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Zika may have damaged more infants’ brains than expected

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It’s a virus some might not even remember, but babies born to mothers infected with Zika who appeared normal at birth still experienced neurological or developmental problems, new research suggests.

A hallmark of infection with the mosquito-borne Zika virus in pregnant women is delivering a baby with an abnormally small head — a condition called microcephaly.

But as children exposed to Zika in the womb are growing up, researchers are learning that it’s not only the youngsters born with microcephaly that they need to worry about.

“Zika virus-exposed infants without microcephaly who may appear normal at the time of birth may have other abnormalities present at higher frequencies than what would be expected in the general population,” said study author Jessica Cranston. She’s a third-year medical student at the David Geffen School of Medicine at the University of California, Los Angeles.

Cranston said it’s important to monitor children who’ve been exposed to Zika to ensure that they grow normally and meet their developmental milestones. By doing so, doctors can detect problems early and offer interventions to potentially improve a child’s development.

Right now, there is no known transmission of Zika virus in the United States. But there were reports of Zika infections in Florida and Texas in 2016 and 2017, according to the U.S. Centers for Disease Control and Prevention. Other countries, including Brazil, experienced significant Zika outbreaks in 2015 and 2016.

Zika virus is transmitted through mosquito bites. People who get infected may not have any symptoms, or they may have mild symptoms. Possible symptoms include fever, rash, headache, joint pain, red eyes and muscle pain. In pregnant women, however, the Zika virus can lead to microcephaly and other brain and birth defects in babies.

The new study included data on nearly 300 infants with known — 74 percent — or suspected Zika infections acquired during pregnancy. Twenty-four percent of the children were born with microcephaly. The rest appeared to have normally developed heads.

The babies’ health and development was followed from December 2015 to July 2019. Children received monthly evaluations during the first six months of life. After the first six months, children were evaluated every three months.

The researchers found that head circumference varied over time for some of the children. In babies born with a normal head size, about 10 percent developed microcephaly during the follow-up.

Conversely, 7.5 percent of those born with microcephaly went on to have a normal head size during the study.

Neurological exams were performed on 213 of the infants. Seventy-five percent had abnormal findings, such as overactive reflexes.

In youngsters with microcephaly, 26 percent had hearing problems and 79 percent had eye abnormalities. The children with normally sized heads didn’t escape having hearing or eye issues — 10 percent had hearing problems and 18 percent had eye abnormalities.

Some children also experienced trouble with growing as expected and some had difficulty swallowing.

Imaging tests were done on 203 children. Ninety-six percent of those with microcephaly had abnormal findings on these tests compared to 29 percent of those with normally sized heads.

The bottom line, said Cranston, is that infants born without obvious symptoms shouldn’t be dismissed as unaffected.

“These infants should be followed closely during the first few years of their lives to monitor for any developmental delay,” she said.

The study was published online July 7 in JAMA Network Open.

Dr. Sarah Mulkey, director of fetal, transitional and neonatal neurology fellowship at Children’s National Hospital in Washington, D.C., wasn’t involved in the latest research, but wrote an editorial accompanying the new study. Mulkey has also conducted research on children born with Zika who appeared to be normal at birth, but later developed neurological issues.

“Initially, we were seeing kids born with obvious birth defects like microcephaly. What we’re now learning is that there is a spectrum of other clinical outcomes. If you had Zika and your child was born without any birth defects, it’s very important to maintain developmental follow-up through school age,” she explained.

Mulkey said it’s crucial to have your child’s head circumference measured regularly — something most pediatricians do. Having a record of your child’s head circumference allows doctors to make sure the brain is developing as it should.

Mulkey noted that the latest findings suggest that “even a low-normal finding may be an indication of a need for neurodevelopmental follow-up.”

She also said that many Zika infections in pregnancy may have gone undiagnosed. If a child is born without an obvious defect, more subtle neurological problems or developmental issues related to Zika may go undetected.

Mulkey said the children with obvious defects are likely just “the tip of the iceberg.”

If you lived in or traveled to an area where Zika was present while you were pregnant, Mulkey said to make sure your child’s pediatrician knows so that they can perform neurodevelopmental screening exams to ensure that your youngster is reaching important developmental milestones.

More information

Learn more about Zika virus from the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.



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FDA issues emergency authorization for first at-home COVID-19 test

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Nov. 18 (UPI) — The U.S. Food and Drug Administration has issued an emergency authorization for the first rapid coronavirus test that can be administered at home.

The agency announced the authorization for the all-in-one test kit late Tuesday in response to a request by Kelly Lewis Brezoczky of Lucira Health, the California-based company that developed the test.

In a letter to Brezoczky, the FDA said the test meets the criteria for an emergency use authorization as there are no available alternatives and the product’s benefits outweigh its known and potential risks.

The test has been authorized for use with samples collected from the nasal cavity of those age 14 years and older whose doctors suspect they have been infected with the coronavirus. Use in doctor’s offices, hospitals, urgent care centers and emergency rooms has been approved for all ages.

While there have been other products approved for collecting samples at home, the Lucira product is the first to be fully self-administered and to provide results without a physician’s assistance.

The company’s website said the test is intended to cost under $50 and is designed to provide results within 30 minutes.

“Today’s authorization for a complete at-home test is a significant step toward FDA’s nationwide response to COVID-19,” Jeff Shuren, director of the FDA’s Center for Devices and Radiological Health, said in a statement.

FDA Commissioner Stephen M. Hahn said the development of a COVID-19 test that can be administered outside a healthcare setting has been a major priority for the FDA, and now that there is one more people who suspect that they may have been infected with the virus can take immediate action to protect themselves and their community.

“We look forward to proactively working with test developers to support the availability of more at-home test options,” he said.

The FDA approval was issued as the nation deals with a growing widespread outbreak. According to data collected by Johns Hopkins University, the United States has recorded more than 150,000 case a day in five of the last six days.

The United States has reported more than 11.3 million infections and nearly 250,000 deaths, making it by far the sickest country to the pandemic.



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Antidepressant might help prevent severe COVID-19

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The antidepressant drug fluvoxamine — best known by the brand name Luvox — may help prevent serious illness in COVID-19 patients who aren’t yet hospitalized, a new study finds.

The study included 152 patients infected with mild-to-moderate COVID-19. Of those, 80 took fluvoxamine and 72 took a placebo for 15 days.

By the end of that time, none of the patients who took the drug had seen their infection progress to serious illness, compared with six (8.3%) of the patients who took the placebo, according to researchers at Washington University School of Medicine in St. Louis.

“The patients who took fluvoxamine did not develop serious breathing difficulties or require hospitalization for problems with lung function,” said first author Dr. Eric Lenze, professor of psychiatry.

“Most investigational treatments for COVID-19 have been aimed at the very sickest patients, but it’s also important to find therapies that prevent patients from getting sick enough to require supplemental oxygen or to have to go to the hospital. Our study suggests fluvoxamine may help fill that niche,” Lenze noted in a university news release.

Fluvoxamine — widely used to treat depression, obsessive-compulsive disorder and social anxiety disorder — is a type of drug called a selective serotonin-reuptake inhibitor (SSRI). This class of drugs also includes medicines such as Prozac, Zoloft and Celexa.

But unlike other SSRIs, fluvoxamine has a strong interaction with a protein called the sigma-1 receptor, which helps regulate the body’s inflammatory response.

“There are several ways this drug might work to help COVID-19 patients, but we think it most likely may be interacting with the sigma-1 receptor to reduce the production of inflammatory molecules,” explained study senior author Dr. Angela Reiersen, associate professor of psychiatry.

“Past research has demonstrated that fluvoxamine can reduce inflammation in animal models of sepsis, and it may be doing something similar in our patients,” she said in the release.

By reducing inflammation, fluvoxamine may prevent a hyperactive immune response in COVID-19 patients. That, in turn, may decrease their risk of serious illness and death, Reiersen said.

“Our goal is to help patients who are initially well enough to be at home and to prevent them from getting sick enough to be hospitalized,” Dr. Caline Mattar, assistant professor of medicine in the Division of Infectious Diseases, said in the release. “What we’ve seen so far suggests that fluvoxamine may be an important tool in achieving that goal.”

Dr. Amesh Adalja is a senior scholar at the Johns Hopkins Center for Health Security in Baltimore. He wasn’t involved in the study, but said the research is “notable not only because of its positive outcome — we desperately need a medication that keeps COVID patients out of the hospital — but also because of the manner in which it was conducted.”

But Adalja stressed that a larger trial is needed “to see if the promising findings hold up.”

The researchers said they plan to begin such a study in the next few weeks and it will include patients from across the United States.

The preliminary study was published online Nov. 12 in the Journal of the American Medical Association.

More information

For more on COVID-19, go to the U.S. Centers for Disease Control and Prevention.

SOURCES: Amesh Adalja, M.D., senior scholar, Johns Hopkins Center for Health Security, Baltimore; Washington University in St. Louis, news release, Nov. 12, 2020

Copyright 2020 HealthDay. All rights reserved.



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Survey: 40% in U.S. planning large gatherings for holidays despite COVID-19 warnings

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Nov. 12 (UPI) — Nearly 40% of U.S. residents plan to participate in gatherings of 10 or more people this holiday season despite concerns over the spread of COVID-19, according to the findings of a survey released Thursday by Ohio State University.

In addition, one-third of respondents said they wouldn’t ask attendees at holiday parties with family or friends to wear masks, and just over 25% indicated that they wouldn’t practice social distancing, the data showed.

“We’re going to look back at what happened during this holiday season and ask ourselves, ‘Were we part of the solution or were we part of the problem?'” Dr. Iahn Gonsenhauser, part of the team that conducted the survey, said in a statement.

“When you’re gathered together around the table, engaged in conversation, sitting less than 6 feet apart with your masks down, even in a small group, that’s when the spread of this virus can really happen,” said Gonsenhauser, chief quality and patient safety officer at Ohio State University Wexner Medical Center.

Researchers at Ohio State surveyed more than 2,000 U.S. residents on their holiday plans in the context of the COVID-19 pandemic.

As of Thursday afternoon, nearly 10.5 million people nationally have been sickened by the virus, and more than 240,000 have died, according to figures from Johns Hopkins University.

In recent weeks, federal, state and local public health officials have advised against traveling or partaking in large social gatherings as the holiday season approaches to limit the risk of spreading the new coronavirus to vulnerable loved ones.

At the very least, they’ve asked that gatherings not happen without wearing a mask and practicing social distancing, or staying 6 feet apart.

Those at risk for severe COVID-19 include the elderly, as well as those with diabetes, heart disease and high blood pressure, all of which are common across the United States, according to the Centers for Disease Control and Prevention.

Still, 38% of respondents to the Ohio State survey indicated they would host or attend a gathering with 10 or more people during the holidays and 33% would not ask others to wear masks, the researchers said.

However, 73% of respondents said they would practice social distancing during the holidays and 79% suggested that they would celebrate or gather only with people with whom they live, the data showed.

Just over 80% indicated that they would ask family and friends invited to events not to come if they had symptoms of COVID-19.

“If you have someone in your household who’s high risk and you’re in a low incidence area, you’re going to want to think twice about having a celebration where people are coming from an area where there’s a lot of virus in the community,” Gonsenhauser said.



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