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Zika virus outbreak: All you need to know

As America battles to control the spread of Zika virus, the WHO on Thursday said that the virus is “spreading explosively” in the Americas, which could see up to 4 million cases over the next year.

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The World Health Organization (WHO) said on Thursday that the Zika virus, linked to severe birth defects in thousands of babies in Brazil, is "spreading explosively" and may infect 3 to 4 million people in the Americas, including 1.5 million in Brazil.
Director-General Margaret Chan told members of WHO's executive board that the spread of the mosquito-borne disease had gone from a mild threat to one of alarming proportions and that she was convening experts to assess it.

Sueli Maria (obscured) holds her daughter Milena, who has microcephaly, (born seven days ago), at a hospital in Recife, Brazil. Milena was born with microcephaly, a neurological disorder that damaged her brain and also affected her vision, a condition associated with an outbreak of Zika virus in Brazil. (Source: Reuters)

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The warning from the World Health Organization came amid a call to arms by officials on both sides of the Atlantic over the mosquito-borne virus, which has been linked to a spike in a rare birth defect in Brazil.
“As long as we don’t have a vaccine against Zika virus, the war must be focused on exterminating the mosquito’s breeding areas,” said Brazilian President Dilma Rousseff.

Hospital staff Oswaldo Cruz prepares to draw blood from baby Lorrany Emily da Silva, who has microcephaly, at the Oswaldo Cruz Hospital in Recife, Brazil. Health authorities in the Brazilian state at the center of a rapidly spreading Zika outbreak have been overwhelmed by the alarming surge in cases of babies born with microcephaly, a neurological disorder associated to the mosquito-borne virus. (Source: Reuters)

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So far, only Brazil has seen a sharp rise in microcephaly cases suspected of a link to Zika.
Abortion is illegal in Brazil except in cases of rape, danger to the mother's life or anencephaly, another birth defect involving the brain. Authorities have said they don't plan to add a microcephaly exception, though the Folha de S. Paulo newspaper argued in an editorial that Zika raises a need to discuss decriminalization of abortion.

Maria Clara (L) and Camile Vitoria hold their brother Matheus, who has microcephaly, in Recife, Brazil. (Source: Reuters)

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The concern is strong enough that the US Centers for Disease Control and Prevention this month warned pregnant women to reconsider visits to areas where Zika is present, and officials in El Salvador, Colombia and Brazil have suggested women stop getting pregnant until the crisis has passed.
El Salvador took an extraordinary step of advising women to avoid pregnancies for two years due to concerns about the rapidly spreading virus. The decision has created a trauma among pregnant women and others who have been wanting a child for long.

Pregnant women wait for a general routine checkup, which includes Zika screening, at the maternity ward of a hospital in Guatemala City, Guatemala, January 28, 2016. (Source: Reuters)

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Developing a safe and effective vaccine could take a year, WHO Assistant Director Bruce Aylward said, and it would take 6-9 months just to confirm whether Zika is the cause of the birth defects, or if the two are just associated. "In the area of vaccines, I do know that there has been some work done by some groups looking at the feasibility of a Zika virus vaccine. Now something like that, as people know, is going to be a 12 month plus time-frame," he said. The United States has two potential candidates for a vaccine for Zika and may begin clinical trials in people by the end of 2016, but there will not be a widely available vaccine for several years, US officials said.

Specimens of Aedes aegypti mosquito are exhibited during a campaign to raise awareness of preventing the entry of the Zika virus into the country, at the Health Ministry in Lima, Peru. The Peruvian Health Ministry is organising a campaign to help prevent the spread of the Zika virus and other mosquito-borne diseases. (Source: Reuters)

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The predominaant effect of the virus is being linked to Microcephaly, a rare neurological condition in which an infant's head is significantly smaller than the heads of other children of the same age and sex. Sometimes detected at birth, microcephaly usually is the result of the brain developing abnormally in the womb or not growing as it should after birth. usually occurs because of abnormal brain development that numerous conditions can trigger: genetic abnormalities, disorders such as Down syndrome, drug or alcohol use, other infections such as cytomegalovirus or even serious nutritional problems.

Pietro Rafael, who has microcephaly, reacts to stimulus during an evaluation session with a physiotherapist at the Altino Ventura rehabilitation center in Recife, Brazil. (Source: Reuters)

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Here are the things you need to know about Zika virus:
1. The virus is transmitted to people through the bite of infected female Aedes mosquitoes, the same type of mosquito that spreads dengue, chikungunya and yellow fever. Efforts to control the spread of the virus include eliminating mosquito breeding sites and taking precautions against mosquito bites such as using insect repellent and mosquito nets.

A health worker shows a flier used to explain people how to prevent Dengue, Chikungunya and Zika viruses in San Salvador, El Salvador January 28, 2016. An outbreak of the mosquito-borne Zika virus is affecting large parts of Latin America and the Caribbean and is likely to spread to all countries in the Americas except for Canada and Chile, the World Health Organization (WHO) has said. (Source: Reuters)

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2.There is no treatment or vaccine available for Zika infection. People who get Zika virus disease typically have a mild fever, skin rash, conjunctivitis, muscle and joint pain and fatigue, with symptoms normally lasting for two to seven days. Most people never develop symptoms. US health officials say the United States has two potential vaccine candidates and may begin human clinical trials by the end of 2016, but there will not be a widely available vaccine for several years.

A Venezuelan health worker fumigates the Valle slum to help control the spread of the mosquito-borne Zika virus in Caracas, January 28, 2016. (Source: Reuters)

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3. The virus has been linked to a devastating birth defect called microcephaly in which babies are born with abnormally small heads and brains that have not developed properly. The WHO said a direct causal relationship between Zika virus infection and birth defects has not yet been established but is strongly suspected. Local health authorities in Brazil in 2015 observed an increase in babies born with microcephaly at the same time as a Zika outbreak. About 4,000 cases of microcephaly have been reported in Brazil since September. Given an estimated 80 percent of people infected have no symptoms, it can be hard to tell if a pregnant woman has been infected. Research by Brazilian authorities indicates the greatest risk of microcephaly appears to be associated with infection during the first trimester of pregnancy.

Health technician Willian Araya shows the cultivated Aedes aegyti mosquito larvae at a laboratory in Ministry of Health in San Jose, Costa Rica. The Health Ministry confirmed on Tuesday, the first case of the Zika virus in the country, according to local media. (Source: Reuters)

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4. The WHO said Zika cases have been reported in 23 countries and territories in the Americas in the current outbreak. Brazil has been the nation most affected. The Pan American Health Organization said Aedes mosquitoes are found in all countries in the Americas except Canada and continental Chile, and the virus will likely reach all countries and territories of the region where Aedes mosquitoes are found.

Chile's Health Minister Carmen Castillo (C) talks to the media during an information campaign on Zika virus by the Chilean Health Ministry at the departures area of Santiago's international airport, Chile January 28, 2016. The banner reads: "Zika virus, know before your trip". (Source: Reuters)

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5. Zika virus is found in tropical locales with large mosquito populations. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Southern Asia and Western Pacific. The virus was first identified in Uganda in 1947 in rhesus monkeys and was first identified in people in 1952 in Uganda and Tanzania, according to the WHO.

Daniele Ferreira holds her son Juan Pedro during a session to stimulate the development of his eyesight at the Altino Ventura rehabilitation center in Brazil. The baby was born with microcephaly. (Source: Reuters)

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6. One case of possible person-to-person sexual transmission has been described but the Pan American Health Organization said more evidence is needed to confirm whether sexual contact is a means of Zika transmission. PAHO said there is currently no evidence the virus can be transmitted to babies through breast milk. PAHO said Zika can be transmitted through blood, but this is an infrequent transmission mechanism.

Geovane Silva holds his son Gustavo Henrique, who has microcephaly, at the Oswaldo Cruz Hospital in Recife, Brazil. (Source: Reuters)

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7. The WHO says that because no big Zika outbreaks were recorded before 2007, little is known about complications caused by infection. Long-term health consequences remain unclear. It is uncertain whether in pregnant women the virus crosses the placenta and causes microcephaly. During an outbreak of Zika from 2013-2014 in French Polynesia, national health authorities reported an unusual increase in Guillain-Barre syndrome, a rare disorder in which the body's immune system attacks part of the nervous system. Health authorities in Brazil have also reported an increase in Guillain-Barre syndrome. Other uncertainties surround the incubation period of the virus and how Zika interacts with other viruses that are transmitted by mosquitoes such as dengue.

Doctor Angela Rocha shows brain scans of a baby born with microcephaly at the Oswaldo Cruz Hospital in Recife, Brazil. Brazilian officials still say they believe there's a sharp increase in cases of microcephaly and strongly suspect the Zika virus, which first appeared in the country last year, is to blame. (Source: AP)

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A map showing the latest countries affected affected by the Zika virus around the world. (Source: Reuters)