What You Need to know About Zika Virus, A Tropical Infection New To The Western Hemisphere

1. 1. 
      

      Short Answers to Hard Questions About Zika Virus

      By DONALD G. McNEIL Jr.

   2. 

      Dejailson Arruda holding his daughter at their home in Santa Cruz do Capibaribe, Brazil, last month. Luiza was born with microcephaly, which has been linked to the Zika virus. CreditFelipe Dana/Associated Press
   3. The Centers for Disease Control and Prevention has warned pregnant women against travel to 13 countries in the Caribbean and Latin America where the Zika virus is spreading. Infection with the virus appears to be linked to the development of unusually small heads and brain damage in newborns. Here are some answers and advice about the outbreak.
   4. How do I know if I’ve been infected? Is there a test?
      It’s often a silent infection, and hard to diagnose.
      Until recently, Zika was not considered a major threat because its symptoms are relatively mild. Only one of five people infected with the virus develop symptoms, which can include fever, rash, joint pain and red eyes. Those infected usually do not have to be hospitalized.

      There is no widely available test for Zika infection. Because is closely related to dengue and yellow fever, it may cross-react with antibody tests for those viruses. To detect Zika, a blood or tissue sample from the first week in the infection must be sent to an advanced laboratory so the virus can be detected through sophisticated molecular testing.
   5. What is the Zika virus?

      A tropical infection new to the Western Hemisphere.

      The Zika virus is a mosquito-transmitted infection related to dengue, yellow fever and West Nile virus. Although it was discovered in the Zika forest in Uganda in 1947 and is common in Africa and Asia, it did not begin spreading widely in the Western Hemisphere until last May, when an outbreak occurred in Brazil.

      Until now, almost no one on this side of the world had been infected. Few of us have immune defenses against the virus, so it is spreading rapidly. Millions of people in tropical regions of the Americas may have had it.
   6. How is the virus spread?

      One more reason to hate mosquitoes.

      Zika is spread by mosquitoes of the Aedes species, which can breed in a pool of water as small as a bottle cap and usually bite during the day. The aggressive yellow fever mosquito, Aedes aegypti, has spread most Zika cases, but that mosquito is common in the United States only in Florida, along the Gulf Coast, and in Hawaii – although it has been found as far north as Washington in hot weather.

      The Asian tiger mosquito, Aedes albopictus, is also known to transmit the virus, but it is not clear how efficiently. That mosquito ranges as far north as New York and Chicago in summer.

      Although the virus is normally spread by mosquitoes, there has been one report of possible spread through blood transfusion and one of possible spread through sex.
   7. How does Zika cause brain damage in infants?
      Experts are only beginning to connect the dots.
      Scientists do not fully understand the connection. The possibility that the Zika virus causes microcephaly – unusually small heads and damaged brains – in embryos emerged in October, when doctors in northern Brazil noticed a surge in babies with the condition.

      It is not known exactly how common microcephaly has become in that outbreak. About three million babies are born in Brazil each year. Normally, about 150 cases of microcephaly are reported, and Brazil says it is investigating more than 3,500 reported cases.

      But reporting of suspected cases commonly rises during health crises.
2. Does it matter when in her pregnancy a woman is infected with Zika virus?
   Earlier seems to be worse.
   The most dangerous time is thought to be during the first trimester – when some women do not realize they are pregnant. Experts do not know how the virus enters the placenta and damages the growing brain of the fetus.

   Closely related viruses, including yellow fever, dengue and West Nile, do not normally do so. Viruses from other families, including rubella (German measles) and cytomegalovirus, sometimes do.
3. Is there a vaccine? How should people protect themselves?
   Protection is a huge challenge in infested regions.
   There is no vaccine against the Zika virus. Efforts to make one have just begun, and creating and testing a vaccine normally takes years and costs hundreds of millions of dollars.

   Because it is impossible to completely prevent mosquito bites, the Centers for Disease Control and Prevention has advised pregnant women to avoid going to regions where Zika is being transmitted, and has advised women thinking of becoming pregnant to consult doctors before going.

   Travelers to these countries are advised to avoid or minimize mosquito bites by staying in screened or air-conditioned rooms or sleeping under mosquito nets, wearing insect repellent at all times and wearing long pants, long sleeves, shoes and hats.

Ebola & Travel: What You Need to Know

Anytime you turn on the news lately, you cannot help but hear more about Ebola. There has been a lot of uncertainty and questions about travel and Ebola, so we have gathered as many resources as possible in this post for you to share with your travelers on the topic.

Wednesday, the Centers for Disease Control and Prevention (CDC) and the Department of Homeland Security’s (DHS) Customs & Border Protection (CBP) announced that they will begin new layers of entry screening at the five U.S. airports that receive more than 94 percent of travelers from the Ebola-affected nations of Guinea, Liberia, and Sierra Leone. 

New York’s JFK International Airport will begin the new screening process this Saturday. The enhanced entry screening at Washington-Dulles, Newark, Chicago-O’Hare, and Atlanta international airports will be implemented next week. Click here for a fact sheet from the CDC and DHS detailing the new screening process and

More News on the Advanced Screening:

Five U.S. Airports to Enhance Screening for Ebola – USA TodayU.S. to Begin Ebola Screenings at 5 Airports – The New York TimesWhy One Public Health Expert Thinks Airport Ebola Screening Won't Work – NPR

Information from ISOS
International SOS (ISOS), a medical and travel security services company, has created a video sharing what business travelers need to know about Ebola.
ISOS tracks the latest news on ebola here.
Ebola Facts
Education materials in multiple languages to understand and spread awareness of Ebola

Information from the CDC:
Facts About Ebola in the US - Infographic
Guidance on Air Medical Transport for Patients with Ebola Virus Disease
Signs & Symptoms
Questions and Answers on Ebola

Why Europe Cannot Ignore This:
More Cases of Ebola In Europe Unavoidable: WHO – Huffington PostAccording to the article, the World Health Organization said on Tuesday that Europe would almost certainly see more cases of Ebola after a nurse in Spain became the first person known to have caught the virus outside Africa.

Ebola in Europe: What Went Wrong – The Daily Beast

Other Helpful Articles on Ebola & Travel:F.A.Q on Ebola and Travel – The New York TimesAdvice for Business Travelers – ISOS
What Travelers Need to Know About the Ebola Virus Outbreak – PeterGreenberg.comWhat Role Do Airports Play in All of This – Politico Morning Transportation
Why hasn’t the U.S. closed its airports to travelers from Ebola-ravaged countries? – Washington PostEbola Patient in Dallas Hospital Dies – USA TodaySecond Possible Ebola Case Reported in Texas – Huffington Post

What’s Next?
On Friday, the House Homeland Security Committee will hold a field hearing on how the government is coordinating its response to the Ebola outbreak.

Looking to learn more? Tune in to a webinar, Risk Radar: Managing the Medical and Security Implications of the Ebola Epidemic - How will you protect your travelers? on October 22 at 12 p.m. ET. The webinar is the first installment of a special Risk Radar webinar series brought to you by the GBTA Risk Committee, and it will examine the Ebola outbreak from both a medical and security perspective to help participants develop a comprehensive understanding of its implications to traveler

A Guide For Fliers Worried About The Ebola Outbreak

Contributed by Scott Mayerson, AP.

FILE - In this Aug. 4, 2014 file photo, a South Korean quarantine officer, right, checks the body temperature of a passenger against the possible infection of Ebola virus at Incheon International Airport in Incheon, South Korea. South Korea has been stepping up monitoring of its citizens returning from trips to West Africa and other areas affected by the deadly Ebola virus. (AP Photo/Yonhap, Shin Jun-hee, File) KOREA OUT As the Ebola outbreak in West Africa grows, airlines around the globe are closely monitoring the situation but have yet to make any drastic changes. Below are some key questions about the disease, what airlines are doing and how safe it is to fly.

Q: Why are airlines concerned?

A: Airlines quickly take passengers from one part of the globe to another. One sick passenger on a plane could theoretically infect hundreds of people who are connecting to flights to dozens of other countries. Health and airline officials note, however, that Ebola only spreads through direct contact. Outbreaks of diseases that can spread through the air, such as the flu and severe acute respiratory syndrome, or SARS, are more problematic for airlines.

Q: Should people travel to West Africa?

A: The Centers for Disease Control and Prevention on Thursday issued a warning for Americans to avoid nonessential travel to the West African nations of Guinea, Liberia, and Sierra Leone.

Q: Is Ebola deadly?

A: Very much so. If contracted, there is no vaccine and no specific treatment. Ebola has a fatality rate of at least 60 percent. The World Health Organization estimated Monday that there have been 887 deaths from the current outbreak.

Q: How is Ebola transmitted?

A: The virus only spreads through direct contact with the blood or fluids of an infected person, according to the CDC. It can also be spread through objects, such as needles, that have been contaminated with infected fluids. No airborne transmission has been documented.

Q: Do U.S. airlines fly to West Africa?

A: Delta Air Lines flies to Dakar, Senegal; Accra, Ghana and Lagos, Nigeria. The airline also flies to Monrovia, Liberia, but for unrelated business reasons previously announced it will cancel that service at the end of September. Delta is letting passengers with flights to the region in the next two weeks push back travel until the end of the month. United Airlines also flies to Lagos, but has not issued any travel waiver. American Airlines does not fly to Africa.

Q: What are U.S. airlines saying about it?

A: There have been no flight cancellations. All three airlines said they are in regular communication with government agencies and health officials and will follow their recommendations.

Q: What about airlines from other countries?

A: European carriers such as Air France-KLM, British Airways and Lufthansa all fly to Western Africa from their hubs in Paris, Amsterdam, London and Frankfurt.

Lufthansa notes that "there is no risk of getting infected by the Ebola virus via air circulation during flight." Crews on Brussels Airlines flights have access to special thermoscans to check passengers' temperature, if they feel it's necessary. And British Airways has briefed all crew members flying to the region about the "causes and symptoms of Ebola." The only airline, so far, to cancel any flights is the Middle East airline Emirates. It has suspended its service to Conakry, Guinea, until further notice. It is still flying to Dakar.

Q: Are passengers leaving Africa being screened?

A: Since the outbreak erupted, the CDC has sent about two dozen staffers in West Africa to help try to track cases, set up emergency response operations and provide other help to control the outbreak. Last week, CDC officials said the agency will send 50 more in the next month. CDC workers in Africa also are helping to screen passengers at airports, according to CDC director Dr. Tom Frieden.

Q: Is the U.S. government doing anything extra for arriving passengers?

A: Border patrol agents at Washington's Dulles International Airport and New York's John F. Kennedy International Airport, in particular, are looking out for travelers who might have been exposed to the virus. They're watching for signs of fever, achiness, sore throat, stomach pain, rash or red eyes. The CDC also has staff at 20 U.S. airports and border crossings evaluating travelers with signs of dangerous infectious diseases and isolating them when necessary.

Q: Has the airline industry dealt with any outbreaks in the past?

A: In 2003, there was a global outbreak of severe acute respiratory syndrome, or SARS. The disease was first reported in Asia but quickly spread to more than two dozen countries in North America, South America and Europe. Unlike Ebola, SARS can spread when an infected person coughs or sneezes. During the 2003 outbreak, 8,098 people worldwide became sick with SARS; 774 of those died. Airports started screening incoming passengers for fever. The disease was devastating for airlines because fearful passengers stayed home.

__

With reports from AP Medical Writer Mike Stobbe, New York.

__

Scott Mayerowitz can be reached at http://twitter.com/GlobeTrotScott.