There have been many ideas thrown around on how to control the Aedes aegypti mosquito responsible for the spread of Zika virus. Florida counties took to the polls this week to vote on whether genetically modified mosquitoes should be released in their communities to help reduce the Aedes population, according to a Kaiser Health News report. In Key Haven, the town proposed to stage the trial, a majority voted against the plan. In Monroe County, where Key Haven sits, a majority voted yes on the proposal. The ballot measure is a commonly called “straw poll” which is non-binding. The final decision on the divided ballot will be made by the Florida Keys Mosquito Control District Board, which is scheduled to meet Nov. 19 to discuss the results of the poll and next steps.

Zika may not be at the forefront of concerns in the U.S. right now, but the Centers for Medicare & Medicaid Services announced $66.1 million in funding to support Zika prevention and treatment. Funding is available to areas with active or local Zika transmission as identified by the Centers for Disease Control and Prevention, according to a CMS release. Puerto Rico has been hit hardest by the virus and will receive $60.6 million of the total funding.

As of November 2, there have been a total of 139 reported locally acquired cases in the continental U.S., with all of those occurring in Florida. Locally acquired cases in U.S. territories, which include American Samoa, Puerto Rico and U.S. Virgin Islands, are tallied at 30,074, according to the Centers for Disease Control and Prevention.

Sept. 29, 2016

Congress has approved a bill that would provide $1.1 billion in funding to fight the Zika virus. While this falls short of President Obama’s call for $1.9 billion, it provides funds of nearly $935 million to fight Zika in the U.S., and another $175 million for the battle abroad, Kaiser Health News reports.

Earlier this month, the Centers for Disease Control and Prevention were stumped over the infection of a Utah patient with no known risk factors. A case study published in The New England Journal of Medicine found that the man contracted the virus through his father’s sweat or tears. The father had levels of the virus that were 100,000 times higher than that in samples from others infected, and eventually passed away. During the father's hospitalization, his son had had contact with his father’s skin and wiped his eyes without gloves, which is thought to be how the virus was transferred.

The same Utah man who had unusually high levels of Zika virus is reported to have died as a result of the Zika virus, not his previous illness as was originally reported, making this the first U.S. Zika death. The unidentified man, 73, contracted Zika while traveling to Mexico and had also been previously infected with dengue virus, which is closely related to Zika, but was hospitalized with sepsis a week after his trip. The medical team that treated the man at University of Utah Health Care reported on the case in the same aforementioned New England Journal of Medicine case study, asserting their belief that Zika infection was the cause of death, not his underlying illnesses.

Sept. 23, 2016

The director of the Centers for Disease Control and Prevention, Tom Frieden, M.D., applauded the efforts of the state of Florida for its response to Zika and described what he said was an “important milestone” in Zika response, during an online CDC briefing.

Florida Surgeon General and Secretary Celeste Philip, M.D., joined Frieden, along with members of the Environmental Protection Agency and Florida Health officials in noting that active Zika virus transmission is no longer ongoing in the Wynwood neighborhood of Miami-Dade County. This “interruption,” as Frieden puts it, is likely due to the new “one-two punch” tactic of mosquito control being used in Wynwood. As part of the area’s comprehensive mosquito control plan, aerial spraying of the insecticide naled is being used, along with Bacillus thuringiensis subspecies israelensis, a naturally occurring bacteria found in soils and whose toxins kill mosquito larvae when swallowed.

“The plain fact is we don’t have a vaccine against Zika, and the mosquito that spreads Zika is difficult to control,” says Frieden. “Aerial application appears to be our strongest tool — currently, the most effective tool — in the Zika-prevention toolbox.”

Frieden pointed to the CDC’s Weekly Morbidity and Mortality Report, noting a significant drop in Aedes aegypti mosquito numbers directly following the use of aerial spraying in Wynwood. Monday, Sept. 19 also marked 45 days without a case of local transmission in that neighborhood.

However, the use of mosquito spraying tactics has drawn a wave of criticism about its impact on citizens and the environment, including a report by The Washington Post on the death of millions of bees following a spraying for Zika in South Carolina.

Frieden says he understands the concern some have about the tactics used to control the mosquito population, but says when used according to the EPA-approved dosage on the label, it’s safe for use.

Sept. 16, 2016

An investigation into a Utah patient with no known risk factors that was infected with the Zika virus is leaving the Centers for Disease Control and Prevention at a loss. Its Morbidity and Mortality Weekly Report found that the infected patient was known to have had close contact with an elderly male family contact who contracted the virus abroad, suggesting the virus may have been transmitted through contact with bodily fluids.

The American Hospital Association urged Congress to provide $1.1 billion in new funding to fight Zika, according to a letter from AHA Executive Vice President Tom Nickels. “Time is not on our side," he said in the letter. "If local Zika transmissions continue, it will become increasingly difficult to eradicate the virus … . Funding also would ensure that the development of a vaccine, diagnostic tests and treatments move forward as quickly as possible."

A recent report released by the Population Institute finds the Southern and Gulf Coast states, which are most vulnerable to a Zika outbreak, are graded the worst at dealing with reproductive health issues. This is an obvious problem, considering that the effects of Zika are most damaging to pregnant mothers and their newborns.

Zika virus numbers according to the CDC, as of Sept. 1:

  • Locally acquired cases in U.S.: 43 (only in Florida)
  • Travel-associated cases reported: 2,290
  • Pregnant women with lab evidence of possible Zika virus infection: 671
  • Live-born infants with birth defects: 17

Aug. 31, 2016

Federal funds to help combat the Zika virus are running thin and the director of the Centers for Disease Control and Prevention is urging Congress to push through funding or there will be no money left to fight the virus, the New York Times reports. The Times notes, as of Aug. 26, the CDC has spent $194 million of the allotted $222 million to fight Zika. Peak mosquito season is only about halfway done in the Gulf Coast, and there is a chance the virus could begin spreading in Houston or New Orleans, in addition to the current active transmission in Florida.

Up to six percent of children born with Zika-associated microcephaly may suffer from hearing loss, the Centers for Disease Control and Prevention weekly Morbidity and Mortality Report notes. The findings are based on an assessment of 70 infants aged zero to 10 months with microcephaly and lab evidence of Zika virus done by the Hospital Agamenon Magalhãesin Brazil.

The Food and Drug Administration determined Theranos Inc. collected data that supported the accuracy of their Zika test but failed to include crucial institution review board approved patient-safety protocols during their testing, the Wall Street Journal reports. Institutional review boards make sure patients are treated safely and ethically during studies. Theranos Inc. has since withdrawn its request for emergency clearance of its Zika-virus blood test. 

Aug. 25, 2016

A “Key Zika Considerations for Healthcare Settings” checklist has been released by the Centers for Disease Control and Prevention to give health care systems and providers guidance on how to prepare for patients seeking a diagnosis and/ or symptom management of Zika. In addition to the nine tips recommended, the resource reinforces the importance of providing easy to understand materials on Zika prevention in areas of clinics and offices that patients and visitors are likely to see or hear the information.

Aug. 23, 2016

Zika infections took a heavy toll on 45 Brazilian babies whose mothers were infected with the virus during pregnancy, according to The New York Times, which took a look at a recent study published in the journal Radiology. The study compiled brain scans and ultrasound pictures of the babies, showing that Zika can reach far beyond microcephaly.

The federal government is trying to speed up Zika infection testing. The Department of Health & Human Services’ Office of the Assistant Secretary for Preparedness and Response has awarded $2.6 million to DiaSorin Group, to develop a Zika virus test that would determine more quickly if a patient was infected with the virus.

The Centers for Disease Control and Prevention issued a new travel guidance urging pregnant women, women of reproductive age and their partners to avoid the designated area of Miami Beach where active Zika virus transmission is confirmed to have taken place. 

Aug. 19, 2016

The Centers for Disease Control and Prevention updated guidelines for evaluation and management of infants with possible congenital Zika virus infection in their Weekly Morbidity and Mortality report. The CDC hadn’t released updated guidelines since February and, in addition to Zika testing guidance this new report includes recommendations for the management, referral to services and follow-up of infants with lab evidence of congenital Zika infection, with or without apparent associated birth defects.

The Centers for Disease Control and Prevention also tied locally acquired cases of Zika virus to a section of Miami Beach, according to a CDC release. This means there are now two areas of active transmission — a small area of Wynwood County and the newly confirmed area in Miami Beach. The same release also has updated travel recommendations, urging pregnant women to avoid travel to the designated area of Miami Beach, in addition to the one-square mile area in Wynwood.

Aug. 17, 2016

Wired takes a look at the financial impact babies born with Zika-related birth defects will have on the health care system and the families that will care for these children. They conclude it may cost $4 million per child to provide all the care needed throughout the child’s lifetime.

An instance of Zika infection linked to travel within the continental U.S. has been confirmed in a Texas resident who visited an area of Miami where cases of local transmission has occurred, and tested positive for the Zika virus, a Texas Department of State Health Services release reports.

An Athena Health study breaks down which specialties are doing the most Zika testing. The breakdown: 38 percent of testing is done in primary care; 37 percent by OB/GYN providers and the next big percentage at 19 is categorized as “other.”

The office of Gov. Rick Scott confirmed two more cases of locally transmitted Zika virus infection in Miami-Dade County, bringing the total number of locally acquired cases to 30. In the release, it also states the Florida Department of Agriculture and Consumer Services has tested more than 25,000 mosquitoes for Zika, with none turning up positive.

Aug. 16, 2016

There are growing concerns that the flooding that took place across southeastern Louisiana may further expose a region already prime for the Zika virus, according to USA Today. It’s no secret that the Aedes aegypti mosquito is well equipped to breed in pools of water, even an amount as small as the head of a pin is enough.

The U.S. Agency for International Development called on innovators to create unique solutions to fight the Zika virus. They received over 900 responses and have narrowed the field down to just 21. Among them are special sandals, outdoor fabric and indoor wall hangings treated with long-lasting mosquito repellent.

There’s a battle going on in the small island of Key Haven, near the Florida Keys, over whether or not to allow the release of genetically modified mosquitoes in the area. The decision will go to a vote in a few months with many residents wary of claims by Oxitec, the manufacturer of the experimental mosquitoes.

Aug. 15, 2016

Recommendations on how long men with Zika symptoms should wait before having a child are likely to change. Currently, the World Health Organization and the Centers for Disease Control and Prevention recommend that men who’ve had symptoms of Zika not attempt to have a child for six months after their illness. However, two reports put this recommendation into question: The semen of two men who acquired Zika in Haiti and traveled to Italy tested positive for Zika — one man tested positive 188 days after first showing symptoms, and the other man’s test results were positive after 181 days. This likely would change recommendations drawn up by the CDC.

The office of Gov. Rick Scott put out a press release announcing three additional people had been infected locally, bringing the total number of locally transmitted cases to 25. The good news is that the Florida Department of Health believes the active transmission is still contained to an area less than one square mile in Miami-Dade County.

One of the most devastating aspects of the Zika virus is its effect on newborns. Those born with microcephaly linked to Zika can have a host of accompanying problems, according to the CDC. Researchers at the University of Southern California have discovered two proteins in the Zika virus that could be responsible for causing the birth defect. A full article on their research was published in the journal Cell Stem Cell, and could be a great step toward developing drugs to prevent Zika-driven conditions, Kaiser Health News reports.

The CDC has put out a proposed rule to amend its domestic and foreign quarantine regulations. According to the report (which is 449 pages long), the amendments are being proposed to aid public health responses to outbreaks of communicable diseases.

Aug. 11, 2016

The Department of Health & Human Services has allocated another $81 million in funds from other projects to pursue a vaccine to battle Zika. HHS Secretary Sylvia Burwell said she was allocating $34 million in funding to the National Institutes of Health and $47 million to the Biomedical Advanced Research and Development Authority. This allocation is on top of the $589 million in funds already repurposed by the HHS from Ebola efforts.

The cases of local transmission in Miami haven’t seemed to scare Americans. A Washington Post-ABC News poll found 65 percent of Americans say they are “not too” or “not at all” concerned about being infected with Zika. Only 12 percent of those polled say they are “very worried”about infection.

Aug. 10, 2016

 
While the Zika virus may have only a mild impact on most of those infected, the effect on pregnant mothers and newborns is well-documented. Tragic news out of Harris County Public Health confirmed the first Zika-associated death of a newborn in Texas yesterday. The HCPH received a positive Zika test result on the infant, a girl born with birth defects that included microcephaly, a Harris County Public Health release reported. The mother, while pregnant, had traveled to Latin America where she is suspected of having been infected.

Before that death was reported, the Texas Health and Human Services Commission announced in a news release that Texas Medicaid would cover the cost of mosquito repellent for women between the ages of 10 and 45 or are pregnant.

Another four cases of Zika have been identified in Florida, bringing the count of locally transmitted cases to 21. Gov. Rick Scott’s office issued a release last night stating that all four cases occurred in the same less-than-one-square-mile area of Wynwood where the other cases were found. Scott urged more funding from the federal government. “This is not only an issue affecting us here in Florida — this is a national issue. Florida is just at the head of it with the first cases of local transmission of Zika,” the governor said in the release.

The federal gridlock over Zika funding has compelled the Centers for Disease Control and Prevention to allocate money from other programs to address the outbreak. The Department of Health & Human Services has repurposed $374 million for domestic Zika response activities and has awarded $4.1 milliont o Hologic Inc. to develop a blood-screening test that will help to detect Zika in patients. 

 

Aug. 9, 2016

 
Another nontravel-related Zika virus case is being investigated in Palm Beach County, which would bring the total number of locally acquired cases in Florida to 17, PalmBeachPost.com reports.  The report notes that Gov. Rick Scott said the infected person recently traveled to Miami-Dade County, where the majority of local Zika cases have occurred. Scott said that state officials believe local transmission is still confined to a one-square-mile area in Miami’s Wynwood neighborhood.
 
The Centers for Disease Control and Prevention now have a Zika text messaging service that provides guidelines dependent on the area to which you are traveling. I signed up and texted that I was traveling to Brazil. Needless to say, the CDC messaged back to notify me of the current Zika outbreak and provided a link to its updated travel recommendations and clinician guidelines for that area. To sign up, text PLAN to 855-255-5606.
 

Aug. 8, 2016

  • In Florida, where there have been at least 15 reported cases of local transmission in Miami, Zika has changed the way OB-GYNs talk with their patients. A National Public Radio blog reports that the Zika virus is now an everyday topic discussed during prenatal care visits.
  • There have been many mosquito-focused tactics discussed in fighting the spread of Zika, but one researcher at Vanderbilt University is working to alter the tastebuds of mosquitoes so that once the culprit lands on a person, the taste receptors in their legs aren’t attracted to the skin.
  • If you watched the women’s U.S. Olympic soccer matches this weekend, you would have heard the team’s goalkeeper, Hope Solo, get an earful of “Zika!” chants every time she touched the ball. The chants were also directed at a few U.S. tennis players Sunday morning, according to USA Today. Hope_Solo_tweet_ZikaThe sour spectators may have been motivated by the fact that a number of American athletes dropped out of the Olympics because of Zika fears. And this photo Solo posted on Twitter probably didn’t help.
  • On Aug. 9 at 2 p.m. ET, the Centers for Disease Control and Prevention will host a webinar on its latest clinical guidance for U.S. health care providers caring for pregnant women with possible Zika virus. Go here to participate. 

Aug. 5, 2016

I’ve been following the Zika virus since January, when the World Health Organization said it was spreading "explosively." A lot has happened since then, including the Centers for Disease Control and Prevention confirming Zika’s link to the heartbreaking congenital birth defect microcephaly, the first cases of active Zika virus transmission in Miami, and the likely unwarranted hysteria over Zika and the 2016 Olympics in Rio de Janeiro.

We will be posting daily updates to this page on all things Zika, including updates from the CDC, guidelines for health care providers, tactics being used to control mosquito populations and longer interviews with Zika virus experts, such as this interview with a CDC official on what health care providers are doing to fight the virus.

The top concern right now is Zika's sometimes devastating outcomes on babies born to mothers infected with the virus. In the U.S., there have been 15 live-born infants with birth defects and a total of 479 pregnant women with lab evidence of Zika virus infection, according to the U.S. Zika Pregnancy Registry run by the CDC.

Resources to combat the virus have been slim since Congress left for recess without approving the $1.9 billion in aid funding requested by President Barack Obama. The CDC has awarded more than $16 million to 40 states and territories in an effort to better collect data on the adverse outcomes of Zika as a stopgap until Congress provides funds.

Below are a few recent Zika virus updates:

The CDC advised pregnant women not to travel to the identified areas where active Zika virus transmission has taken place in the Wynwood neighborhood of Miami. In an interview with the Mayo Clinic News Network, Pritish Tosh, M.D., Mayo Clinic infectious diseases specialist, said the travel advisory is “a testament to the strength of the epidemiology that has been going on and how well the CDC and other health authorities have been working at this.”

The National Institutes of Health announced the launch of its first clinical trial of a Zika vaccine. At least 80 volunteers, ages 18 to 35, are participating in three testing sites in the U.S. “A safe and effective vaccine to prevent Zika virus infection and the devastating birth defects it causes is a public health imperative,” National Institute of Allergy and Infectious Diseases Director Anthony Fauci, M.D., said in a news release.

Despite all the athletes who have dropped out of the Olympics and calls by some groups to move the games from Rio, STATnews.com reports that there are surprisingly few mosquitoes because, right now, it’s winter in Brazil.

For more on the Zika virus, visit www.cdc.gov/zika or www.aha.org/zika