy by means of serial fetal ultrasonography or fetal brain MRI,” wrote Dr. Rita W. Driggers of Johns Hopkins University, Baltimore, and her associates (N Engl J Med. 2016 March 30. doi: 10.1056/NEJMoa1601824).

©Rattikankeawpun/Thinkstock.com

The study also continues to help fill in the gaps in research highlighted by Dr. Lyle R. Petersen and his associates at the Centers for Disease Control and Prevention, in an overview of the virus published in the same issue (N Engl J Med. 2016 March 30. doi: 10.1056/NEJMra1602113).

“These include a complete understanding of the frequency and full spectrum of clinical outcomes resulting from fetal Zika virus infection and of the environmental factors that influence emergence, as well as the development of discriminating diagnostic tools for flaviruses, animal models for fetal developmental effects due to viral infection, new vector control products and strategies, effective therapeutics, and vaccines to protect humans against the disease,” the CDC authors wrote.

In the case study, a 33-year-old Finnish woman developed an infection from Zika virus in her 11th week of pregnancy while on vacation in Mexico, Guatemala, and Belize. She experienced the common Zika virus symptoms of a mild fever, eye pain, rash, and muscle pain for 5 days and had evidence of Zika virus RNA in her blood between 16 and 21 weeks’ gestation.

Although the fetal head size remained within the normal range during the 16th and 17th weeks of pregnancy, fetal head circumference dropped from the 47th percentile at 16 weeks gestation to the 24th percentile at 20 weeks’ gestation. Ultrasound and MRI imagery found fetal brain abnormalities, including a thin cerebral mantle and potential agenesis of the corpus callosum at 19 and 20 weeks’ gestation, but neither microcephaly nor calcifications in the brain were seen.

“We suspect these reductions in brain growth would have eventually met the criteria for microcephaly,” the researchers wrote. “As this case shows, the latency period between Zika virus infection of the fetal brain and the detection of microcephaly and intracranial calcifications on ultrasonography is likely to be prolonged.”

Negative findings during this time could be “falsely reassuring and might delay critical time-sensitive decision making,” they added.

The woman chose to terminate the pregnancy at 21 weeks, and high viral loads of Zika were found in the fetal brain during a postmortem exam. The fetus also had lower amounts of Zika RNA in the muscle, liver, lung, and spleen, as did the mother’s amniotic fluid.

“Although the evidence of the association between the presence of Zika virus in pregnant women and fetal brain abnormalities continues to grow, the timing of infection during fetal development and other factors that may have an effect on viral pathogenesis and their effects on the appearance of the brain abnormalities are poorly understood,” the case study researchers wrote.

The CDC authors also note the challenges of differentiating Zika virus infections from dengue or other flavivirus infections. “Reliable testing regimens for the diagnosis of prenatal and antenatal Zika virus infection have not been established,” they wrote.

The CDC authors also predict millions more Zika cases in the Americas, given the incidence of dengue and chikungunya cases previously, but the burden of long-term effects is harder to predict. “The long-term outlook with regard to the current Zika outbreak in the Americas is uncertain,” they wrote. “Herd immunity sufficient to slow further transmission will undoubtedly occur, although this will not obviate the need for immediate and long-term prevention and control strategies.”

Researchers from the CDC and those who reported the case study reported having no financial disclosures.

A new case study adds yet more evidence to the link between congenital Zika virus infection and fetal brain damage while offering insights into how the virus affects brain development at different stages.

“Our study highlights the possible importance of [Zika virus] RNA testing of serum obtained from pregnant women beyond the first week after symptom onset, as well as a more detailed evaluation of the fetal intracranial anatomy by means of serial fetal ultrasonography or fetal brain MRI,” wrote Dr. Rita W. Driggers of Johns Hopkins University, Baltimore, and her associates (N Engl J Med. 2016 March 30. doi: 10.1056/NEJMoa1601824).

©Rattikankeawpun/Thinkstock.com

The study also continues to help fill in the gaps in research highlighted by Dr. Lyle R. Petersen and his associates at the Centers for Disease Control and Prevention, in an overview of the virus published in the same issue (N Engl J Med. 2016 March 30. doi: 10.1056/NEJMra1602113).

“These include a complete understanding of the frequency and full spectrum of clinical outcomes resulting from fetal Zika virus infection and of the environmental factors that influence emergence, as well as the development of discriminating diagnostic tools for flaviruses, animal models for fetal developmental effects due to viral infection, new vector control products and strategies, effective therapeutics, and vaccines to protect humans against the disease,” the CDC authors wrote.

In the case study, a 33-year-old Finnish woman developed an infection from Zika virus in her 11th week of pregnancy while on vacation in Mexico, Guatemala, and Belize. She experienced the common Zika virus symptoms of a mild fever, eye pain, rash, and muscle pain for 5 days and had evidence of Zika virus RNA in her blood between 16 and 21 weeks’ gestation.

Although the fetal head size remained within the normal range during the 16th and 17th weeks of pregnancy, fetal head circumference dropped from the 47th percentile at 16 weeks gestation to the 24th percentile at 20 weeks’ gestation. Ultrasound and MRI imagery found fetal brain abnormalities, including a thin cerebral mantle and potential agenesis of the corpus callosum at 19 and 20 weeks’ gestation, but neither microcephaly nor calcifications in the brain were seen.

“We suspect these reductions in brain growth would have eventually met the criteria for microcephaly,” the researchers wrote. “As this case shows, the latency period between Zika virus infection of the fetal brain and the detection of microcephaly and intracranial calcifications on ultrasonography is likely to be prolonged.”

Negative findings during this time could be “falsely reassuring and might delay critical time-sensitive decision making,” they added.

The woman chose to terminate the pregnancy at 21 weeks, and high viral loads of Zika were found in the fetal brain during a postmortem exam. The fetus also had lower amounts of Zika RNA in the muscle, liver, lung, and spleen, as did the mother’s amniotic fluid.

“Although the evidence of the association between the presence of Zika virus in pregnant women and fetal brain abnormalities continues to grow, the timing of infection during fetal development and other factors that may have an effect on viral pathogenesis and their effects on the appearance of the brain abnormalities are poorly understood,” the case study researchers wrote.

The CDC authors also note the challenges of differentiating Zika virus infections from dengue or other flavivirus infections. “Reliable testing regimens for the diagnosis of prenatal and antenatal Zika virus infection have not been established,” they wrote.

The CDC authors also predict millions more Zika cases in the Americas, given the incidence of dengue and chikungunya cases previously, but the burden of long-term effects is harder to predict. “The long-term outlook with regard to the current Zika outbreak in the Americas is uncertain,” they wrote. “Herd immunity sufficient to slow further transmission will undoubtedly occur, although this will not obviate the need for immediate and long-term prevention and control strategies.”

Researchers from the CDC and those who reported the case study reported having no financial disclosures.

A new case study adds yet more evidence to the link between congenital Zika virus infection and fetal brain damage while offering insights into how the virus affects brain development at different stages.

“Our study highlights the possible importance of [Zika virus] RNA testing of serum obtained from pregnant women beyond the first week after symptom onset, as well as a more detailed evaluation of the fetal intracranial anatomy by means of serial fetal ultrasonography or fetal brain MRI,” wrote Dr. Rita W. Driggers of Johns Hopkins University, Baltimore, and her associates (N Engl J Med. 2016 March 30. doi: 10.1056/NEJMoa1601824).

©Rattikankeawpun/Thinkstock.com

The study also continues to help fill in the gaps in research highlighted by Dr. Lyle R. Petersen and his associates at the Centers for Disease Control and Prevention, in an overview of the virus published in the same issue (N Engl J Med. 2016 March 30. doi: 10.1056/NEJMra1602113).

“These include a complete understanding of the frequency and full spectrum of clinical outcomes resulting from fetal Zika virus infection and of the environmental factors that influence emergence, as well as the development of discriminating diagnostic tools for flaviruses, animal models for fetal developmental effects due to viral infection, new vector control products and strategies, effective therapeutics, and vaccines to protect humans against the disease,” the CDC authors wrote.

In the case study, a 33-year-old Finnish woman developed an infection from Zika virus in her 11th week of pregnancy while on vacation in Mexico, Guatemala, and Belize. She experienced the common Zika virus symptoms of a mild fever, eye pain, rash, and muscle pain for 5 days and had evidence of Zika virus RNA in her blood between 16 and 21 weeks’ gestation.

Although the fetal head size remained within the normal range during the 16th and 17th weeks of pregnancy, fetal head circumference dropped from the 47th percentile at 16 weeks gestation to the 24th percentile at 20 weeks’ gestation. Ultrasound and MRI imagery found fetal brain abnormalities, including a thin cerebral mantle and potential agenesis of the corpus callosum at 19 and 20 weeks’ gestation, but neither microcephaly nor calcifications in the brain were seen.

“We suspect these reductions in brain growth would have eventually met the criteria for microcephaly,” the researchers wrote. “As this case shows, the latency period between Zika virus infection of the fetal brain and the detection of microcephaly and intracranial calcifications on ultrasonography is likely to be prolonged.”

Negative findings during this time could be “falsely reassuring and might delay critical time-sensitive decision making,” they added.

The woman chose to terminate the pregnancy at 21 weeks, and high viral loads of Zika were found in the fetal brain during a postmortem exam. The fetus also had lower amounts of Zika RNA in the muscle, liver, lung, and spleen, as did the mother’s amniotic fluid.

“Although the evidence of the association between the presence of Zika virus in pregnant women and fetal brain abnormalities continues to grow, the timing of infection during fetal development and other factors that may have an effect on viral pathogenesis and their effects on the appearance of the brain abnormalities are poorly understood,” the case study researchers wrote.

The CDC authors also note the challenges of differentiating Zika virus infections from dengue or other flavivirus infections. “Reliable testing regimens for the diagnosis of prenatal and antenatal Zika virus infection have not been established,” they wrote.

The CDC authors also predict millions more Zika cases in the Americas, given the incidence of dengue and chikungunya cases previously, but the burden of long-term effects is harder to predict. “The long-term outlook with regard to the current Zika outbreak in the Americas is uncertain,” they wrote. “Herd immunity sufficient to slow further transmission will undoubtedly occur, although this will not obviate the need for immediate and long-term prevention and control strategies.”

Researchers from the CDC and those who reported the case study reported having no financial disclosures.

The Centers for Disease Control and Prevention has issued interim guidance for U.S. health care providers to safely care for survivors of Ebola virus disease (EVD).

The guidance includes information about sequelae of EVD as well as data on Ebola virus persistence in EVD survivors, and infection prevention and control recommendations for U.S. health care providers when evaluating a patient who is an EVD survivor. Of the eleven patients with Ebola virus disease who were managed in U.S. health care facilities during 2014-2015, nine survived. The CDC notes in the guidance that it is also possible that some EVD survivors from West Africa could seek medical care in the United States.

Courtesy of CDC

In most cases, the CDC notes, persons who have completely recovered from EVD do not experience a relapse of Ebola virus associated with systemic illness, although survivors can experience complications after surviving acute EVD. Reported complications among EVD survivors include nonspecific fatigue, joint pain, muscle aches, headaches, suppurative parotitis, pericarditis, orchitis, sexual dysfunction, hair loss, vision loss (including uveitis and permanent blindness), hearing loss, tinnitus, paresthesia or dysesthesia, memory loss, insomnia, depression, anxiety, and posttraumatic stress disorder.

The risk of infectivity from patients with persistent infection is unknown, the CDC guidance states, but “appears to be low and is likely to decrease over time.” The guidance includes infection control practices that should be used to “ensure that health care personnel do not contract infections from patients, whether or not they are known to be infectious,” and that personnel do not spread infectious material to other patients during routine medical care.

Medical professionals can view the complete care guidance on the CDC website. The CDC has also published additional resources to supplement the guidance. These include:

Messages for the Care of Survivors of Ebola Virus Disease. Topics in this resource include health problems EVD survivors may experience, guidance to use standard precautions for all patient care, and recommendations for when extra precautions may be needed.

FAQ on Screening for Ebola Virus Disease for Providers, Healthcare Facilities, and Health Departments. FAQs include information on adjusting screening practices for acutely ill patients while reiterating that a thorough travel history for all patients should be obtained to ensure proper infection control measures are in place. Additionally, information on hospital management recommendations for evaluating ill travelers from West Africa are included.

[email protected]

On Twitter @richpizzi

The Centers for Disease Control and Prevention has issued interim guidance for U.S. health care providers to safely care for survivors of Ebola virus disease (EVD).

The guidance includes information about sequelae of EVD as well as data on Ebola virus persistence in EVD survivors, and infection prevention and control recommendations for U.S. health care providers when evaluating a patient who is an EVD survivor. Of the eleven patients with Ebola virus disease who were managed in U.S. health care facilities during 2014-2015, nine survived. The CDC notes in the guidance that it is also possible that some EVD survivors from West Africa could seek medical care in the United States.

Courtesy of CDC

In most cases, the CDC notes, persons who have completely recovered from EVD do not experience a relapse of Ebola virus associated with systemic illness, although survivors can experience complications after surviving acute EVD. Reported complications among EVD survivors include nonspecific fatigue, joint pain, muscle aches, headaches, suppurative parotitis, pericarditis, orchitis, sexual dysfunction, hair loss, vision loss (including uveitis and permanent blindness), hearing loss, tinnitus, paresthesia or dysesthesia, memory loss, insomnia, depression, anxiety, and posttraumatic stress disorder.

The risk of infectivity from patients with persistent infection is unknown, the CDC guidance states, but “appears to be low and is likely to decrease over time.” The guidance includes infection control practices that should be used to “ensure that health care personnel do not contract infections from patients, whether or not they are known to be infectious,” and that personnel do not spread infectious material to other patients during routine medical care.

Medical professionals can view the complete care guidance on the CDC website. The CDC has also published additional resources to supplement the guidance. These include:

Messages for the Care of Survivors of Ebola Virus Disease. Topics in this resource include health problems EVD survivors may experience, guidance to use standard precautions for all patient care, and recommendations for when extra precautions may be needed.

FAQ on Screening for Ebola Virus Disease for Providers, Healthcare Facilities, and Health Departments. FAQs include information on adjusting screening practices for acutely ill patients while reiterating that a thorough travel history for all patients should be obtained to ensure proper infection control measures are in place. Additionally, information on hospital management recommendations for evaluating ill travelers from West Africa are included.

[email protected]

On Twitter @richpizzi

The Centers for Disease Control and Prevention has issued interim guidance for U.S. health care providers to safely care for survivors of Ebola virus disease (EVD).

The guidance includes information about sequelae of EVD as well as data on Ebola virus persistence in EVD survivors, and infection prevention and control recommendations for U.S. health care providers when evaluating a patient who is an EVD survivor. Of the eleven patients with Ebola virus disease who were managed in U.S. health care facilities during 2014-2015, nine survived. The CDC notes in the guidance that it is also possible that some EVD survivors from West Africa could seek medical care in the United States.

Courtesy of CDC

In most cases, the CDC notes, persons who have completely recovered from EVD do not experience a relapse of Ebola virus associated with systemic illness, although survivors can experience complications after surviving acute EVD. Reported complications among EVD survivors include nonspecific fatigue, joint pain, muscle aches, headaches, suppurative parotitis, pericarditis, orchitis, sexual dysfunction, hair loss, vision loss (including uveitis and permanent blindness), hearing loss, tinnitus, paresthesia or dysesthesia, memory loss, insomnia, depression, anxiety, and posttraumatic stress disorder.

The risk of infectivity from patients with persistent infection is unknown, the CDC guidance states, but “appears to be low and is likely to decrease over time.” The guidance includes infection control practices that should be used to “ensure that health care personnel do not contract infections from patients, whether or not they are known to be infectious,” and that personnel do not spread infectious material to other patients during routine medical care.

Medical professionals can view the complete care guidance on the CDC website. The CDC has also published additional resources to supplement the guidance. These include:

Messages for the Care of Survivors of Ebola Virus Disease. Topics in this resource include health problems EVD survivors may experience, guidance to use standard precautions for all patient care, and recommendations for when extra precautions may be needed.

FAQ on Screening for Ebola Virus Disease for Providers, Healthcare Facilities, and Health Departments. FAQs include information on adjusting screening practices for acutely ill patients while reiterating that a thorough travel history for all patients should be obtained to ensure proper infection control measures are in place. Additionally, information on hospital management recommendations for evaluating ill travelers from West Africa are included.

[email protected]

On Twitter @richpizzi

Health care providers working in labor and delivery rooms should employ the standard precautions for infection control to reduce the theoretical risk of Zika transmission, according to recommendations from the Centers for Disease Control and Prevention.

“Because of the potential for exposure to large volumes of body fluids during the labor and delivery process and the sometimes unpredictable and fast-paced nature of obstetrical care, the use of Standard Precautions in these settings is essential to prevent possible transmission of Zika virus from patients to health care personnel,” Dr. Christine K. Olson and her colleagues at the CDC wrote in the Morbidity and Mortality Weekly Report.

©AlexLMX/Thinkstock

No cases of occupational transmission of Zika via bodily fluids have been reported so far, but sexual transmission has occurred and the virus’s RNA has been found in blood, urine, saliva, and amniotic fluid. The risk of occupational exposure therefore theoretically exists, the authors wrote (MMWR. 2016 Mar 22. doi: 10.15585/mmwr.mm6511e3er).

The standard precautions are aimed at preventing transmission of any infectious agent present in blood, body fluids, secretions, nonperspiration excretions, nonintact skin, and mucous membranes. They include five main elements: hand hygiene, use of personal protection equipment (PPE), respiratory hygiene and cough etiquette, safe injection practices, and safe handling of potentially contaminated equipment or surfaces in the patient environment.

Standard PPE recommendations in labor and delivery rooms include eye protection during deliveries to prevent contamination from blood and bodily fluids and the use of double-gloving since the outer layer often contains perforations.

Health care personnel should already be following these standard precautions in all health care settings, but the CDC report will likely remind providers of the importance of these infection control procedures and improve compliance, said Dr. Aaron Caughey, chair of the department of obstetrics and gynecology and associate dean for Women’s Health Research and Policy at Oregon Health and Science University, Portland.

“Those are the standard recommendations on every labor floor for delivery currently, so absolutely it’s feasible,” he said in an interview. However, “for a low-risk woman doing a vaginal delivery without complications, I know that some people skimp on eyewear, and I know there are occasionally people who will wear just one pair of gloves,” he said.

The CDC report also noted varying levels of adherence to the standard precautions.

“Numerous barriers to the appropriate use of PPE have been cited, including the perception that PPE is uncomfortable and limits dexterity, fogging of goggles or face masks, the misperception that prescription eyeglasses provide adequate eye protection, lack of available PPE, forgetting to use PPE, lack of time in urgent clinical situations to don appropriate PPE, the perception that the patient poses minimal risk, and concerns about interference with patient care,” Dr. Olson and her colleagues wrote.

Dr. Caughey drew parallels to the late 1980s and early 1990s, when compliance with eye safety and glove safety precautions increased dramatically alongside the HIV epidemic.

“With these recommendations, it will probably get a little more heightened, particularly if there are parts of the country where Zika becomes endemic,” he said. “The big difference with Zika is if a man contracts Zika or a woman who’s not pregnant contracts Zika, the risks to them are very, very low. It’s really about pregnant women and the risk to the fetus.”

The CDC authors specifically noted that the theoretical risk for Zika transmission is most relevant for female health care personnel who may be pregnant, or for male or female health care personnel attempting to conceive. They recommended that personnel determine the most appropriate PPE based on the likelihood of body fluid exposure for each type of procedure or activity.

An amniotomy or placement of an intrauterine pressure catheter may require mask, eye protection, gloves and an impermeable gown, for example, but vaginal exams of pregnant women with minimal cervical dilation and intact membranes likely only call for the use of gloves. Anesthesia providers should wear sterile gloves and a surgical mask when they place catheters or administer intrathecal injections, and all providers should wear double gloves while handling sharps.

“When performing procedures including vaginal deliveries, manual placenta removal, bimanual uterine massage, and repair of vaginal lacerations, PPE should include (in addition to mucous membrane and skin protection) impermeable gowns and knee-high impermeable shoe covers,” they wrote.

Health care providers working in labor and delivery rooms should employ the standard precautions for infection control to reduce the theoretical risk of Zika transmission, according to recommendations from the Centers for Disease Control and Prevention.

“Because of the potential for exposure to large volumes of body fluids during the labor and delivery process and the sometimes unpredictable and fast-paced nature of obstetrical care, the use of Standard Precautions in these settings is essential to prevent possible transmission of Zika virus from patients to health care personnel,” Dr. Christine K. Olson and her colleagues at the CDC wrote in the Morbidity and Mortality Weekly Report.

©AlexLMX/Thinkstock

No cases of occupational transmission of Zika via bodily fluids have been reported so far, but sexual transmission has occurred and the virus’s RNA has been found in blood, urine, saliva, and amniotic fluid. The risk of occupational exposure therefore theoretically exists, the authors wrote (MMWR. 2016 Mar 22. doi: 10.15585/mmwr.mm6511e3er).

The standard precautions are aimed at preventing transmission of any infectious agent present in blood, body fluids, secretions, nonperspiration excretions, nonintact skin, and mucous membranes. They include five main elements: hand hygiene, use of personal protection equipment (PPE), respiratory hygiene and cough etiquette, safe injection practices, and safe handling of potentially contaminated equipment or surfaces in the patient environment.

Standard PPE recommendations in labor and delivery rooms include eye protection during deliveries to prevent contamination from blood and bodily fluids and the use of double-gloving since the outer layer often contains perforations.

Health care personnel should already be following these standard precautions in all health care settings, but the CDC report will likely remind providers of the importance of these infection control procedures and improve compliance, said Dr. Aaron Caughey, chair of the department of obstetrics and gynecology and associate dean for Women’s Health Research and Policy at Oregon Health and Science University, Portland.

“Those are the standard recommendations on every labor floor for delivery currently, so absolutely it’s feasible,” he said in an interview. However, “for a low-risk woman doing a vaginal delivery without complications, I know that some people skimp on eyewear, and I know there are occasionally people who will wear just one pair of gloves,” he said.

The CDC report also noted varying levels of adherence to the standard precautions.

“Numerous barriers to the appropriate use of PPE have been cited, including the perception that PPE is uncomfortable and limits dexterity, fogging of goggles or face masks, the misperception that prescription eyeglasses provide adequate eye protection, lack of available PPE, forgetting to use PPE, lack of time in urgent clinical situations to don appropriate PPE, the perception that the patient poses minimal risk, and concerns about interference with patient care,” Dr. Olson and her colleagues wrote.

Dr. Caughey drew parallels to the late 1980s and early 1990s, when compliance with eye safety and glove safety precautions increased dramatically alongside the HIV epidemic.

“With these recommendations, it will probably get a little more heightened, particularly if there are parts of the country where Zika becomes endemic,” he said. “The big difference with Zika is if a man contracts Zika or a woman who’s not pregnant contracts Zika, the risks to them are very, very low. It’s really about pregnant women and the risk to the fetus.”

The CDC authors specifically noted that the theoretical risk for Zika transmission is most relevant for female health care personnel who may be pregnant, or for male or female health care personnel attempting to conceive. They recommended that personnel determine the most appropriate PPE based on the likelihood of body fluid exposure for each type of procedure or activity.

An amniotomy or placement of an intrauterine pressure catheter may require mask, eye protection, gloves and an impermeable gown, for example, but vaginal exams of pregnant women with minimal cervical dilation and intact membranes likely only call for the use of gloves. Anesthesia providers should wear sterile gloves and a surgical mask when they place catheters or administer intrathecal injections, and all providers should wear double gloves while handling sharps.

“When performing procedures including vaginal deliveries, manual placenta removal, bimanual uterine massage, and repair of vaginal lacerations, PPE should include (in addition to mucous membrane and skin protection) impermeable gowns and knee-high impermeable shoe covers,” they wrote.

Health care providers working in labor and delivery rooms should employ the standard precautions for infection control to reduce the theoretical risk of Zika transmission, according to recommendations from the Centers for Disease Control and Prevention.

“Because of the potential for exposure to large volumes of body fluids during the labor and delivery process and the sometimes unpredictable and fast-paced nature of obstetrical care, the use of Standard Precautions in these settings is essential to prevent possible transmission of Zika virus from patients to health care personnel,” Dr. Christine K. Olson and her colleagues at the CDC wrote in the Morbidity and Mortality Weekly Report.

©AlexLMX/Thinkstock

No cases of occupational transmission of Zika via bodily fluids have been reported so far, but sexual transmission has occurred and the virus’s RNA has been found in blood, urine, saliva, and amniotic fluid. The risk of occupational exposure therefore theoretically exists, the authors wrote (MMWR. 2016 Mar 22. doi: 10.15585/mmwr.mm6511e3er).

The standard precautions are aimed at preventing transmission of any infectious agent present in blood, body fluids, secretions, nonperspiration excretions, nonintact skin, and mucous membranes. They include five main elements: hand hygiene, use of personal protection equipment (PPE), respiratory hygiene and cough etiquette, safe injection practices, and safe handling of potentially contaminated equipment or surfaces in the patient environment.

Standard PPE recommendations in labor and delivery rooms include eye protection during deliveries to prevent contamination from blood and bodily fluids and the use of double-gloving since the outer layer often contains perforations.

Health care personnel should already be following these standard precautions in all health care settings, but the CDC report will likely remind providers of the importance of these infection control procedures and improve compliance, said Dr. Aaron Caughey, chair of the department of obstetrics and gynecology and associate dean for Women’s Health Research and Policy at Oregon Health and Science University, Portland.

“Those are the standard recommendations on every labor floor for delivery currently, so absolutely it’s feasible,” he said in an interview. However, “for a low-risk woman doing a vaginal delivery without complications, I know that some people skimp on eyewear, and I know there are occasionally people who will wear just one pair of gloves,” he said.

The CDC report also noted varying levels of adherence to the standard precautions.

“Numerous barriers to the appropriate use of PPE have been cited, including the perception that PPE is uncomfortable and limits dexterity, fogging of goggles or face masks, the misperception that prescription eyeglasses provide adequate eye protection, lack of available PPE, forgetting to use PPE, lack of time in urgent clinical situations to don appropriate PPE, the perception that the patient poses minimal risk, and concerns about interference with patient care,” Dr. Olson and her colleagues wrote.

Dr. Caughey drew parallels to the late 1980s and early 1990s, when compliance with eye safety and glove safety precautions increased dramatically alongside the HIV epidemic.

“With these recommendations, it will probably get a little more heightened, particularly if there are parts of the country where Zika becomes endemic,” he said. “The big difference with Zika is if a man contracts Zika or a woman who’s not pregnant contracts Zika, the risks to them are very, very low. It’s really about pregnant women and the risk to the fetus.”

The CDC authors specifically noted that the theoretical risk for Zika transmission is most relevant for female health care personnel who may be pregnant, or for male or female health care personnel attempting to conceive. They recommended that personnel determine the most appropriate PPE based on the likelihood of body fluid exposure for each type of procedure or activity.

An amniotomy or placement of an intrauterine pressure catheter may require mask, eye protection, gloves and an impermeable gown, for example, but vaginal exams of pregnant women with minimal cervical dilation and intact membranes likely only call for the use of gloves. Anesthesia providers should wear sterile gloves and a surgical mask when they place catheters or administer intrathecal injections, and all providers should wear double gloves while handling sharps.

“When performing procedures including vaginal deliveries, manual placenta removal, bimanual uterine massage, and repair of vaginal lacerations, PPE should include (in addition to mucous membrane and skin protection) impermeable gowns and knee-high impermeable shoe covers,” they wrote.

The Food and Drug Administration has approved Anthim (obiltoxaximab) injection to treat inhalational anthrax, in combination with appropriate antibacterial drugs.

Anthim is a monoclonal antibody that neutralizes toxins produced by the bacterium Bacillus anthracis. Anthim was approved under the FDA’s Animal Rule, which allows efficacy findings from adequate and well-controlled animal studies to support FDA approval when it is not feasible or ethical to conduct efficacy trials in humans. Anthim is also approved to prevent inhalational anthrax when alternative therapies are not available or not appropriate.

©Carolina K Smith MD/Fotolia.com

The drug was developed by Elusys Therapeutics Inc. of Pine Brook, N.J., in conjunction with the U.S. Department of Health and Human Services’ Biomedical Advanced Research and Development Authority.

Inhalational anthrax is a rare disease that can occur after exposure to infected animals or contaminated animal products, or as a result of an intentional release of anthrax spores. When inhaled, the anthrax bacteria replicate in the body and produce toxins that can cause massive and irreversible tissue injury and death.

Anthim’s effectiveness was demonstrated in studies conducted in animals based on survival at the end of the studies. More animals treated with Anthim lived, compared with animals treated with placebo. Anthim administered in combination with antibacterial drugs resulted in higher survival outcomes than antibacterial therapy alone.

The safety of Anthim was evaluated in 320 healthy human volunteers. The most frequently reported side effects were headache, itching (pruritus), upper respiratory tract infections, cough, nasal congestion, hives, and bruising, swelling and pain at the infusion site.

For more information, see the FDA’s approval announcement.

[email protected]

On Twitter @richpizzi

The Food and Drug Administration has approved Anthim (obiltoxaximab) injection to treat inhalational anthrax, in combination with appropriate antibacterial drugs.

Anthim is a monoclonal antibody that neutralizes toxins produced by the bacterium Bacillus anthracis. Anthim was approved under the FDA’s Animal Rule, which allows efficacy findings from adequate and well-controlled animal studies to support FDA approval when it is not feasible or ethical to conduct efficacy trials in humans. Anthim is also approved to prevent inhalational anthrax when alternative therapies are not available or not appropriate.

©Carolina K Smith MD/Fotolia.com

The drug was developed by Elusys Therapeutics Inc. of Pine Brook, N.J., in conjunction with the U.S. Department of Health and Human Services’ Biomedical Advanced Research and Development Authority.

Inhalational anthrax is a rare disease that can occur after exposure to infected animals or contaminated animal products, or as a result of an intentional release of anthrax spores. When inhaled, the anthrax bacteria replicate in the body and produce toxins that can cause massive and irreversible tissue injury and death.

Anthim’s effectiveness was demonstrated in studies conducted in animals based on survival at the end of the studies. More animals treated with Anthim lived, compared with animals treated with placebo. Anthim administered in combination with antibacterial drugs resulted in higher survival outcomes than antibacterial therapy alone.

The safety of Anthim was evaluated in 320 healthy human volunteers. The most frequently reported side effects were headache, itching (pruritus), upper respiratory tract infections, cough, nasal congestion, hives, and bruising, swelling and pain at the infusion site.

For more information, see the FDA’s approval announcement.

[email protected]

On Twitter @richpizzi

The Food and Drug Administration has approved Anthim (obiltoxaximab) injection to treat inhalational anthrax, in combination with appropriate antibacterial drugs.

Anthim is a monoclonal antibody that neutralizes toxins produced by the bacterium Bacillus anthracis. Anthim was approved under the FDA’s Animal Rule, which allows efficacy findings from adequate and well-controlled animal studies to support FDA approval when it is not feasible or ethical to conduct efficacy trials in humans. Anthim is also approved to prevent inhalational anthrax when alternative therapies are not available or not appropriate.

©Carolina K Smith MD/Fotolia.com

The drug was developed by Elusys Therapeutics Inc. of Pine Brook, N.J., in conjunction with the U.S. Department of Health and Human Services’ Biomedical Advanced Research and Development Authority.

Inhalational anthrax is a rare disease that can occur after exposure to infected animals or contaminated animal products, or as a result of an intentional release of anthrax spores. When inhaled, the anthrax bacteria replicate in the body and produce toxins that can cause massive and irreversible tissue injury and death.

Anthim’s effectiveness was demonstrated in studies conducted in animals based on survival at the end of the studies. More animals treated with Anthim lived, compared with animals treated with placebo. Anthim administered in combination with antibacterial drugs resulted in higher survival outcomes than antibacterial therapy alone.

The safety of Anthim was evaluated in 320 healthy human volunteers. The most frequently reported side effects were headache, itching (pruritus), upper respiratory tract infections, cough, nasal congestion, hives, and bruising, swelling and pain at the infusion site.

For more information, see the FDA’s approval announcement.

[email protected]

On Twitter @richpizzi

A faster diagnostic tool for Zika virus infection than those currently used received approval by the Food and Drug Administration under an Emergency Use Authorization, the agency reported Friday, the same day the Centers for Disease Control and Prevention reported that 116 U.S. residents have tested positive for Zika as of Feb. 26.

The Trioplex Real­time RT-­PCR Assay requires only a single test to differentiate current chikungunya, dengue or Zika infections instead of three separate tests. The CDC will start distributing the test to qualified domestic and international labs over the next two weeks, but U.S. hospitals and similar primary care settings will not have the test.

©Felipe Caparrós Cruz/Thinkstock

Nearly a quarter (24%) of the 116 cases reported by the CDC were diagnosed using reverse transcription-polymerase chain reaction (RT-PCR) to detect Zika RNA, and nearly all the remaining (76%) relied on detection of anti-Zika antibodies with ELISA serologic testing. Two cases were determined based on epidemiological links to a confirmed case and serologic evidence of an unspecified flavivirus infection. These cases do not include additional onesdiagnosed and reported from state and territorial departments with local lab testing.

“Zika virus disease should be considered in patients with acute onset of fever, rash, arthralgia or conjunctivitis who traveled to areas with ongoing transmission or had unprotected sex with someone who traveled to those areas and developed compatible symptoms within two weeks of returning,” said Dr. Paige Armstrong, of the Epidemic Intelligence Service at the CDC in Atlanta, and her associates (MMWR 2016 March 18).

The researchers reported on all U.S. residents who received positive lab tests for Zika infection from the CDC between January 1, 2015, and February 26, 2016. Among the cases, from 33 states and Washington, D.C., one was an infant with microcephaly who contracted the virus congenitally, five had recently had sexual contact with someone who had traveled to an area where Zika was actively circulating, and 110 had traveled to a region active with Zika. Haiti, El Salvador, Colombia, Honduras and Guatemala comprised the most commonly visited countries among the cases.

Most infections of Zika, transmitted primarily by the Aedes aegypti mosquito, remain asymptomatic, and even those with the characteristic symptoms of rash, fever, arthralgia and nonpurulent conjunctivitis tend to have a mild illness. Nearly all (96%) of the 116 cases had at least two of these symptoms, and 65% had three or more. Among all the cases, 98% experienced a rash, 82% a fever, 66% joint pain, 57% headache, 55% myalgia and 37% conjunctivitis. Four were hospitalized, and none died.

“Until more is known about the effects of Zika virus infection on the developing fetus, pregnant women should postpone travel to areas where Zika virus transmission is ongoing,” Dr. Armstrong and associates wrote. “Pregnant women who develop a clinically compatible illness during or within two weeks of returning from an area with Zika virus transmission should be tested for Zika virus infection; testing may also be offered to asymptomatic pregnant women 2–12 weeks after travel to an area with active Zika transmission.”

The study was funded by the CDC, and the authors reported no disclosures.

A faster diagnostic tool for Zika virus infection than those currently used received approval by the Food and Drug Administration under an Emergency Use Authorization, the agency reported Friday, the same day the Centers for Disease Control and Prevention reported that 116 U.S. residents have tested positive for Zika as of Feb. 26.

The Trioplex Real­time RT-­PCR Assay requires only a single test to differentiate current chikungunya, dengue or Zika infections instead of three separate tests. The CDC will start distributing the test to qualified domestic and international labs over the next two weeks, but U.S. hospitals and similar primary care settings will not have the test.

©Felipe Caparrós Cruz/Thinkstock

Nearly a quarter (24%) of the 116 cases reported by the CDC were diagnosed using reverse transcription-polymerase chain reaction (RT-PCR) to detect Zika RNA, and nearly all the remaining (76%) relied on detection of anti-Zika antibodies with ELISA serologic testing. Two cases were determined based on epidemiological links to a confirmed case and serologic evidence of an unspecified flavivirus infection. These cases do not include additional onesdiagnosed and reported from state and territorial departments with local lab testing.

“Zika virus disease should be considered in patients with acute onset of fever, rash, arthralgia or conjunctivitis who traveled to areas with ongoing transmission or had unprotected sex with someone who traveled to those areas and developed compatible symptoms within two weeks of returning,” said Dr. Paige Armstrong, of the Epidemic Intelligence Service at the CDC in Atlanta, and her associates (MMWR 2016 March 18).

The researchers reported on all U.S. residents who received positive lab tests for Zika infection from the CDC between January 1, 2015, and February 26, 2016. Among the cases, from 33 states and Washington, D.C., one was an infant with microcephaly who contracted the virus congenitally, five had recently had sexual contact with someone who had traveled to an area where Zika was actively circulating, and 110 had traveled to a region active with Zika. Haiti, El Salvador, Colombia, Honduras and Guatemala comprised the most commonly visited countries among the cases.

Most infections of Zika, transmitted primarily by the Aedes aegypti mosquito, remain asymptomatic, and even those with the characteristic symptoms of rash, fever, arthralgia and nonpurulent conjunctivitis tend to have a mild illness. Nearly all (96%) of the 116 cases had at least two of these symptoms, and 65% had three or more. Among all the cases, 98% experienced a rash, 82% a fever, 66% joint pain, 57% headache, 55% myalgia and 37% conjunctivitis. Four were hospitalized, and none died.

“Until more is known about the effects of Zika virus infection on the developing fetus, pregnant women should postpone travel to areas where Zika virus transmission is ongoing,” Dr. Armstrong and associates wrote. “Pregnant women who develop a clinically compatible illness during or within two weeks of returning from an area with Zika virus transmission should be tested for Zika virus infection; testing may also be offered to asymptomatic pregnant women 2–12 weeks after travel to an area with active Zika transmission.”

The study was funded by the CDC, and the authors reported no disclosures.

A faster diagnostic tool for Zika virus infection than those currently used received approval by the Food and Drug Administration under an Emergency Use Authorization, the agency reported Friday, the same day the Centers for Disease Control and Prevention reported that 116 U.S. residents have tested positive for Zika as of Feb. 26.

The Trioplex Real­time RT-­PCR Assay requires only a single test to differentiate current chikungunya, dengue or Zika infections instead of three separate tests. The CDC will start distributing the test to qualified domestic and international labs over the next two weeks, but U.S. hospitals and similar primary care settings will not have the test.

©Felipe Caparrós Cruz/Thinkstock

Nearly a quarter (24%) of the 116 cases reported by the CDC were diagnosed using reverse transcription-polymerase chain reaction (RT-PCR) to detect Zika RNA, and nearly all the remaining (76%) relied on detection of anti-Zika antibodies with ELISA serologic testing. Two cases were determined based on epidemiological links to a confirmed case and serologic evidence of an unspecified flavivirus infection. These cases do not include additional onesdiagnosed and reported from state and territorial departments with local lab testing.

“Zika virus disease should be considered in patients with acute onset of fever, rash, arthralgia or conjunctivitis who traveled to areas with ongoing transmission or had unprotected sex with someone who traveled to those areas and developed compatible symptoms within two weeks of returning,” said Dr. Paige Armstrong, of the Epidemic Intelligence Service at the CDC in Atlanta, and her associates (MMWR 2016 March 18).

The researchers reported on all U.S. residents who received positive lab tests for Zika infection from the CDC between January 1, 2015, and February 26, 2016. Among the cases, from 33 states and Washington, D.C., one was an infant with microcephaly who contracted the virus congenitally, five had recently had sexual contact with someone who had traveled to an area where Zika was actively circulating, and 110 had traveled to a region active with Zika. Haiti, El Salvador, Colombia, Honduras and Guatemala comprised the most commonly visited countries among the cases.

Most infections of Zika, transmitted primarily by the Aedes aegypti mosquito, remain asymptomatic, and even those with the characteristic symptoms of rash, fever, arthralgia and nonpurulent conjunctivitis tend to have a mild illness. Nearly all (96%) of the 116 cases had at least two of these symptoms, and 65% had three or more. Among all the cases, 98% experienced a rash, 82% a fever, 66% joint pain, 57% headache, 55% myalgia and 37% conjunctivitis. Four were hospitalized, and none died.

“Until more is known about the effects of Zika virus infection on the developing fetus, pregnant women should postpone travel to areas where Zika virus transmission is ongoing,” Dr. Armstrong and associates wrote. “Pregnant women who develop a clinically compatible illness during or within two weeks of returning from an area with Zika virus transmission should be tested for Zika virus infection; testing may also be offered to asymptomatic pregnant women 2–12 weeks after travel to an area with active Zika transmission.”

The study was funded by the CDC, and the authors reported no disclosures.