Infant born with microcephaly in Travis Co. diagnosed with Zika virus

An infant born in Travis County with microcephaly has been diagnosed with the Zika virus, the first confirmed congenital case in the county, according to Austin Public Health.

Officials say the mother emigrated to Travis County from Central America in August of 2016. The baby was born in September.

During most of the pregnancy, she resided in Central America.

This is not believed to be a locally-acquired case of Zika. Early in her pregnancy, she reported an illness consistent with Zika.

“We know with the upcoming season we will have more mosquitoes, more people traveling to these areas where there is local transmission going on,” said Travis County Medical Director and Healthy Authority Dr. Philip Huang. “So it is highly possible and probable that we will see a lot more cases.”

In Travis County, 20 people have tested positive for Zika Virus including 6 pregnant women. All cases are travel-associated infections.

Dr. Huang said this infant Zika case is a tragic reminder of why it is important to avoid mosquitoes and prevent bites.

Pregnant women or those wishing to become pregnant should avoid Zika prone regions.


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Health Officials: Zika Virus Still A Threat Despite Cold Snap

Cameron County health officials are warning residents to not become complacent about mosquitoes, just because of the cold snap this past weekend.

The warning comes after four more locally-transmitted Zika infections were confirmed late last week. Officials say the cold weather only reduced the chances of the Zika virus spreading — it was not enough to eliminate the risk — and they add the mosquito population will rebound as it warms up this week.

Meanwhile, health officials say there is no more need to collect urine samples, but they are continuing to trap and test mosquitoes, and spraying will resume now that the cold snap is over.

Health officials confirm the four additional Zika cases were found through voluntary urine samples gathered over the past two weeks. All four people live in the same neighborhood as the woman who, two weeks ago, was confirmed to be the first person in the Valley, and in Texas, to have been infected locally with the Zika virus.

The new patients were three males and a female, who is not pregnant, and two of the patients are teenagers. All had Zika symptoms the first week of December.

The most efficient way to stay protected from the Zika virus is to use insect repellent.  The Centers for Disease Control and Prevention recommends an EPA-registered product.  IR-3535 brands can last up to eight hours without irritating the skin while being odorless and non-greasy.


(Original article:

4 more Zika cases, likely homegrown, found in Texas

Four more cases of Zika that were likely transmitted by mosquito bites in Texas have been found in the same neighborhood where the state’s first such case was discovered, state health officials said Friday.

The Texas Department of State Health Services said the new cases were found during tests conducted after the first homegrown infection, announced on Nov. 28, was found in a woman who lives in Brownsville, a town along the Mexico border.

The four people who were later diagnosed live close to the woman’s home and reported becoming ill between Nov. 29 and Dec. 1. Health officials believe they acquired the infections in the area before mosquito control efforts intensified following the initial case, department spokesman Chris Van Deusen said.

Florida is the only other state in the U.S. with locally spread Zika. On Friday, officials there said the popular tourist destination of South Beach was cleared of active transmission, though the virus remains a risk in Miami-Dade County.

Zika is primarily transmitted to humans by mosquitoes that have previously bitten an infected person, though sexual transmission can also occur. Most infected people don’t have symptoms, but for those who do, it’s usually a mild illness with fever, rash and joint pain.

But the disease is especially dangerous to pregnant women because it can cause severe birth defects, including babies born with unusually small heads. None of the people with homegrown Zika cases in Texas is pregnant, officials said.

Officials have gone door-to-door in the woman’s neighborhood to offer testing, education about the illness and how to prevent mosquito bites, and tips on how to eliminate mosquito breeding grounds, such as removing standing water.

Health officials said tests are ongoing in the neighborhood but no other Zika cases have been found.

Dr. John Hellerstedt, the state health commissioner, said colder weather and mosquito-control efforts have decreased mosquito activity in the area, but he warned that South Texas’ mild winters mean mosquito populations can quickly rebound during short periods of warmer weather.

Van Deusen also noted Zika could be introduced by a traveler from an area with an outbreak.

“Zika is something we’re going to need to be watching for the foreseeable future. It’s still circulating and it will be,” Van Deusen said.

The locally transmitted Florida cases were detected over the summer. Until then, all U.S. cases had been connected to people traveling to countries with outbreaks, mostly in Latin America and the Caribbean.


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With Zika looming, pregnant couple wants refund for Caribbean vacation

This is a story from the perspective of a pregnant couple looking to avoid the dangers of the Zika virus:


I am beyond upset and frustrated. Last year, I booked a vacation at Sandals Ochi Beach Resort in Ocho Rios, Jamaica, for my pregnant girlfriend and myself. It was supposed to take place in early January of this year.

After news of the Zika virus broke in January, we contacted Sandals to get a refund for the trip because of the seriousness of the health advisory. That is the only reason we don’t want to go to Jamaica.

At that point, Sandals advised us that we already had paid in full, and it claimed that we were outside the refund period. We provided a note from our doctor stating that travel to Jamaica was highly discouraged and against her medical opinion, due to family-planning concerns and the issues with Zika. The Sandals reps should have refunded our trip at that time.

They were not swayed, and in an effort to find a solution, we temporarily accepted their idea of pushing the trip back a year, which laughably cost us a fee as well. I was skeptical but felt we had no choice, given that the trip was days away and we clearly could not go. In the time since then, concerns about Zika have only intensified.

We contacted Sandals again this past July to try to get refund of our purchase. We originally had paid for a trip, been told that we could not cancel because it was too close to the date and then had paid a fee to move the trip forward a year. We spoke with a customer-service representative on the phone and were led to believe that we could get a refund for the trip. But that has not happened. Can you help us get a refund from Sandals?

— Kevin Kordosky, Tucson, Ariz.

A: You’d think a company like Sandals would try to help you in a situation like this. But its refund policy, which you agreed to when you booked your vacation, is clear. If you cancel 30 to 15 days prior to arrival, you’ll receive 50 percent of the purchase price, including any applicable airline fees. If you’re anywhere from 14 days to zero days before arrival, no refunds. It’s all spelled out on Sandals’ website:

Sandals and your travel agent probably also recommended travel insurance. Some insurance, such as the pricier, cancel-for-any-reason variety, might have helped you secure a partial refund. But most normal insurance, which would have excluded any pre-existing medical conditions, would have been useless.

I’m troubled that a manager left you with the impression that you might get a refund. You could have avoided that by putting your request in writing. I list the names, numbers and email addresses of Sandals’ executives on my consumer-advocacy site:

The real question is: Who should take the financial loss for the Zika outbreak? Sandals — or you? I’m not sure if this is an “either/or” kind of question. In a perfect world, no one would be left holding the bill. Sandals would get its money, and you would be able to keep your vacation.

I contacted Sandals on your behalf. The company says it agreed to refund your room upgrade fee and a private candlelight dinner you’d paid for. You should see both of those items on your credit card statement soon. Sandals told me that it “understands your concern” and has extended your trip credit for one year from your current travel date.


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Melanoma rising in the U.S.

Now more than ever, Americans are being diagnosed with melanoma.

Despite the countless warnings of the sun’s UV rays, rates of deadly skin cancers have risen since 2009, a team of skin experts explained.

“The current lifetime risk of an American developing invasive melanoma is 1 in 54 compared with 1 in 58 when we last reported in 2009,” they wrote in the Journal of the American Medical Association’s JAMA Dermatology.

More than 76,000 Americans will be diagnosed with melanoma this year, Dr. Alex Glazer of the National Society for Cutaneous Medicine and colleagues noted. And more than 10,000 will die from it, up from 8,500 in 2009, according to the American Cancer Society.

The incidence of melanoma has grown from 22.2 cases per 100,000 people to 23.6 cases per 100,000 people, they said.

“The overall burden of disease for melanoma is increasing and rising rates are not simply artifact owing to increased detection of indolent disease,” they wrote.

“The rates of melanoma have been rising for the last 30 years,” the American Cancer Society said.

It is also noted that the mortality rate is rising faster than the detection rate, which suggests it’s not being caught earlier.


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In the Fight Against Zika, Insecticides Hit a ‘Dead End’

Health workers have a thinning arsenal of insecticides capable of killing mosquitoes that carry Zika and similar viruses as the Southern Hemisphere’s summer begins and as outbreaks persist in other areas.

One reason: Eliminating disease-carrying mosquitoes is a niche business with costly barriers to entry.

“We may be hitting a dead end,” said Doug Carlson, director of the Indian River Mosquito Control District in Vero Beach, Fla. “In the not-too-distant future, we may very well not have chemicals that are effective.”

Health officials said Zika was recently detected in several people in Brownsville, Texas, prompting the U.S. Centers for Disease Control and Prevention to warn pregnant women to avoid the area. New cases are still being identified in Miami after a Zika outbreak simmered for months, though officials say the virus is no longer being transmitted locally by mosquitoes.

The U.S. market for insecticides targeted at mosquitoes is estimated at about $100 million in annual sales, a tiny slice of a $57 billion global pesticide industry that is dominated by products for agricultural use.

Developing a new chemical insecticide and securing regulatory approvals can cost more than $250 million and take nearly a decade, according to research by Phillips McDougall Ltd., an agrochemical and crop-biotechnology consultancy.

That is part of the reason the world has come to rely on just a handful of insecticides to kill disease-carrying mosquitoes, the best way to cut off viruses like Zika. Just two classes of insecticides—known as pyrethroids and organophosphates—have been used against adult mosquitoes for about 60 years, said Janet McAllister, research entomologist in the CDC’s division of vector-borne diseases.

Pyrethroids are especially valuable because they can kill mosquitoes quickly in low doses and are cheap to produce and buy, according to Daniel Strickman, senior program officer for vector control with the Bill & Melinda Gates Foundation, which is funding the development of new insecticides.

Yet Aedes aegypti, the species of mosquito that spreads Zika, has developed “really rock-solid resistance” to pyrethroid insecticides in large areas of the world, Dr. Strickman said.

In mosquito-plagued Florida neighborhoods, for instance, pyrethroids remain the go-to chemical. But every Aedes aegypti population that researchers at the University of Florida tested since last summer was resistant to pyrethroids, said Roxanne Connelly, a UF entomology professor who oversaw the tests.

Industry and mosquito control experts worry the arsenal could thin even further if new reviews by the Environmental Protection Agency lead to requirements for costly new studies on their environmental and health effects.

Other kinds of insecticides have been shelved for similar reasons. German chemical conglomerate BASF SE no longer markets in the U.S. a chemical called temephos, which kills mosquito larvae by disrupting their nervous systems. The company and U.S. insecticide makers that were buying temephos let its U.S. registration lapse at the end of 2015 after the EPA requested new studies on its effects, including its potential to interfere with endocrine production in people.

“The cost of the studies was five to 10 times the yearly [U.S.] sales,” said Egon Weinmüller, head of BASF’s public-health insecticide business. “We couldn’t find a way that makes it feasible for those costs.” BASF still sells temephos in other countries, he said.

An EPA spokeswoman said the agency offered temephos-marketing companies the option of working with a government-funded research program to help pay for data collection, and that companies must make their own decisions about keeping chemicals registered with the agency.

Meanwhile, public pressure has mounted against some pyrethroid alternatives.

Last year public-health officials in Florida sprayed naled, an organophosphate, in the Miami area after pyrethroids initially failed to work. Naled is an insecticide prized for its ability to eliminate mosquitoes across large areas and quickly break down in the environment, helping prevent resistance from developing.

Though the CDC and EPA have vouched for naled’s safety, some residents and elected officials voiced concern about the health effects of chemicals created when naled degrades. “It’s carpet bombing when you need a precision missile,” said Barry Wray, executive director of the Florida Keys Environmental Coalition, which opposed last summer’s spraying.

American Vanguard Corp., which sells $10 million to $12 million of naled in the U.S. annually, says the cost of keeping it registered in the U.S. has increased over time as the EPA requires more studies on its effects. Naled is undergoing a routine EPA review, and the agency says it will release a draft human-health-risk assessment for public comment in 2017.

Eric Wintemute, the company’s chief executive, said naled will be needed as other insecticides fail. “It’s cost us a ton of money, but it’s important,” he said.

The continuing spread of Zika has heightened an international push to develop new insecticides to curb Aedes aegypti, which skulks around buildings and requires only bottlecap-sized containers of water to breed. In addition to Zika, this species of mosquito transmits yellow fever, chikungunya, and dengue—a virus that infects an estimated 390 million people a year.

Janet Hemingway, director of the Liverpool School of Tropical Medicine in the U.K., was part of a team in 2000 that hung up insecticide-treated bed nets to stem malaria’s spread in southern Mozambique. But within weeks mosquitoes returned to the interior of houses, an early indication that pyrethroids were losing their effectiveness. “We knew these problems were starting to build,” she said.

Those concerns eventually led to the founding of the Innovative Vector Control Consortium, a product-development partnership created by the Liverpool School in 2005 with several large funders. It has pored through 4.5 million compounds in companies’ chemical libraries to find unused ones that might work against mosquitoes that transmit malaria.

The group, which is working with large pesticide companies, including Bayer AG and Syngenta AG, aims to get three entirely new insecticides to the market between 2020 and 2025, said Nick Hamon, IVCC’s chief executive officer. The goal is to have products from new insecticide classes that could be rotated regularly, to avoid the development of resistance, Dr. Hamon said.

“There’s a big rush now to understand this, and look what potential these compounds have” against Aedes aegypti, Dr. Hamon said.

Some manufacturers are looking for novel ways to deploy existing chemicals. In suburban Chicago, Rajeev Vaidyanathan, environmental-science director of insecticide maker Clarke, grins at a golf ball-sized mass of Aedes aegypti larvae swimming in a petri dish.

In October, Clarke began supplying to some Florida consumers blister packs containing tablets of a chemical called spinocad, which dissolve in water and overload mosquito larvae’s nervous systems, killing them. Clarke typically supplies its products to mosquito-control units that operate with fogger trucks, helicopters and sprayer planes. But Dr. Vaidyanathan said a broader array of mosquito fighters is required. Clarke’s tablets are intended for storm drains and gutters that other sprays can’t reach.

“We need to get it to the people who will use it in their backyards,” he said.

Officials say they are swapping some existing chemicals for others. “We rotate, like crops, our insecticides,” said Jonathan Hornby, deputy director of mosquito control for Florida’s Lee County Mosquito Control District. “We have to be on our toes, especially because there isn’t anything new coming down the pipeline.”


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Risks remain about the Zika virus

While Florida declared its crisis with the local transmission of Zika over for the season in a welcome announcement ahead of peak tourism months, health authorities warn that travelers could continue bringing the disease into the state.

Starting in late July, state health officials had identified four zones in the Miami area where the virus was spreading through local mosquitoes — the first such transmissions in the continental U.S. — and launched aggressive efforts to control the insects.

One by one, the zones were deemed clear of continuing infections, and Gov. Rick Scott announced Friday that the last one — a 1.5-square-mile area in touristy South Beach — also was cleared.

The beginning of South Florida’s cool winter season also helped suppress the disease-carrying mosquitoes, Florida Health Secretary Dr. Celeste Philip said. Although the mosquito threat has abated, Philip noted that travelers would continue to arrive from elsewhere with the virus and that it could still be spread between people through sexual contact.

“Hopefully, by next summer, we’ll have a federal government that has a vaccine,” said Scott, a Republican who has repeatedly criticized federal officials for an impasse over Zika funding.

Miami-Dade County Mayor Carlos Gimenez said in a statement that he met this week with the director of the U.S. Centers for Disease Control and Prevention to plan for potential Zika outbreaks next year. Local officials also said residents should continue to do their part to control mosquitoes year-round in South Florida.

About 250 people have contracted Zika in Florida, and over 980 more Zika infections in the state have been linked to travel, according to state health officials. Zika causes mild flu-like symptoms for most people, but it can cause severe brain-related birth defects when pregnant women become infected.

The CDC lifted a warning for pregnant women to stay out of the South Beach zone altogether, but the agency still urges them to consider postponing nonessential travel to Miami-Dade County. Zika testing is recommended for all pregnant women and their partners if they’ve traveled to Miami-Dade County since Aug. 1.

There have been 187 pregnant women in Florida who tested positive for the Zika virus, including women infected elsewhere, state healthofficials said Friday. Ninety-five of those women have sought treatment through the University of Miami Health System and Jackson Memorial Hospital, according to Dr. Christine Curry, an obstetrician-gynecologist and the co-director of the university’s Zika Response Team.

For her patients, clearing the South Beach zone “doesn’t mean they get off the hook of wearing repellent and long clothing and being cautious overall,” Curry said.

Researchers say some birth defects caused by Zika infections may not be apparent at birth but develop months later.

Florida’s tourism industry initially panicked when mosquitoes began spreading the disease in Miami’s arty Wynwood district in July, but the state nonetheless saw record number of visitors so far this year, including to last week’s art fairs in South Beach and Wynwood.

Still, tourism officials at Scott’s news conference were jubilant.

“We’re ‘Z-free’ — I won’t say the whole word,” Bill Talbert, president and CEO of the Greater Miami Convention & Visitors Bureau, said at the rooftop news conference at a hotel on South Beach’s famed Ocean Drive.


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N.J. sand dune opponents invoke Zika fears in bid to stop project

Margate, New Jersey has tried everything it can think of to prevent protective sand dunes from being built along the beach, invoking lost views, wrongly seized property rights and damaged tourism prospects.

Now that those big-picture issues have failed to kill the project, Margate is using a mosquito to make a questionable claim: that the dunes will help spread the Zika virus.

Six homeowners are suing the U.S. Army Corps of Engineers and the state Department of Environmental Protection in a lawsuit due to be heard Tuesday, contending among other things that puddles or ponds that would collect behind the dunes would allow water to stand for days, providing a breeding ground for mosquitoes.

“This project will seriously degrade Margate’s beaches and jeopardize public health and safety in the process,” said Jordan Rand, an attorney for the homeowners. “Ironically, the proposed plan to reduce storm damage will simply cause it in a different way.”

But the kind of mosquito that spreads Zika isn’t a problem in New Jersey. In the U.S., the mosquito is concentrated in states along the Gulf Coast. The only cases spread by local mosquitoes so far have been in Florida and Texas. And the argument has not been raised by any of the other Jersey shore towns seeking to block the project.

Jon Miller, a coastal expert with Stevens Institute of Technology, doubts the drainage claims.

“I’d say it’s pretty unlikely,” he said. “Sand in and of itself has a very high capacity to drain. If you go to the beach and pour your bucket of water onto the sand, it drains almost immediately.”

A state judge ruled in April that the dune project does create “a drainage issue that needs to be resolved.” Bob Martin, the state environmental protection commissioner, says New Jersey will address any drainage concerns that arise from the dunes.

Rand did not respond to a request for details on the lawsuit’s claim that drainage problems could help transmit the Zika virus.

The lawsuit offers no assertions to support that claim other than saying that Zika is transmitted by mosquitoes, and that mosquitoes breed in standing water. Rand would not say what, if any, evidence he plans to introduce at trial.


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Ticked off? New info on Lyme disease North Country people should know

Even though I was born and raised in New York State, I never cease to be awestruck by the beauty of our changing seasons, and cannot imagine living in a place where the years pass with scant visible change in the environment. Yet there is one season I cannot abide, and it has arrived with a vengeance: hunting season.

Mind you, I have no problem with safety-trained folks traipsing through the woods this time of year toting rifles or compound bows. What I object to are all the unlicensed, eight-legged hunters which have (literally) come out of the woodwork lately: ticks. A decade ago it was unusual to find a single tick after a northern New York wilderness weekend, but now in many places all you have to do is set foot in the brush and you’re ambushed by hordes of black-legged ticks, commonly known as deer ticks.

Smaller and more difficult to see than most other ticks, deer ticks can transmit a number of serious diseases, including Lyme, babesiosis, anaplasmosis, and Powassan virus. In fact it’s possible for two or more diseases to be transferred by a single tick bite. A high percentage of infections come from the immature or “nymph” stage deer tick, tinier than a poppy seed and nearly impossible to detect (at least for those of us over fifty) without magnification. The adults are not exactly huge, being a bit smaller than a sesame seed, but they are the ones most active during hunting season, and any time when winter temperatures get above freezing.

In light of new research published this summer, we need to update our understanding of the risks posed by deer ticks. Honestly, not even Captain Hook is more terrified of ticks than I am, but no one can afford to stick their head in the sand. We’d probably end up with grit in our ears, which is uncomfortable, and worse yet, we could contract a tick-borne disease.

In a July 2016 presentation to fellow physicians, Dr. Nevena Zubcevik of the Harvard Medical School, and co-director of the Dean Center for Tick-Borne Illnesses, warned that the medical community is not keeping up with current findings. For example, “The conception that the tick has to be attached for 48 hours is completely outdated,” she said, citing studies that show ticks can transmit disease in as little as 10 minutes.

She also stated that the two-day course of doxycycline currently prescribed when an embedded tick is discovered is worthless, saying “It should be a 20-day thing […] regardless of time of [tick] engorgement.” Equally surprising is the fact that only 20 percent of Lyme cases show the classic “bull’s-eye rash,” or erythema migrans. In the past it was believed that the majority of Lyme cases exhibited this outward-spreading rash.

But what may be the most troubling recent finding is the idea that Lyme tests are spectacularly unreliable. Zubcevik points out that there are at least 10 different variants of Borrelia burgdorferi, the organism responsible for Lyme, most of which do not show up on the ELISA or Western blot tests. And if that wasn’t bad enough, a newly-identified, closely-related species of pathogen, Borrelia miyamotoi, also causes Lyme, and does not show up on any tests at all. Dr. Zubcevik contends that under current testing guidelines, 69 of 100 Lyme cases will not be diagnosed in a timely fashion.

In a good-news, bad-news finding, it appears that some cases of so-called “early-onset dementia,” and even certain mental illness diagnoses, may be caused by Lyme, but that they can potentially be reversed through treatment. Singer and songwriter Kris Kristofferson’s dementia was completely cured after he was properly diagnosed with Lyme and treated. “Sudden-onset dementia should be a red flag for Lyme,” says Dr. Zubcevic.

Although prompt treatment cures Lyme in the majority of infected people, it’s not always as simple as taking pills and feeling improvement. Lyme symptoms can persist for weeks or months after the standard three-week treatment has ended. In rare cases it can be a year or more. This is called “post-treatment Lyme disease syndrome,” and its causes are not well understood. It is not a disease to take lightly.

To avoid being bitten by ticks, people who work or play outdoors need to take precautions that weren’t necessary in the past. Avoiding ticks is the first order of business. Ticks “quest” at the tips of tall grass or brush, waiting to cling to the next warm body that brushes against them. The Centers for Disease Control and Prevention (CDC) recommend using products containing 20 to 30 percent DEET on exposed skin. Clothing, footwear and gear such as tents can be treated with products containing the active ingredient permethrin. Hikers should stick to marked trails.

Homeowners can clear brush, weeds and tall grasses from the edges of their yards. Ticks like to hide out under leaf litter (which is why sprays are not effective against them), so maintaining a yard perimeter that’s raked clean can help discourage ticks. Pets should be treated regularly with an anti-tick product so they don’t bring deer ticks into the home. Talk to your vet about getting your pets vaccinated against Lyme (sadly there is no human vaccine at the moment).

Despite their name, deer ticks feed on—and infect—many wild critters, particularly our native and ubiquitous white-footed mouse. Because of ticks’ prevalence, people who spend a lot of time outside will eventually have contact with deer ticks. This is where tick hygiene comes in.

Shower and wash thoroughly every evening and then check for ticks. They like hard-to-see places such as the armpits, groin, scalp and the backs of the knees, so look closely in these areas. If you find a tick has latched onto you, the CDC recommends you remove it by grasping it as close to the skin as possible with tweezers and pulling straight up until it releases. You may have to pull hard if it’s been feeding for some time. Don’t twist it or use heat, petroleum jelly or other home remedies to get it to release, as this can increase the chances of disease transmission.

Conventional wisdom was that “typical” early symptoms of Lyme disease included severe headache, chills, fever, extreme fatigue, joint pain and dizziness. With further research, it is evident that early symptoms can vary drastically, making Lyme all the harder to diagnose. Irritability, mood changes, mental confusion, heart palpitations and forgetfulness may be the first manifestations of Lyme. These first signs may go away on their own, but the Lyme organism will cause even more serious health issues in the future if ignored.

If you’ve been bitten by a tick and have any of these symptoms, see your doctor right away. She or he can order a blood test, or may even prescribe antibiotics based on symptoms.

Hunting should be a choice—follow tick-hygiene guidelines so you don’t fall prey to ticks this autumn.


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Maryland now focusing on the Zika virus

Zika research in the state of Maryland is in full force.

Although Maryland accounts for fewer than 3 percent of the Zika cases nationwide, there are at least five sites in the state researching the virus: the Johns Hopkins Hospital, U.S. Army Medical Research Institute of Infectious Diseases, the University of Maryland School of Medicine, Walter Reed Army Institute of Research in Silver Spring and the National Institutes of Health Clinical Center in Bethesda.

“There is a lot of research going on in biomedical sciences located in the Baltimore-Washington corridor,” said Dr. Matt Laurens, a pediatrician and the director of international clinical trials for the University of Maryland School of Medicine. “It is a magnet for biomedical research.”

Being a leader in medical research is a natural fit for Maryland, said Chris Garrett, a spokesman for the Maryland Department of Health and Mental Hygiene.

“(It) is characteristic of Maryland, given our proximity to the nation’s capital, as well our stature in public health, preparedness and response,” Garrett said. “Maryland was one of the principal states leading the response to the Ebola virus in 2014 and 2015, as well.”

The hospital-based Johns Hopkins Zika Center opened in Baltimore this summer to help patients and infants with Zika. According to Johns Hopkins’ website, the center has specialists from epidemiology, infectious diseases, maternal-fetal medicine, orthopedics, pediatrics, physiotherapy, psychiatry and social work to treat patients with Zika.

Patients from around the world are welcome at the center, which is integrated into the hospital. Patients with similar symptoms are treated in rooms near each other for convenience, although there is not a separate wing of the hospital for the Zika Center.

Dr. William May, associate professor of ophthalmology at the Wilmer Eye Institute and co-director of the Johns Hopkins Zika Center, said he has seen two patients from Maryland, including one baby.

The most common symptoms of Zika in adults are fevers, rashes, joint pain and conjunctivitis, as well as muscle pain and headaches.

According to the Centers for Disease Control, Zika also can cause Guillain-Barre Syndrome, an autoimmune reaction where the immune system attacks the nerves and can cause severe paralysis. Patients usually recover, but it is fatal in 1 percent of victims.

However, the virus can have much more serious effects on babies.

Typically contracted in the womb when their mothers are bitten by a mosquito carrying the virus, babies with Zika can have severe fetal birth defects, including eye problems, hearing loss and impaired growth. According to the CDC, it also can cause microcephaly, a birth defect that causes a baby’s head to to be smaller and the brain to not fully develop or grow.

Microcephaly can lead to seizures, developmental and intellectual delays, hearing loss, and vision and feeding problems. In severe situations, it can also lead to death, according to the CDC.

There have been more than 100 cases of locally acquired Zika cases in the United States, all in Florida. Of the more than 4,000 cases of Zika confirmed in the states, about 3,900 have been travel-related, or contracted when people were travelling outside the country.

Maryland has had 105 confirmed cases of Zika as of Oct. 27, none locally contracted.

Yet with the mosquito population dwindling in the fall and winter months, the Zika focus shifts, said Garrett.

“There is a danger with people associating Zika solely with mosquito transmission,” Garrett said.

Besides being transmitted through the bite of an infected mosquito, Zika can be contracted through sex, blood transfusions, or laboratory exposure, according to the CDC.

There has been one documented case in Maryland of Zika being contracted through sexual activity. A woman contracted the virus after having sex with an asymptomatic man less than two weeks after he returned from the Dominican Republic.

About 80 percent of people who get Zika are asymptomatic, said Laurens, making it difficult to track and contain the virus.

May said he believes the virus will spread throughout the United States in a matter of years.

“It has taken about a year and a half for it to go through Central and South America into the United States,” he told the University of Maryland’s Capital News Service. “If it keeps up that rate it will take over the U.S.”

The Walter Reed Army Institute of Research has been working with Beth Israel Deaconess Medical Center in Boston on a vaccine for Zika. According to Debra Yourick, a representative for Walter Reed, researchers completed the second round of preclinical studies in August.

The researchers found a vaccine that completely protected rhesus monkeys from experimental infection with the Zika virus, according to an Aug. 4 news release.

Yourick also said clinical trials are scheduled to begin next week at Walter Reed’s Clinical Trials Center, as well as at other, unannounced locations.

The National Institute of Allergy and Infectious Diseases, a part of the National Institutes of Health Clinical Center in Bethesda, is working with the University of Maryland School of Medicine and Emory University to develop a vaccine, as well.

At least 80 volunteers, ages 18-35, are enrolled in the study among the three sites. According to a report from the NIH, the study began in July and will continue until December 2018.

Unlike the flu shot or other vaccines, the immunization the NIH is developing for Zika does not contain the virus. Instead, Laurens said, it is DNA-based.

The vaccine instructs the body to make a small amount of Zika virus protein, which may build an immune response, according to the NIH.

“That is what we are evaluating in this phase 1 study,” Laurens said. “We hope that the vaccine will produce a robust immune response, capable of preventing Zika infection in persons vaccinated.”

The CDC is still researching how long Zika can stay in genital fluids, how common it is for Zika to be passed during sex and whether Zika passed to a pregnant women during sex has different risks for birth defects than Zika transmitted by a mosquito bite, according to the CDC website.

To combat Zika, the Maryland Department of Agriculture has been using prevention techniques.

“The best way to prevent (mosquitoes) from carrying anything is to not allow them to breed,” said Brian Prendergast, the program manager of mosquito control for the Maryland Department of Agriculture.

The Maryland Department of Agriculture has 15 state inspectors who go to Maryland homes, checking for still water. The inspectors generally work during mosquito season, which is May to August, said Prendergast.

But due to the unseasonably warm weather this year, the inspectors were still working into late October, he said.

After the inspectors receive permission from the homeowner, they search the front and back yards for any water vessels. The Aedes species of mosquitoes that can carry Zika breeds in objects that hold rainwater, Prendergast said.

“They do not breed in swamps or ditches or puddles,” he added.

These mosquitoes cannot travel far, often less than 50 yards. Because they are not flying long distances, finding their rafts (mosquitoes’ nests) is essential.

“If we eliminate their breeding, we eliminate the skeeters,” Prendergast said.

When examining the yard, the inspector dumps out any item that holds water. They then place it in a way that will hold no water in the future, before notifying the homeowner about what they found.

“We expend a lot of energy because people do not take the simple step of dumping anything that can hold rainwater,” Prendergast said.

The inspectors from the Maryland Department of Agriculture use three pesticides to kill mosquito larvae and a different pesticide on adult mosquitoes, Prendergast said. The inspectors can treat “any type of standing water that can’t be dumped with pesticides,” he said.

The three pesticides the inspectors use against the larvae include two chemicals and a bacterium. The tools “have no toxicity to anything other than mosquito larvae and midge larvae,” Prendergast said. “It all is environmentally friendly.”

To control adult mosquitoes, the inspectors use a pesticide called Bifenthrin, and the Department of Agriculture also uses trucks spraying Permanone 30-30 pesticide.

Prendergast stressed all the pesticides used are “biorational,” or nontoxic.

Preventing mosquitoes from reproducing is a big step for preventing Zika transmission, but, Garrett said, his focus is still on people.

“Marylanders need to make sure they follow the CDC guidance on prevention,” he said. “Particularly if they or their partners have occasion to travel to areas with ongoing Zika transmission.”

Zika is not common in Maryland, and Garrett sees the collaboration of different groups as a good way to maintain that, and potentially defeat the virus.

“We all want to see an end to the scourge of Zika and to the birth defects it has been proven to cause.”


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