Zika virus risk in 50 US cities, says study

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If you are planning on travelling to the US this summer, be warned about a potential Zika virus outbreak.

A study published in the PLOS Currents Outbreaks journal says, key factors that can combine to produce a Zika virus outbreak are expected to be present in a number of US cities, including popular destinations such as New York, Los Angeles, and Florida, during the peak summer months.

The density of Aedes aegypti mosquito, which spreads the Zika virus in much of Latin America and the Caribbean, is likely to increase across much of the southern and eastern United States as the weather warms, said experts at the US-based National Center for Atmospheric Research (NCAR).
Zika virus risk in 50 US cities, says study - Times of India

It was weird coming across this article.
 
Through mosquito bites
Zika virus is transmitted to people primarily through the bite of an infected Aedes species mosquito (A. aegypti and A. albopictus). These are the same mosquitoes that spread dengue and chikungunya(http://www.cdc.gov/chikungunya/index.html) viruses.

  • These mosquitoes typically lay eggs in and near standing water in things like buckets, bowls, animal dishes, flower pots and vases. They prefer to bite people, and live indoors and outdoors near people.
    • Mosquitoes that spread chikungunya, dengue, and Zika are aggressive daytime biters. They can also bite at night.
  • Mosquitoes become infected when they feed on a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites.
From mother to child
  • A mother already infected with Zika virus near the time of delivery can pass on the virus to her newborn around the time of birth.
  • A pregnant woman can pass Zika virus to her fetus during pregnancy. We are studying the adverse pregnancy and infant outcomes associated with Zika virus infection during pregnancy.
  • To date, there are no reports of infants getting Zika virus through breastfeeding. Because of the benefits of breastfeeding, mothers are encouraged to breastfeed even in areas where Zika virus is found.
Through sexual contact
  • Zika virus can be spread by a man to his sex partners.
  • In known cases of likely sexual transmission, the men had Zika symptoms, but the virus can be transmitted before, during, and after symptoms develop.
  • In one case, the virus was spread a few days before symptoms developed.
  • The virus is present in semen longer than in blood.
Through blood transfusion
  • As of February, 1, 2016, there have not been any confirmed blood transfusion transmission cases in the United States.
  • There have been multiple reports of blood transfusion transmission cases in Brazil. These reports are currently being investigated.
  • During the French Polynesian outbreak, 2.8% of blood donors tested positive for Zika and in previous outbreaks, the virus has been found in blood donors.
Risks
Transmission | Zika virus | CDC
 
Panama reports Zika baby brain case...

Zika: Panama has 'first microcephaly case outside Brazil'
Sat, 19 Mar 2016 - A baby is born in Panama with a brain disorder thought to be linked to the Zika virus, in what may be the first such case outside Brazil in the current outbreak.
Panama has registered a baby born with a brain disorder believed linked to the Zika virus, in what is thought to be the first such case outside Brazil in the current outbreak. Traces of the mosquito-born virus were found in the baby's umbilical cord. The baby had been born with an underdeveloped brain, a condition known as microcephaly, which health experts suspect is linked to the virus.

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Brazil suspects most of its 860 cases of microcephaly are related to Zika. The Panamanian baby's mother had not reported any symptoms of Zika during her pregnancy. Her baby died four hours after being born. The World Health Organization (WHO) has declared a global public health emergency over the possible connection between the mosquito-born virus and microcephaly. The current Zika outbreak began almost a year ago in Brazil.

Microcephaly cases have been centred in north-east Brazil, but the outbreak has affected people in more than 20 countries in the Americas. Some governments have advised women to delay getting pregnant, but before now no infants with microcephaly have tested positive for Zika outside Brazil in the current outbreak. Some cases of the brain condition were reported in an outbreak in French Polynesia in 2013.

Zika: Panama has 'first microcephaly case outside Brazil' - BBC News
 
This summer more Than 30 States at 'High Risk' for Zika...

CDC Chief: More Than 30 States at 'High Risk' for Zika Transmission
March 24, 2016 | Zika is an emergency; infected mosquitos may arrive in the U.S. this summer; "and there's much that we still don't know about it," Tom Frieden, director of the Centers for Disease Control and Prevention, told Congress on Wednesday.
He said 30 or more states are at risk of transmission -- southern states more so than others. And warmer weather accelerates the danger: "Here, it's possible that come summer, we will have a situation where a woman gets pregnant, and through bad luck, gets bitten by a mosquito that is infected with Zika and may have an affected child. We want to do everything in our power to prevent that from occurring." Friedan said at least 13 states have aedes aegypti, the mosquito that is most effective at spreading the virus. "Aedes albopictus also can spread Zika. It is probably a less efficient vector, and there are more than 30 states" with that type of mosquito.

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An infant born with microcephaly, is examined by a neurologist at the Pedro I hospital in Campina Grande in Paraiba state, Brazil. Since Zika was first detected in Brazil, the two states have accounted for almost half of the 6,158 reported cases of babies born with shrunken heads, a rare condition known as microcephaly.​

Frieden said one of the problems with controlling the spread of Zika is that "surveillance for mosquitoes is not perfect, it's not up to date" in the states that may be affected. The Obama administration is requesting $1.856 billion in emergency spending to respond to the Zika virus, both domestically and internationally. Of that total, $828 million would go to the CDC. "Our staff are working literally around the clock," Frieden said. "We've produced more than a half a million test kits. We have more than 800 staff working on the Zika response now. We're scraping together money from wherever we can find it to respond effectively, but a robust response I do believe will take emergency funding."

Frieden told a House Appropriations subcommittee that Zika meets the definition of a potentially catastrophic emergency: "There has never before been a mosquito-borne illness that can cause a birth defect; we've never seen that before. Potentially catastrophic -- each child affected can cost more than $10 million, and it's a horrific tragedy for the families that are involved. "And we don't know the full range of illness. Microcephaly is a horrific birth defect, but that may be just part of a spectrum of severe problems that these infants may face. And permanent, these are lifelong disabilities that they will be facing."

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Zika virus 'scarier than thought' - US...

Zika virus 'scarier than thought' says US
Mon, 11 Apr 2016 - The Zika virus is "scarier" than first thought and its impact on the US could be greater than predicted, American public health officials says.
The Zika virus is "scarier" than first thought and its impact on the US could be greater than predicted, public health officials have admitted. A wider range of birth defects has been linked to the virus, said Dr Anne Schuchat of the US Centers for Disease Control and Prevention. And the mosquitoes that carry the virus could travel to more US states than previously thought, she said. The current Zika outbreak began almost a year ago in Brazil. It has been linked to thousands of birth defects in the Americas. "Most of what we've learned is not reassuring," said Dr Schuchat at White House briefing on Monday. "Everything we know about this virus seems to be scarier than we initially thought."

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Earlier this year, US President Obama asked the US Congress for $1.8bn (£1.25bn) in emergency funding to combat the virus. In the meantime it has been using money totalling $589m left over from the Ebola virus fund. That was a temporary stopgap and inadequate to get the job done, said Dr Anthony Fauci of the National Institutes of Health. The US now needs more money to fight the mosquitoes and to fund better research into vaccines and treatments, he said. "When the president asked for $1.9 billion, we needed $1.9 billion."

Without want to be alarmist, he said there had been recent discoveries about how destructive Zika appeared to be to foetal brains. There were also reports of rare neurologic problems in adults, he said. The CDC announced that Puerto Rico is to receive $3.9m in emergency Zika funding as the number of cases there doubles every week. In February, the first US case of locally transmitted Zika was reported in Dallas, Texas - spread through sexual contact, not a mosquito bite.

Zika virus 'scarier than thought' says US - BBC News
 
US confirms Zika causes birth defects...

US health experts confirm that Zika causes birth defects
Wed, 13 Apr 2016 - The US Centers for Disease Control and Prevention (CDC) confirms that the Zika virus causes severe birth defects including microcephaly.
Hundreds of babies were born in Brazil last year with microcephaly, a syndrome where children are born with unusually small heads. The defects coincided with a spike in Zika infections, leading experts to suspect the mosquito-borne virus. Research has now affirmed those experts' suspicions, the CDC said. "This study marks a turning point in the Zika outbreak. It is now clear that the virus causes microcephaly," said Dr Tom Frieden, the head of the CDC.

On Monday, US health officials warned the Zika outbreak could have more of an effect on the United States and called for additional funding to combat the virus. "Everything we know about this virus seems to be scarier than we initially thought," said Dr Anne Schuchat of the CDC. Zika virus was first diagnosed in 1947 in Uganda, but symptoms have typically been mild, including rash, joint pain and fever. The current outbreak started in 2015 in Brazil and the symptoms have been much more severe. Nearly 200 babies have died as result of the virus.

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Researchers are interesting learning why some cases of the virus result in birth defects while others do not. Some women who were infected with Zika while pregnant gave birth to apparently healthy children. There have been 346 confirmed cases of Zika in the continental United States, according to the CDC, all associated with travel. CDC officials said the findings do not change the agency's earlier guidance to pregnant women.

The CDC has discouraged pregnant women from travelling to places where the Zika virus is spreading, mostly in Latin America and the Caribbean. Dr Frieden said intensive research was under way to find out much more about the mosquito-borne virus and to develop a vaccine for it, although he warned that that could still be years away. This is the first time that mosquito bites have caused birth defects, Dr Frieden said. The virus can be transmitted by sexual contact as well.

US health experts confirm that Zika causes birth defects - BBC News

See also:

White House: House-Passed Zika Bill ‘Akin to Passing Out Umbrellas’ Before a Hurricane
April 13, 2016 – White House spokesperson Josh Earnest said Wednesday that a bill allows the FDA to include Zika drug developers in its voucher program is an “insufficient” response to the Zika outbreak and “akin to passing out umbrellas in the advance of a potential hurricane. ”
“The passage of that bill … is positive, but a rather meager accomplishment,” Earnest said, adding that “in some ways it’s akin to passing out umbrellas in the advance of a potential hurricane, so an umbrella might come in handy, but it’s gonna be insufficient to ensure that communities all across the country are protected from a potentially significant impact.” “That’s what we’re focused on,” he said. “Some of you may be familiar with the expression of being a day late and a dollar short. In this case, Congress is two months late and $1.9 billion short in providing the assistance that our public health professionals say that they need to make sure that they respond appropriately to this situation.”

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The Zika virus is believed to be responsible for babies being born with abnormally small heads.​

The bill provides financial incentives to companies working on Zika drug treatments and includes those drug developers in the Food and Drug Administration’s priority review voucher program. The House passed the bill on a voice vote Tuesday. It was already approved by the Senate. “The bill that Congress passed yesterday doesn’t include any funding,” Earnest explained, adding that it won’t “do anything to help local communities across the country that carry this virus or fight the mosquitoes that carry this virus.

“It’s not going to expand access to diagnostic tests that would allow people to more easily get tested and get a prompt result from that test about whether or not they have the Zika virus,” he said. “All of these are steps that are critical to ensuring that we’re protecting the pregnant women and their newborn children from a virus that we know has a potentially devastating impact, so no. I’m not prepared to give Congress credit for that legislation,” Earnest said. “It is a positive step, but it is a far cry from what our public health experts tell us is necessary to prepare for the situation,” Earnest added.

White House: House-Passed Zika Bill ‘Akin to Passing Out Umbrellas’ Before a Hurricane
 
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One third of global population lives in Zika areas...

2.2 billion in 'at risk' Zika areas
Wed, 20 Apr 2016 - More than two billion people live in parts of the world where the Zika virus can spread, maps published in the journal eLife show.
The Zika virus, which is spread by Aedes aegypti mosquitoes, triggered a global health emergency this year. Last week the US Centers for Disease Control and Prevention confirmed that the virus causes severe birth defects. The latest research showed mapping Zika was more complex than simply defining where the mosquito can survive. One of the researchers, Dr Oliver Brady from the University of Oxford, told the BBC: "These are the first maps to come out that really use the data we have for Zika - earlier maps were based on Zika being like dengue or chikungunya. "We are the first to add the very precise geographic and environmental conditions data we have on Zika." By learning where Zika could thrive the researchers could then predict where else may be affected. The researchers confirmed that large areas of South America, the focus of the current outbreak, are susceptible.

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In total, 2.2 billion people live in areas defined as being "at risk". The infection is suspected of leading to thousands of babies being born with underdeveloped brains. The at-risk zones in South America include long stretches of coastline as well as cities along the Amazon river and its tributaries snaking through the continent. And in the US, Florida and Texas could sustain the infection when temperatures rise in summer. Dr Brady added: "Mosquitoes are just one condition needed for Zika to spread but there's a whole range of other ones. "It needs to be warm enough for Zika to replicate inside the mosquito and for there to be a large enough [human] population to transmit it."

Both Africa and Asia have large areas that could be susceptible to the virus, the researchers said. However, the study cannot answer why large numbers of cases have not already been reported. One possible explanation is that both continents have already had large numbers of cases and the populations there have become largely immune to the virus. An alternative is that cases could be being misdiagnosed as other infections such as dengue fever or malaria. Europe seems likely to be unaffected, but that could change as more evidence emerges on which mosquitoes the viruses can spread in.

Zika virus: 2.2 billion people in 'at risk' areas - BBC News

See also:

Senate GOP shoots for quick action on Zika funding bill
April 20, 2016 | WASHINGTON (AP) — Democrats say top GOP lawmakers are proposing to partially fund President Barack Obama's request for money to fight the Zika virus.
The $1.1 billion measure circulating Wednesday comes in advance of an Appropriations panel meeting on Thursday and was being worked on with Democrats in hopes of winning their support. The measure has not been finalized and is part of continuing negotiations. The money would be used to try to slow the spread of the Zika virus and develop a vaccine against it. Top Appropriations Committee Democrat Barbara Mikulski of Maryland said the Zika issue is "in play" for a Thursday panel vote. "It's a possibility and I hope by this afternoon to have moved it to a probability," Mikulski said. "I am very hopeful they are coming to the table and we'll see what happens in the next 24 hours," said Sen. Patty Murray, D-Wash., a key negotiator. "I think we're working toward something that could produce results even this week," said Sen. Roy Blunt, R-Mo., who has responsibility for a panel that oversees the bulk of the request.

Republicans controlling Congress have increasingly come under pressure to respond to Obama's $1.9 billion request to combat Zika, which can cause grave birth defects such as microcephaly and is expected to worsen in coming months. Republicans succeeded in forcing the administration to shift almost $600 million of previously-approved funds for immediate action against Zika. But the White House and its Democratic allies say more money is needed now and they have turned up the heat on Republicans, who are responsible for shepherding the Obama request since they are in control of both sides of Capitol Hill. They are demanding that the Zika-fighting money be added to the budget as an "emergency supplemental," which means it would be added on to December's catchall spending measure for the ongoing fiscal year.

White House spokesman Peter Boogaard said Wednesday, "While we are reassured that there appears to be initial steps to rectifying Congress's failure to act to date, any proposal that does not provide needed assistance in this fiscal year and does not protect or replenish the funding critical to our ongoing Ebola response will be insufficient to the risks facing the country." "It's not just about the timing, which is critical," said top House Democrat Nancy Pelosi of California. "It's also about where this money is coming from. The supplemental is an emergency — doesn't need to be offset" by accompanying spending cuts.

It's not clear how GOP leaders might try to advance the measure, though it's unlikely to advance on its own. The Appropriations panel has two measures before it on Thursday and there is also a widely-backed measure funding energy and water projects pending on the Senate floor. "It's an important issue. We're in discussion with them about how much do they really need. They have taken our suggestion and transferred some of the Ebola money," Senate Majority Leader Mitch McConnell, R-Ky., said on Tuesday. "And I don't think that in the end there will be any opposition to addressing what we think is going to be a fairly significant public health crisis." A key consideration for lawmakers is making sure that Zika money is approved before Congress leaves Washington in mid-July for a seven-week break.

Senate GOP shoots for quick action on Zika funding bill
 
Zika gonna be a pandemic...

Zika Outbreaks Expected in Large Portion of Americas
May 03, 2016 | WASHINGTON — Some 500 million people in the Americas and the Caribbean are at risk of getting the Zika virus. So far, 37 countries and territories are reporting transmission of the virus. Peru is the latest country to report transmission. The virus is also in Saint-Barthélemy, a French territory in the Caribbean. The virus itself is largely inconsequential, but doctors and medical scientists involved in public health say getting across the message that a mild disease could be devastating to unborn babies is challenging.
Zika causes microcephaly, a birth defect where the head and brain are abnormally small, but as of yet, researchers don't know what percentage of pregnant women who get the virus end up delivering babies with microcephaly. One study shows a one percent risk. Another small study puts the risk at 29 percent. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said no one knows the true risk. A much larger study is now being conducted but until the results are in, the best answer is, "We don't know," Fauci said.

So far, most cases of microcephaly have been reported in Brazil, but cases have also been reported in Colombia, Panama, Martinique and the United States. The Zika virus is also associated with a form of paralysis called Guillian-Barre syndrome. Seven countries have reported cases of Guillian-Barre which can be fatal. The only protection against this mosquito-bourne virus is not to get bitten or not to get pregnant, as women in some countries have been advised. The problem is the Aedes aegypti mosquito that carries the Zika virus is hard to contain. It prefers human blood to that of animals, and it likes to live indoors. It's also a day-time biter. In many parts of the Americas, birth control is not readily available, another complicating factor. The only answer lies in the development of a vaccine. One will be tested on humans by September, but it could still be at least three years before it becomes available.

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Government fumigators prepare to spray homes for mosquitoes in Havana, Cuba​

Meantime, helping children born with microcephaly is expensive. Some may need lifelong care. "What we see now is the tip of the iceberg," said Dr. Sylvain Aldighieri, the Zika Incident Manager for the Pan American Health Organization. Aldighieri added that these children, even those without microcephaly but whose mothers had Zika while pregnant, will have to be followed for a period of two to four years in order to understand the extent of the damage. Microcephaly can cause blindness, physical deformities beyond small heads, and can affect the intellect.

Aldighieri and Fauci spoke at a press conference at the Pan American Health Organization's headquarters in Washington, D.C. The U.S. Congress has not yet approved $1.9 billion in emergency funding that President Obama requested in February. Fauci said the funding "is absolutely essential." He said he had to move money from programs on malaria, influenza and tuberculosis to provide funds for Zika research. Without the additional funds, "We cannot do the job that needs to be done." he said. Fauci expects the virus to be transmitted in the U.S., but he also said Zika is likely to be contained such as similar viruses like dengue and chikungunya have been contained in the past.

Zika Outbreaks Expected in Large Portion of Americas
 
Zika may cause baby eye problems...

Concern Zika causes baby eye problems
Wed, 25 May 2016 - Scientists studying the Zika outbreak in Brazil are becoming increasingly concerned the virus may cause eye damage in babies.
Stanford University researchers found abnormal bleeding and lesions in the eyes of three infant boys whose mothers had caught Zika while pregnant. They want any babies known to be affected by Zika to have eye checks. The journal of Ophthalmology findings follow another recent study that saw similar eye problems in Zika babies. The disease is already known to cause a serious baby brain defect called microcephaly.

What is not clear is whether eye problems might be a complication of this rather than the Zika infection itself. Either is possible. All of the three infants the researchers from Stanford and the University of Sao Paulo examined also had microcephaly. The eye damage they found in the baby boys was to the light-sensitive layer of tissue at the back of the eye, called the retina. There was abnormal blood vessel growth, bleeding and torpedo-shaped lesions.


Researcher Dr Darius Moshfeghi said the next step was to determine the root cause - Zika or microcephaly - to better understand which infants would need eye checks. "To begin with it's probably sensible just to screen babies with microcephaly," he said. "But if it turns out that Zika can cause these eye problems independently, then we would need to screen all infants of infected mothers."

He said some of the eye abnormalities would resolve or be treatable, but others could cause lasting, irreversible damage to vision. With no vaccine or treatment, pregnant women have been advised to cover up to protect themselves against the biting mosquitoes that carry Zika. More than 60 countries and territories now have continuing Zika transmission.

Concern Zika causes baby eye problems - BBC News
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Zika skeeters may be in Florida...
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New US Zika Case May Be First in US Caused by Mosquito
July 20, 2016 - Health officials in Florida are analyzing a new Zika infection in the Miami area that they think may be the nation's first transmission of Zika from a mosquito bite.
The U.S. Centers for Disease Control and Florida's Department of Health said this week that the Zika case had been confirmed, but that there were no links to transmission through travel. It has not been made clear whether the case could have originated from sexual contact with an infected person. Earlier this week, the CDC announced that the caregiver for an elderly Utah man who died of a Zika infection also had contracted the infection, although for the caregiver the case was not serious. The caregiver was not believed to have traveled to any areas that are affected by Zika, nor had sex with any infected person.

The CDC said the elderly patient had "uniquely high amounts of virus" in his blood — more than 100,000 times higher than seen in blood samples from other infected people. Health authorities are investigating how the caregiver might have contracted the infection from the older victim. Zika has been detected in bodily fluids including semen, blood, urine and breast milk.

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Robert Muxo of Miami-Dade County mosquito control, takes a sample of water that was standing in a potted plant in Miami, June 21, 2016. Health officials are concerned about the spread of the Zika virus in the U.S., which is spread by the Aedes aegypti mosquito.​

The man who died caught the virus while traveling abroad. He was the first person in the United States to die after becoming infected. Officials said the exact cause of his death was not clear because the man was elderly and had an underlying heath condition. Zika is spread primarily through mosquito bites. Experts are especially concerned about infected mosquitoes biting pregnant women. They say this can cause microcephaly, a birth defect characterized by smaller-than-average head size and possible deficiency in brain development.

New US Zika Case May Be First in US Caused by Mosquito
 
Zika inna U.S....
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Mosquitoes have apparently begun spreading Zika in U.S.
Jul. 29, 2016 — Mosquitoes have apparently begun spreading the Zika virus on the U.S. mainland for the first time, Florida officials said Friday in a long-feared turn in the epidemic that is sweeping Latin America and the Caribbean.
Four recently infected people in the Miami area — one woman and three men — are believed to have caught the virus locally through mosquito bites, Gov. Rick Scott said at a news conference. No mosquitoes in Florida have actually been found to be carrying Zika, despite the testing of 19,000 by the state lab. But other methods of Zika transmission, such as travel to a stricken country or sex with an infected person, have been ruled out. U.S. health officials said they do not expect a widespread outbreak of the sort seen in Brazil and other countries. While officials have long predicted mosquitoes in the continental U.S. would begin spreading Zika this summer, they have also said they expect only isolated clusters of infections. More than 1,650 people in the mainland U.S. have been infected with Zika in recent months. But the four people in Florida are believed to be first ones to contract the virus within the 50 states from mosquitoes. "This is not just a Florida issue. It's a national issue — we just happen to be at the forefront," Scott said.

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Florida agricultural officials immediately announced more aggressive mosquito-control efforts, and Florida politicians rushed to reassure tourists that it's still safe to visit the state. Some medical experts said pregnant women should not travel to the Miami area, especially if it involves spending time outdoors. However, the U.S. Centers for Disease Control and Prevention is not recommending people avoid visiting South Florida. The virus is so mild that most people who are infected don't even know they are sick, but infection during pregnancy can cause babies to born with disastrously small heads and other severe brain-related defects. The four Florida infections are thought to have occurred in a small area just north of downtown Miami, in the Wynwood arts district, the governor said. The area, known for bold murals spray-painted across warehouses, art galleries, restaurants and boutiques, is rapidly gentrifying and has a number of construction sites where standing water can collect and serve as a breeding ground for the tropical mosquito that carries Zika.

People in Florida's Miami-Dade and Broward counties are being tested to learn whether there are more cases, the governor said. "If I were a pregnant woman right now, I would go on the assumption that there's mosquito transmission all over the Miami area," warned Dr. Peter Hotez, a tropical medicine expert at the Baylor College of Medicine. He said that while health officials have reported four infections, there are probably more that have not been diagnosed, and that people should not be surprised if mosquitoes are soon found to be spreading Zika in Louisiana and Texas as well. Earlier this week, federal authorities told blood centers in the Miami-Fort Lauderdale areas this to stop collecting blood until they screen it for the virus. Dr. Tom Frieden, the CDC director, said the evidence suggests that the mosquito-borne transmission occurred several weeks ago over several city blocks. Zika primarily spreads through bites from a specific species of tropical mosquito that can also carry other diseases, including dengue fever and chikungunya.

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