Wednesday, 3 February 2016

The Zika virus

Update 23 Jan 2017: 458 cases of Zika infection reported in 2016

Minister for Health Gan Kim Yong stated that as of 31 Dec 2016, 458 Zika cases have been reported to the Ministry of Health (MOH) since the first discovered case of Zika infection in August last year.

This was one of his answers to the questions filed by Mr Ang Wei Neng, MP for Jurong GRC, who asked the Minister for Health whether he can provide an update on the spread of the Zika virus in Singapore, how many new Zika cases have been reported in November and December 2016, how many of these cases are of pregnant women, and what is the total number of pregnant women infected by the Zika virus in Singapore and of these, how many have given birth and whether any of these babies have birth defects.

The Minister said that the incidence of new reported cases has been on the decline. 12 cases were reported in November and 4 cases were reported in December. "In comparison, 283 cases and 43 cases were reported in September and October respectively," he noted.

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Tracking of Zika Cases and After-Effects

As at 31 Dec 2016, 458 Zika cases have been reported to the Ministry of Health.  The incidence of new reported cases has been on the decline.  12 cases were reported in November and 4 cases were reported in Dec.  In comparison, 283 cases and 43 cases were reported in September and October respectively.

As of 31 Dec 2016, a total of 17 pregnant women have been diagnosed with Zika and reported to MOH.  Four of the women have since given birth, and their babies show no signs of abnormalities thus far.  One had a miscarriage for reasons not linked to Zika while two pregnancies were terminated for personal reasons.  As the two foetuses were at early gestation, it is not possible to determine whether there will be Zika-related abnormalities.  The remaining 10 cases are in their 2nd and 3rd trimesters and their babies will be monitored over 3 years as part of the monitoring programme.  There is currently no obvious evidence to show that there are any Zika-related abnormalities.

MOH has put in place a programme to monitor infants whose mothers were exposed to the Zika virus during their pregnancies.  We will track their development until they are three years old. Given the presence of the Aedes mosquito here in Singapore, we are likely to continue to have Zika cases in Singapore.  Some of these cases may be undiagnosed as the infection may result in mild or even no symptoms.  I urge fellow Singaporeans to remain vigilant, and to do our part to prevent mosquito breeding so as to protect ourselves and our loved ones.


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First case of Zika virus in Singapore
Residents walking in Watten Estate, on May 13, 2016, after the first case of imported Zika virus infection was found.ST PHOTO: DESMOND WEE

The 1st imported case of the Zika virus infection has been reported in Singapore on Friday (May 13).

The patient is a 48-yr-old male Singapore permanent resident who had travelled to Sao Paulo in Brazil from Mar 27 to May 7.

The Ministry of Health (MOH) and the National Environment Agency (NEA) said in a joint statement that they were informed of the case on Friday.


Zika fever in Southeast Asia and islands of the Pacific Ocean

 Zika virus was first isolated in 1947 from a sentinel rhesus monkey stationed on a tree platform in the Zika forest, Uganda. The virus is a member of the Flaviviridae family and is a single-stranded RNA virus with a positive-polarity RNA genome.

It is transmitted to humans by mosquitoes, and thus far, only Aedes mosquitoes are known to be the vector of Zika virus. The Aedes species that can carry the virus includes Aedes africanus, Aedes apicocoargenteus, Aedes luteocephalus, Aedes furcifer, Aedes vitattus and Aedes aegypti.3 Other pathogenic vector-borne flaviviruses include dengue, West Nile, Japanese encephalitis and yellow fever.

The first human case of Zika virus infection was reported in Nigeria in 1954. Subsequently between 1968 and 2002, 606 strains of Zika virus including 10 human strains were isolated in Central and West Africa.2 Other than being endemic in Africa, Zika virus is also present in Asia. In 1966, Zika virus was isolated from a pool of Aedes aegypti mosquitoes caught from shop houses in Pahang state of Malaysia.2 Seven patients in Central Java of Indonesia were reported to be infected with Zika virus in 1977.


The Zika virus had been detected in areas in Africa, South-east Asia and the Pacific Islands

According to a journal published by MOH in March 2014, 2 tourists from Canada and Germany were diagnosed with Zika fever after returning from Thailand in 2013. That same year, Australia also reported a case of Zika fever in a returning citizen from Indonesia.

These cases may have indicated the presence of an outbreak of the virus in Thailand and Indonesia, the journal said.

In January 2016, Taiwan had its first reported case of the virus. A 24-yr-old man from northern Thailand was hospitalised in the country after travelling there for work on Jan 10.

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Tropical Asia braces for Zika as Thailand appears to steer clear

Tropical Southeast Asian countries said on Friday they were bracing for the mosquito-borne Zika virus, with Malaysia saying it could "spread quickly" if introduced, but Thailand appeared to be bucking the trend with just a handful of cases a year.

Zika, linked to severe birth defects including babies born with abnormally small heads, is wreaking havoc in Brazil where the government has deployed more than 200,000 troops to eradicate mosquitoes.

The World Health Organization (WHO) said on Thursday that the virus was "spreading explosively" and could infect as many as four million people in the Americas.


Indonesia Confirms Zika Case, Urges Calm
Health experts have warned Asia is vulnerable to the virus, as the Aedes aegypti mosquito thrives in its congested cities

Indonesia today officially confirmed a case of the Zika virus dating back to last year but said it was prepared to handle any outbreak of the disease which has sparked alarm in the Americas.

Government officials confirmed a single case of the mosquito-borne Zika virus had been detected in Jambi on Sumatra island. It was discovered by researchers studying specimens taken during a dengue fever outbreak between December 2014 and April 2015.

"We found an infected patient in Jambi. The presentation by the health minister showed that it is under control," senior minister Puan Maharani told reporters after a high-level meeting convened by President Joko Widodo to discuss the virus.


As Zika spreads, UNICEF calls on Malaysians to be on alert

With the Zika virus now a public health emergency affecting more than 20 countries in Latin America and the Caribbean, UNICEF is working with governments in the region to mobilize communities to protect themselves from infection.

Meanwhile, in Malaysia, Ms. Marianne Clark-Hattingh, UNICEF’s new country representative calls on members of the public, especially pregnant women, to be cautious following the health alert on Zika issued by Malaysia’s Ministry of Health last week.

“Although our health emergency expert has stated that there is still no conclusive evidence of the causal link between microcephaly and the Zika virus, she has called for immediate action given the spread of the outbreak. In Latin America and the Caribbean, UNICEF and partners are acting fast to provide women and pregnant mothers with the information they need to protect themselves and their babies, as well as engage with communities on how to stop the mosquito that is carrying and transmitting this virus,” said Ms. Clark-Hattingh.


Zika virus detected in PH

AN AMERICAN woman who visited the Philippines for four weeks in January tested positive for the Zika virus upon returning home, an indication that mosquitoes carrying the disease are lurking somewhere in the country, the Department of Health (DOH) said Sunday.

In a press briefing, Health Secretary Janette Garin said the “nonpregnant US resident” was the Philippines’ second laboratory-confirmed case of the mosquito-borne virus, which has been linked to microcephaly, a severe brain defect in infants, and to a neurological disorder called Guillain-Barré syndrome (GBS).

The country had its first reported case of Zika virus infection in 2012—a 15-year-old boy in Cebu who had no travel history.


First Zika virus case detected in Taiwan
The Zika virus has arrived in Taiwan, the Ministry of Health and Welfare said Tuesday, after a Thai national coming to Taiwan to work for the first time was confirmed to be infected with the virus.

The 24-year-old man was detected with a fever when he arrived at Taoyuan International Airport on Jan. 10. Further tests showed that he had the mosquito-borne disease, and he is now being observed at a local hospital.

Liu Ting-ping (劉定萍), director of the Epidemic Intelligence Center under the Centers for Disease Control, said the Thai national had a fever and a headache before coming to Taiwan and was stopped at the fever screening station at the airport.


How Common Is Zika In Thailand?

Just over a month ago, two Zika cases were tied to Thailand. One was in a resident of the country and another was in a traveler who was found to have the disease as he passed through Taiwan. Does this mean a possible repeat of what we have seen in Central and South America could occur in South East Asia?

Health records indicate this may be unlikely as Zika has been present in the region for decades. A recent report by Reuters tracked the illness in the South East Asia region. The report found sporadic cases since 2007 in various countries and islands including Thailand, the Philippines, Fiji, Samoa, New Zealand and Australia. But, few of these cases have resulted in true outbreaks.

In the case of Thailand, the country has averaged just five Zika cases per year since 2012. Whether this could change due to travel from areas where outbreaks have occurred in the Americas is unknown, but health officials are taking precautions. Pesticides are being used in Bangkok and other regions, and disease awareness campaigns are underway throughout the country.


Now Vietnam reports its first two cases of the Zika virus - one in a pregnant woman
The Zika virus is thought to cause microcephaly, a disease characterised by unusually small heads that can result in developmental problems in babies. Pictured is a baby in Brazil with microcephaly

Two women in Vietnam have been infected with the Zika virus, health ministers have announced. The younger of the patients is eight weeks pregnant, they added.

The Zika virus, which is carried by mosquitoes and transmitted to humans, is thought to cause microcephaly. Characterised by unusually small heads, microcephaly can result in developmental problems in babies.


It is not clear if either of the women have recently travelled abroad, or whether they were infected with Zika in Vietnam.

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First Zika-linked deaths reported in Colombia

Colombia said on Friday (Feb 5) three people had died of complications of the Zika virus sweeping Latin America, as the UN urged increased access to abortion because of fears of severe birth defects.

In the first direct statements from government health officials blaming Zika for causing deaths, Colombia's National Health Institute (INS) said the patients died after contracting the virus and developing a rare neurological disorder called Guillain-Barre syndrome.

Cases of the syndrome - in which the immune system attacks the nervous system, causing weakness and sometimes paralysis - have increased in tandem with the Zika outbreak, fuelling suspicions that it is a complication of the otherwise mild tropical fever, which is also blamed for causing brain damage in babies born to infected mothers.

related:
Athletes weigh gold lust against Zika health fears
Puerto Rico declares public health emergency over Zika virus
CDC widens Zika virus guidelines for pregnant women
CDC: Link between Zika, microcephaly looks "stronger and stronger"
WHO seeks US$25 million for six-month fight against Zika
Brazil finds Zika in saliva, urine; expert warns against kissing
UN prods Latin America on abortion as Zika spreads

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Scientists find Zika in saliva and urine


Brazilian scientists say they have found Zika in the saliva and urine of two patients, as US health officials advised more stringent measures for monitoring pregnant women for Zika and preventing sexual transmission of the virus.

The disease that has spread rapidly through the Americas and led to a global health scare over its possible link to severe birth defects, is primarily transmitted by mosquito.
The possibility of infection via body fluids complicates efforts to combat the outbreak.

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CDC issues new safe-sex guidelines around Zika virus

Men exposed to the Zika virus and who have a pregnant partner should use a condom or abstain from sex until the baby is born, the Centers for Disease Control and Prevention advised Friday in guidelines aimed at preventing sexual transmission of the virus.

Officials also said that pregnant women who have been exposed to Zika should talk with their doctors about testing for the virus.

While saying that the situation with Zika is "evolving rapidly" and that much had been learned in just the past two weeks, CDC Director Dr. Tom Frieden stressed in a news briefing that the primary concern with Zika at this time is protecting pregnant women and their unborn babies from a neurological disorder known as microcephaly.

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Mosquitos and Zika: the insect behind the outbreak

A major problem with the current Zika outbreak is that there is, at present, no vaccine for the virus. Researchers worldwide are stepping up efforts toward a vaccine, but such research invariably requires a lot of time and money. For now then, the focus on tackling the disease turns elsewhere.

Following an Emergency Committee meeting, the World Health Organization (WHO) Director-General, Dr. Margaret Chan stated that the most important protective measures to be taken were "the control of mosquito populations and the prevention of mosquito bites in at-risk individuals, especially pregnant women."

The mosquitos that are behind the transmission of the Zika virus are those belonging to the Aedes species, namely Aedes aegypti and Aedes albopictus. These mosquitos spread the virus by feeding on people already infected with Zika, becoming infected themselves and then passing the virus on when feeding on another human.

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In Brazil, pregnant women urged to be cautious with a kiss

In a sign of mounting global concern over the Zika virus, health officials on Friday warned pregnant women to think twice about the lips they kiss and called on men to use condoms with pregnant partners if they have visited countries where the virus is present.

U.N. officials also called on many Catholic-majority countries in Latin America to loosen their abortion laws to allow women to terminate pregnancies if they fear the fetus may be at risk for a rare birth defect that causes brain damage and an abnormally small head, which may be linked to the virus.

The flurry of recommendations began in Brazil, where a top health official warned pregnant women to be cautious with their kisses.


World Health Organisation declares Zika virus public health emergency
Nadja Cristina Gomes Bezerra holds her three-month-old daughter, Alice Vitoria, who has microcephaly. Photograph: Mario Tama/Getty Images

The World Health Organisation has declared that the clusters of brain-damaged babies born in Brazil – linked to but not proven to be caused by the Zika virus – constitute a public health emergency of international concern.

The declaration, made by the WHO director Margaret Chan, will trigger funding for research to try to establish whether the Zika virus, spread by mosquitoes, is responsible for the large numbers of babies born with abnormally small heads in Brazil. It will also put resources behind a massive effort to prevent pregnant women becoming infected and, through mosquito control, stop the virus spreading.

Chan called the birth of thousands of babies with microcephaly “an extraordinary event and a public health threat to other parts of the world”. She was speaking following a meeting of the WHO’s international health regulations emergency committee, summoned to advise the director general on whether to make the declaration, which calls in international resources and expertise.

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What’s being done about Zika in Asia

ON MONDAY, February 1, the World Health Organization (WHO) declared the Zika virus as a “Public Health Emergency of International Concern”, indicating the urgency of the recent outbreak.

The Zika virus is transmitted mainly through the bite of Aedes mosquitoes (a rare sexually transmitted case has been confirmed in Texas). The main concern surrounding the virus is grounded on its possible links to microcephaly, a condition that causes babies to be born with abnormally small heads. This has led to warnings from health ministries all around the world, urging pregnant women to avoid the affected countries, which are mainly clustered in Latin America.

In response to this explosive pandemic spanning across Latin America, Asian countries have stepped up precautionary measures, including Singapore. Here’s a look at what’s being done:

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Sexually-transmitted Zika case confirmed in Texas

A person in Texas has been infected with the Zika virus after having sex with an ill person who had returned from a country where the disease was present, Dallas County health officials said Tuesday.

It's the first case of the virus being transmitted in the U.S. during the current outbreak of Zika, which has been linked to birth defects in the Americas. Dallas County Health and Human Services said it received confirmation of the case from the U.S. Centers for Disease Control and Prevention.

Health officials did not release any details about the Texas patient, citing privacy issues. In a tweet, Dallas health officials said the first person infected had been to Venezuela, but did not detail when and where that person or the second person was diagnosed.

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9 Important Questions About Zika Virus, Answered

There are many things we don’t know about Zika virus, the mosquito-borne disease that may infect three to four million people before the epidemic dies out, according to the World Health Organization. Experts suspect Zika may be responsible for thousands of babies born with birth defects and an increase in neurological disorders, but it’s going to be a while before we have clear answers on if, and how, the virus actually causes these problems.

On Monday WHO declared that clusters of these birth defects in French Polynesia and Brazil, as well as their possible link to Zika virus, are a public health emergency of international concern. The designation, which the international health agency has only ever applied to three other disease outbreaks, will marshal global resources to help research the virus and its possible connection to the birth defect microcephaly and neurological disorders like Guillian-Barre syndrome. The PHEIC declaration will also help expedite research on creating fast diagnostic tools, vaccines and cures.

Complex, long-term studies are underway to assess the virus, WHO officials said. Until then, here's what we know about Zika and its potential causal link to these serious conditions:
  • What is Zika virus?
  • How do you get Zika virus?
  • Why is everyone so scared of Zika virus?
  • Is there a way to protect myself against Zika virus?
  • Do we know for sure that Zika virus causes microcephaly?
  • Does a pregnant woman need symptoms for her fetus to run risk of microcephaly?
  • What should pregnant women who traveled from a Zika-affected country do now?
  • Does Zika virus also cause Guillian-Barré syndrome?
  • What should I do if I’d traveled to a Zika-affected area and think I have the illness?
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Why you can't just wipe out mosquitoes to get rid of the Zika virus

Feb 1 On Saturday Colombia's national health institute confirmed that more than 2,100 pregnant Colombian women are infected with the Zika virus, which has been linked to a devastating birth defect that affects a fetus' brain.

The mosquito-borne disease, for which there is no vaccine or treatment, has been quickly spreading across the Americas since May, when the first confirmed Zika infection was reported in Brazil. More than 4 million people could be infected by the end of the year, according to the World Health Organization.

In response to the outbreak, governments have urged women to delay getting pregnant. The CDC has cautioned pregnant women against traveling in Zika-affected areas. But the disease's catastrophic impact, together with the suffering caused by malaria and other mosquito-borne diseases, raises an obvious question: Why not kill all mosquitoes?

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WHO declares global emergency over Zika virus spread
A health worker carries out fumigation as part of preventive measures against the Zika virus and other mosquito-borne diseases at the cemetery of Carabayllo on the outskirts of Lima, Peru February 1, 2016. Photo: Reuters

The World Health Organization declared a global emergency over the explosive spread of the Zika virus, which has been linked to birth defects in the Americas, calling it an “extraordinary event” that poses a public health threat to other parts of the world.

The UN agency took the rare step despite a lack of definitive evidence proving the mosquito-borne virus is causing a surge in babies born with brain defects and abnormally small heads in Brazil and following a 2013-14 outbreak in French Polynesia.

Yesterday’s (Feb 1) emergency meeting of independent experts was called in response to the spike in babies born with microcephaly in Brazil since the virus was first found there last year. Officials in French Polynesia also documented a connection between Zika and neurological complications when the virus was spreading there two years ago, at the same time as dengue fever

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The Zika virus

Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.
  • Genre: Flavivirus
  • Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
  • Reservoir: Unknown
Key Facts:
  • Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
  • People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
  • There is no specific treatment or vaccine currently available.
  • The best form of prevention is protection against mosquito bites.
  • The virus is known to circulate in Africa, the Americas, Asia and the Pacific.
Signs and Symptoms:
  • The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days.
  • During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.
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Zika virus
Electron micrograph of Zika virus. Virus particles are 40 nm in diameter, with an outer envelope and a dense inner core

Zika virus is related to dengue, yellow fever, Japanese encephalitis, and West Nile viruses. The illness it causes is similar to a mild form of dengue fever, is treated by rest, and cannot yet be prevented by drugs or vaccines. There is a possible link between Zika fever and microcephaly in newborn babies by mother-to-child transmission, as well as a stronger one with neurologic conditions in infected adults, including cases of the Guillain–Barré syndrome.

In January 2016, the U.S. Centers for Disease Control and Prevention (CDC) issued travel guidance on affected countries, including the use of enhanced precautions, and guidelines for pregnant women including considering postponing travel. Other governments or health agencies soon issued similar travel warnings, while Colombia, the Dominican Republic, Ecuador, El Salvador, and Jamaica advised women to postpone getting pregnant until more is known about the risks.

Along with other viruses in this family, Zika virus is enveloped and icosahedral and has a nonsegmented, single-stranded, positive-sense RNA genome. It is most closely related to the Spondweni virus and is one of the two viruses in the Spondweni virus clade.

The virus was first isolated in April 1947 from a rhesus macaque monkey that had been placed in a cage in the Zika Forest of Uganda, near Lake Victoria, by the scientists of the Yellow Fever Research Institute. A second isolation from the mosquito A. africanus followed at the same site in January 1948. When the monkey developed a fever, researchers isolated from its serum a transmissible agent that was first described as Zika virus in 1952. In 1968, it was isolated for the first time from humans in Nigeria. From 1951 through 1981, evidence of human infection was reported from other African countries such as the Central African Republic, Egypt, Gabon, Sierra Leone, Tanzania, and Uganda, as well as in parts of Asia including India, Indonesia, Malaysia, the Philippines, Thailand, and Vietnam.

There are two lineages of Zika virus, the African lineage and the Asian lineage. Phylogenetic studies indicate that the virus spreading in the Americas is most closely related to French Polynesian strains. Complete genome sequences of Zika viruses have been published. Recent preliminary findings from sequences in the public domain uncovered a possible change in nonstructural protein 1 codon usage that may increase the viral replication rate in humans.

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Zika virus: 6 things to know about the growing outbreak

The mosquito-borne Zika virus is drawing global attention due to its rapid spread and its possible connection to a rare neurological birth defect.

Earlier today, the head of the World Health Organization said Zika is "spreading explosively" and that an emergency meeting would take place Monday to decide if the virus outbreak should be declared an international health emergency. Brazil has reported more than 4,000 cases of babies born recently with microcephaly, a brain condition characterized by an abnormally small head that can lead to developmental issues or even death. That number compares with fewer than 150 cases in the country for all of 2014. And with no vaccine or treatment for Zika, it is likely to keep spreading.

Here's what you need to know about the virus that is putting health officials around the world on alert.
  • What is Zika?
  • How is Zika transmitted?
  • What are the symptoms?
  • Which areas are affected by Zika?
  • Will it come to Canada?
  • What's being done to prevent Zika?
related:
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Zika Symptoms, Diagnosis, & Treatment
 
Symptoms
  • About 1 in 5 people infected with Zika virus become ill (i.e., develop Zika).
  • The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache. The incubation period (the time from exposure to symptoms) for Zika virus disease is not known, but is likely to be a few days to a week.
  • The illness is usually mild with symptoms lasting for several days to a week.
  • Zika virus usually remains in the blood of an infected person for a few days but it can be found longer in some people.
  • Severe disease requiring hospitalization is uncommon.
  • Deaths are rare.
Diagnosis
  • The symptoms of Zika are similar to those of dengue and chikungunya, diseases spread through the same mosquitoes that transmit Zika.
  • See your healthcare provider if you develop the symptoms described above and have visited an area where Zika is found.
  • If you have recently traveled, tell your healthcare provider when and where you traveled.
  • Your healthcare provider may order blood tests to look for Zika or other similar viruses like dengue or chikungunya.

Treatment
  • No vaccine or medications are available to prevent or treat Zika infections.
  • Get plenty of rest.
  • Drink fluids to prevent dehydration.
  • Take medicine such as acetaminophen to relieve fever and pain.
  • Do not take aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen. Aspirin and NSAIDs should be avoided until dengue can be ruled out to reduce the risk of hemorrhage (bleeding). If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication.
  • If you have Zika, prevent mosquito bites
  • During the first week of infection, Zika virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites.
  • An infected mosquito can then spread the virus to other people.
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Zika Disease: Another Reason to Hate Mosquitoes

By the time the 48-year-old man showed up at a clinic in New York City he had been sick for almost two weeks. A blotchy, red rash still blanketed his torso and his body ached. He had just gotten over a triple-digit fever, intense lower back pain and a painful eye infection. Five weeks earlier he had embarked on a long vacation to South America and Polynesia but during his trip he had felt fine. He had hopscotched from country to country until he capped his stint through French Polynesia with a trip to Mooréa, an island about 16 kilometers northwest of Tahiti. The South Pacific paradise was teeming with some hungry mosquitos. But he wasn’t worried about the bites. He knew he was up on all his travel vaccinations.

Even after a handful of telltale bumps erupted on his skin he was all right for several days. Then, some 12 hours after leaving Mooréa, he was not. First, he started to feel tired and developed an intransigent rash on the back of his neck. The rash appeared right where his camera strap often rubbed, so at first he did not think much about it. “It was like a mosquito bite gone rogue,” he says. But then the rash started to creep downward across his body. His fatigue grew and his temperature spiked. Soon his eyes turned swollen and red and dripped stringy mucous. His lower back hurt, too, and popping painkillers offered little relief. A tough week followed. Some nine days later he felt better but still had a pernicious red rash that had crept across his back, arms and legs. Soon he made an appointment at a clinic.

Once there, his doctors struggled to make a diagnosis. Mosquitoes can carry a raft of diseases like malaria, dengue, West Nile or chikungunya. But none of those diagnoses seemed to be a perfect fit. Although he had aches and pains typical of dengue or chikungunya, his medical team believed it was unlikely he had contracted those ailments based on where he traveled. His lab test results were equally puzzling. Blood tests showed he had antibodies for West Nile virus and dengue. Yet his team could not even trust those findings. The two viruses come from the same family as several other mosquito-borne pathogens so the lab test may have detected the antibodies – possible holdovers from a yellow fever vaccination or earlier infections – and then falsely indicated he had those maladies instead of one of their viral cousins. That phenomenon, called cross-reactivity, could allow the real disease to fly under the radar, his team said.

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Zika virus: Up to four million Zika cases predicted

Three to four million people could be infected with Zika virus in the Americas this year, the World Health Organization (WHO) predicts.

Most will not develop symptoms, but the virus, spread by mosquitoes, has been linked to brain defects in babies.

Meanwhile, the US says it hopes to begin human vaccine trials by the end of 2016.

related:

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Four million could be affected by vicious zika virus

Zika is now present in 23 countries and territories in the Americas. Brazil, the hardest-hit country, has reported around 4,000 cases of the devastating birth defect called microcephaly that are strongly suspected to be related to Zika.

The World Health Organisation (WHO), stung by criticism that it reacted too slowly to West Africa's Ebola epidemic, convenes an emergency meeting tomorrow to help determine its response to the spread of the virus.

The US Centers for Disease Control and Prevention has activated an emergency operations centre staffed around the clock to address Zika.

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Race for Zika vaccine gathers momentum

Companies and scientists are racing to create a Zika vaccine as concern grows over the mosquito-borne virus that has been linked to severe birth defects and is spreading quickly through the Americas.

Zika is now present in 23 countries and territories in the Americas. Brazil, the hardest-hit country, has reported around 3 700 cases of the devastating birth defect called microcephaly that are strongly suspected to be related to Zika.

The Geneva-based World Health Organisation (WHO), stung by criticism that it reacted too slowly to West Africa's Ebola epidemic, convenes an emergency meeting on Monday to help determine its response to the spread of the virus.

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Zika Virus Is At Least 50 Years Old. Here's Why You're Only Hearing About It Now.

As the Zika virus spreads, so has widespread alarm and confusion. The leader of the World Health Organization said Wednesday that it is "spreading explosively," estimating up to 4 million infections over the next year.

The Centers for Disease Control and Prevention has said that a U.S. outbreak of the mosquito-borne virus, which is spreading rapidly through mostly central and south America, is "likely," but the risk for local transmission is low. In Brazil, the virus has been linked to several thousand cases of microcephaly, a rare birth defect which causes shrinkage of the skull and brain.

"The level of concern is high, as is the level of uncertainty," WHO director-general Dr. Margaret Chan told the organization's executive board members. "We need to get some answers quickly."

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Zika Feared to Be Greater Health Threat Than Ebola

The Zika virus outbreak in Latin America could be a bigger threat to global health than the Ebola epidemic that killed more than 11,000 people in Africa.

That's according to several public health experts who spoke with the Guardian and Examiner newspapers ahead of an emergency meeting of the World Health Organization on Monday, which will decide whether the Zika threat should be rated a global health crisis.

Brazilian public health authorities are reporting an increase in cases of microcephaly, a fetal deformation where infants are born with abnormally small heads. The incidence of the normally rare birth defect is 10 times higher than normal.

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Zika ‘spreading explosively’

The Department of Labor and Employment (DOLE) said yesterday the deployment of overseas Filipino workers (OFWs) in Latin American (Lat-Am) countries with cases of Zika Virus Disease (ZVD) will continue for now despite the warning of the World Health Organization (WHO) that the virus is “spreading explosively” in the Americas.

Labor and Employment Secretary Rosalinda Baldoz disclosed that Philippine Overseas Employment Administration (POEA) is still waiting for the necessary notification from concerned agencies before it could stop OFWs from heading into the 23 ZVD-affected countries in the said region.

“Will wait for the Department of Foreign Affairs (DFA) and Department of Health (DOH) to issue the (required) alert signal,” Baldoz said.

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First Local Case of Tropical Disease Chikungunya Debuts in the U.S.

The day we knew would come is finally here. The first locally acquired case of the tropical disease chikungunya was reported in the U.S. today.

The mosquito-borne viral disease first debuted in the Western Hemisphere last year and has since sprawled across the Caribbean, with cases in Puerto Rico and U.S. Virgin Islands. The first U.S.-infected patient is a man in Florida who had not recently traveled outside the country, according to the Centers for Disease Control and Prevention. So far this year, 243 cases have occurred in the U.S. but all of those stemmed from travelers returning from other countries where the virus is thriving.

The infection causes joint and muscle pain that persists for weeks. In rare circumstances the pain can remain for years. Currently, no vaccines or therapies exist for the virus (except pain killers). Public health experts advise communities to clear out standing water near their homes to curtail prime real estate for mosquitoes.

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Mosquitoes have been around for over 30 million years

Let's say it's summer time. You're out in your backyard enjoying the sun and grilling your dinner. Ouch! You look down at your arm and see a painful, swelling mosquito bite. Moments later, you feel another one bite you. What are these pesky insects? Why do they bite? Do they carry diseases? What can you do to protect yourself.

In this article, we'll take a close-up look at mosquitoes -- how they breed, how they bite, what diseases they carry and what you can do to control them.

Mosquitoes are insects that have been around for more than 30 million years. And it seems that, during those millions of years, mosquitoes have been honing their skills so that they are now experts at finding people to bite. Mosquitoes have a battery of sensors designed to track their prey, including: Chemical sensors - mosquitoes can sense carbon dioxide and lactic acid up to 100 feet (36 meters) away. Mammals and birds gives off these gases as part of their normal breathing. Certain chemicals in sweat also seem to attract mosquitoes (people who don't sweat much don't get nearly as many mosquito bites).

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The War On Mosquitoes

Singapore has had its first dengue death this year. The victim, a woman who had been transferred from Changi General Hospital to Gleneagles Hospital under an existing agreement between the two, died on Wednesday.

The woman, believed to be in her late 50s, was moved to the private hospital at the end of last year. Her condition deteriorated and she was moved to intensive care. She died of dengue hemorrhagic fever.

More than 20,000 people were infected with dengue last year, and five died. The epidemic has continued into this year, with 437 people infected last week.

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World steps up Ebola action as infections soar

Europe said on Thursday (Oct 16) it will review how passengers leaving Ebola-hit African countries are screened for infection, as it seeks to contain the escalating spread of a virus recognised as the worst global health emergency in years.

The World Health Organisation also said it was ramping up its efforts to help 15 African countries defend themselves against the virus.

The European Commission "will immediately undertake an audit of exit screening systems in place in the affected countries ... to check their effectiveness and reinforce them as necessary," the bloc's health commissioner, Tonio Borg, said.

related:

Ebola death toll in West Africa passes 1,000

The World Health Organization says the death toll in the Ebola outbreak in West Africa has passed 1,000

The U.N. health agency said in a news release on Monday that 1,013 people have died in the outbreak, which has hit Guinea, Liberia, Sierra Leone and possibly Nigeria.

Authorities have recorded 1,848 suspected, probable or confirmed cases of the disease, which causes a high fever, vomiting and bleeding. The outbreak was first identified in March in Guinea, but it likely started months earlier.


Dengue Fever Outbreak
 
A contractor fogs a condominium garden in Singapore in an effort to kill mosquitoes, on Sept. 5. The Singapore government is running a vigorous campaign to eliminate mosquito breeding habitats to reduce the incidence of dengue fever
 
Authorities in Singapore are warning that Singapore’s most deadly outbreak of dengue fever since 2005 could get worse, after the disease claimed its seventh victim despite a vigorous effort by the government to control the epidemic.

 More than 20,000 cases of the tropical, mosquito-borne disease have been identified in Singapore so far in 2013, spawning a series of multi-lingual YouTube videos about and a “Do The Mozzie Wipeout” campaign, launch in April, that promotes a series of at-home steps one can go through to kill mosquitoes and stop the disease from spreading.

In recent months the National Environment Agency, or NEA, has continued to boost measures to bring the rate of infection down by asking for public suggestions about how to make the fight against dengue more fun and engaging, particularly for children.

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