Tag Archives: Zika

House Speaker Ryan: All options open on Zika funding

Aedes aegypti mosquitoes

WASHINGTON (Reuters) – House Speaker Paul Ryan on Wednesday said a range of options to provide funds to fight Zika, adding that lawmakers take the threat seriously but have not yet decided the best way to allocate resources to prevent and combat the deadly virus.

“We’re looking at all different options,” adding that the White House has begun providing congressional staff with answers to questions over President Barack Obama’s funding request. “The administration has a bit of a track record of over-requesting what they need.”

(Reporting by Susan Heavey)

Zika spread, impact ‘scarier than we initially thought’: U.S. health official

Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Disease, speaks about the Zika virus from the White House in Washington

WASHINGTON (Reuters) – The spread and impact of the Zika virus is wider than initially anticipated and the first vaccine candidate for the virus should be available in September, U.S. health officials said on Monday.

Dr. Anne Schuchat, a deputy director of the Centers for Disease Control and Prevention, told reporters the type of mosquito in which the virus is carried is present in more U.S. states than initially thought. She said what authorities are learning about the virus is “scarier than we initially thought.”

Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said at a White House briefing the first Zika vaccine candidate should be available in September.

(Adds dropped word “initially” in quote in headline and second paragraph)

(Reporting by Clarece Polke; Editing by Tim Ahmann)

Zika Spreading in Puerto Rico

A health worker prepares insecticide before fumigating a neighborhood in San Juan

By Julie Steenhuysen

SAN JUAN (Reuters) – The United States faces its first real challenge with the Zika virus on the island territory of Puerto Rico, a part of the nation that is perhaps least prepared to cope with what is expected to be its worst outbreak.

Zika is spreading rapidly in Puerto Rico and is expected to peak in late summer and early fall. By year’s end, public health officials estimate, hundreds of thousands of people will have been infected.

It is the only part of the country that is experiencing a major local outbreak, but the virus is expected to reach southern U.S. states within weeks with warmer temperatures and rising mosquito populations.

Health officials from across the United States are gathering today at the headquarters of the Centers for Disease Control and Prevention in Atlanta to outline a national strategy for combating Zika. In a measure of the concern surrounding the outbreak in Puerto Rico, CDC director Tom Frieden toured the island, meeting with top health officials and local experts last month to assess the situation first-hand.

Puerto Rico is beset with problems already hampering the response: abundant mosquitoes, high levels of insecticide resistance and economic woes that have left vector control in shambles.

“We don’t have good surveillance” here, Frieden said in an interview at the Puerto Rican health department in San Juan during his tour. “We don’t have good control measures.”

First detected in Brazil last year, the Zika outbreak is spreading through the Americas. The World Health Organization declared a global health emergency last month because of growing evidence that Zika can cause microcephaly, a rare birth defect defined by an unusually small head. In adults, the virus has been linked to the typically rare autoimmune disorder, Guillain-Barre syndrome.

EARLY LESSONS

Fighting Zika in Puerto Rico is complicated by the toll of a decade-long recession. Nearly half of its 3.5 million residents live in poverty, and mosquitoes are an accepted nuisance. Puerto Rico has seen repeated outbreaks of dengue and more recently, chikungunya. Both viruses are carried by Aedes aegypti, the same species of mosquito that carries Zika.

“Here in Puerto Rico, we’re really starting from square one,” said Audrey Lenhart, a CDC vector control expert in an interview at the CDC’s Emergency Operations Center in San Juan.

In its latest report, the Puerto Rican health department said there are now 350 confirmed cases of Zika infection, including 40 pregnant women.

“We have a very serious combination of problems,” said Dr. Alberto de la Vega, an obstetrician specializing in high-risk pregnancies at San Juan’s University Hospital at the Puerto Rico Medical Center.

“If you don’t have access to money to buy repellent, to sleep with an air conditioner on so mosquitoes won’t bite you, to have mosquito nets around you and you live in areas where there’s more stagnant water, obviously you have higher risks,” he said.

To mitigate the risk of microcephaly among newborns, the CDC and the Puerto Rican government are distributing Zika protection kits to pregnant women that include condoms to prevent sexual transmission from an infected partner, insect repellent, bed nets and larvicide tablets for standing water that cannot be drained.

De la Vega says many locals are resigned to the idea that everyone in Puerto Rico will be infected. He said he won’t accept that people are “surrendering like that.”

NO VECTOR CONTROL

Government mosquito abatement resources are scarce, with fewer than a dozen trucks equipped with insecticide sprayers. Of the municipalities that do have trucks, most are used to kill nuisance mosquitoes that bite but do not carry disease, said Manuel Lluberas, a Puerto Rico-born entomologist who works at H.D. Hudson Manufacturing, a maker of spraying equipment.

Lluberas, who advises the WHO and the World Bank on vector control programs, said there are a few municipalities that spray insecticide once every seven to 10 days or once every few weeks. Spraying “needs to be done a lot more frequently” to be effective, he said.

Scientists at CDC’s Dengue Laboratory in San Juan have been testing insecticides on mosquitoes gathered from 17 sites on the island. Frieden said in one of the experiments, mosquitoes placed in bottles coated with a commonly effective insecticide “were happily flying around.”

Eliminating Zika will require spraying insecticide indoors on walls, under beds, behind furniture and inside closets, where Aedes aegypti hide. So far, only two insecticides – deltamethrin and bifenthrin – are approved for indoor residual spraying, and researchers have found high levels of resistance to bifenthrin in Puerto Rico.

Mosquito experts have found similar resistance in parts of Texas and California.

“You find resistance in mosquitoes in one locale, and 20 miles away they are not resistant,” said Joseph Conlon, technical advisor for the American Mosquito Control Association, which represents researchers, public health officials and pesticide makers.

Dr. Janet McAllister, a CDC entomologist, said indoor spraying campaigns will be carried out by local contractors, who will target only areas where the mosquitoes hide instead of coating entire walls, as is typically done to control mosquitoes that carry malaria. “People would not really be coming into direct contact with those surfaces,” McAllister said.

She said the CDC does not plan to use experimental methods, including genetically modified mosquitoes, such as those from Intrexon’s Oxitec now being tested in Brazil, or those infected with Wolbochia bacteria that prevent Zika transmission.

Given the urgency of the outbreak, health officials need to focus on known methods of curbing mosquitoes “rather than doing research on things that may or may not work,” she said.

(Reporting by Julie Steenhuysen; Editing by Michele Gershberg and Lisa Girion)

Mosquitoes’ rapid spread poses threat beyond Zika

LONDON (Reuters) – As the world focuses on Zika’s rapid advance in the Americas, experts warn the virus that originated in Africa is just one of a growing number of continent-jumping diseases carried by mosquitoes threatening swathes of humanity.

The battle against the insects on the streets of Brazil is the latest in an ancient war between humankind and the Culicidae, or mosquito, family which the pests frequently win.

Today, mosquito invaders are turning up with increasing regularity from Washington DC to Strasbourg, challenging the notion that the diseases they carry will remain confined to the tropics, scientists documenting the cases told Reuters.

Ironically, humans have rolled out the red carpet for the invaders by transporting them around the world and providing a trash-strewn urban landscape that suits them to perfection.

The Aedes aegypti species blamed for transmitting Zika breeds in car tyres, tin cans, dog bowls and cemetery flower vases. And its females are great at spreading disease as they take multiple bites to satisfy their hunger for the protein in human blood they need to develop their eggs.

Around the world, disease-carrying mosquitoes are advancing at speed, taking viruses such as dengue and Zika, plus a host of lesser-known ills such as chikungunya and St. Louis encephalitis, into new territories from Europe to the Pacific.

“The concern is that we have these species spreading everywhere. Today the focus is on Zika but they can carry many different viruses and pathogens,” said Anna-Bella Failloux, head of the department that tracks mosquito viruses at France’s Institut Pasteur.

In 2014, there was a large outbreak of chikungunya, which causes fever and joint pains, in the Caribbean, where it had not been seen before, while the same virus sickened Italians in 2007 in a wake-up call for public health officials.

Europe has seen the re-emergence of malaria in Greece for the first time in decades and the appearance of West Nile fever in eastern parts of the continent.

Out in the Atlantic, the Madeira archipelago reported more than 2,000 cases of dengue in 2012, in a sign of the northerly advance of what – at least until Zika – has been the world’s fastest-spreading tropical disease.

In the past 40 years, six new invasive mosquito species have become established in Europe, with five arriving since 1990, driven in large part by the international trade in used vehicle tyres. Mosquitoes lay their eggs in the tyres and they hatch when rain moistens them at their destination.

North American health experts are also racing to keep up, with the first appearance of Aedes japonicus, an invasive mosquito, in western Canada last November and Aedes aegypti found in Washington DC, apparently after spending the winter in sewers or Metro subway stations.

SPREAD UNPRECEDENTED

The speed of change in mosquito-borne diseases since the late 1990s has been unprecedented, according to Jolyon Medlock, a medical entomologist at Public Health England, a government agency.

For many experts, the biggest potential threat is Aedes albopictus, otherwise known as the Asian tiger mosquito, which is expanding its range widely and is capable of spreading more than 25 viruses, including Zika.

“There is strong evidence that Aedes albopictus is now out-competing aegypti in some areas and becoming more dominant,” said Ralph Harbach, an entomologist at London’s Natural History Museum, who has been studying mosquitoes since 1976.

In the United States, Aedes albopictus has been found as far north as Massachusetts and as far west as California. In Europe it has reached Paris and Strasbourg.

Adding to the challenge for public health authorities are the blurred lines between diseases carried by different mosquitoes, as shown by research in Brazil this month that another common mosquito, Culex quinquefasciatus, may also be able to carry Zika.

Both Aedes aegypti and Culex quinquefasciatus probably first arrived in the Americas from Africa on slave ships, scientists believe. In the centuries since, commerce has shuttled other species around the world, while air travel has exposed millions of people to new diseases.

“You’ve got a global movement of mosquitoes and a huge increase in human travel. Humans are moving the pathogens around and the mosquitoes are waiting there to transmit them,” said Medlock.

Human incursions into tropical forests have aggravated the problem. Deforestation in Malaysia, for example, is blamed for a steep rise in human cases of a type of malaria usually found in monkeys.

DON’T KILL THE GOOD GUYS

There have been some victories against mosquitoes, thanks to insecticide-treated bed nets and vaccines against viruses like yellow fever and Japanese encephalitis, as well as a new one for dengue approved in December.

But mosquitoes still kill around 725,000 people a year, mostly due to malaria, or 50 percent more than are killed by other humans, according to the Bill & Melinda Gates Foundation.

Climate change adds a further twist. A 2 to 3 degree Celsius rise in temperature can increase the number of people at risk of malaria by 3 to 5 percent, or more than 100 million, according to the World Health Organization.

Hotter weather also speeds up the mosquito breeding cycle from around two weeks at 25 degrees to 7 to 8 days at 28 degrees, according to the Institut Pasteur’s Failloux.

So is it time to wipe out mosquitoes altogether?

Aggressive action in the 1950s and 1960s, including the use of the pesticide DDT, certainly pushed them back for a while.

Today, genetic modification, radiation and targeted bacteria are being considered.

Trying to eliminate all mosquitoes, however, would make no sense, since there are 3,549 species and fewer than 200 bite humans.

“It might be possible to wipe out a few species but we don’t want to wipe out the good guys because a lot of them serve as food for frogs, fish and bats,” said Harbach. “Many also visit flowers to feed on nectar and may play a role in pollination.”

Some are even our friends. Harbach has a soft spot for the Toxorhynchites genus, which have a convenient penchant for eating Aedes aegypti larvae.

(Editing by Giles Elgood)

CDC director calls Zika in Puerto Rico a ‘challenge and crisis’

SAN JUAN, PUERTO RICO (Reuters) – During a tour of Zika preparations in Puerto Rico, Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, called Zika a “tremendous challenge and crisis” and said protecting pregnant women from the virus is a top priority.

In Brazil, Zika has been linked to a spike in cases of microcephaly, a birth defect marked by small head size and underdeveloped brains.

“Until a few months ago, no one had any idea that Zika could cause birth defects,” Frieden told reporters Tuesday at a briefing in Puerto Rico’s health department.

Frieden has been working with CDC staff and the Puerto Rican government on strategies to protect pregnant from becoming infected with the mosquito-borne virus, which Frieden called a top priority.

In Puerto Rico, the Aedes aegypti mosquito that carries Zika is widespread, and Frieden said controlling it will require a multi-pronged approach involving government, municipalities, neighbors, families and society at large.

Cases of Zika are doubling weekly in Puerto Rico, and the CDC expects hundreds of thousands of individuals will become infected, including thousands of pregnant women.

To protect pregnant women, Frieden recommended using insect repellent daily and reliably.

He also suggested adding window screens and air conditioning, where possible. And he called for reducing standing water in and around homes to eliminate mosquito breeding habitats.

Frieden’s comments, delivered mostly in Spanish, followed two days of briefings with staff at the CDC’s Emergency Operations Center in San Juan. CDC researchers are monitoring the outbreak and studying the best ways to prevent Zika infections through education campaigns, and the distribution of Zika prevention kits for pregnant women.

Much remains unknown about Zika, including whether the virus actually causes microcephaly in babies. Brazil said it has confirmed more than 640 cases of microcephaly, and considers most of them to be related to Zika infections in the mothers. Brazil is investigating more than 4,200 additional suspected cases of microcephaly.

At the CDC’s Dengue Branch in Puerto Rico, scientists are conducting research on the most effective mosquito control measures, and processing diagnostic tests from blood samples delivered daily to the laboratory.

Dr. Jorge Munoz, branch director, said in an interview they are capable of processing 400 to 500 blood samples a week. Scientists at the laboratory developed a triple test that can detect Zika, dengue and chikungunya – three different viruses carried by the Aedes aegypti mosquito that is endemic in Puerto Rico.

The test will be crucial in helping to quickly sort out whether Zika was the cause of an infection or whether it was dengue and chikungunya, which also cause infection and illness.

“Puerto Rico is in a very different situation from the rest of the United States,” Frieden told the briefing.

Besides the high density of Aedes aegypti mosquitoes, Puerto Rico has a lot of housing without window screens or air conditioning.

“The combination of those two things, when you add Zika in, means the likelihood of a very large number of cases,” Frieden said.

“In rest of the United States, we may see clusters,” he said. But if Zika behaves the way chikungunya and dengue have, “we will not see widespread transmission.”

(Reporting by Julie Steenhuysen; Editing by Bernard Orr)

Zika response in focus with new evidence of birth defect link

GENEVA/WASHINGTON (Reuters) – Evidence mounted on Friday linking Zika to the birth defect microcephaly, and the U.N. health agency set a review of travel advice related to the outbreak of the virus while U.S. officials planned strategy to control the mosquitoes that spread it.

The virus is capable of rapidly infecting and harming developing fetal brain cells, scientists said in a study that provided insight into how the virus might cause microcephaly in fetuses.

The researchers said the study, published on Friday in the journal Cell Stem Cell, does not prove a direct causal link between Zika and microcephaly in newborns, a condition defined by unusually small heads that can result in developmental problems. But they said it does identify where the virus may be inflicting the most damage in developing fetuses.

Zika has been linked to numerous cases of microcephaly in Brazil, where the current outbreak began. The virus is spreading rapidly in Latin America and in Caribbean nations, prompting the World Health Organization last month to declare a global public health emergency.

The WHO on Friday said there is accumulating evidence of a link between the virus and microcephaly as well as a rare disorder called Guillain-Barre syndrome in which the immune system attacks part of the nervous system.

The WHO’s Emergency Committee will meet Tuesday to review “evolving information” and its recommendations on travel, trade and mosquito control in what is thought to be high season for transmission of the virus in the southern hemisphere.

The WHO last month advised pregnant women to consider delaying travel to areas where Zika is spreading.

Travel to Brazil has been a particular concern because the Summer Olympics will be held in Rio de Janeiro in August.

Dr. Bruce Aylward, WHO’s executive director for outbreaks and health emergencies, said recently published studies in the Lancet medical journal on microcephaly and by the U.S. Centers for Disease Control and Prevention (CDC) on Guillain-Barre had strengthened the case that Zika is responsible.

The White House and the CDC will bring together U.S. state and local officials on April 1 for a summit at the CDC’s Atlanta headquarters to urgently craft a plan to attack the hard-to-control mosquito that spreads the virus.

The White House is inviting officials involved in mosquito control and public health to discuss how best to track and control the spread of the virus and respond when people are infected.

U.S. federal health officials expect the first locally transmitted cases of the Zika virus in the continental United States by June or July.

“We can’t say for sure that we’re not going to have a major outbreak in the United States. I do not think we will, but we will be prepared for it anyway,” Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said at an event presented by the Harvard T.H. Chan School of Public Health in collaboration with Reuters.

MICROCEPHALY OUTSIDE BRAZIL

There were fresh signs on Friday of Zika-linked microcephaly cases outside Brazil. The first microcephaly case linked to Zika was reported in Colombia.

In addition, doctors in Venezuela reported their first suspected Zika-linked microcephaly case in a fetus that died whose mother likely was infected with the virus.

Much remains unknown about Zika, including whether the virus actually causes microcephaly. Brazil said it has confirmed more than 640 microcephaly cases and considers most to be related to Zika infections in the mothers. Brazil is investigating more than 4,200 additional suspected microcephaly cases.

The study in Cell Stem Cell showed that Zika infects a kind of neural stem cell that gives rise to the cerebral cortex, the brain’s outer layer responsible for intellectual capabilities and higher mental functions.

These cells, exposed to the virus in laboratory dishes, became infected within three days, turned into “virus factories” for viral replication and died more quickly than normal, the researchers said.

Florida State University researcher Hengli Tang, the study’s lead author, told Reuters the study suggests the virus would be capable of doing the damage seen in microcephaly.

French scientists, in a retrospective study of a 2013-2014 Zika outbreak in French Polynesia, said last week they had proved a link between Zika and Guillain-Barre, suggesting countries hit by the Zika outbreak will see a rise in the neurological condition.

“The important thing is the data is moving in one direction. And that’s the reason we’ve asked the Emergency Committee again next week to convene and look at these data,” the WHO’s Aylward said, referring to a group of independent experts chaired by David Heymann.

(Reporting by Stephanie Nebehay in Geneva and Roberta Rampton in Washington; Additional reporting by Andrew M. Seaman and Bill Berkrot in New York, Alexandra Ulmer and Corina Pons in Caracas and Julia Symmes Cobb in Bogota; Writing by Will Dunham; Editing by Michele Gershberg and Leslie Adler)

U.S. officials investigating 14 new cases of Zika possibly being spread through sex

Health officials are investigating more than a dozen new reports of the Zika virus possibly being transmitted sexually, suggesting the method may be more probable than originally believed.

The virus is most commonly spread when an infected mosquito bites a person, but the Centers for Disease Control and Prevention (CDC) announced Tuesday that United States public health departments had received 14 new reports about the virus potentially being spread through sex.

Several of those cases involved pregnant women, the CDC said.

Earlier this month, the World Health Organization (WHO) declared a Public Health Emergency of International Concern in response to the Zika virus. Scientists are still investigating whether the virus can lead to microcephaly, a rare condition in which children are born with unusually small heads, or Guillain-Barre Syndrome, a nervous system illness that can cause paralysis.

The WHO says the evidence about a potential link between Zika and the disorders “remains circumstantial,” though a growing amount of data that suggests the virus plays a “causal role.”

There is currently no vaccine against Zika, though the WHO says some are being developed.

The CDC maintains the best way to prevent Zika infections is to prevent mosquito bites, and has issued travel notices for several countries where the virus is currently being transmitted.

However, the new reports about possible sexual transmission prompted the organization to reiterate its advisories for people who have traveled to those countries. The CDC says pregnant women and their partners should use condoms throughout their pregnancy, or abstain entirely.

The CDC said it has confirmed two cases of Zika in women whose only possible exposure to the virus was “sexual contact” with infected men who had recently traveled to countries where mosquitos are known to be transmitting Zika. Another four potential cases are currently awaiting confirmation from lab tests, and the other cases are currently being investigated.

“These new reports suggest sexual transmission may be a more likely means of transmission for Zika virus than previously considered,” the CDC said in a news release.

In all 14 cases, the CDC said the travelers were male and began displaying symptoms about two weeks before their “non-traveling female partner” reported an illness. The CDC says Zika stays in semen longer than blood, though scientists do not know exactly how long the virus lingers.

The CDC says it’s not yet known if women can transmit Zika to their partners through sex.

To date, the CDC has not reported any instances of people acquiring Zika from mosquitos in the United States. However, there have been 82 cases of people getting sick after returning home.

The organization says only about 1 in 5 people infected with Zika display symptoms, and they usually experience a mild illness that lasts about a week.

Fijian islands still cut off after cyclone, fear of Zika and Dengue outbreaks

SYDNEY (Reuters) – Fiji sent boats on Tuesday carrying desperately needed aid to remote islands and coastal villages devastated by a powerful cyclone which killed at least 29 people, as aid workers warned of possible outbreaks of Zika and Dengue viruses.

There are fears the death toll could rise in the nation of 900,000 people when communication resumes with the smaller islands hit by Cyclone Winston on Saturday.

Aerial footage of outlying islands taken by the Royal New Zealand Air Force, and posted on the Fiji government’s official website, showed whole villages flattened and flooded after Winston’s destructive winds, up to 200 mph, tore through the archipelago of 300 islands. Thousands of Fijians live in tin or wooden shacks in low-lying coastal areas.

Authorities have warned of “catastrophic” damage to Koro Island, Fiji’s seventh-largest island, and more than 8,000 people continue to shelter in evacuation centers across the country.

Prime Minister Frank Bainimarama reassured Fijians that the government was doing all it could amid growing criticism of the slow emergency response in some parts of the country.

“We realize the desperate position that you are in,” Bainimarama said in a statement after visiting an evacuation center. “We will not rest until we have reached you and given you the helping hand you so badly need and deserve.”

“Unfortunately the recovery process will take time, perhaps a long time,” he added. “Almost no part of our nation has been left unscarred.”

Aid workers warned of potential outbreaks of the Zika and Dengue viruses, both carried by mosquitoes which will breed in the stagnant water left by the storm.

“The threat of dengue and Zika in the coming days in Fiji is real,” said Chris Hagarty, senior health program manager at Plan International Australia.

“The period immediately following a disaster of this scale can be a particularly dangerous one.”

The World Health Organization declared a Zika outbreak in South America an international health emergency on Feb. 1, citing a “strongly suspected” relationship between Zika infection in pregnancy and microcephaly, a condition marked by unusually small heads that can result in developmental problems.

Much remains unknown about Zika, including whether the virus actually causes microcephaly. Brazil has confirmed more than 500 cases of microcephaly, and considers most of them related to Zika infections in mothers. Brazil is investigating more than 3,900 additional suspected cases of microcephaly.

Fiji’s international airport at Nadi has reopened and an aeromedical evacuation team was being sent to outer islands on Tuesday to provide urgent support and supplies, including water and hygiene kits, medicines and access to shelter.

(Editing by Michael Perry)

Cuba deploys army in effort to avoid Zika virus

HAVANA (Reuters) – Cuban President Raul Castro called on the entire Cuban population to help eradicate the mosquitoes that carry the Zika virus on Monday and ordered 9,000 army troops to help stave off the disease.

Cuba has yet to detect a case of Zika but the outbreak is affecting large parts of Latin America and the Caribbean and is likely to spread to all countries in the Americas except for Canada and Chile, the World Health Organization (WHO) has said.

“It’s necessary for every single Cuban to take up this battle as a personal matter,” Castro wrote in a national message sounding the alarm over Zika, which is carried by mosquitoes that transmit the virus to humans and which is suspected of causing birth defects after infecting pregnant women.

Cubans should clean up potential environments for the Aedes genus of mosquitoes, said Castro, who also is general of the armed forces.

“The Revolutionary Armed Forces will assign more than 9,000 troops, among them active duty officers and reserve officers … to the anti-vector and cleanup efforts, with the additional support of 200 officers of the National Revolutionary Police,” Castro said.

The ruling Communist Party and the government have adopted an action plan under the direction of the Health Ministry to deal with the Zika that will also help combat the mosquito-borne diseases dengue and chikungunya, Castro said.

One Health Ministry employee, who asked not to be identified as she was not authorized to talk with journalists, said the country’s vast network of neighborhood doctors and clinics were watching for Zika symptoms and suspected cases would be quarantined in hospital wards prepared for an eventual outbreak.

“There are no confirmed cases yet but there will be. To date there have been two suspected cases that turned out negative,” said the employee, who has real-time access to epidemiological data.

The government, which has fumigated neighborhoods and homes for decades to contain dengue, put doctors on alert for the virus weeks ago and ramped up mosquito eradication efforts.

Military officers could be seen over the weekend, clip boards instead of rifles in hand, directing fumigation in Havana.

The WHO declared the outbreak an international health emergency on Feb. 1, citing a “strongly suspected” relationship between Zika infection in pregnancy and microcephaly, a condition marked by abnormally small head size.

However, much remains unknown about Zika, including whether the virus actually causes microcephaly.

(Reporting by Marc Frank and Daniel Trotta; Editing by Bill Trott)

Zika-hit Puerto Rico prepares to import all of its blood supplies

WASHINGTON (Reuters) – New guidelines barring the collection of blood in areas with outbreaks of the mosquito-borne Zika virus will be put to the test first in cash-strapped Puerto Rico, where health officials have two weeks to start importing the island’s supply.

The U.S. Food and Drug Administration said earlier this week that areas with active domestic transmission of Zika virus should stop collecting blood locally.

Puerto Rico has reported a small number of cases of local transmission, and U.S. health officials expect many thousands of residents to be infected once the mosquito season reaches its peak this summer.

Local health officials fear switching to imports could undermine the island’s voluntary donation network, which provides the bulk of its needs. The new guidelines will require Puerto Rico to obtain its entire supply from the continental United States at a cost of up to $100,000 a week, said Jose O. Alsina, vice president and chief operating officer of Puerto Rico’s Banco de Sangre de Servicios Mutuos, the island’s largest blood bank.

The U.S. territory is struggling with about $70 billion in debt and a 45 percent poverty rate. The island has already defaulted on some debt payments and its Governor Alejandro Garcia Padilla has warned that the government is close to running out of money.

Alsina said its eight blood banks can’t afford to buy blood and make payroll, which includes about 400 drivers, phlebotomists, nurses and others. Blood bank officials are asking the government to help pay for the imports so they can maintain their infrastructure until local collection can resume. They also have asked for extra time to collect blood locally before having to import it all.

“Laying off people, even for a short time, would be devastating,” Alsina said.

The FDA said that it recognized the new rules would create hardships but stressed they were necessary to ensure safety. The Zika virus has been found in blood, and experts are concerned about the possibility that it could be transmitted through transfusion.

The FDA “is actively engaged in conversations with local health authorities and blood collection establishments in Puerto Rico in order to minimize the impact to the greatest extent possible,” said agency spokeswoman Tara Goodin.

The Zika outbreak began in Brazil last year and has spread rapidly through the Americas. The World Health Organization declared it a global health emergency earlier this month because the virus is suspected of causing microcephaly, a birth defect marked by unusually small heads that can cause developmental disabilities.

President Barack Obama has asked Congress to approve $1.8 billion in supplemental emergency funding to help combat the virus, with $250 million designated for Puerto Rico.

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, has told lawmakers some of the funds should finance the development of a blood screening test that he hoped could be available in six to 12 months.

TEMPORARY TEST

In the meantime, researchers at the Blood Systems Research Institute (BSRI), a unit of the blood and transfusion services company Blood Systems Inc, are evaluating the possibility of refining an existing Zika test to temporarily screen blood from Puerto Rico.

The test was developed nearly a decade ago by the CDC and has been used mainly for research purposes. Dr. Michael Busch, director of the BSRI said he believes his institute could refine the test and screen the Puerto Rican blood supply until a commercial test becomes available later this year.

Busch said the institute is in discussions with the FDA and believes it could scale up capacity to test Puerto Rican blood donations and submit an application for approval by the end of March. The CDC test could screen the average amount of blood Puerto Rico uses per week but not much more, Busch said.

The U.S. Virgin Islands and American Samoa also have been identified by CDC as areas with active Zika transmission, but both already import their blood supply from the continental United States and Hawaii, respectively, the FDA said.

U.S. health officials expect to see localized outbreaks in the southeastern United States later this year.

The further the virus spreads, the greater the area that will need to be supplied by Zika-free regions of the country, potentially squeezing overall blood supply.

OneBlood, which collects most of the blood used in Florida, said it will implement a screening test as soon as one is authorized by the FDA. The organization is in “close contact” with the FDA, CDC and Florida Department of health “should additional measures be needed,” said spokesman Pat Michaels.

(Reporting by Toni Clarke; Editing by Michele Gershberg and Lisa Girion)