Issue link: https://www.epageflip.net/i/671362
ByLauranNeergaard TheAssociatedPress WASHINGTON Zika may stand convicted of causing devastating birth defects but there still are lots of questions about how much of a threat the virus poses to pregnant women, and what to do about it. Part of the answer has to do with geography: So far, mosquitoes aren't spread- ing Zika in the mainland U.S. That means for now, the main advice for pregnant women here is to avoid travel to Zika-affected parts of Latin America or the Ca- ribbean. But that could change as mosquito sea- son gets into full swing at home. "It would not be sur- prising at all, if not likely, that we're going to see of a bit" of local Zika transmis- sion, Dr. Anthony Fauci of the National Institutes of Health told Fox News Sun- day. Here are some questions and answers about what experts know, and need to learn, as the first mosquito- borne virus known to cause birth defects inches closer to the U.S. Q: Just what birth de- fects can Zika cause? A: Zika had been consid- ered a nuisance virus un- til a massive outbreak be- gan last year in Brazil and doctors there reported ba- bies being born with unusu- ally small heads, called mi- crocephaly. Last week, the U.S. Centers for Disease Control and Prevention said Zika was indeed the culprit — and that it caused a par- ticularly severe form of mi- crocephaly, with serious un- derlying brain damage, as well as other brain-related abnormalities. Studies increasingly show Zika gets into a fe- tus' developing brain and kills cells, or stops them from growing further, and even can kill the fetus. But even if the brain seemed to be developing normally, still other studies have found stillbirths, poor fetal growth and other problems. Q: If a mother-to-be be- comes infected, how likely is her baby to be harmed? A: No one knows yet. One modeling study of an out- break in French Polyne- sia suggested 1 percent of babies born to women in- fected during the first tri- mester alone would have microcephaly. In another study, ultrasound exams spotted some sort of abnor- mality, not just microceph- aly, in nearly 30 percent of women who had Zika dur- ing pregnancy. Studies bet- ter designed to answer that question are under way now. Q: Does it matter when during pregnancy the mother is infected? A: Specialists think the first trimester is especially vulnerable, because that's when organs develop. But the brain continues to grow throughout pregnancy and some studies have found signs of trouble even if in- fection occurred much later. Q: Can the fetus be harmed even if the mother didn't know she was in- fected? A: Again, that's not clear. Most adults report either mild or no symptoms from Zika, but it could just be that they didn't notice. Q: Then how would preg- nant women know if they'd been infected? A: Any who did travel to Zika-affected areas should tell their doctors, who can order the appropriate test- ing to help determine their risk. There is no treatment for Zika, but those who were infected may need ul- trasound exams to check how the fetus is developing. Q: Are mosquitoes the only risk? A: They're the main way Zika spreads, and the rea- son for CDC's advice for women who are pregnant or attempting conception not to travel to Zika-af- fected areas. But the virus can be spread through sex- ual intercourse, too, as it lasts longer in semen than in blood. So if a man is ex- posed while his partner is pregnant, the CDC advises abstaining or using con- doms until the baby is born. Q: Is there any risk to fu- ture pregnancies if a non- pregnant woman is in- fected? A: The CDC says women who traveled to a Zika-af- fected area or who became infected should wait eight weeks before attempting conception. She may be ad- vised to wait longer if the father-to-be also was ex- posed or infected. Q: How could Zika be- gin spreading in the main- land U.S.? A: All it takes is the right kind of mosquito biting a returning traveler who's infected, and then biting someone else nearby. That's why CDC wants all return- ing travelers to take steps to avoid mosquito bites for three weeks after they re- turn home — by using in- sect repellent, covering up, or staying indoors. Q: Do officials expect widespread outbreaks in the U.S.? A: No, but they do expect local clusters of cases — just like has happened in previ- ous years with a Zika rel- ative named dengue fever that's spread by the same mosquito, a species named Aedes aegypti. It's not just a threat in the South but reaching into parts of the Midwest and Northeast. Q: When will we see a vaccine? A: Not for a while. NIH's Fauci hopes to begin small safety steps of a candi- date by September but that wouldn't make any dent in the Latin American out- break. VIRUS Still many questions about Zika's threat to pregnant women By Lindsey Tanner The Associated Press OAK LAWN, ILL. It happens every day to the most vul- nerable infants in hospital intensive care units: frag- ile babies born way too soon are poked, prodded and jabbed as part of medi- cal care meant to help them survive — and it can be heart-wrenching to watch. Heel sticks for blood tests, inserting IV tubes, adjusting breathing ma- chines — even the gentlest jostling to remove a ban- dage from translucent skin can cause kittenlike whim- pers and tiny arms and legs to suddenly jerk. Sometimes there's no sound at all — just a dip on the heart rate monitor. It used to be thought that these infants were too young to feel pain. But even now, experts say, pain re- lief for newborns and espe- cially preemies is often in- adequate, despite evidence that low-tech comforting methods and medication can both be effective. The American Academy of Pediatrics has new advice — and an admonishment. Pain in newborns "con- tinues to be inconsistently assessed and inadequately managed," the academy says. Remedies "are cur- rently underused for rou- tine minor yet painful pro- cedures." Preventing and reduc- ing pain, particularly in preemies, is important be- cause of the potential con- sequences for infant devel- opment, the academy said in a policy issued in Febru- ary. Research suggests re- peated bouts of pain leave infants prone to potential long-term ill effects includ- ing changes in nerve struc- tures and brain develop- ment, and hypersensitivity to touch and stress — and it's the smallest and sickest babies who experience the greatest number of painful procedures. Pain assessment can be a significant challenge in preemies, said newborn specialist Erin Keels, the policy's lead author and a nurse at Nationwide Chil- dren's Hospital in Colum- bus, Ohio. Preemie's pain cues aren't always obvious. They often have multiple health prob- lems that need attention, and in busy intensive care units, pain relief for every day minor procedures can sometimes get overlooked, she said. The new guidance was prompted in part by re- cent research showing benefits from alterna- tives to medication, Keels said. These include sugar- dipped pacifiers, tight swaddling and skin-to- skin contact with moms and dads. Newer ways to measure infant pain also are being tested, in- cluding measuring brain waves and electrical im- pulses in the skin. Pain management dur- ing surgery and other ma- jor procedures typically re- quires medication, often opioids including morphine. Short-term side effects of these drugs may include a slowed heart rate, low blood pressure, and drug depen- dence. Some small stud- ies have linked use of these drugs in extremely prema- ture babies with slowed weight gain, smaller head size and behavior troubles later in childhood, but re- search on appropriate doses and potential long-term ef- fects "is woefully lacking," the academy says. It urges more research on using these drugs and other medications in infants. "While we want to man- age pain appropriately, we also have to pay attention to not going too far in the other extreme," said Dr. Wil- liam MacKendrick, medical director of the infant spe- cial care unit at NorthShore Evanston Hospital in Evan- ston, Illinois. He was not in- volved in the policy. U.S. hospitals are re- quired to assess patients' pain in order to be accred- ited, and it's an issue new- born specialists are increas- ingly paying attention to. At Advocate Children's Hospital in Oak Lawn, Illi- nois, tiny twins Evelyn and Olivia Niedermeyer are helping find answers. The babies were born more than a month early, in January, weighing less than 3 pounds. They're en- rolled in a study compar- ing infants' reactions to two different tiny devices used to detect retinopathy, an eye disease that can cause blindness in very premature babies. The metal devices prop eyelids open so doctors can look beyond the eyeballs' surface into the retina. The hospital is trying to find out which of the two devices causes less discomfort, said Debra Skopec, a new- born intensive care nurse and the study's leader. INFANTS Better preemie pain relief sought ASSOCIATEDPRESSPHOTOS Parents Bryan Niedermeyer and Angelica Juarez visit with Olivia Niedermeyer, their preemie daughter, a er she and twin sister Evelyn underwent eye exams at Advocate Children's Hospital in Chicago. A nurse measures preemie Olivia Niedermeyer a er the baby underwent an eye exam at Advocate Children's Hospital in Chicago. The Associated Press SACRAMENTO Thousands of Californians are owed money in life insurance benefits, in some cases over $100,000, because they did not know they were beneficiaries, state officials said. In many cases insurance companies made no effort to notify the beneficiaries, and the state Controller's Office is trying to get about $307 million to its proper owners. The trust of a single person in Los Angeles County is owed $583,000, and the heirs of at least 50 others across the state are owed at least $150,000, the San Fran- cisco Chronicle reported Sunday. The newspaper says some of those owed money have since themselves died, and the money is owed to un- known heirs. CALIFORNIA State: Many are owed unclaimed life insurance Paid advertisement Newpatientsalwayswelcome! Dr.AuroraBarriga,Optometrist 715 Jackson St., Suite A, Red Bluff (530) 527-9242 Red Bluff Vision Center An Optometric Practice YourFullServiceEyeCareProfessionals Quality Eye Care, Quality Eyewear Come see us for your vision exams and treatment of medical eye problems such as dry eye, allergies, blurred vision and eye injuries. Ocular eye evaluations for diabetes, glaucoma, hypertension (high blood pressure), cataracts, and high risk medications as well. Call to schedule an appointment for you and your family members today! www.redbluffvision.com Please visit our web site at Sponsoredby The Saturday Market SlowFood Shasta Cascade ® Your community YEAR-ROUND Certified Farmers & Artisan Market 8-12:30, every Saturday Home Depot parking lot April 23, 9am-12pm Join us for our EVENT HEALTH » redbluffdailynews.com Tuesday, April 26, 2016 MORE ATFACEBOOK.COM/RBDAILYNEWS AND TWITTER.COM/REDBLUFFNEWS A4