Dallas, Texas: DCHHS Confirms Locally Acquired Sexually Transmitted Zika Infection

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Although the evidence for sexual transmission of the Zika virus has been limited (see  EID Journal dispatches on Probable Non–Vector-borne Transmission of Zika Virus, Colorado, USA & Potential Sexual Transmission of Zika Virus), we've started to see warnings over the possibilities from health agencies (see UK PHE Warns On Potential Sexual Transmission Of Zika).

Today, we appear to have additional confirmation, with the following statement released this afternoon from Dallas County Health and Human Services (DCHHS). 

 I expect we'll hear a lot more about this case in the hours and days ahead.

FOR IMMEDIATE RELEASE

DCHHS Reports First Zika Virus Case in Dallas County Acquired Through Sexual Transmission

DALLAS (Feb. 2, 2016) – Dallas County Health and Human Services (DCHHS) has received confirmation from the Centers for Disease Control and Prevention (CDC) of the first Zika virus case acquired through sexual transmission in Dallas County in 2016. The patient was infected with the virus after having sexual contact with an ill individual who returned from a country where Zika virus is present. For medical confidentiality and personal privacy reasons, DCHHS does not provide additional identifying information.

“Now that we know Zika virus can be transmitted through sex, this increases our awareness campaign in educating the public about protecting themselves and others,” said Zachary Thompson, DCHHS director. “Next to abstinence, condoms are the best prevention method against any sexually-transmitted infections.” 

Zika virus is transmitted to people by mosquitoes and through sexual activity. The most common symptoms of Zika virus are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting several days to a week.

DCHHS advises individuals with symptoms to see a healthcare provider if they have visited an area where Zika virus is present or had sexual contact with a person who traveled to an area where Zika virus is present. There is no specific medication available to treat Zika virus and there is not a vaccine. The best way to avoid Zika virus is to avoid mosquito bites and to avoid sexual contact with a person who has Zika virus.

“Education and awareness is crucial in preventing Zika virus,” said Dr. Christopher Perkins, DCHHS medical director/health authority. “Patients are highly encouraged to follow prevention recommendations to avoid transmitting and spreading Zika virus.”

DCHHS recommends the following to avoid Zika virus:

           

Use the 4Ds to reduce the chance of being bitten by a mosquito.

• DEET All Day, Every Day: Whenever you’re outside, use insect repellents that contain DEET or other EPA approved repellents and follow instructions.
•  DRESS: Wear long, loose, and light-colored clothing outside.
•  DRAIN: Remove all standing water in and around your home.
•  DUSK & DAWN: Limit outdoor activities during dusk and dawn hours when mosquitoes are most active.

Travelers can protect themselves by doing the following:

Choose a hotel or lodging with air conditioning or screens on windows or doors.

Sleep under a mosquito bed net if you are outside or in a room that is not well-screened

Sexual partners can protect each other by using condoms to prevent spreading sexually-transmitted infections.

There are currently no reports of Zika virus being locally-transmitted by mosquitoes in Dallas County. However, imported cases make local spread by mosquitoes possible because the mosquitoes that can transmit the virus are found locally. DCHHS advises recent travelers with Zika virus symptoms as well as individuals diagnosed with Zika virus protect themselves from further mosquito bites.

For more information on Chikungunya, Dengue and Zika viruses, go to the DCHHS website. ###

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WHO MERS-CoV Update - Saudi Arabia

Credit FAO

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In January, after a very quiet couple of months on the MERS front, we saw a spate of MERS cases reported out of Saudi Arabia all involving camel contact (see here and here), several involving Camels That Tested Positive For MERS-CoV In A Jeddah Market.

Today the World Health Organization has posted an update on five of these recent cases, including two asymptomatic cases, and one who is listed as being a relative of closes contacts to a camel. 

While the vast majority of people have been exposed to MERS from other infected humans, infected camels appear responsible for sporadically `seeding' the virus into the human population, where it tends to transmit in health care settings particularly well.


Finding ways to curb this camel-to-human transmission is viewed as the most effective way to keep MERS in check.

Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia

Disease outbreak news
2 February 2016 

Between 22 and 27 January 2016, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 5 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection.

Details of the cases

• A 47-year-old male from Al-Kharj city developed symptoms on 24 January and, on 26 January, was admitted to hospital. The patient, who has comorbidities, tested positive for MERS-CoV on 27 January. Currently, he is in stable condition in a negative pressure isolation room on a ward. The patient has a history of frequent contact with camels and consumption of their raw milk. He has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.
• A 21-year-old, non-national male from Alkumrah city was identified through contact tracing while asymptomatic. The patient, who has no comorbidities, tested positive for MERS-CoV on 23 January. Currently, he is still asymptomatic and in home isolation. The patient has a history of contact with MERS-CoV positive camels. He has no history of exposure to other known risk factors in the 14 days prior to detection.
• A 45-year-old, non-national male from Alkumrah city was identified through contact tracing while asymptomatic. The patient, who has no comorbidities, tested positive for MERS-CoV on 23 January. Currently, he is still asymptomatic and in home isolation. The patient has a history of contact with MERS-CoV positive camels. He has no history of exposure to other known risk factors in the 14 days prior to detection.
• An 85-year-old male from Muthnab city developed symptoms on 11 January and, on 19 January, was admitted to hospital. The patient, who has comorbidities, tested positive for MERS-CoV on 21 January. Currently, he is in stable condition in a negative pressure isolation room on a ward. The patient has a history of contact with his relatives who have a history of contact with camels. He has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.
• A 58-year-old male from Jeddah city developed symptoms on 12 January and, on 19 January, was admitted to hospital. The patient, who has comorbidities, tested positive for MERS-CoV on 21 January. Currently, he is in stable condition in a negative pressure isolation room on a ward. The patient has a history of frequent contact with camels and consumption of their raw milk. He has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.

Contact tracing of household and healthcare contacts is ongoing for these cases.

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Thailand Reports `1st' Domestic Case Of Zika

UPDATED (see bottom)

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Thailand is one of several Southeast Asian nations where Zika has been suspected to be circulating, but due to the background noise from Dengue and Chikungunya, and a lack of Zika-specific testing, it has never been proven.

At least, not until today. 

First a report from AFP, then I'll be back with more.

Thailand confirms first domestic case of Zika virus

AFP News 2 February 2016

A man has contracted the Zika virus in Thailand, officials said Tuesday, as a global alert intensifies over the mosquito-borne infection blamed for a surge in serious birth defects in South America.

Authorities said the 22-year-old Thai man is likely to have caught the same strain of the virus that has caused panic in countries such as Brazil and Colombia.

(Continue . . .)

The Zika status of countries like Vietnam, Laos, Cambodia, and even China are suspect because the testing routinely done for dengue can show positive results for Zika as well.  

As more specific PCR testing for Zika becomes widely available it is likely the list of countries where autochthonous transmission takes place will rise considerably. 

One clue that Zika might have been in Thailand prior to today's report came from a 2014 case report from the American Journal of Tropical Medicine and Hygiene that described a Canadian tourist who returned from Thailand and was subsequently diagnosed with Zika. 

First Case of Zika Virus Infection in a Returning Canadian Traveler

Kevin Fonseca,^* Bonnie Meatherall, Danielle Zarra, Michael Drebot, Judy MacDonald, Kanti Pabbaraju, Sallene Wong, Patricia Webster, Robbin Lindsay, and Raymond Tellier

Abstract

A woman who recently traveled to Thailand came to a local emergency department with a fever and papular rash. She was tested for measles, malaria, and dengue. Positive finding for IgM antibody against dengue and a failure to seroconvert for IgG against dengue for multiple blood samples suggested an alternate flavivirus etiology. Amplification of a conserved region of the non-structural protein 5 gene of the genus Flavivirus yielded a polymerase chain reaction product with a matching sequence of 99% identity with Zika virus. A urine sample and a nasopharygeal swab specimen obtained for the measles investigation were also positive for this virus by reverse transcription polymerase chain reaction. Subsequently, the urine sample yielded a Zika virus isolate in cell culture. This case report describes a number of novel clinical and laboratory findings, the first documentation of this virus in Canada, and the second documentation from this region in Thailand.

Since arboviruses are best transported over long distances by viremic humans on holiday, popular tourist destinations like Brazil, Thailand, and the Islands of the Caribbean - which all feature abundant mosquito vectors - seem to be natural hot spots for Zika and CHKV.

A notion that, as a Floridian, already has me stocking up on DEET for the summer ahead.


Update: 

Although the media reports are calling this the first domestic case of Zika in Thailand, I was alerted by Gert van der Hoek of Flutrackers to a recent study (also in Am J Trop Med Hyg)  where 7 Zika cases were confirmed in Thailand between 2012-2014. 

Detection of Zika Virus Infection in Thailand, 2012–2014

Rome Buathong, Laura Hermann,^* Butsaya Thaisomboonsuk, Wiriya Rutvisuttinunt, Chonticha Klungthong, Piyawan Chinnawirotpisan, Wudtichai Manasatienkij, Ananda Nisalak, Stefan Fernandez, In-Kyu Yoon, Passakorn Akrasewi, and Tanarak Plipat

Abstract

Zika virus (ZIKV) is an emerging mosquito-borne pathogen with reported cases in Africa, Asia, and large outbreaks in the Pacific. No autochthonous ZIKV infections have been confirmed in Thailand. However, there have been several cases reported in travelers returning from Thailand.

Here we report seven cases of acute ZIKV infection in Thai residents across the country confirmed by molecular or serological testing including sequence data. These endemic cases, combined with previous reports in travelers, provide evidence that ZIKV is widespread throughout Thailand.

 

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Updating Russia's Flu Outbreak

http://www.influenza.spb.ru

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North America's flu season has been slow in getting started, but yesterday's unexpected CDC HAN Advisory on Severe Influenza reminds us there is plenty of flu season left , and that seasonal flu is always unpredictable.

As mentioned last week, unlike North America (see An Update On The Russian Influenza Epi Report), Eastern Europe and Russia have been reporting heavy flu activity for several weeks, with A(H1N1)pdm09 being the dominant strain.  

The hyperbolic nature of local media reports makes it difficult to gauge the true impact of this year's epidemic, but it appears that thousands of schools across Russia have been closed due to this outbreak.  A sampling of (translated) headlines includes:

The flu epidemic in Russia: in quarantine closed 9,000 schools

Quarantine in schools Saratov extended until February 8

In the Saratov region 415 schools are closed for quarantine

Igor Molchanov: "School of Saratov have to close for a week"  

The official information we are getting comes from the  WHO National Influenza Centre Of Russia.  These reports tend to lag a week or two behind current events, but their Epi Week 4 Influenza Epidemic report summarizes:

Influenza and ARI morbidity data. Influenza activity increased significantly on the week 04.2016. The nationwide ILI & ARI morbidity level (91.9 per 10 000 of population) exceeded the national baseline by 32.2%.

Etiology of ILI & ARI morbidity. The overall proportion of respiratory samples positive for influenza in traditional surveillance system was estimated as 33.6%. Influenza A(H1N1)pdm09 dominated (91.9% of influenza cases). Influenza A(H3N2) and B cases registered sporadically. Percent of positive ARI cases of non-influenza etiology (PIV, adeno- and RSV) was estimated as 19.6% of investigated patients by IFA and 7.3% by PCR.

In sentinel surveillance system clinical samples from 68 SARI and 60 ILI/ARI patients were investigated by rRT-PCR. 21 (30.8%) influenza A(H1N1)pdm09 cases among SARI patients and 10 (16.7%) influenza A(H1N1)pdm09 cases among ILI/ARI patients were detected.

Antigenic characterization. Totally 84 influenza A(H1N1)pdm09 and 2 influenza A(H3N2) viruses were characterizated antigenically in HI in two NICs of Russia since the beginning of the season. 43 (51.2%) influenza A(H1N1)pdm09 strains were related closely to influenza A/California/07/09 virus, 41 (48.8%) influenza A(H1N1)pdm09 viruses had decreased up to 1/8 - 1/16 titers in interaction with antiserum to this virus. Two A(H3N2) strains were similar to influenza A/Hong-Kong/4801/2014 virus, with antiserum to influenza A/Switzerland/9715293/2013 they reacted up to 1/4 - 1/8 of homological titer.

Genetic characterization. 11 investigated influenza A(H1N1)pdm09 virus strains were A/South Africa/3626/2013-like. All viruses bear clade 6B specific mutations in HA (S84N, S162+N and I216T) and formed new genetic group according to phylogenetic analysis. One A(H1N1)pdm09 sequence obtained directly from autopsy sample showed the presence of additional mutation D222G in HA1.

 

The A(H1N1)pdm09 virus has remained remarkably stable since it emerged 7 years ago, but the antigenic and genetic characterizations above describe three interesting attributes: 

1. Nearly half of the samples tested (and the majority since January 1st) show reduced titers against the current vaccine strain.
2. Most of the samples tested since January 1st fall into the emerging 6B subclade  defined by HA1 amino acid substitutions S162N and I216T (see  Influenza virus characterisation, Summary Europe, December 2015).
3. One sequence obtained from an autopsy showed the D222G mutation which has been linked to enhanced virulence

The H1N1 vaccine strain used today is essentially the same one as was developed in 2009, while we've seen the H3N2 vaccine strain replaced numerous times over the past 7 years.

It is inevitable that through the process of antigenic drift, the H1N1 strain will eventually acquire enough genetic changes to require an updated vaccine virus.

But for that to happen, a biologically `fit', antigenically drifted virus must outperform the old virus and become dominant.  And right now, it is too soon to know if these reduced titer viruses will fit that bill.

It is, however, something to watch.

 
The D222G (or D225G in influenza H3 numbering) mutation mentioned above is not new. We saw it described as early as the summer of 2009, but it really came to prominence in the fall of that year when scientists in Norway linked it to deeper lung infections and greater virulence.

This relatively rare amino acid substitution at position 222 (225 using H3 Numbering) from aspartic acid (D) to glycine (G) allows the virus to bind to receptors found deeper in the lungs, and is linked to the development of more severe pneumonia.

In 2013, in EuroSurveillance: Revisiting The D222G Mutation In A/H1N1pdm09, we saw a study that suggested this mutation may actually degrade H1N1's transmissibility, and that most of the time this variant comes about through a spontaneous mutation in the host after the host has been infected. 

D222G's rarity, showing up in only 1%-2% of isolates tested, has kept this mutation from being a major public health concern (Cite).

But another study that appeared last year in the EID Journal (see  Severity of Influenza A(H1N1) Illness and Emergence of D225G Variant, 2013–14 Influenza Season, Florida, USA) cautioned:

Abstract

Despite a regional decline in influenza A(H1N1)pdm09 virus infections during 2013–14, cases at a Florida hospital were more severe than those during 2009–10. Examined strains had a hemagglutinin polymorphism associated with enhanced binding to lower respiratory tract receptors. Genetic changes in this virus must be monitored to predict the effect of future pandemic viruses.

This is all very interesting from virological standpoint, but its significance beyond Russia's current outbreak remains unclear. New influenza clades, subclades and variants continually emerge, and most fail to thrive, or are quickly overrun by other, more successful strains.   

We'll have to wait to see if these clade 6B mutations are winners or losers in influenza's evolutionary lottery.

But with the selection of next fall's seasonal flu vaccine components only a few weeks away, influenza scientists are undoubtedly taking a hard look at the recent rise of clade 6B H1N1 viruses as they try to devine influenza's future.

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CDC Adds 4 Destinations To Zika Travel Alert

Credit CDC Map & Data

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The list of countries where the Zika virus is currently reported to be transmitting increases every couple of days, and seems likely to do so for some time.  Overnight the CDC added 4 more destinations to their Zika Travel Alert:

• American Samoa
• Costa Rica
• Curacao
• Nicaragua

This brings to 26 the number of countries and territories in the Americas that have been affected - up from only two (Brazil & Columbia) in October - and 29 worldwide.  Many countries are not yet testing for the virus, or are awaiting test results, and so this list should not be considered definitive.

CDC adds 4 destinations to interim travel guidance related to Zika virus

 

Media Statement

For Immediate Release: Monday, February 1, 2016

Contact: Media Relations,
(404) 639-3286

CDC is working with other public health officials to monitor for ongoing Zika virus‎ transmission. Today, CDC added the following destinations to the Zika virus travel alerts:  American Samoa, Costa Rica, Curacao, and Nicaragua.   

CDC has issued a travel alert (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing. For a full list of affected countries/regions: http://www.cdc.gov/zika/geo/index.html. Specific areas where Zika virus transmission is ongoing are often difficult to determine and are likely to continue to change over time.

As more information becomes available, CDC travel alerts will be updated. Travelers to areas where cases of Zika virus infection have been recently confirmed are at risk of being infected with the Zika virus. Mosquitoes that spread Zika are aggressive daytime biters, prefer to bite people, and live indoors and outdoors near people. There is no vaccine or medicine available for Zika virus. The best way to avoid Zika virus infection is to prevent mosquito bites.

Some travelers to areas with ongoing Zika virus transmission will become infected while traveling but will not become sick until they return home. Some people who are infected do not have any symptoms. Symptoms include fever, rash, joint pain, and red eyes. Other commonly reported symptoms include muscle pain and headache. The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon and case fatality is low. Travelers to these areas should monitor for symptoms or illness upon return. If they become ill, they should tell their healthcare professional where they have traveled and when.

Until more is known, CDC continues to recommend that pregnant women and women trying to become pregnant take the following precautions:

• Pregnant women should consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who must travel to one of these areas should talk to their doctor or other healthcare professional first and strictly follow steps to avoid mosquito bites during the trip.
• Women trying to become pregnant should consult with their healthcare professional before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip. 

Guillain-Barré syndrome (GBS) has been reported in patients with probable Zika virus infection in French Polynesia and Brazil. Because we do not know if Zika virus infection causes GBS, research efforts are underway to examine if there is a potential link between Zika and GBS.

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WHO Statements On Today's IHR Committee Decision To Declare a PHEIC

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The World Health Organization has posted two statements on today's decision to declare the clusters of microcephaly tentatively linked to the Zika virus a Public Health Emergency Of International Concern (PHEIC).


First, the committee's decision:

WHO statement on the first meeting of the International Health Regulations (2005) (IHR 2005) Emergency Committee on Zika virus and observed increase in neurological disorders and neonatal malformations

WHO statement
1 February 2016

The first meeting of the Emergency Committee (EC) convened by the Director-General under the International Health Regulations (2005) (IHR 2005) regarding clusters of microcephaly cases and other neurologic disorders in some areas affected by Zika virus was held by teleconference on 1 February 2016, from 13:10 to 16:55 Central European Time.

The WHO Secretariat briefed the Committee on the clusters of microcephaly and Guillain-Barré Syndrome (GBS) that have been temporally associated with Zika virus transmission in some settings. The Committee was provided with additional data on the current understanding of the history of Zika virus, its spread, clinical presentation and epidemiology. 

The following States Parties provided information on a potential association between microcephaly and/or neurological disorders and Zika virus disease: Brazil, France, United States of America, and El Salvador.

The Committee advised that the recent cluster of microcephaly cases and other neurologic disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes a Public Health Emergency of International Concern (PHEIC). 

The Committee provided the following advice to the Director-General for her consideration to address the PHEIC (clusters of microcephaly and neurologic disorders) and their possible association with Zika virus, in accordance with IHR (2005).

Microcephaly and neurologic disorders

• Surveillance for microcephaly and GBS should be standardized and enhanced, particularly in areas of known Zika virus transmission and areas at risk of such transmission.
• Research into the etiology of new clusters of microcephaly and neurologic disorders should be intensified to determine whether there is a causative link to Zika virus and/or other factors or co-factors.

As these clusters have occurred in areas newly infected with Zika virus, and in keeping with good public health practice and the absence of another explanation for these clusters, the Committee highlights the importance of aggressive measures to reduce infection with Zika virus, particularly among pregnant women and women of childbearing age.

As a precautionary measure, the Committee made the following additional recommendations:

Zika virus transmission

• Surveillance for Zika virus infection should be enhanced, with the dissemination of standard case definitions and diagnostics to at-risk areas.
• The development of new diagnostics for Zika virus infection should be prioritized to facilitate surveillance and control measures.
• Risk communications should be enhanced in countries with Zika virus transmission to address population concerns, enhance community engagement, improve reporting, and ensure application of vector control and personal protective measures.
• Vector control measures and appropriate personal protective measures should be aggressively promoted and implemented to reduce the risk of exposure to Zika virus.
• Attention should be given to ensuring women of childbearing age and particularly pregnant women have the necessary information and materials to reduce risk of exposure.
• Pregnant women who have been exposed to Zika virus should be counselled and followed for birth outcomes based on the best available information and national practice and policies.

Longer-term measures

• Appropriate research and development efforts should be intensified for Zika virus vaccines, therapeutics and diagnostics.
• In areas of known Zika virus transmission health services should be prepared for potential increases in neurological syndromes and/or congenital malformations.

Travel measures

• There should be no restrictions on travel or trade with countries, areas and/or territories with Zika virus transmission.
• Travellers to areas with Zika virus transmission should be provided with up to date advice on potential risks and appropriate measures to reduce the possibility of exposure to mosquito bites.
• Standard WHO recommendations regarding disinsection of aircraft and airports should be implemented.

Data sharing

• National authorities should ensure the rapid and timely reporting and sharing of information of public health importance relevant to this PHEIC.
• Clinical, virologic and epidemiologic data related to the increased rates of microcephaly and/or GBS, and Zika virus transmission, should be rapidly shared with WHO to facilitate international understanding of the these events, to guide international support for control efforts, and to prioritize further research and product development.

Based on this advice the Director-General declared a Public Health Emergency of International Concern (PHEIC) on 1 February 2016. The Director-General endorsed the Committee’s advice and issued them as Temporary Recommendations under IHR (2005). The Director-General thanked the Committee Members and Advisors for their advice.

WHO Director-General Margaret Chan's statement on the IHR Emergency Committee's decision follows:

WHO Director-General summarizes the outcome of the Emergency Committee on Zika

WHO statement on the first meeting of the International Health Regulations (2005) Emergency Committee on Zika virus and observed increase in neurological disorders and neonatal malformations
 
1 February 2016 

I convened an Emergency Committee, under the International Health Regulations, to gather advice on the severity of the health threat associated with the continuing spread of Zika virus disease in Latin America and the Caribbean. The Committee met today by teleconference.

In assessing the level of threat, the 18 experts and advisers looked in particular at the strong association, in time and place, between infection with the Zika virus and a rise in detected cases of congenital malformations and neurological complications. 

The experts agreed that a causal relationship between Zika infection during pregnancy and microcephaly is strongly suspected, though not yet scientifically proven. All agreed on the urgent need to coordinate international efforts to investigate and understand this relationship better. 

The experts also considered patterns of recent spread and the broad geographical distribution of mosquito species that can transmit the virus. 

The lack of vaccines and rapid and reliable diagnostic tests, and the absence of population immunity in newly affected countries were cited as further causes for concern.

After a review of the evidence, the Committee advised that the recent cluster of microcephaly cases and other neurological disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes an “extraordinary event” and a public health threat to other parts of the world. 

In their view, a coordinated international response is needed to minimize the threat in affected countries and reduce the risk of further international spread.

Members of the Committee agreed that the situation meets the conditions for a Public Health Emergency of International Concern.

I have accepted this advice.
 
I am now declaring that the recent cluster of microcephaly cases and other neurological disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes a Public Health Emergency of International Concern.
 
A coordinated international response is needed to improve surveillance, the detection of infections, congenital malformations, and neurological complications, to intensify the control of mosquito populations, and to expedite the development of diagnostic tests and vaccines to protect people at risk, especially during pregnancy.
 
The Committee found no public health justification for restrictions on travel or trade to prevent the spread of Zika virus.

At present, the most important protective measures are the control of mosquito populations and the prevention of mosquito bites in at-risk individuals, especially pregnant women.

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WHO: Zika Virus & Microcephaly Constitute A PHEIC (Public Health Emergency)

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Although a causal link between the Zika virus and the apparent spike in microcephaly in Brazil has yet to be established the World Health Organization has decided the recent surge in microcephalic births is reason enough to declare a PHEIC (Public Health Emergency Of International Concern).

By itself, the Zika Virus would not be considered a public health emergency, according to panel chair David Heymann, as it is normally a mild virus.  

But when you add in the clusters of microcephaly in French Polynesia and Brazil - and reports of increased Guillain-Barré syndrome (GBS) - all concurrent with the arrival of Zika, the overall picture warrants today's emergency declaration.


Statements from Director-General Margaret Chan and panel Chair David Heymann - along with transcripts from the press conference - should be available shortly.  I'll update this post when they become available.

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