A really good source for both lay public and health care providers is the CDC (perhaps not a surprise). They do a good job of explaining what we know and importantly what we don't know.
See for example:
> "We’re sort of in a hard place," Jamieson told The New York Times. "We can’t provide a lot of information about where these women are in their pregnancy. We don’t want to inadvertently disclose information about difficult decisions these women are making about their pregnancies."
Is there a point where the impending public health crisis becomes more important than patient privacy?
Yes, because you can not make one exception otherwise it will be used all the time to circumvent patient doctor privilege. The old saying, "give them an inch and they take a mile" is exactly this case.
Of course you can make one exception. That's why it's called an exception. The law is chock-full of exceptions, often carefully written to delineate their scope.
One important thing to note is that as of today's data, the CDC is not reporting any locally acquired cases [1] in the States (though that does not apply to US Territories). It is possible to infer, though certainly not conclusive, that the current pregnancy-related cases are either due to travel-related or sexual transmission, or possibly local if the pregnancy is in a Territory.
Release some money to start combatting Zika? Educating people to start using Deet, tracking clusters, hiring people to start eradicating standing pools of water, doing more comprehensive tracking of impact on people, babies, and, if it actually gets really bad, taking heightened measures to wipe out mosquitos that are vectors in more problematic areas - including releasing male mosquitos that are unlikely to fertilize larvae that will grown into yet more zika passing mosquitoes.
I'm just surprised at the lack of basic, non-identifying info being presented here. No mention of general locale, no mention of how far along in terms of percentages these women are, no mention of travel history statistics for the group, no information on whether or not the two deaths were from pregnancy-related causes, no info on how many non-microcephaly births, no info on anything, period. What's the point of this other than to spread hysteria?
This is in an earlier comment below, but I think it's worth repeating:
"We can’t provide a lot of information about where these women are in their pregnancy. We don’t want to inadvertently disclose information about difficult decisions these women are making about their pregnancies"
Which really isn't much of an excuse. There are decades of accepted best practices to responsibly disclosing and discussing cases like this in a professional and non-identifying manner that does not compromise their healthcare or their privacy.
We're also not talking about 2 women or even 20, it's over two hundred. Lots of wiggle room there, there are probably smaller groups of people in the USA afflicted by random diseases discussed in depth with much vigor and zeal at medical conferences each month with no such complaints.
There is a large fraction of the country that regards termination of pregnancy as literal child murder. Severe microcephaly is as good a reason to terminate a 'viable' pregnancy as can be found, with care for a microcephalic child costing far greater wealth than the average family has in their future; Most of the women not being identified will choose to abort.
"Abortion is murder" is something we've been deadened to through repetition, but the literal proclamation of abortion to be "murder", and "murder" to be murder, ethically requires extreme measures to fight it, to the believer. It is only through utter cowardice or lack of true belief that we manage to operate abortion clinics with a rate of violent assault in the last few decades cumulative of around 10%. These people are potentially dangerous, but within a family are also likely to do things like shunning/disowning relatives or seeking a divorce if this info becomes public.
>>What's the point of this other than to spread hysteria?
Hysteria can be a good thing. I can start a public debate, for example, which can start putting pressure on Congress to start thinking of serious solutions.
To be clear, we do not need Congress to think of a serious solution; we need Congress to authorize funding. Once we have the money allocated, we know how to deal with things like zika.
I find zika to be problematic. I get that we're all supposed to be scared, and that we should not have children. But there seems to be a severe lack of facts that reminds me of the recent ebola situation. It turns out, ebola isn't very contagious, nor is it deadly to first world countries. I get the feeling zika is being hyped for reasons that have a lot more to do with cya than actual facts in evidence.
Isn't Ebola very contagious, just not airborne? Also didn't a strain of it go airborne in a primate enclosure Virginia in the 1990s? Asking because I thought that was the case but can't remember. I read "In the Hot Zone" a few years back but don't remember the details.
Zika was first detected in Uganda. It seems that the first HIV cases occurred in the Democratic Republic of the Congo (DRC). And EVD near the border of South Sudan and DRC.
That's also pretty much where we humans came from. Is that just random coincidence? Or is there perchance a reservoir of sequences that are well prepared to mess with humans?
Totally serious. The human line, related species and shared pathogens co-evolved for about a million years. But humans arguably left much of that behind as they spread to Europe, Asia, etc. They became associated with new pathogens, for sure. But for only about 10% as long.
For many decades the Congo has had a lot of unsanitary bush meat hunting and food-prep practices, including a massive amount of primate consumption. That's the primary theory of how the Simian Immunodeficiency Virus made the jump from primate to human. West Africa also is having this problem with Ebola. You're right as far as the reservoir of sequences is "well prepared" by incubating in old world primate hosts. I don't know the story behind Zika or EVD.
Like most invasive species, humans face significantly less predation and parasitism in foreign lands.
The mosquito in question doesn't live in colder environments, this is the same reason why Massachusetts doesn't have a Malaria problem.
"Although the climate in some newly invaded areas is conducive to reproduction and survival of this mosquito, in other areas, harsh winters may prevent survival of overwintering eggs into the spring."
See http://jme.oxfordjournals.org/content/early/2016/06/07/jme.t...
Thanks. Looks like a great read about zoonotic diseases.
But what I'm wondering is whether zoonotic diseases from Central Africa generally represent more serious threats than do those from the rest of the world.
Those diseases traveled just as much as we did since the time of 'Lucy'.
The reason you see more of these from Central Africa (and that's one of the reasons I linked the book) if I understand it correctly is that there are some traditions there that make the species jump that much easier.
But all it really takes is a large number of people and a large number of animals in close proximity. Nature tends to find ways to exploit such opportunities.
Central Afrika is also the place where apes live in relative closeness to humans - and it is easy to see how we could be susceptible to viruses common to a biologically close species, especially if we are so dumb to eat them.
But the regular outbreaks of bird flu show, that this is not limited to one specific location. With the bird flu, its the markets in Asia, where close contact between poultry and humans creates regular transition of viruses to humans. Fortunately, recent more strict regulations seem to have reduced the bird flu outbreaks.
I'm not quite sure what you're asking and I am not going to ask you to elaborate to appear as though I am being intelligent by asking questions because this conversation is not in real-time, I may not come back here for a few days. No it is not a random coincidence that the diseases you mention came from adjacent regions...it is specifically because those regions are tropical, and have a lot of disease vectors. Read up on, "tropical disease," and how vectors play into disease. Disease comes from random mutations, and when you have a high density of random mutations and things that can carry those new diseases around, you have a higher likelihood of any given species (e.g. humans, for example), contracting a novel disease. While humans originated in the same area as where those diseases are coming from relative to the size of the earth, humans came from a completely geographically distinct and isolated area, e.g. the Rift Valley vs the Congo Basin which is separated by the Mitumba mountain range and has a completely different ecological character. Congo = Jungle. Rift Valley = Savannah. Much more vectors and biological diversity in Congo than Rift Valley.
Edit: For those who are saying, "We are dumb to eat apes." You are actually dumb for not realizing why people would eat apes, because you have a wide range of information gathering resources at your disposal to understand why people would eat apes, but you are not using it, while most of the people who eat apes totally lack information. They are ignorant, while you are actually just dumb.
I think it's worth reminding people that we do have the ability to wipe out specific mosquito species, and that aedes aegypti is an invasive one that spreads most Zika.
"Set in 2027, when no child has been born for 18 years and science is at loss to explain the reason, African and East European societies collapse and their dwindling populations migrate to England and other wealthy nations."
Terrific but possible scenario. Quote from "children of man synopsis"
The idea that Zika is somehow worse than the numerous common infections that cause microcephaly and birth defects (cytomegalovirus, toxoplasmosis, chicken pox) is prima facie radiculous. Zika is native to and widespread in Africa which seems to be having no problem increasing its population. Additionally it's been present in Asia for quite a while and although it caused the same problems, maternal immunity basically negates the problem of a fetus catching the disease in utero. Honestly the best thing we could do is to get our children infected and immune.
42 comments
[ 3.2 ms ] story [ 99.8 ms ] threadhttp://www.cdc.gov/zika/pregnancy/question-answers.html
Is there a point where the impending public health crisis becomes more important than patient privacy?
Well, safe on that count. The only identifying info they've provided is that they are female and pregnant.
[1] http://www.cdc.gov/zika/geo/united-states.html
Stay safe everyone.
"We can’t provide a lot of information about where these women are in their pregnancy. We don’t want to inadvertently disclose information about difficult decisions these women are making about their pregnancies"
We're also not talking about 2 women or even 20, it's over two hundred. Lots of wiggle room there, there are probably smaller groups of people in the USA afflicted by random diseases discussed in depth with much vigor and zeal at medical conferences each month with no such complaints.
I wonder if there's any merit to this hypothesis.
Can you elaborate on where you see the difference in how privacy is handled?
"Abortion is murder" is something we've been deadened to through repetition, but the literal proclamation of abortion to be "murder", and "murder" to be murder, ethically requires extreme measures to fight it, to the believer. It is only through utter cowardice or lack of true belief that we manage to operate abortion clinics with a rate of violent assault in the last few decades cumulative of around 10%. These people are potentially dangerous, but within a family are also likely to do things like shunning/disowning relatives or seeking a divorce if this info becomes public.
Hysteria can be a good thing. I can start a public debate, for example, which can start putting pressure on Congress to start thinking of serious solutions.
That's also pretty much where we humans came from. Is that just random coincidence? Or is there perchance a reservoir of sequences that are well prepared to mess with humans?
The mosquito in question doesn't live in colder environments, this is the same reason why Massachusetts doesn't have a Malaria problem.
"Although the climate in some newly invaded areas is conducive to reproduction and survival of this mosquito, in other areas, harsh winters may prevent survival of overwintering eggs into the spring." See http://jme.oxfordjournals.org/content/early/2016/06/07/jme.t...
Right. Good point!
Is a good and accessible read on the subject. Though it won't do anything good for your ability to sleep.
But what I'm wondering is whether zoonotic diseases from Central Africa generally represent more serious threats than do those from the rest of the world.
The reason you see more of these from Central Africa (and that's one of the reasons I linked the book) if I understand it correctly is that there are some traditions there that make the species jump that much easier.
But all it really takes is a large number of people and a large number of animals in close proximity. Nature tends to find ways to exploit such opportunities.
But the regular outbreaks of bird flu show, that this is not limited to one specific location. With the bird flu, its the markets in Asia, where close contact between poultry and humans creates regular transition of viruses to humans. Fortunately, recent more strict regulations seem to have reduced the bird flu outbreaks.
https://en.wikipedia.org/wiki/Bushmeat#Role_in_spread_of_dis...
Edit: For those who are saying, "We are dumb to eat apes." You are actually dumb for not realizing why people would eat apes, because you have a wide range of information gathering resources at your disposal to understand why people would eat apes, but you are not using it, while most of the people who eat apes totally lack information. They are ignorant, while you are actually just dumb.
https://en.wikipedia.org/wiki/Aedes_aegypti
http://www.theguardian.com/global/2016/feb/10/should-we-wipe...
The entire case doesn't hold up to our standards of legal review, and isn't even capable of happening today.
Terrific but possible scenario. Quote from "children of man synopsis"