Tag Archives: World Health Organization

Yemen set to run out of fuel and vaccine in a month: UNICEF

A boy is being treated at a malnutrition treatment center in Sanaa, Yemen November 4, 2017.

GENEVA (Reuters) – Yemen’s stocks of fuel and vaccines will run out in a month unless a Saudi-led military coalition allows aid into the blockaded port of Hodeidah and Sanaa airport, UNICEF’s representative in the country said on Friday.

Meritxell Relano, speaking by phone to reporters in Geneva, said fuel prices had risen 60 percent and there were urgent concerns about a diphtheria outbreak, as well as food shortages because of the port closure.

“The situation that was already catastrophic is just getting worse,” she said. “The impact of this is unimaginable in terms of health and diseases.”

After two years of civil war, Yemen has 7 million people on the brink of famine and has had 900,000 suspected cholera cases in the past six months.

The number of new cases has fallen consistently for the past eight weeks, according to data from the World Health Organization.

But progress against cholera, which has killed 2,196 people, could be reversed by the blockade, WHO spokeswoman Fadela Chaib told a regular U.N. briefing in Geneva.

“If the closure is not stopped in the coming days, we may see that the progress is stopped,” Chaib said. “We can see even more cases and more deaths as a result of not being able to get access to people.”

The closure of Hodeidah port prevented a ship setting sail from Djibouti with 250 tonnes of WHO medical supplies on Wednesday. Trauma kits in particular are running short.

“If the hostilities continue and the ports remain closed, we will not be able to perform life-saving surgeries or provide basic healthcare,” Chaib said.

 

(Reporting by Tom Miles; Editing by Andrew Roche)

 

Plague in Madagascar Surprises and Alarms World Health organizations, U.S. not immune

World Health Organization responding to Seychelles plague

By Kami Klein

Experts are alarmed at a recent outbreak of plague that is spreading through major populated areas in Madagascar.  So far there has been 1,836 suspected or confirmed cases of pneumonic plague and 133 deaths in areas that have never seen this form of the disease before.

Every year Africa and Madagascar deal with an outbreak of plague within their borders. The World Health Organization (WHO) anticipates this in outlying areas and is ready to step in with antibiotics and information which eventually curtails the outbreak.  This year, health organizations around the world were surprised as the plague has spread so quickly and is primarily being found in heavily populated areas. While they anticipate around 400 cases a year, this year’s outbreak began sooner and a different strain of the disease has the world watching.

What is causing the alarm is that 65% of the plague occurring in Madagascar, pneumonic plague, is the only form that can be spread from human to human through droplets from coughing.  This makes containing the disease much more difficult and the chances that there will be more deaths almost certain.

According to the Center for Disease Control here in the United States, there are major differences in bubonic plague and pneumonic. Bubonic plague is spread to humans by the bites of infected fleas that live on small mammals such as rats.Without treatment, it kills up to two-thirds of those infected. One in 10 cases will develop into pneumonic plague which is almost always fatal if not treated quickly with antibiotics. This form, can and will spread from human to human which is the case in this outbreak. The good news is that a simple short course of antibiotics can cure the plague, providing it is given early.

Dr. Tim Jagatic told BBC News that the outbreak had spread to populated areas when a man infected with bubonic plague had traveled from the highlands to the capital and then on to the coastal city of Tamatave by bus.

“He had the bubonic form of the plague and entered into one of the major cities, where the bubonic version of the disease had the potential of turning into the pneumonic form without treatment.”

“He was in a closed environment with many people when he started to develop severe symptoms, and he started to transmit the pneumonic form of the disease to others.”

“So it wasn’t recognised until later,” he said, allowing the disease to “proliferate over a period of time unabated”.

This  case infected 31 other people, according to the WHO, four of whom died. It wasn’t until a couple of weeks later that an outbreak of the plague was detected and officially confirmed.

Although a travel ban has not been issued as of yet, officials do expect another spike in the disease before the season ends in April.  Medical personnel are all on  alert in parts of Africa that are most frequented by Madagascar citizens. WHO has delivered nearly 1.2 million doses of antibiotics and released $1.5 million dollars in emergency funds to fight the plague in Madagascar.

Though not widely publicized, the United States does have several cases of plague per year mostly in the Southwest. Dr Tim Jagatic, a doctor with Doctors without Borders currently working in Madagascar stated that the conditions which cause the plague outbreaks on the African island are also found in the US.

“Something today that very few people are aware of is that in the United States for instance, in the south-west, there’s an average of 11 cases of bubonic plague per year.

“These outbreaks occur simply because this is a bacteria which is able to maintain a reservoir in wild animals and every once in awhile, when humans come into contact with fleas that have had contact with the wild animals, it is able to transmit to humans.”

Information Sheet on the Plague

Information Sheet on the Plague

 

Sources:   BBC, WHO,CDC, New York Post  CNN

Venezuela doctors in protest urge stronger WHO stance on health crisis

People hold letters which read "Hunger" during a protest outside the World Health Organization (WHO) office in Caracas, Venezuela September 25, 2017. REUTERS/Ricardo Moraes

By Alexandra Ulmer

CARACAS (Reuters) – Venezuela’s doctors, fed up with what they called the World Health Organization’s passive attitude toward the country’s deep medical crisis, protested at the agency’s Caracas office on Monday to demand more pressure on the government and additional assistance.

Venezuela is suffering from a roughly 85 percent shortage of medicines, decrepit hospital infrastructure, and an exodus of doctors during a brutal recession.

Once-controlled diseases like diphtheria and measles have returned due in part to insufficient vaccines and antibiotics, while Venezuelans suffering chronic illnesses like cancer or diabetes often have to forgo treatment.

Malnutrition is also rising, doctors say.

Rare government data published in May showed maternal mortality shot up 65 percent while malaria cases jumped 76 percent. The former health minister was fired shortly after the bulletin’s publication, and it has not been issued since.

In the latest protest by an umbrella group of health associations, dozens of doctors and activists gathered at the Pan American Health Organization (PAHO), the WHO’s regional office, urging the agency step up pressure on Nicolas Maduro’s leftist government and provide more aid during its 29th Pan American Sanitary Conference this week.

“There’s been a complicit attitude because they haven’t denounced things,” Dr. Rafael Muci said during the rally.

“This is an unlivable country, and no one is paying attention,” he said, adding he earns about $8 a month at a state hospital.

In a statement on Monday, PAHO stressed its main role was to provide “technical cooperation” and highlighted recent help in providing vaccines.

The Venezuelan government, which accuses activists of whipping up panic and the business elite of hiding medicines, did not respond to a request for comment.

Venezuelans seeking certain drugs often have to scour pharmacies, seek foreign donations or turn to social media.

Sociologist Maria Angelica Casanova, 51, has struggled to find psychiatric medicines for a year. “Sometimes they come, sometimes they don’t. It’s serious,” she said, as passers-by shouted “Down with Maduro!”

Measles, which were controlled after a mass immunization in the 1990s, has returned to Venezuela’s jungle state of Bolivar, PAHO data show.

As the crisis stokes emigration, Venezuela’s health problems could be exported, doctors warned.

“We don’t know how many people who are emigrating could have some of these pathogens in incubation period,” said Andres Barreto, an epidemiologist who had participated in the measles vaccination drive.

(Reporting by Alexandra Ulmer; Additional reporting by Johnny Carvajal; Editing by Richard Chang)

Yemen’s cholera death toll rises to 1,500: WHO

FILE PHOTO: Women sit with relatives infected with cholera at a hospital in the Red Sea port city of Hodeidah, Yemen May 14, 2017. REUTERS/Abduljabbar Zeyad

ADEN (Reuters) – The death toll from a major cholera outbreak in Yemen has risen to 1,500, Nevio Zagaria, the World Health Organization’s (WHO) representative in Yemen, said on Saturday, and appealed for more help to put an end to the epidemic.

Yemen has been devastated by a 27-month war between a Saudi-led coalition and the armed Iran-aligned Houthi group, making it a breeding ground for the disease, which spreads by faeces getting into food or water and thrives in places with poor sanitation.

Speaking at a joint news conference with representatives of the United Nations Children Fund (UNICEF) and the World Bank, Zagaria said that had been some 246,000 suspected cases in the period to June 30.

The WHO said this week that the outbreak had reached the halfway mark at 218,798 cases as a massive emergency response has begun to curb its spread two months into the epidemic.

Although most of Yemen’s health infrastructure has broken down and health workers have not been paid for more than six months, the WHO is paying “incentives” to doctors, nurses, cleaners and paramedics to staff an emergency cholera network.

With funding help from the World Bank, the WHO is setting up treatment centers with 50-60 beds each, overseen by shifts of about 14 staff working around the clock. The aim is to reach 5,000 beds in total.

(Reporting by Mohammed Mukhashaf, writing by Sami Aboudi; editing by Jason Neely)

New WHO head seeks U.S. bipartisan support for global health

Newly elected Director-General of the World Health Organization (WHO) Tedros Adhanom Ghebreyesus attends a news conference at the United Nations in Geneva, Switzerland, May 24, 2017. REUTERS/Denis Balibouse

By Stephanie Nebehay

GENEVA (Reuters) – The new head of the World Health Organization (WHO) voiced hope on Wednesday that bipartisan support would prevail in the U.S. Congress to fund global health initiatives, despite deep budget cuts proposed by the Trump administration.

But Tedros Adhanom Ghebreyesus, a former Ethiopian health and foreign minister elected as the first African WHO director-general on Tuesday, also said the United Nations agency would be seeking new donors.

U.S. President Donald Trump proposed cuts on Tuesday of about 32 percent from U.S. diplomacy and aid budgets, or nearly $19 billion. His fellow Republicans in Congress assailed his plan, making it unlikely the cutbacks will take effect.

Tedros, asked about the proposed cuts to U.S. and multilateral aid agencies, told a news conference that donors should not suddenly pull out of existing programmes.

“I am a strong believer that there should be an exit strategy, that means a gradual exit that avoids any shocks,” he said. “When there are finance cuts like this, the most affected are the poor.”

But he added: “I don’t take it as a closed issue, and I will continue to engage and use that bipartisan position that I have already experienced while working as minister of health in my own country, but also when I was chairing the Global Fund (to Fight AIDS, Tuberculosis and Malaria).”

The United States currently provides nearly $835 million to WHO’s budget of $5.8 billion for 2016-2017, WHO figures show, combining both U.S. assessed and voluntary contributions.

Tedros said he preferred to see global agencies including WHO, the World Bank, GAVI vaccine alliance and Global Fund as part of one “big envelope”.

“We need to expand the donor base … If we have as many countries as possible who can contribute, it could be any amount, I think that will help,” he said.

“By expanding the donor base, we help the health financing to have a kind of shock absorber.”

U.S. Secretary for Health and Human Services Tom Price, in a speech to the WHO’s annual ministerial assembly on Monday, did not refer to U.S. contributions while voicing support for WHO.

“But it also means taking a clear-eyed view of what needs to change for it to fulfil that most important mission – ensuring a rapid and focused response to potential global health crises,” Price said.

“Reform with this focus must be this organisation’s number one priority,” he said. “The United States wants and we all need a strong WHO.”

(Reporting by Stephanie Nebehay; Editing by Tom Heneghan)

WHO confirms second Ebola case in Congo outbreak

FILE PHOTO: A health worker sprays a colleague with disinfectant during a training session for Congolese health workers to deal with Ebola virus in Kinshasa October 21, 2014. REUTERS/Media Coulibaly

By Aaron Ross

KINSHASA (Reuters) – The World Health Organization (WHO) confirmed on Sunday a second case of Ebola in Democratic Republic of Congo after an outbreak this week of 17 other suspected cases.

Health officials are trying to trace 125 people thought to be linked to the cases identified in the remote northeastern province of Bas-Uele province in northeastern Congo near the border with Central African Republic, WHO’s Congo spokesman Eugene Kabambi said.

Three people have so far died among the 19 suspected and confirmed cases, he added.

It was not immediately clear how the first victim, a deceased male, caught the virus, although past outbreaks have been linked to contact with infected bush meat such as apes.

The outbreak comes just a year after the end of an epidemic in West Africa killed more than 11,300 people mostly in Guinea, Sierra Leone and Liberia.

However, Congo, whose dense forests contain the River Ebola near where the disease was first detected in 1976, has experienced many outbreaks and has mostly succeeded in containing them without large-scale loss of life.

The GAVI global vaccine alliance said on Friday some 300,000 emergency doses of an Ebola vaccine developed by Merck <MRK.N> could be available in case of a large-scale outbreak and that it stood ready to support the Congo government on the matter.

(Reporting by Aaron Ross; Writing by Emma Farge; Editing by Louise Ireland and Gareth Jones)

Asia outbreaks prompt question: Is all Zika dangerous?

A worker sprays insecticide for mosquitos at a village in Bangkok, Thailand,

By Julie Steenhuysen and Amy Sawitta Lefevre

CHICAGO/BANGKOK(Reuters) – Zika’s rampage last year in Brazil caused an explosion of infections and inflicted a crippling neurological defect on thousands of babies – an effect never seen in a mosquito-borne virus.

It also presented a mystery: why had a virus that had been little more than a footnote in the annals of infectious diseases taken such a devastating turn in the Americas? How had Africa and Asia, where Zika had quietly circulated for decades, escaped with no reports of major outbreaks or serious complications?

Scientists initially theorized that Zika’s long tenure in Africa and Asia may have conferred widespread immunity. Or, perhaps older strains were less virulent than the one linked in Brazil to more than 2,100 cases of microcephaly, a birth defect characterized by arrested brain development.

Now, amid outbreaks in Singapore, Thailand, Vietnam and other parts of Southeast Asia, a much graver explanation is taking shape: perhaps the menace has been there all along but neurological complications simply escaped official notice.

The question is driving several research teams, according to leading infectious disease experts and public health officials.

The answer is immediately important for Asia, the region most affected by Zika after the Americas. Thailand has been hardest hit with more than 680 reported Zika infections this year, followed by Singapore with more than 450 and Vietnam with as many as 60.

Much of the population lives in the so-called “dengue belt,” where mosquito-borne diseases are prevalent. And vulnerable countries – including Vietnam, the Philippines, Pakistan and Bangladesh – are ill-prepared to handle an outbreak with any serious consequences, experts said.

Lacking evidence of varying degrees of virulence, public health officials have warned Asia leaders to prepare for the worst. The scientific community is following similar assumptions.

“Zika is Zika until proven otherwise. We assume that all Zikas are equally dangerous,” said Dr. Derek Gatherer, a biomedical expert at Lancaster University in Britain.

WHICH ZIKA?

The World Health Organization recognizes two major lineages of Zika. The first originated in Africa, where it was discovered in 1947 and has not been identified outside that continent. The Asian lineage includes strains that have been reported in Asia, the Western Pacific, Cabo Verde and, notably, the Americas, including Brazil.

The Asian lineage was first isolated in the 1960s in mosquitoes in Malaysia. But some studies suggest the virus has been infecting people there since the 1950s. In the late 1970s, seven cases of human infection in Indonesia were reported.

The first record of a widespread outbreak was in 2007 on Micronesia’s Island of Yap.

Experts began to suspect a link to birth defects during a 2013 outbreak in French Polynesia when doctors reported eight cases of microcephaly and 11 other cases of fetal malformation.

In 2015, it hit Brazil, causing spikes in an array of neurological birth defects now called congenital Zika virus syndrome, as well as Guillain-Barre syndrome, a neurological disorder that can lead to temporary paralysis.

Viruses mutate rapidly, which can lead to strains that are more contagious and more virulent. Many researchers theorized early on that the devastation in Brazil was caused by an Asian strain that had mutated dramatically.

That theory relies, among other things, on the absence of Zika-related microcephaly in Asia. So when Zika broke out in parts of Asia earlier this year, researchers were on the lookout.

If researchers were to connect a case of microcephaly to an older Asian strain – and not one that boomeranged back from Brazil — it would debunk the early theory. It would mean Zika “did not mutate into a microcephaly-causing variant as it crossed the Pacific,” Gatherer said.

At least three microcephaly cases have been identified in Asia, but the verdict is still out.

For two microcephaly cases in Thailand, public health officials could not determine whether the mothers had an older Asian strain of Zika or a newer one that returned from the Americas, said Dr Boris Pavlin, WHO’s acting Zika incident manager at a recent briefing.

In Vietnam, where there have been no reports of imported Zika infection, officials are investigating a third case of microcephaly. If it is linked to Zika, Pavlin said it would suggest the older strains there could cause microcephaly and, perhaps, Guillain-Barre.

In Malaysia, where at least six cases of Zika infection have been reported, authorities have identified both an older Southeast Asian strain and one similar to the strain in the Americas, suggesting the possibility that strains from both regions could be circulating in some countries.

The hunt is on in Africa as well. In Guinea-Bissau, five microcephaly cases are under investigation to determine whether the African lineage of Zika can cause microcephaly.

It is a top research priority at WHO, said Dr Peter Salama, executive director of the agency’s health emergencies program, in a press briefing Tuesday.

“That is a critical question because it has real public health implication for African or Asian countries that already have Zika virus transmission,” Salama said. “We are all following this extremely closely.”

 

HERD IMMUNITY

Scientists also are trying to learn whether people in places where Zika is endemic are protected by “herd immunity.” The phenomenon limits the spread of virus when enough of a population is inoculated against infection through vaccination, prior exposure or both.

Experts believe Zika moved explosively in the Americas because there was no prior exposure. It’s not clear how widely Zika has circulated in Africa and Asia, whether there could be pockets of natural immunity – and, importantly, whether immunity to one strain would confer immunity to another.

One recent review of studies suggests 15 to 40 percent of the population in some African and Asian countries may have been previously infected with Zika, said Alessandro Vespignani, a professor of health sciences at Northeastern University in Boston.

That’s far below the 80 percent population immunity one mosquito borne virus expert estimated in the journal Science would be necessary to block Zika.

Researchers also believe it’s possible that microcephaly went undetected in parts of Asia and Africa where birth defects weren’t well tracked.

That too, is under investigation, said Dr David Heymann, Chair of the WHO Emergency Committee, at a press briefing last week.

“Now,” he said, “countries are beginning to look back into their records to see on their registries what the levels of microcephaly have been.”

(Reporting by Julie Steenhuysen in Chicago and Amy Sawitta Lefevre in Bangkok; Additional reporting by Mai Nguyen and My Pham in Hanoi and Susan Heavey in Washington; Editing by Michele Gershberg and Lisa Girion)

Thailand confirms first Zika-linked microcephaly in Southeast Asia

City worker fumigates area to get rid of mosquitoes carrying Zika

By Aukkarapon Niyomyat

BANGKOK (Reuters) – Thailand reported on Friday the first confirmed cases in Southeast Asia of microcephaly linked to mosquito-borne Zika, as the World Health Organization urged action against the virus across the region.

The confirmation of two case of microcephaly, a birth defect marked by small head size, came a day after U.S. health officials recommended that pregnant women postpone non-essential travel to 11 Southeast Asian countries because of the risk of Zika.

“We have found two cases of small heads linked to Zika, the first cases in Thailand,” Prasert Thongcharoen, an adviser to the Department of Disease Control, told reporters in Bangkok.

He declined to say where in Thailand the cases were found but officials have said they were not in Bangkok.

The World Health Organisation (WHO) said the cases were the first of Zika-linked microcephaly in Southeast Asia and the virus infection represented a serious threat to pregnant women and their unborn children.

“Countries across the region must continue to strengthen measures aimed at preventing, detecting and responding to Zika virus transmission,” Dr Poonam Khetrapal Singh, the WHO’s regional director, said in a statement.

U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly, which can lead to severe developmental problems in babies.

VIRUS SPREADING

The connection between Zika and microcephaly first came to light last year in Brazil, which has confirmed more than 1,800 cases of microcephaly that it considers to be related to Zika infections in the mothers.

Zika has spread extensively in Latin American and the Caribbean over the past year or so, and more recently it has been cropping up in Southeast Asia.

Thailand has confirmed 349 Zika cases since January, including 33 pregnant women, and Singapore has recorded 393 Zika cases, including 16 pregnant women.

Some health experts have accused Thai officials of playing down the risk of Zika to protect its thriving tourist industry, but Prasert dismissed that.

“Thailand is not hiding anything and is ready to disclose everything,” he said, adding that other countries in Southeast Asia might also have cases of Zika-linked microcephaly that they have not disclosed.

The WHO said Thailand’s response was an example for the region.

“Thailand’s diligence underscores the commitment of health authorities to the health and wellbeing of the Thai public, and provides a positive example to be emulated,” Singh said.

The U.S. Centers for Disease Control and Prevention (CDC) said on Thursday people should consider postponing travel to Brunei, Myanmar, Cambodia, Indonesia, Laos, Malaysia, Maldives, Philippines, Thailand, Timor-Leste (East Timor), and Vietnam.

The CDC has already issued a “travel notice” for Singapore, and said such a warning would be considered for the new countries if the number of cases rose to the level of an outbreak.

Thailand’s confirmation of Zika-linked microcephaly comes ahead of China’s week-long “Golden Week” holiday with Thailand expecting 220,000 Chinese visitors, up from 168,000 for the week in 2015, Tourism Authority of Thailand governor Yuthasak Supasorn told Reuters.

NO VACCINE

There is no vaccine or treatment for Zika. An estimated 80 percent of people infected have no symptoms, making it difficult for pregnant women to know whether they have been infected.

There are also no specific tests to determine if a baby will be born with microcephaly, but ultrasound scans in the third trimester of pregnancy can identify the problem, according to the WHO.

Zika is commonly transmitted through mosquitoes but can also be transmitted sexually.

Another Thai health ministry adviser urged everyone to work to stop the spread of mosquitoes but said people should not panic.

“Don’t have sex with a Zika-infected person. If you don’t know if they are infected, then use a condom,” the adviser, Pornthep Siriwanarangsan, told reporters. “We can’t stop women from becoming pregnant … but we mustn’t panic.”

Health authorities in the region said they were stepping up monitoring, but there has been little testing and officials said the real number of cases was bound to be higher than the confirmed figure.

“We do not test everybody, we test only those who are symptomatic,” said Paulyn Jean Rosell-Ubia, health secretary in the Philippines, which has reported 12 Zika cases.

“Yes, we are positive that the number is higher because we are not testing everyone.”

Malaysia, which has reported six cases of Zika, including two in pregnant women, said it would seek information from Thailand on the particular strain of the Zika virus there.

“We are taking serious notice of the reports in Thailand, and we will reach out to the Thai authorities for more information … so that we can be more prepared,” Malaysia’s health minister, Subramaniam Sathasivam, told Reuters.

Authorities in Vietnam, which has reported three cases of Zika, ordered stepped up monitoring of pregnant women.

In Indonesia’s capital, Jakarta, head of disease outbreak and surveillance Dwi Oktavia said there had been no sign of any increase in birth defects there. Indonesia had one Zika case in 2015 but has confirmed none since then.

Microcephaly in babies can lead to respiratory problems related to malformation of the brain, a serious threat to the lives of babies. Children with microcephaly face lifelong difficulties, including intellectual impairment.

Zika was first identified in Uganda in 1947 and first isolated in Asia in the 1960s. It was unknown in the Americas until 2014.

(Additional reporting by Amy Sawitta Lefevre, Juarawee Kittisilpa and Panarat Thepgumpanat, Kanupriya Kapoor in JAKARTA, Roxanna Latiff in KUALA LUMPUR, Karen Lima in MANILA and Pham Thi Huyen My in HANOI; Writing by Robert Birsel; Editing by Alex Richardson)

Health official warns Zika virus could spread across U.S. Gulf

The New York State Department of Health unveiled a Zika Prevention Kit for pregnant women during the rollout of a Zika Information hotline and

By Chris Prentice

(Reuters) – One of the top U.S. public health officials on Sunday warned that the mosquito-borne Zika virus could extend its reach across the U.S. Gulf Coast after officials last week confirmed it as active in the popular tourist destination of Miami Beach.

The possibility of transmission in Gulf States such as Louisiana and Texas will likely fuel concerns that the virus, which has been shown to cause the severe birth defect known as microcephaly, could spread across the continental United States, even though officials have played down such an outcome.

Concern has mounted since confirmation that Zika has expanded into a second region of the tourist hub of Miami-Dade County in Florida. Miami’s Wynwood arts neighborhood last month became the site of the first locally transmitted cases of Zika in the continental United States.

“It would not be surprising we would see additional cases perhaps in other Gulf Coast states,” Dr. Anthony Fauci, director of the allergy and infectious diseases unit of the National Institutes of Health (NIH), said in an interview on Sunday morning with ABC News.

Fauci noted that record flooding this month in Louisiana – which has killed at least 13 people and damaged some 60,000 homes damaged – has boosted the likelihood Zika will spread into that state.

“There’s going to be a lot of problems getting rid of standing water” that could stymie the mosquito control efforts that are the best way to control Zika’s spread, he said.

U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly, a birth defect marked by small head size that can lead to severe developmental problems in babies. The connection between Zika and microcephaly first came to light last fall in Brazil, which has now confirmed 1,835 cases of microcephaly that it considers to be related to Zika infections in the mothers.

On Friday, Florida Governor Rick Scott confirmed that state health officials had identified five cases of Zika believed to be contracted in Miami Beach.

The U.S. Centers for Disease Control and Prevention told pregnant women they should avoid the trendy area and suggested those especially worried about exposure might consider avoiding all of Miami-Dade County.

NIH’s Fauci on Sunday said the conditions of most of the country make it unlikely there would be a “diffuse, broad outbreak,” even though officials need to prepare for that possibility.

He compared it with diseases such as Dengue, which is endemic in certain tropical and subtropical regions of the world but rarely occurs in the continental United States. In Miami’s Wynwood area, experts have seen “substantial” knockdowns of mosquito populations.

Still, its containment is more complicated because Zika can be sexually transmitted, Fauci said.

“This is something that could hang around for a year or two,” he said.

The World Health Organization has said there is strong scientific consensus that Zika can also cause Guillain-Barre, a rare neurological syndrome that causes temporary paralysis in adults.

(Reporting by Chris Prentice in New York; Editing by Alan Crosby)

Doctors turn militant over Venezuela’s health crisis

Patients lie in hospital beds in the hallway of Venezuelan hospital

By Corina Pons

MERIDA, Venezuela Reuters) – A dozen doctors hold a hunger strike in the corridors of an Andean city hospital. In another provincial city, hundreds of protesting medics suspend appointments.

In the capital, staff from a pediatric hospital wave placards at the entrance to a hospital pleading for aid.

Not usually active in politics, many of the OPEC nation’s 40,000 doctors are becoming increasingly militant over drastic shortages of medicines, equipment and personnel amid a punishing economic crisis.

With eight out of 10 medicines now scarce, according to the main pharmacy group, protesting doctors are demanding that President Nicolas Maduro’s socialist government declare a national health crisis and allow foreign humanitarian aid.

“I started to see patients, both in the operating theater and in the emergency ward, dying for lack of medicines,” said David Macineiras, a 30-year-old orthopedic surgeon and one of 12 doctors who went on hunger strike at the main state hospital in the western highland city of Merida.

“They arrive in bad conditions and we can’t even get adrenaline to deal with a cardiac arrest,” he said, describing the case of a woman who died for lack of adrenaline. Macineiras himself was hospitalized for four days after his hunger strike.

The protests involve a small percentage of doctors, in part because medics – especially younger ones – depend on the state to complete their residencies and studies and so have good reason to avoid conflict.

Doctors who hold high-ranking positions in public health acknowledge there are problems, but insist that none are sufficiently severe as to put patient lives at risk.

Christian Pino, a surgeon at the Merida hospital who also joined the strike, insists the opposite is true.

He recently operated on an elderly woman who due to chronic hospital shortages had to bring her own supplies, including saline solution. It ran out before the operation finished.

“In post-op, we didn’t have any serum to hydrate her, so the patient died,” he said at the hospital where stretchers packed corridors and incubators stood abandoned with handwritten signs saying they were out of service.

In June, Pino read a list of doctors’ demands in Venezuela’s National Assembly before the opposition-led legislature declared a state of medical emergency and approved channels for foreign humanitarian aid.

“I prefer to raise my voice with my colleagues than be an accomplice to this,” Pino said.

But the government-leaning Supreme Court shot down the assembly’s proposal. Government officials deny Venezuela is facing a humanitarian crisis and say there is no need for humanitarian assistance.

Maduro is fiercely proud of health advances under the 1999-2013 rule of socialist leader Hugo Chavez, and he says adversaries are exaggerating the problems now.

“There is no humanitarian crisis, I say it with absolute responsibility,” Foreign Minister Delcy Rodriguez recently told an Organization of American States meeting on Venezuela.

DEPRESSING DATA

Up-to-date data is hard to find, but what little is available points to a severe deterioration.

Health ministry statistics show that in 2015 for every 100 people discharged from state hospitals, 31 died – a rate six times higher than the previous year. Infant mortality was 2 percent of births last year, 100 times worse than 2014.

It is a huge challenge for the ruling Socialist Party which, under Chavez, ran enormously popular free health projects such as Cuban-staffed clinics in the slums but is now finding its welfare programs stretched.

According to the World Health Organization (WHO), Venezuela and Guyana were the only countries in South America to see maternal death rates worsen last year.

Health Minister Luisana Melo recently recognized health sector problems but said authorities are working to reduce the rates of infant mortality and death during childbirth.

She said shortages only affect around 15 percent of medicines and that Venezuelans tend to consume more medicine than they need to.

The government says a U.S.-backed “economic war” by political opponents and hostile business groups has caused the crisis, exacerbated by a plunge in the price of oil, which accounts for 95 percent of export revenues.

Huge lines snake around most pharmacies from before dawn, with some people staying all night to stake a place. Rowdy scenes are common, and soldiers guard the crowds.

In Merida, orthopedic surgeon Carlos Hidalgo said he joined the hunger strike after a patient arrived with an open fracture of the tibia and femur and there was no saline solution to clean the wound.

“They went to a kiosk and bought water to wash him with that,” he said. An infection set in and the patient’s leg was amputated.

“That’s why we protested, not because of our working conditions,” said Hidalgo, who makes 16,000 bolivars a month, equivalent to about $25 at the weaker of two official exchange rates and just $16 on the black market.

Some doctors are also worried about their legal liability. Medics in the city of Barquisimeto decided to ask patients’ relatives to sign a permission slip acknowledging the poor conditions they were working under.

At hospitals there, medics have held two strikes this year. Surgeries were halted on a recent day due to lack of gloves.

Idabelias Arias, the head of the emergency ward at a pediatric hospital in Barquisimeto, has had to use basic CPR (Cardiopulmonary resuscitation) to revive children for lack of adrenaline. “Doctors are doing war medicine here.”

(Writing by Andrew Cawthorne; Editing by Kieran Murray)