Zika

NATIONAL. Science Says: Pregnant or trying? Don’t let Zika guard down (Associated Press)

By LAURAN NEERGAARD

WASHINGTON (AP) — The Zika virus may not seem as big a threat as last summer but don’t let your guard down — especially if you’re pregnant or trying to be.

While cases of the birth defect-causing virus have dropped sharply from last year’s peak in parts of Latin America and the Caribbean, Zika hasn’t disappeared from the region and remains a potential threat.

It’s hard to predict how much risk people face in locales with smoldering infection, or if cases might spike again. For now, pregnant women still are being urged not to travel to a country or area with even a few reported cases of Zika, because the consequences can be disastrous for a fetus’ brain ...

Back in the U.S., public health advocates worry that $1.1 billion Congress approved last year to study and fight Zika is running out — including funding for a birth defects surveillance program intended to monitor affected babies’ development and connect them to health services.

That surveillance is critical for knowing what’s going on, said Dr. Oscar Alleyne of the National Association of County and City Health Officials. “Otherwise we’re flying blind.”

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HOUSTON. Houston Braces for Another Brush With the Peril of Zika (The New York Times)

HOUSTON — With 4.5 million people in a hot, muggy metropolis built atop a bayou, America’s fourth-largest city, Houston, is a perfect target for the mosquito-borne Zika virus. But it may be better prepared than any other urban center to stop an outbreak...

The $1.1 billion in Zika funding that Congress passed last year runs out in September. The Trump administration seeks to cut the C.D.C. budget by $1.2 billion, to what the agency had 20 years ago.

Many county health departments depend on C.D.C. grants, and they have already been “eviscerated,” said Claude Jacob, president of the health officials’ association. Some 43,000 public health jobs were cut over the last decade.

“We need a contingency fund for epidemics,” said Dr. Paul Jarris, chief medical officer of the March of Dimes, which fights for Zika funding because of the danger to infants. “If we have a hurricane, FEMA doesn’t have to wait for months until Congress responds. Not having a fund just doesn’t make sense.”

Money is not the only obstacle to turning back the virus.

If there is no intense epidemic somewhere in the Western Hemisphere this summer, it will be hard to test any candidate Zika vaccine, said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.

For a valid study, between 2,500 and 5,000 people — ideally in several locations — must get either a vaccine or a placebo.

“If we get a big, big outbreak, we can get an answer about the vaccine’s efficacy by mid-2018,” he said. “If we don’t, it may take till 2020 or 2021.”

Read more. 

NATIONAL. Zika remains a serious threat. Federal funding cuts will make the problem even worse. (ScienceBlogs: The Pump Handle)

By Kim Krisberg

Last year’s emergency Zika funding is about to run out and there’s no new money in the pipeline. It’s emblematic of the kind of short-term, reactive policymaking that public health officials have been warning us about for years. Now, as we head into summer, public health again faces a dangerous, highly complex threat along with an enormous funding gap.

“The Zika threat will get worse,” said Claude Jacob, chief public health officer at the Cambridge Public Health Department in Massachusetts and president of the National Association of County & City Health Officials (NACCHO). “And the consequences for women and their babies are very serious.”

Jacob spoke during a May 31 press briefing on the 2017 Zika threat organized by NACCHO, March of Dimes, and the Big Cities Health Coalition (a forum for the nation’s largest metropolitan health departments). Speakers discussed the state of the Zika outbreak — there are now nearly 5,300 Zika cases reported in the U.S., including more than 1,800 pregnant women — as well as evolving research on the virus’ health effects. But the overarching message was clear: keeping the Zika virus at relative bay will require continued and sustained investment. Gaps in funding, they said, will have an especially acute impact at the community level, where local public health agencies serve as a frontline defense against the mosquito-borne virus.

“Local health departments need that sustained investment — they can’t wait for Congress to take months to act,” said Oscar Alleyne, senior advisor for public health programs at NACCHO, referring to Congress’ months-long delay in authorizing the 2016 Zika funding. “We can’t wait until there’s a fire to want to go out and buy a fire truck.”

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DALLAS. Risk of the Zika virus growing in the U.S. (The Dallas Examiner)

By DENISHA McKNIGHT

As the seasons change from warm to hot, residents should be very cautious of not only the heat but also the rising health risks, such as the Zika virus.

“With summer coming, the Zika threat will get worse,” said Claude Jacob, president of the National Association of County and City Health Officials during a press conference discussing the Zika threat May 31.

Many people are at risk of contracting the virus through a mosquito bite this summer, particularly people who live close to the Gulf Coast and pregnant women. Last year, there were 5,300 Zika cases reported in the U.S. Furthermore, 250 pregnant women were confirmed to have Zika and, of those, 10 percent delivered babies with Zika-related birth defects, according to the Centers for Disease Control.

Reports haven’t been broken down racially yet, but researchers have considered several social variables.

“They are taking it into consideration. Social determinants are important,” said Oscar Alleyne, NACCHO senior adviser. “People who work outside have a higher risk, and people whose housing is less safe such as lack of air conditioning and screens are at higher risk as well. People who are lower on the socio-economic gradient [also] are more at risk.”

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NATIONAL. Public health officials fear Trump budget cuts in fight against Zika virus (USA Today)

Kate Covington and Jayne O'Donnell

Spending cuts in the Trump administration's proposed budget for 2018 will hit the agencies dedicated to fighting the Zika virus as the season for the mosquito-borne illness is starting and when the demand for higher spending is needed, city and county health officials say.

Members of the National Association of County and City Health Officials (NACCHO) and the March of Dimes are lobbying Congress for more funding that covers a longer period of time to combat Zika, but say they are trying to develop a bigger coalition to make their case.

"We cannot wait until there’s a fire to want to go out and buy a fire a truck,” says Oscar Alleyne, NACCHO’s senior adviser for public health programs.

President Trump's budget proposed huge cuts to the agencies dedicated to — and most effective at —  fighting Zika at the Centers for Disease Control and Prevention and other public health services, said NACCHO President Claude Jacob.

Public health officials have been down this road before. Congress took 233 days to respond to the Zika outbreak last year, but a portion of the $1.1 billion lawmakers appropriated went to local health departments "to fund their work on the front lines of the outbreak," says Chrissie Juliano, director of NACCHO's Big Cities Health Coalition.

Health departments shifted around "scarce dollars" last summer and  provided education on how to protect against Zika and targeted expectant parents and those who traveled to infected regions of other countries, she added.

"We are working hard this year to ensure this sort of long delay in the federal response to a rapidly spreading disease outbreak does not occur again," says Juliano.

A hiring freeze at the Department of Health and Human Services poses a threat along with the $838 million that will be cut from the National Institute of Allergy and Infectious Diseases, the organization that oversees vaccine development, Kaiser Health News reported recently.

CDC says about 5,300 cases of Zika have been reported in the United States as of May 31, with 224 acquired from local mosquitoes and 5,206 in people who traveled to affected areas. Over 36,000 cases have been reported in U.S territories, CDC statistics show.

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NATIONAL. Zika: What to Expect this Year (WebMD)

By Kathleen Doheny

The Zika virus, spread by the bite of infected mosquitoes and other means, is here to stay, and with it the potential for serious birth defects, public health experts warned today.

From January 2015 to May 31, 2017, 5,285 cases of Zika have been reported on the U.S. mainland, said Oscar Alleyne, PhD, senior adviser for public health programs for the National Association of County and City Health Officials. The group hosted a Zika virus update during a press conference co-sponsored by the Big Cities Health Coalition and the March of Dimes.

In addition, more than 36,000 confirmed Zika cases have happened in U.S. territories. Of the 250 pregnant U.S. women confirmed with Zika infection in 2016, 10% delivered a baby with Zika-related birth defects, Alleyne said.

With government funding possibly expiring for some Zika-related programs, consumers need to stay vigilant and educated more than ever, the experts said.

"Zika is real," said Paul Jarris, MD, chief medical officer for the March of Dimes, at the press conference. "Protect yourself. Know before you go (if the virus is present at your destination)," he warned travelers. If it is present, travelers should consider postponing their trip, especially if you are trying to get pregnant.

Read more.

NATIONAL. Zika's Set to Return to Mainland U.S., But Budget Cuts Threaten Response (HealthDay News)

By Dennis Thompson

The Zika virus will strike the continental United States again this summer, and looming federal budget cuts will make it hard for local officials to curb its spread, public health experts said Wednesday.

The experts believe it's a foregone conclusion that more local Zika outbreaks will occur on the U.S. mainland in the coming months, much like what happened in Miami and Brownsville, Texas, last summer.

"We can virtually guarantee there will be activity, particularly along the Gulf region," said Michael Osterholm. He directs the University of Minnesota's Center for Infectious Disease Research and Policy.

Local health departments will shoulder the burden of any response to a local Zika outbreak, infection control experts said during a media briefing hosted by the National Association of County & City Health Officials (NACCHO).

NATIONAL. Federal Budget Cuts Could Be 'Catastrophic' for Zika Control (Medscape)

By Megan Brooks

With summer around the corner, public health officials in the United States are gearing up to combat the threat posed by the Zika virus.

In the coming months, the threat of Zika "will get worse, and the consequences of inaction are very real for pregnant women and their babies," Claude Jacob, president of the National Association of County and City Health Officials (NACCHO), warned today during a media briefing.

NACCHO, along with the Big Cities Health Coalition (BCHC) and the March of Dimes, held the briefing to discuss the threat posed by the Zika virus this summer.

Zika infections continue to be "widespread in Puerto Rico and the US Virgin Islands, and of course we had outbreaks in Miami and Brownsville, Texas, last year, and we expect more local outbreaks of Zika in this country, the mainland as well as other territories," said Paul Jarris, MD, chief medical officer of the March of Dimes. The Southern and Gulf Coast regions in the United States are particularly vulnerable to Zika outbreaks.

When it comes to Zika, "we absolutely need to maintain vigilance and funding for Zika as it spreads and we learn more about the effects on pregnancy and newborns," said Dr Jarris.

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NATIONAL. Proposed funding cuts may increase Zika threat: Health officials (Business Insurance)

By Gloria Gonzalez

The budget proposed by President Donald Trump combined with a bill to repeal President Barack Obama’s signature health care law could worsen the threat Zika poses to the United States this year, according to local and national health care experts.

As of May 24, 5,300 cases of Zika have been reported on the U.S. mainland, according to the U.S. Centers for Disease Control and Prevention.

“With summer coming, the Zika threat will get worse,” Claude Jacob, president of the National Association of County and City Health Officials and chief public health officer, Cambridge Public Health Department in Cambridge, Massachusetts, said during a webinar on Wednesday.

Despite the Zika threat, Congress took 233 days last year to provide emergency funding to address the disease, he said.

“The president’s proposed budget continues to threaten our ability to address Zika and other public health challenges,” Mr. Jacob said, citing the proposal to reduce the CDC budget by $1.2 billion, as well as a potential $40 million reduction to the Epidemiology and Laboratory Capacity for Infectious Diseases program and a $109 million proposed reduction to the Public Health Emergency Preparedness Program.

“A cut of $1.2 billion to that agency would be dire because so much of CDC’s money goes to state and local departments to support their public health activities such as preparing for and responding to Zika,” said Laura Hanen, interim executive director and chief of government affairs of NACCHO. “You need to have sustained federal funding over time to deal with the day-to-day emergencies that health departments are facing. And then when something like Ebola or Zika comes along that has unique circumstances and needs additional funding from the federal government, then you can go to Congress and ask for supplemental funds.”

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NATIONAL. House Democrats blast Trump's leaked contraception rule (Politico)

By DAN DIAMOND

ZIKA VIRUS

Advocates warn that Congressional funding is sorely needed. Congressional inaction on committing additional funding to combat the Zika virus, along with proposed budget cuts to federal health agencies, could increase the risk for virus outbreaks this summer, public health experts from Big Cities Health Coalition, the National Association of County and City Health Officials and the March of Dimes told reporters on Wednesday.

“Failing to fund this system will be catastrophic,” said Dr. Oscar Alleyne, NACCHO's senior advisor for public health programs. The $1.1 billion that Congress allocated toward fighting Zika is expected to run out in September and the White House’s initial budget proposes more than $1 billion in cuts to the CDC budget.

… NACCHO's Laura Hanen said that the Trump administration’s proposed CDC budget cuts, along with funding cuts to epidemiology and lab services, will limit the ability of local and state health departments to track the disease and contain outbreaks.

“The fact that the President’s budget would present such a deep cut when we are dealing with emergencies,” she said, “would have a deleterious impact on Zika.”

Read more.

KANSAS CITY. West Nile investigated in boy’s death, which would be Missouri’s earliest fatal case (Kansas City Star)

BY ANDY MARSO

“Mosquito populations as a whole tend to spike in June, July and August, but we mostly see mosquitoes carrying West Nile (at the) end of July through September,” Rogers said. “They’re more prone to carrying it later in the year.”

Rogers said “it’s uncommon” to see cases in May in this region.

But with milder winters and wetter springs the last few years, mosquito season is coming earlier. KDHE put out a news release last year on June 10 warning that mosquito counts, including those of the Culex species that carry West Nile, were already high in Sedgwick County.

Until this year that was the only county the Kansas Biological Survey examined. But this year Rogers said the University of Kansas department is expanding mosquito surveillance to a few more locations and will continue to add more counties if it gets more funding.

Health officials say the best ways to prevent mosquito-borne diseases are to wear long sleeves and pants, use window screens to keep mosquitoes out of the home and apply insect repellant before going outside.

The Kansas Biological Survey is also studying the range of the mosquito species that carry the Zika virus, the Aedes aegypti and Aedes albopictus. Those species have been found in some parts of Kansas and Missouri, but the only confirmed cases of Zika in the area so far have been in people who traveled to other countries and imported it.

Zika is a relatively mild illness except when it occurs during pregnancy, when it can cause the birth defect microcephaly. A study of almost 1,500 pregnant women with Zika in the continental United States found that it caused birth defects in about 5 percent of cases.

There were about 5,000 confirmed cases of Zika in the continental United States last year, according to the Centers for Disease Control. But only 224 were believed to be from local mosquitoes and all of those cases were in Florida or Texas.

There’s been no confirmed cases of locally acquired Zika in the continental United States yet this year. But Claude-Alix Jacob, the president of the National Association of County and City Health Officials, said local health officials should stay wary.

“With summer coming, the Zika threat will get worse,” Jacob said.

Read more.

MIAMI. Public health officials prep for Zika (Naples Daily News)

By Liz Freeman

Deep funding cuts to the Centers for Disease Control and Prevention would severely undermine response to a renewed Zika threat that’s expected as the summer mosquito season ramps up, a panel of public health officials said Wednesday.

The consequences of a $1.2 billion cut, which is one-eighth of the CDC’s entire budget, would trickle down to county health departments in Florida and Texas that were hard hit by Zika last summer.

The county agencies relied on federal support for laboratory testing and ground-level surveillance.

President Trump’s budget proposal also includes cutting $109 million to the public health emergency preparedness program and another $40 million to the epidemiology and laboratory capacity program, according to Laura Hanen, interim executive director and chief of government affairs for the National Association of County and City Health Officials.

Hanen was part of a press briefing Wednesday about the status of Zika and how Trump’s proposed cuts would come on top of one-time Zika funding last year that expires shortly.

Congress allocated $1.1 billion for a Zika response in 2016.

There is no more money coming behind that unless Congress recommends a comprehensive approach,” she said.

What’s really needed is a permanent public health emergency fund so there isn’t a scramble to secure money to react each time there’s a public health threat, said Dr. Paul Jarris, chief medical officer with the March of Dimes.

“That is not how FEMA operates,” Jarris said, referring to the Federal Emergency Management Agency that responds to hurricanes and other natural disasters.

Read more.

NEW YORK CITY. Why Congress drags its feet on Zika: New York City's health commissioner blames racism (NY Daily News)

The public health community is watching in astonishment as Congress continues to drag its feet on funding to fight Zika, a disease that threatens one of the most basic human functions — the ability to produce healthy babies.

The usual political gridlock is playing a role, but there’s something else that few people acknowledge: Zika is perceived as a disease of the south, mostly affecting people of color. The media have bombarded us with images of brown babies with microcephaly who live in the Caribbean and Latin America. Our Congress, which is dominated by an increasingly anti-immigrant party, may not feel a sense of urgency to respond to this evolving tragedy.

Read more.

NATIONAL. Stop Pushing Our Luck - Without the Necessary Funds, Fighting Zika, Ebola and Other infectious Disease is a Losing Battle (U.S. News)

By Jonathan Fielding Cofounder of The Big Cities Health Coalition

In 2014, we were lucky. There were only four diagnosed cases of Ebola virus in the United States. But in Africa, there were over 25,000 diagnosed cases of Ebola virus and more than 11,000 deaths, amounting to a public health tragedy.

The response to Ebola was helter-skelter. Doctors Without Borders was the first to warn about the rapidly expanding epidemic in Africa, but local governments and international organizations were slow to respond. The World Health Organization provided neither the leadership nor the operational coordination necessary to fight Ebola.

Fortunately, the director of the Centers for Disease Control and Prevention sounded the alarm that started to mobilize U.S. resources to help the affected West African countries. But U.S. public health officials were also challenged as they tried to address the threat from Ebola. At the beginning of our involvement, there were no well coordinated plans to identify Ebola treatment centers; implement quarantines; store and deploy the necessary level of protective equipment; manage and dispose of waste material; or monitor international travelers.

There are still active cases of Ebola in Africa, but you would not know it by scanning the news. Zika is the public health emergency du jour. And we are about to make many of the same mistakes we made not only with Ebola, but also with the SARS and West Nile viruses and H1N1 bird Flu. In all these instances, we were lucky. We rang the emergency sirens, marshaled resources, stretched medical and public health assets as thin as we could and made it through the crisis.

According to the CDC, as of August 4, there were over 510 pregnant women in the U.S. with laboratory evidence of Zika infection. The CDC has identified a neighborhood in Miami where mosquitoes are spreading the Zika virus and advised pregnant women not to travel to the area.

State and local public health officials are mobilizing to fight, often with insufficient resources. Meanwhile the mosquitoes are now in the continental U.S. and there is evidence that efforts to eradicate the pests may not be working as anticipated. We will need to be lucky, again, in the fight against Zika.

How long will our luck last? This question haunted the work of an independent panel established by the U.S. Department of Health and Human Services to review the response to Ebola, which I chaired. Our focus was on Ebola; What lessons did we learn, how can we do better next time? And our fear is that our luck is running out.

Zika is the next public health threat, but it is not the last. As our small planet's population grows it increases contact with animal reservoirs for serious infectious diseases, both those you heard of – HIV, Ebola, malaria, dengue fever – and those you probably haven't – Marburg, hantavirus and hendra virus. The CDC reports that more than 6 of every 10 infectious diseases in humans come from animals.

There is a lot we can do to ensure that we are prepared to detect and contain most infectious diseases. The independent panel made 48 specific recommendations to help strengthen public health capabilities, coordination and communication. These recommendations underscore the complexity of the public health community and the range of competencies that are needed to address a public health threat. In the U.S. alone, multiple agencies and stakeholders are part of the public health response team. These include the HHS Office of the Secretary; the CDC, the Food and Drug Administration; the Department of Homeland Security; the State Department; state, county and city health officials; the Federal Emergency Management Agency; U.S. Agency for International Development and more. The number is further compounded by international organizations and governments.

HHS must play a greater role in coordinating the global public health response through implementation of the Global Health Security Agenda, a cooperative arrangement launched in 2014 by over 50 nations, nongovernmental organizations and other stakeholders; better coordination with other government agencies, and state, local and private sector partners; and clear delineation of roles and responsibilities within and among HHS offices.

When novel infectious agents threaten us, HHS and its key public health agency, the CDC, have the daunting responsibility of communicating rapidly evolving and complicated messages to Congress, the public and other stakeholders. With Zika, the agencies are doing an admirable job, with clear though if necessarily evolving messages delivered by trained spokespeople. They have learned the lessons from lapses in communication about Ebola to clarify what is not known and the inherent uncertainty on where Zika could next be transmitted.

Additional resources – money and people – will be needed to implement the panel's recommendations. The WHO needs additional financial, technical and logistical support to support the Global Outbreak Alert and Response Network. NGOs, often the first line of detection and response, need additional resources to be more visible and effective in the corners of the world where public health threats emerge.

et as the need for additional resources has grown, funding for state and local health departments has dropped. Local governments report cuts in federal support of up to 50 percent. And state budget constraints have resulted in fewer resources to fight emerging threats. As a result, public health officials are using funds allocated to fight Ebola, which is still active in Africa, in the fight against Zika. They are rolling the dice, hoping that Ebola does not re-emerge as an imminent public health threat.

But the biggest crap shoot is happening now in Washington. Congress adjourned for its summer recess without approving additional funds to fight Zika. Politics as usual got in the way of addressing this major public health threat with fights on not only the level of funding but also abortion and other unrelated, contentious issues.

The most important recommendation from the independent panel is to create a flexible contingency fund to support preparedness and response activities. Public health should not be a partisan issue. Public health officials should have the resources they need to detect and protect us from Ebola, Zika, West Nile, Marburg, hantavirus or whatever comes next.

We will continue to need luck as we fight public health threats. But without the necessary resources, our luck will run out.

MIAMI & HOUSTON. New Zika Cases in Florida Show U.S. Cities' Struggle Without Federal Funding (Governing)

After Congress left cities to fend for themselves, four new cases -- possibly the first to be contracted by mosquitoes in the U.S. -- suggest how difficult it is for them to combat the virus on their own.

BY MATTIE QUINN 

Congressional inaction on Zika funds has hampered efforts on the local level to stop the spread of the disease. That was more or less proven Friday when Florida Department of Health officials said it's highly likely that four new cases in Miami were the first to be contracted by infected mosquitoes in the U.S.

To date, there have been 1,658 cases of Zika in the continental United States. But so far, they've all involved someone who had traveled to a foreign country or had sex with someone who had recently been to a Zika-affected country.

President Obama in May proposed $1.9 billion to help combat the spread of the virus. Congress, however, was unable to agree on that number and left for recess without allocating any extra money for state and local governments.

Even if Congress does allocate Zika funding, local officials say they may already have missed an important window for combatting the virus.

“The real tragedy is that now is the time when you need the extra money and resources: July and August is mosquito control time all across the U.S.,” said Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine. “Everything from here on out is just going to be damage control.”

In the absence of federal funding, localities have been left to fend for themselves.

“The Centers for Disease Control is not going to fight this disease. This is going to be a fight almost exclusively at the local level,” said Hotez.

Beyond mosquito control, which is hardest in the summer months, Hotez says local health centers must start being constantly on the lookout for possible cases.

Read more.

NATIONAL. Op-Ed: Get real about minimizing risk of future Zika and Ebola cases (Seattle Times)

Unreliable funding of public health agencies exposes communities unnecessarily to threats like the Zika virus. An always-prepared national public health system requires sustained support, not the same old political theater.

By David Fleming

Special to The Times

THE debate over how to respond to the Zika virus has produced some of the most dramatic political theater seen in Congress since the Ebola outbreak in 2014. It’s an edge-of-your seat drama, and Washington, D.C.,’s media brain trust knows it: a mysterious, life-threatening virus with tropical origins, high stakes for American families and a national leadership at war over how to deal with it.

The international medical community found that Zika causes microcephaly, a debilitating brain defect in fetuses that can prevent a child from ever walking or talking. While the U.S. Congress is making progress, it still has not adopted the emergency funding requested by the White House in February. Instead, the federal government just cut health departments’ emergency-preparedness budgets by 7 percent.

Read more.

NATIONAL. Health Departments Cut Programs While Awaiting Zika Funding (National Public Radio)

While Congress fidgets over whether and how to pay for the fight against the Zika virus, state and local health departments are scrambling and slimming down.

That's because these front-line public health agencies have already seen their budgets chopped because of the debate.

The Centers for Disease Control and Prevention in April cut $44 million from its fund that helps state and local governments prepare for public health emergencies. It was part of the $589 million the White House moved from other programs – mostly money allocated for domestic and international responses to the Ebola virus – to combat Zika as it awaited action on Capitol Hill.

New York City's health department lost $1.1 million in the deal.

Marisa Raphael, the deputy commissioner in New York's Office of Emergency Preparedness and Response, says she expects to have to cut jobs.

"We depend on this grant to create an infrastructure for our preparedness and our response," Raphael tells Shots. "That's everything from our lab staff to our surveillance staff, so when we have this cut, that does immediately impact our capabilities."

Read more.

SEATTLE. It’s time for Congress to step up and stop the spread of Zika virus (Seattle Times)

By Seattle Times Editorial Board

CONGRESS must act quickly to help stop the spread of the Zika virus.

As of April 20, the Centers for Disease Control and Prevention reported nearly 400 cases throughout the U.S., including two in Washington, and infections in 33 pregnant women.

Lawmakers should grant President Obama’s $1.9 billion emergency funding request to control Zika-carrying mosquitoes, develop a vaccine and assist countries dealing with much higher rates of infection.

Dr. William Dobyns, a Zika expert and pediatric neurologist at Seattle Children’s who is tracking its spread, showed The Seattle Times jarring photos of babies born to mothers infected with the virus. Some will never walk or talk.

Read more.