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ByMichaelTarm The Associated Press CHICAGO The judge in Dennis Hastert's hush- money case signaled Wednesday that he will consider the former U.S. House speaker's lies to in- vestigators that he was being extorted on a false claim of sexual abuse at his sentencing hearing, where prosecutors say one person who says he was abused is expected to speak. Someone identified in court papers as "Individ- ual D," one of at least four former students who pros- ecutors say Hastert sexu- ally abused, would be one of two witnesses who want to make statements at the April 27 sentencing, pros- ecutors also said at a Chi- cago hearing. The other is a sister of a now-deceased accuser. Hastert has pleaded guilty to breaking bank- ing law to pay $3.5 million to ensure someone called "Individual A" in court pa- pers stayed silent about be- ing abused when he was 14 at a high school where Hastert coached wrestling until 1981. Hastert wasn't charged with sex abuse because statutes of limi- tations long since ran out. Judge Thomas M. Dur- kin made clear he is dis- turbed by prosecutors' ac- counts that Hastert lied to federal agents investi- gating about why he was withdrawing large sums of cash by falsely accusing "Individual A" of extorting him on what Hastert said was a bogus accusation of sexual abuse. Hastert, the judge said, was accusing someone he victimized of "holding him up." And he said that be- havior, unlike the abuse allegations, wasn't distant history. "That's not conduct that's 40 years old," Durkin said. "That conduct is ... a year old." About Hastert's false allegations against Individual A he added: "That's a big one." When federal agents first questioned Hastert in December 2014, they had no inkling that sexual abuse was at the core of his payments, prosecutors said in a filing last week. But within weeks, Hastert began claiming that Indi- vidual A was extorting him on false accusations. But after Hastert agreed to record calls to Individ- ual A and after agents later interviewed the man, agents concluded he never tried to threaten Hast- ert. Prosecutors say Indi- vidual A even asked Hast- ert repeatedly to bring in lawyers to formalize their agreement — but it was Hastert who refused to in- volve anyone else, prosecu- tors said. Hastert sexually abused at least four members of the wrestling team when he taught and coached at Yorkville High from 1965 until 1981, according to prosecutors. They cite In- dividual A as saying the abuse occurred in a mo- tel room when he was 14 and on the way home from wrestling camp. Hastert allegedly touched others in a locker room after saying he would give them mas- sages. Two wrestlers said Hastert performed sex acts on them. Prosecutors also described a recliner where Hastert often sat in the locker room with a direct view of the stalls where the boys showered. The prosecutors have said they would have pre- ferred sex-abuse charges, but the statute of limita- tion on sexual abuse ran out decades ago. Still, pros- ecutors considered Hast- ert's conduct with the vic- tims, all boys 14 to 17 years old, so egregious that they chose to pursue the bank- ing charge to ensure he faced some punishment. Defense lawyers have asked for the judge to spare Hastert prison time and give him probation in- stead, citing his health and the steep price they say he's already paid in pub- lic shame. FORMER HOUSE SPEAKER Ha st er t ac cu se r to speak at sentencing MATTMARTON—THEASSOCIATEDPRESSFILE Former U.S. House Speaker Dennis Hastert leaves the federal courthouse in Chicago a er a hearing in his hush- money case. HEALTH FELIPE DANA — THE ASSOCIATED PRESS FILE Lara, who is less then 3months old and was born with microcephaly, is examined by a neurologist at the Pedro I hospital in Campina Grande, Paraiba state, Brazil. By Mike Stobbe The Associated Press NEW YORK Confirming the worst fears of many preg- nant women in the United States and Latin America, U.S. health officials said Wednesday there is no lon- ger any doubt the Zika vi- rus causes babies to be born with abnormally small headsandotherseverebrain defects. Since last year, doctors in Brazil have been linking Zika infections in pregnant womentoariseinnewborns withmicrocephaly,oran un- usually small skull. Most outside experts were cau- tious about drawing such a connection.ButnowtheU.S. Centers for Disease Control and Prevention says enough evidence is in. "There is no longer any doubt that Zika causes mi- crocephaly," CDC Director Dr. Tom Frieden said. The CDC said it is also clear that Zikacausesotherseriousde- fects, including damaging calcium buildups in the de- veloping brain. Among the evidence that clinched the case: Signs of the Zika virus, which is spread primarily through mosquito bites and can also be transmitted through sex, have been found in the brain tissue, spinal fluid and am- niotic fluid of microcephaly babies. TheCDC andother health agencies have been operat- ing for months on the as- sumption that Zika causes brain defects, and they have been warning pregnant women to use mosquito re- pellent,coverup,avoidtravel to Zika-stricken regions and either abstain from sex or rely on condoms. Those guidelines will not change. But the new finding should help officials make a more convincing case to the public for taking precau- tions. Some experts hope it will change public thinking about Zika the way the 1964 surgeongeneral'sreportcon- vincedmanyAmericansthat smoking causes lung cancer. "We've been very careful over the last few months to say, 'It's linked to, it's associ- ated with.' We've been care- ful to say it's not the cause of," said the CDC's Dr. Sonja A. Rasmussen. "I think our messages will now be more direct." The World Health Orga- nization has made similar statements recently. A WHO official applauded the CDC report. "We feel it's time to move from precautionary lan- guage to more forceful lan- guage to get people to take action," said Dr. Bruce Ayl- ward, who is leading WHO's Zika response. The CDC announced its conclusion in a report pub- lished online by the New England Journal of Medi- cine. Zika has been sweep- ing through Latin America and the Caribbean in recent months, and the fear is that it will only get worse there and in the U.S. with the on- set of mosquito season this spring and summer. Public health authori- ties have mounted aggres- sive mosquito-eradication efforts, including extensive spraying and campaigns to eliminate the sources of standing water in which mosquitoes breed. Those can include flower pots, swimming pool covers, dis- carded tires and pet water bowls. The virus causes only a mild and brief illness, at worst, in most people. But in the last year, infections in pregnant women have been strongly linked to fe- tal deaths and devastating birth defects, mostly in Bra- zil, where the Health Minis- try said Tuesday that 1,113 cases of microcephaly have been confirmed since Octo- ber. So far, there have been no documented Zika infec- tions in the U.S. caught from mosquitoes. Nearly 350 ill- nesses in the 50 states were reported as of last week, all linked to travel to Zika out- break regions. Thirty-two of the victims were pregnant. The CDC report comes at a time when health offi- cialshavebeenbeggingCon- gress to approve an emer- gency $1.9 billion in supple- mental funding to fight Zika internationally and prepare for its spread in the U.S. Ear- lier Wednesday, top House Republicans said they will probably grant a portion of that, but probably not until September. Asthemicrocephalycases rose in Latin America, a number of theories circu- lated through the public. Some claimed the cause was a vaccine given to pregnant women. Some suspected a mosquito-killing larvi- cide, and others wondered whether genetically mod- ified mosquitoes were to blame. Investigators gradu- ally cast those theories aside and found more and more circumstantial evidence im- plicating Zika. CDC officials relied on a checklist devel- oped by a retired University of Washington professor, Dr. Thomas Shepard, who listed seven criteria for es- tablishing if something can be called a cause of birth de- fects. CDC: No longer doubt Zika causes severe birth defects By Matthew Perrone The Associated Press WASHINGTON Critics of how prescription painkill- ers are administered in the U.S. are calling on health of- ficials to phase out hospital procedures and question- naires used to manage pain. They say the current sys- tem inadvertently encour- ages the overprescribing of addictive drugs like Vicodin and OxyContin, fueling an epidemic of overdoses tied to the opioid medications. Deaths linked to misuse and abuseofprescriptionopioids increased to nearly 19,000 in 2014, the highest figure on record, according to the Centers for Disease Control and Prevention. More than five dozennon- profit groups and medical expertssentaletterWednes- day to the Joint Commis- sion, a nonprofit agency that accredits U.S. hospi- tals, asking it to revisit its standards for pain manage- ment. Only hospitals that have been accredited can receive payments from gov- ernment plans like Medi- care and Medicaid, making the group's standards highly influential. The letter specifically takes issue with guidelines instructing doctors to ask patients to assess their pain. "The Pain Management Standards foster dangerous pain control practices, the endpoint of which is often the inappropriate provision of opioids with disastrous adverse consequences for in- dividuals, families and com- munities," states the letter, which is co-signed by health commissioners from Ver- mont, Pennsylvania, Alaska and Rhode Island. The Chicago-based Joint Commission rejected the idea that its standards push clinicians to prescribe opi- oids. Instead, the group said its standards require doc- tors to assess patients for pain and manage it. "The standards do not require the use of drugs to manageapatient'spain;and when a drug is appropriate, the standards do not specify which drug should be pre- scribed," it said. The group also stressed that it does not view pain as a "vital sign," a medical mantra often debated by pain specialists and their critics. Beginning in the 1990s, pain specialists and patient groups encouraged doctors to treat pain a vi- tal sign that should be rou- tinely monitored, alongside biological measures like body temperature, heart rate and blood pressure. "All pain was viewed as be- ing bad and so it pushed providers too often to over- prescribe opioids," said Dr. Michael Carome of the con- sumer advocacy group Pub- lic Citizen, one of the groups signing the letter. Wednesday's effort was spearheaded by Physicians for Responsible Opioid Pre- scribing, which advocates for alternative treatments to opioids, including non- opioid pain relievers, physi- cal therapy and psychother- apy. The group is funded by Phoenix House, a nonprofit chainofaddictiontreatment centers. The same coalition filed a petitionWednesdaywiththe federal agency that admin- isters Medicare and Medic- aid, the government health programs for the elderly, disabled and poor. The let- ter asks that officials elim- inate certain pain-related questions from patient-sat- isfaction questionnaires, such as: "During this hospi- tal stay, how often was your pain well controlled?" The groups argue that such questions inadver- tently encourage aggressive use of painkillers to main- tain high patient-satisfac- tion metrics. "Aggressive manage- ment of pain should not be equated with quality health care as it can result in un- helpful and unsafe treat- ment," states the petition, which calls on the govern- ment to release a proposal for a new questionnaire within 90 days. HEALTH Painkiller critics take aim at hospital surveys, procedures | NEWS | REDBLUFFDAILYNEWS.COM THURSDAY, APRIL 14, 2016 4 B