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In Memoriam

It is with great sorrow that we announce the passing of Donald Ainslee Henderson, MD, MPH, our distinguished colleague and friend at the UPMC Center for Health Security. Dr. Henderson died on August 19 in Baltimore, Maryland. We invite DA's friends and colleagues to share their memories of DA in the comment section of the Bifurcated Needle blog. Read now
 
Today's Headlines: August 26, 2016
 
Zika Virus
 
CDC: US Zika Virus Cases at a Glance (H5N1) CDC has updated its "At a Glance" overview of Zika Virus. Go to article

Study Hints at Greater Zika Sexual Transmission Threat to Fetuses (CIDRAP) In findings today that raise more concerns about Zika sexual transmission, experiments on pregnant mice showed that the virus replicates in vaginal tissue for several days after infection and can spread to fetal brains and that replication in the genital tract might be more robust than in other sites in the body. Go to article

FDA Recommends Universal Testing of All Donated Blood in US for Zika (Avian Flu Diary) As the Zika virus has encroached further into the Northern Americas, we've seen a series of increasingly tougher measures designed by the FDA to protect the blood supply, starting with FDA: Recommendations To Reduce Risk Of Zika Infection From Human Cell & Tissue Transplants issued on March 1st. Go to article

Planned Parenthood Joins Campaign to Rid Miami Neighborhoods of Zika (NPR: Shots) In Little Haiti, Liberty City, and a number of other neighborhoods in Miami, canvassers are now walking door to door to spread the word about the risks of Zika, one household at a time--hoping to reach 25, 000 people the next six weeks. In some neighborhoods, these workers aren't sponsored by federal or state health agencies, but by Planned Parenthood. Go to article

Zika Fetal Neuropathogenesis: Etiology of a Viral Syndrome (PLOS: Neglected Tropical Diseases) The ongoing Zika virus epidemic in the Americas and the observed association with both fetal abnormalities (primary microcephaly) and adult autoimmune pathology (Guillain-Barre syndrome) has brought attention to this neglected pathogen. While initial case studies generated significant interest in the Zika virus outbreak, larger prospective epidemiology and basic virology studies examining the mechanisms of Zika viral infection and associated pathophysiology are only now starting to be published. Go to article

Congenital Zika Virus Syndrome in Brazil: a Case Series of the First 1501 Livebirths with Complete Investigation (The Lancet) n November, 2015, an epidemic of microcephaly was reported in Brazil, which was later attributed to congenital Zika virus infection. 7830 suspected cases had been reported to the Brazilian Ministry of Health by June 4, 2016, but little is known about their characteristics. We aimed to describe these newborn babies in terms of clinical findings, anthropometry, and survival. Go to article

Zika's Accidental Ally: Miami's Luxury High-rises (National Geographic) As Zika virus settles into Florida--there are now 43 cases in the state that aren't linked to travel, and two hot spots of transmission in Miami--health authorities fighting the disease are running up against unexpected difficulties. Go to article

Zika Virus's Spread Pushes Testing Labs to Expand Capacity (Wall Street Journal: Subscription Required) As summer drew near, the nation's health officials took stock of whether they could handle a surge in demand for Zika diagnostic tests if disease-carrying mosquitoes began to proliferate. Go to article

Coinfections of Zika and Chikungunya Viruses in Bahia, Brazil, Identified by Metagenomic Next-Generation Sequencing (Journal of Clinical Microbiology) Metagenomic next-generation sequencing of samples from 15 patients with documented Zika virus infection in Bahia, Brazil, from April 2015 to January 2016 identified coinfections with chikungunya virus in 2 of 15 ZIKV-positive cases by PCR (13.3%). Go to article

Prospective Zika Virus Disease Cohort: Systematic Screening (The Lancet) In December, 2015, the first imported case of Zika virus infection was diagnosed in French Guiana in a group of 136 travellers returning from Suriname. No autochthonous cases had been detected in French Guiana at that time. To prevent secondary cases, we systematically screened co-travellers 1, 10, and 30 days after their return (clinical examination, urine samples, and blood samples). Go to article

Early Growth and Neurologic Outcomes of Infants with Probable Congenital Zika Virus Syndrome (Emerging Infectious Diseases) We report the early growth and neurologic findings of 48 infants in Brazil diagnosed with probable congenital Zika virus syndrome and followed to age 1-8 months. Most of these infants had microcephaly (86.7%) and craniofacial disproportion (95.8%). The clinical pattern included poor head growth with increasingly negative z-scores, pyramidal/extrapyramidal symptoms, and epilepsy. Go to article

Guillain-Barre Syndrome During Ongoing Zika Virus Transmission--Puerto Rico, January 1-July 31, 2016 (MMWR) Guillain-Barre syndrome is an uncommon autoimmune disorder characterized by varying degrees of weakness, sensory abnormalities, and autonomic dysfunction due to peripheral nerve or nerve root damage. Countries affected by Zika virus have reported increased numbers of cases of GBS. After identification of local transmission of Zika virus in Puerto Rico in December 2015, the Puerto Rico Department of Health implemented the GBS Passive Surveillance System in February 2016. Go to article

Likely Sexual Transmission of Zika Virus from a Man with No Symptoms of Infection--Maryland, 2016 (MMWR) In June 2016, the Maryland Department of Health and Mental Hygiene was notified of a nonpregnant woman who sought treatment for a subjective fever and an itchy rash, which was described as maculopapular by her provider. Laboratory testing at the Maryland DHMH Laboratories Administration confirmed Zika virus infection. Go to article


Biological Agents & Infectious Diseases

Zika Is Just the First Front in the 21st-Century Biowar (Foreign Policy) here are many national security challenges facing the US, but too often our focus is exclusively on threats from terrorism, geopolitics and cyberattacks. As the country confronts the arrival of the Zika virus and contemplates travel bans to Miami, it's time to have an adult conversation about the threats posed by biology. Go to article


Global Health Security

The Rise and Fall of Middle Eastern Health Systems (Project Syndicate) Much of the progress in the Arab countries of the Middle East and North Africa in recent decades appears to have been reversed by the political unrest and civil wars afflicting the region. This reversal is especially visible in the health systems of Egypt, Jordan, Libya, Syria, Tunisia, and Yemen, which previously had been steadily improving. Go to article

Gaps Remain in Russia's Response to HIV/AIDS (The Lancet) Russia has drafted its first national HIV/AIDS policy in a decade, but it falls far short of what is needed to curb the country's growing epidemic, say experts. Fiona Clark reports from Moscow Russia reached its 1 millionth case of HIV in January, 2016. Go to article


Medicine & Public Health

Prevention and Control of Seasonal Influenza with Vaccines--Recommendations of the Advisory Committee on Immunization Practices--United States, 2016-17 Influenza Season (MMWR) This report updates the 2015-16 recommendations of the Advisory Committee on Immunization Practices regarding the use of seasonal influenza vaccines (Grohskopf LA, Sokolow LZ, Olsen SJ, Bresee JS, Broder KR, Karron RA. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices, US, 2015-16 influenza season. Go to article


Science & Technology

Using Simulation to Aid Trial Design: Ring-vaccination Trials (bioRxiv) Background The 2014-5 West African Ebola epidemic highlights the need for rigorous, rapid clinical trials under difficult circumstances. Challenges include temporally and spatially patchy transmission, and the responsibility to deliver public health interventions during a randomized trial. An innovative design such as ring vaccination with an immediate arm and a delayed arm can address these issues, but complex trials raise complex analysis issues. Go to article

CRISPR/Cas9Ggene Drives in Genetically Variable and Non-randomly Mating Wild Populations (bioRxiv) Synthetic gene drives based on CRISPR/Cas9 have the potential to control, alter or suppress populations of crop pests and disease vectors, but it is unclear how they will function in wild populations. Using genetic data from four populations of the flour beetle Tribolium castaneum, we show that most populations harbor genetic variants in Cas9 target sites, some of which would render them immune to drive. Go to article

Newly Discovered 'Multicomponent' Virus Can Infect Animals (Science Daily) Scientists have identified a new "multicomponent" virus -- one containing different segments of genetic material in separate particles -- that can infect animals, according to research published today in the journal Cell Host & Microbe. Go to article

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