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US considers travel warnings over Zika virus

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United States federal health officials are debating whether to warn pregnant women against travel to Brazil and other Latin American and Caribbean countries where mosquitoes are spreading the Zika virus, which has been linked to brain damage in newborn babies, according to reports.

Officials say it could be the first time the Atlanta-based Centers for Disease Control and Prevention (CDC) advises pregnant women to avoid a specific region during an outbreak, reported the New York Times on Wednesday.

But some infectious disease specialists say while such a warning is warranted, it could have a devastating effect on travel and tourism, the Times said.

A CDC spokesman said the agency hoped to make a final announcement either on Thursday or Friday.

“We can’t make these decisions in a vacuum,” the Times quoted the spokesman, Thomas Skinner, as saying. “We’re consulting with other experts outside.”

The Times noted that the virus first appeared on the South American continent in May, and although it often causes only mild rashes and fevers, women who have had it, particularly in the first trimester of pregnancy, appear to be much more likely to have children with small heads and damaged brains, a condition called microcephaly.

Dr. Lyle R. Petersen, director of vector-borne diseases for the C.D.C., said Wednesday that the agency had found Zika virus in tissue from four Brazilian infants, two of whom had microcephaly and died shortly after birth, and two of whom died in the womb, according to the Times.

It said microcephaly has several other causes, including genetic defects or rubella or cytomegalovirus in the mother during pregnancy.

Samples from the fetuses “looked like what you’d see if an infection was the cause,” Dr. Petersen said.

Although the travel advice would most obviously apply to Brazil, which is struggling with an alarming surge in newborns with microcephaly, it could soon apply to much of tropical Latin America and the Caribbean, the Times said.

It said local transmission of Zika virus has been found in 14 Western Hemisphere countries and territories, namely Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Puerto Rico, Paraguay, Suriname and Venezuela.

The virus is carried by mosquitoes, in particular Aedes aegypti, the yellow fever mosquito.

Although no transmission within the 50 states of the United States has been found, one case has been confirmed in Puerto Rico, the Times said.

It said some American virologists are already warning women who are pregnant or trying to have children to avoid traveling to the region.

“If my daughter was planning to get pregnant, I’d advise her not to go the Caribbean,” said Dr. Peter J. Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine.

“This is going to decimate Caribbean tourism,” he added. “But we can’t wait to act until nine months from now, when congenital defects turn up in the labor and delivery suites.”

The Washington-based Pan-American Health Organization (PAHO) said late last week that it was working with member-countries in the region “to prevent, detect and respond to this new threat.”

PAHO said that, starting in March 2014 and through the first week of 2016, 14 countries and territories of the Americas, including the Caribbean, have reported cases of Zika infection.

The virus, which is transmitted to humans by infected Aedes aegypti mosquitos, causes symptoms including light fever, rash, conjunctivitis and muscle pain, PAHO said.

It said a current concern is the effect of Zika virus on pregnant women and new-born babies.

In November 2015, PAHO said the Ministry of Health of Brazil noted a marked increase in microcephaly, in which the head circumference of new-borns is smaller than expected.

PAHO said that discovery coincided with Zika virus circulation in the country.

With support from PAHO and other agencies, “health authorities are carrying out studies to clarify the causes, risk factors, and consequences of this increase in microcepha­ly,” the statement said.

Since October 2015, PAHO said other countries and territories of the Americas, including Caribbean Community (CARICOM)-member Suriname, have reported the presence of the virus.

PAHO said there is little information on transmission of the Zika virus from mother to baby during pregnancy or childbirth, stating that perinatal transmission has been reported with other vector-borne viruses, such as dengue and chikungunya.

PAHO said studies are now being conducted on possible mother-to-child transmission of the virus and its possible effects on the baby.

Treatment consists of relieving pain, fever, and any other symptom that inconveniences the patient, PAHO said.

To prevent dehydration, PAHO recommends controlling the fever, rest, and drinking of plenty of water, adding that there is no vaccine or specific drug for this virus.

Since the Aedes mosquito is found throughout the region, except in continental Chile and Canada, PAHO said it is likely that outbreaks will occur in other countries that have not yet reported any cases.

Updated 3:05 am, July 10, 2018
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