CDC Cites 279 Zika Linked Pregnancies In US & Territories

[niman]

CDC presser cites 279 Zika linked pregnancies in US and territories.

Edited May 20, 2016 by niman

[niman]

CDC Says 279 Pregnant Women in U.S., Territories Infected With Zika

The higher number reflects changes in reporting criteria rather than a sudden spike in cases

 

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Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, speaks during a Zika briefing in Washington on May 3. PHOTO: ZUMA PRESS

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BETSY MCKAY

May 20, 2016 10:12 a.m. ET

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At least 279 pregnant women in the U.S. and its territories have been infected with the Zika virus, more than double the number most recently reported, federal health officials said Friday.

The higher number reflects changes in reporting criteria rather than a sudden spike in U.S. Zika cases. It includes all pregnant women in the U.S. and its territories who have tested positive for Zika infection, whether or not they developed symptoms or complications in their pregnancies, the Centers for Disease Control and Prevention said in a report Friday. The previous numbers included only pregnant women who had Zika symptoms or pregnancy complications, the CDC said.

The new numbers come from two registries set up by the agency in February to gain a fuller picture of the effects of Zika on pregnant women and their unborn children, the CDC said. It has registered and is monitoring 157 pregnant women in U.S. states and the District of Columbia, and 122 pregnant women in U.S. territories—mostly Puerto Rico—who were infected with Zika through May 12.

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The surveillance system it was relying on previously had recorded 113 pregnant women as of May 11, including 48 in U.S. states and D.C., and 65 in U.S. territories.

The CDC has said that the vast majority of people infected with Zika don’t develop symptoms. While the agency has determined that Zika can cause a condition known as microcephaly and other severe birth defects in fetuses, it is not known how often that occurs when a pregnant woman is infected with Zika. Studies have shown that birth defects may develop whether or not an infected pregnant woman develops symptoms of Zika.

“Following pregnant women with laboratory evidence of possible Zika-virus infection in the surveillance system, regardless of symptoms, allows better characterization of the full impact and consequences of infection to the mother and her offspring, and might allow for better stratification of risk of adverse congenital outcomes,” the CDC said Friday.

Of the 157 pregnant women in U.S. states who tested positive for Zika, 73, or 49%, had symptoms of the disease, the CDC said. Of the 122 Zika-positive pregnant women in U.S. territories, 80, or 66%, had symptoms.

Write to Betsy McKay at [email protected]

http://www.wsj.com/articles/cdc-says-279-pregnant-women-in-u-s-territories-infected-with-zika-1463753568

 

[niman]

CDC monitoring nearly 300 pregnant women with Zika in U.S. states, territories

 

The Centers for Disease Control and Prevention said Friday that it is monitoring 279 pregnant women with likely Zika virus infections across U.S. states and territories. The largest number of cases by far are in Puerto Rico, where officials are keeping tabs on 122 pregnant women. But they also are tracking 157 other pregnant women across the country.

"One challenge of this Zika virus outbreak is the lack of understanding of the magnitude of risk and the spectrum of outcomes associated with Zika virus infection during pregnancy," researchers wrote in a report published Friday. The surveillance effort, they noted, is expected to change that, "enhance risk assessment and counseling of pregnant women and families, advance clinical care, and assist states and territories to anticipate and plan needed resources and increase prevention efforts."

The report does not detail the outcomes of any pregnancies currently being monitored but says that information "will be shared in future reports." Researchers said the agency will begin posting a weekly update on the number of cases being watched.

 

 

 

[CDC says microcephaly could be "tip of the iceberg" of brain, developmental problems] 

CDC has concluded that there is little doubt the mosquito-borne virus can cause pregnancy complications and severe fetal abnormalities, as well as some neurological problems in adults. The most pronounced in utero is microcephaly, a rare condition marked by an abnormally small head and a lack of brain development. Hundreds of babies with that devastating condition already have been born in countries such as Columbia and Brazil, where the current Zika outbreak began last year.

 

The disease has since spread to dozens of countries and island territories, primarily in South and Central America, as well as the Caribbean. The escalating numbers have prompted the CDC to urge pregnant women in particular to avoid traveling to Zika-affected areas.

Earlier this month, Puerto Rico reported its first Zika-related microcephaly case. A health department statement referred to a male fetus that showed "severe microcephaly and calcifications in the brain accompanied by Zika-wide presence of the virus." It said the case was detected early through "robust surveillance systems," with the abnormalities identified via ultrasound. Health Secretary Ana Rius told reporters in San Juan that the fetus had been turned over to U.S. health officials for testing. She declined to say whether the woman involved had an abortion or miscarried.

In late February, the CDC reported that at least two pregnant women in the United States infected with the Zika virus had chosen to have abortions, while two others had suffered miscarriages. One woman gave birth to an infant with serious birth defects, while two others delivered healthy infants.

 

At the time, the agency was developing two surveillance systems in conjunction with state and local health officials -- one to monitor people specifically in Puerto Rico, where the virus already was spreading rapidly, and another to monitor cases in the rest of the United States.

With summer temperatures nearly here, U.S. health officials have been warning about expected local outbreaks of the virus in states, particularly in the South and the Southwest. Both regions are home to the Aedes aegypti mosquito, the primary vector for the virus.

Countries such as El Salvador and Jamaica have actually urged women to postpone pregnancy.

President Obama is scheduled to receive an Oval Office briefing late Friday morning about the country's Zika planning from CDC director Tom Frieden, Health and Human Services Secretary Sylvia Burwell and Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Friday's news also comes amid the latest push in Congress for more resources to prepare for and combat the spread of Zika domestically. On Thursday, the Senate approved $1.1 billion in emergency funding, substantially more than the $622 million funding package the House approved a day earlier -- in part by using money set aside for Ebola.

The White House, which in February requested $1.9 billion for its Zika response, called the House's measure "woefully inadequate."

As of this week, the United States had 544 reported cases of Zika, nearly all of them involving people who had traveled to countries already plagued by the virus. A handful of infections have been sexually transmitted, but none has yet been acquired from mosquitoes in this country. In addition, there have been more than 800 Zika cases in U.S. territories, the vast majority of those in Puerto Rico, where local transmissions through mosquitoes have been common.

https://www.washingtonpost.com/news/to-your-health/wp/2016/05/20/zika-hed-goes-here-and-here-and-here-tktk/

[niman]

The Count of American Zika Cases Just Got Bigger

The CDC is now reporting that nearly 300 women in the U.S. and its territories have the virus.

Zika's mosquito vectors at a Kansas lab Josh Replogle / AP

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• NORA KELLY
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•  12:48 PM ET
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•  POLITICS

The Centers for Disease Control and Prevention announced Friday that 279 pregnant women in the United States and its territories have tested positive for the Zika virus, which can cause the birth defect microcephaly.

At first glance, that figure looks like a frightening uptick in the number of cases—it’s more than double the number released just last week. But the agency was quick to note that the new numbers reflect updated reporting standards that encompass a greater pool of women.

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The Still Uncertain Future of Zika Funding

Previously, the CDC only reported the number of pregnant women who tested positive for Zika and either showed symptoms or had Zika-related complications, a news release explains. Now, the agency is reporting all pregnant women who have “any laboratory evidence” of possible infection, no matter what. The CDC made the change after seeing reports of asymptomatic pregnant women who delivered children with birth defects. Researchers still haven’t nailed down women’s “absolute risk” of having microcephalic babies, a CDC official recently told PBS NewsHour.

Researchers have known for months that not every Zika patient shows symptoms; indeed, most infected people don’t. That’s in part what makes the virus so concerning. Before the virus emerged in South America in 2015 and began creeping northward, public-health-research agencies had not focused on it. In recent months, everything scientists have learned about Zika is “a bit scarier than we initially thought,” the CDC principal deputy director Anne Schuchat said last month. Researchers have established a causal link between Zika and microcephaly, as well as a link with the autoimmune disorder Guillain-Barré; they know it can be transmitted sexually; and there have been reports of brain and spinal-cord infections related to Zika. Its range is amplifying as well, even as outbreaks in some locations, such as Brazil, have quieted. The World Health Organization reported Friday that the Asian strain of Zika, which appeared in Brazil last year, is now in Africa.

http://www.theatlantic.com/politics/archive/2016/05/zika-cdc-congress/483737/

 

[niman]

Why the number of pregnant US women with possible Zika infections just tripled

Updated by Julia Belluz on May 20, 2016, 12:50 p.m. ET @juliaoftoronto [email protected]

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If you've been watching cable news, you might get the impression that an epidemic of Zika among pregnant women has suddenly spiraled out of control in the United States.

According to a report on Friday from the Centers for Disease Control and Prevention, 279 pregnant women with possible Zika infection in US states and territories are being monitored — tripling the agency's previous estimates.

 

Have cases suddenly spiked? Not exactly. What actually happened is that the CDC changed the method it's been using to count cases. The new approach uses a broader definition — and one that better reflects what we're learning about how the disease can affect fetuses.

RelatedSimple Zika advice for women, from a top CDC official

Until today, the CDC only looked at women who had both evidence of Zika virus in blood tests as well as symptoms or complications during pregnancy. That methodology was based on the belief that there was an association between symptomatic women and birth defects associated with the virus, like microcephaly — which is characterized by a shrunken head and incomplete brain development. (Zika symptoms include fever, rash, joint pain, and red eyes — but they only occur in a minority of people who have the virus.)

Newer research has indicated that some women who test positive for the virus but recalled having no symptoms later delivered babies with microcephaly and other brain defects.

By the new count, there were 157 pregnant women on the US mainland with possible Zika infection and 122 pregnant women in Puerto Rico — a total of 279 women. The CDC had previously said it was monitoring just 113 pregnant women, a number that excluded those who didn't report Zika symptoms or pregnancy complications.

The CDC has not yet reported on the outcomes of pregnancies they're monitoring.

 

Zika definitely causes birth defects

According to the Centers for Disease Control and Prevention, there's indisputable evidence that Zika causes microcephaly.

The association between the condition and Zika has been seen in this outbreak in Brazil, as well as in reanalyses of the data from previous outbreaks, such as one in the French Polynesian islands in 2013 to 2014. Other countries, including Cabo Verde, Colombia, Martinique, and Panama, have also reported microcephaly or other fetal malformations to the WHO over the last year.

In addition to microcephaly, researchers have found that the virus seems to kill off the tissue in entire regions of the brain, damage babies' eyes, and heighten the risk of miscarriage and fetal death.

Researchers believe pregnant women are at a greatest risk of having babies with birth defects if they are infected in the first trimester. They've also estimated that women infected with Zika during the first trimester of their pregnancies face a one in 100 chance of delivering a baby with microcephaly.

Zika wouldn't be the first virus to cause microcephaly. Rubella famously caused an epidemic of birth defects before the advent of the vaccine, and cytomegalovirus (CMV) can damage fetuses too.

But Zika is the first mosquito-borne virus to threaten fetuses. And even if birth defects turn out to be a very rare complication of Zika, the risk to fetuses was enough to prompt the WHO to declare a rare global public health emergency earlier this year.

Health officials urge pregnant women to avoid travel to places where Zika is circulating

In total, there have been about 550 cases of Zika in the United States — but most have originated in places where the virus is currently circulating, and a minority have occurred because of sexual contact with a traveler.

"Although the mosquitoes that carry Zika are here, Zika is not currently here," Dr.Denise Jamieson, an obstetrician-gynecologist and the chief of CDC's women's health and fertility branch, told us in April.

So she advised pregnant women in the continental US to avoid travel to areas where there is ongoing Zika transmission. (This includes more than 40 countriesaround the world.)

"For women who live here and are pregnant — they should avoid mosquito bites."

http://www.vox.com/2016/5/20/11720672/zika-pregnancy-cases-US

 

[niman]

New Report Says 279 U.S. Pregnant Women Have Zika

The new CDC numbers include pregnant women without symptoms, giving a more accurate picture

• By Dina Fine Maron on May 20, 2016

 

 

Health workers conduct fumigation against Aedes aegypti mosquitoes in Bukit Duri, Jakarta, Indonesia on April 1, 2016. Credit: Photo by Dasril Roszandi/NurPhoto via Getty Images

Tracking of the Zika virus indicates that 279 pregnant women across the United States and its territories now have it, according to new official figures. Most of these women are still pregnant and are being monitored to see if their fetuses develop abnormalities including microcephaly.

The new numbers, published Friday in a report from the U.S. Centers for Disease Control and Prevention, underscore the challenge of preventing Zika from spreading to pregnant women and their fetuses. The official count includes cases up to May 12 and will be updated every Thursday at noon. The women in all of these cases had tested positive for the virus or responded to antibody testing—indicating they were likely positive—but not all the women had symptoms or pregnancy complications.

Before Friday’s announcement, the number of pregnant women who tested positive for Zika but did not have any of its symptoms was not publicly reported. Instead, only the number of pregnant women with lab evidence of the virus—and symptoms or complications—was publicly tracked. So far there have been “less than a dozen” adverse outcomes such as birth defects or miscarriages among these 279 women, but tracking is ongoing, says Margaret Honein, chief  of CDC’s birth defects branch. Exactly how often birth defects occur among pregnant women with Zika remains unknown.

The CDC’s change in tracking and publishing numbers was prompted by evidence that asymptomatic women have given birth to children with abnormalities, Honein says. “We have been monitoring women with both symptomatic and asymptomatic  Zika since February,” when the U.S. tracking began, she adds. “The change is that we are now publicly reporting the number to give a more transparent picture of all the monitoring that we are doing.” 

Zika is being locally transmitted by mosquito bites in some U.S. territories, where a total of 122 women are known to have contracted the virus. The 157 pregnant women in the continental U.S. are believed to have contracted it during travels outside of the country or from sexual contact with an infected partner who had traveled. So far there has been no confirmed case from a local mosquito bite in the continental U.S. But the mosquitoes biologically capable of transmitting the disease are found in about two-thirds of country, and public health authorities expect that there will be small clusters of Zika caused by those bugs.

Because of the threat to pregnant women, CDC also announced Friday that it has launched two new Zika-related pregnancy tracking systems—one for the U.S. and most of its territories and one specific to Puerto Rico—to officially record the broader population of Zika-infected pregnant with laboratory evidence of the virus, regardless of their symptoms. CDC is not yet sharing any specific patient details about individual cases, or whether the women contracted the virus sexually or during travel.

http://www.scientificamerican.com/article/new-report-says-279-u-s-pregnant-women-have-zika/