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19 SPOTLIGHT ON ZIKA CDC Prepared to Deploy Rapid Response Teams When Zika Becomes Transmitted Locally in US By Brian Zimmerman F ederal health officials at the CDC plan to send a rap- id-response team to any mainland community and communities in Hawaii that report local transmission of the Zika virus, according to the Miami Herald. In June, the organization was closely monitoring six states — Flor- ida, Alabama, Arizona, Louisiana, Mississippi and Texas — for local transmission. The multi-level response plan will include case monitoring to curtail infection spread, testing, timely investigation and prompt communication with the public. Officials are expecting local transmission in those six states specifically because the primary vector behind Zika proliferation is the Aedes aegypti mosquito, which can be found throughout the southern U.S. "We don't think this is going to be a very common prob- lem, but we do think it's going to be a very high-profile problem," Tom Frieden, MD, told the Herald. Because Americans generally have more access to air condition- ing and window screens and live in less dense popula- tion environments than individuals in other Zika-affect- ed regions, the U.S. is likely to see scattered individual cases, not clusters or wide-ranging outbreaks, accord- ing to Dr. Frieden. However, a major issue of concern is managing the gen- eral anxiety that could be incited by local transmission. Local governors have expressed concern about lab testing capabilities and adequacy of mosquito control, which is locally funded. "One of the things they're concerned about, if they had local transmission, is they might have huge demand for testing that isn't really clinically indicated," said Dr. Frie- den. "That could overwhelm lab capacity." n Study Finds Zika Virus May Affect Infants Without Microcephaly By Max Green A s the Zika virus continues to spread, popping up across North America and other parts of the globe, clinicians have looked for tell-tale signs that infants may be affected by the virus, which can cause significant neurological damage and birth defects in babies born to Zika-positive mothers. So far, the primary symptom is believed to have been microcephaly, a birth defect in which babies are born with smaller-than-normal heads, but new research detailed in The Lancet Infectious Diseases, suggests the initial focus on microcephaly may be too narrow a marker for determining which infants are impacted by Zika. In reviewing more than 600 cases of babies born to mothers with Zika, the researchers found "rashes in the third trimester of pregnancy were associated with brain abnormalities despite normal sized heads," the paper reads. These infants showed no signs of obvious birth de- fect, but their brain scans showed they had characteristics comparable to those with congenital Zika virus infection. Additionally, the researchers suggest maternal history of a rash caused by Zika virus could be predictive of Zika virus congenital syndrome, even in cases where no apparent birth defect occurs. "Because many definite or probable cases present normal head circumference values and their mothers do not report having a rash, screening criteria must be revised in order to detect all affected newborn babies," the authors concluded. n KEYNOTES BY DR. RONALD DEPINHO, DR. CHARLES W. SORENSON, DR. RICHARD GILFILLAN, CATHERINE JACOBSON, WARNER THOMAS & JONATHAN BUSH To learn more & register, visit www.BeckersHospitalReview.com/conference or call 800-417-2035 5TH ANNUAL CEO & CFO ROUNDTABLE SAVE THE DATE! November 7-9, 2016 Swissotel | Chicago, Illinois