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NEW YORK (AP) — Zika infections have been confirmed in nine pregnant women in the United States, including one who gave birth to a baby with a rare birth defect, health officials said Friday.
The Centers for Disease Control and Prevention said it's investigating 10 more reports of pregnant travelers with Zika. All got the virus while visiting or living in places with Zika outbreaks.
Also on Friday, the CDC issued a caution to people planning to attend the Olympics this summer in Rio de Janeiro.
The U.S. cases add to reports out of Brazil. Officials there are exploring a possible link to babies born with unusually small heads, a rare birth defect called microcephaly, which can signal underlying brain damage.
Zika has become epidemic in Latin America and the Caribbean since last fall. The virus, mainly spread through mosquito bites, causes mild illness or no symptoms in most people.
Since August, the CDC has tested 257 pregnant women for Zika; eight were positive, and a state lab confirmed a ninth.
— Three of the women have delivered babies; two of the newborns are apparently healthy, and one was born with microcephaly.
— Two had miscarriages, but it's unknown if the Zika infection was the cause.
— Two women had abortions, one after scans showed the fetus had an undeveloped brain. Details were not provided for the second case.
— Two pregnancies are continuing with no reported complications.
Five of the women had Zika symptoms in the first trimester, including the miscarriages, abortions and newborn with microcephaly.
In its report Friday, the CDC did not give the women's hometowns; state health officials have said there were two pregnant women with Zika in Illinois, three in Florida and one in Hawaii, who gave birth to a baby with microcephaly. That mother had lived in Brazil early in her pregnancy.
The CDC said all are U.S. residents, but it declined to answer a question on their citizenship.
The health agency said the nine women had been to places with Zika outbreaks — American Samoa, Brazil, El Salvador, Guatemala, Haiti, Honduras, Mexico, Puerto Rico and Samoa.
Those destinations are among the 30 places now on the CDC's travel alert. It recommends that pregnant women postpone trips to those areas.
While the link between Zika and the birth defect has not been confirmed, the possibility has prompted health officials to take cautionary steps to protect fetuses. That includes advice that Zika-infected men who have pregnant partners use condoms or abstain from sex.
In new guidance issued Friday night, the CDC addressed people planning to travel to Brazil for the 2016 Olympic Games in August and the 2016 Paralympic Games in September. The agency again advised that pregnant women consider not going and that their male sexual partners use condoms after the trip or abstain from sex during the pregnancy.
Women who are trying to become pregnant should talk to their doctors before making the trip, the CDC advised.
The CDC also recommends that all travelers use insect repellent while in Zika outbreak areas and continue to use it for three weeks after travel in case they might be infected but not sick. That's to prevent mosquitoes from biting them and possibly spreading Zika to others in the U.S. The type of mosquito that spreads Zika is in parts of the South.
The CDC has set up a voluntary registry to collect information about Zika-infected women and their babies. Officials also have made Zika a reportable disease.
Research also is underway into a possible link between Zika and a paralyzing condition in adults called Guillain-Barre.
The CDC on Friday also updated its investigation into 14 cases of possible sexual transmission of Zika from male travelers to their sex partners in the United States. Two cases have been confirmed, four more are probable and two have been dropped, the report said.
Zika is primarily spread by mosquito bites, and transmission through sex was thought to be extremely rare. It's been surprising that this many instances appear to have happened in the United States, CDC Director Dr. Tom Frieden noted during a call with reporters.
Similarly, the number of U.S. cases involving evidence of microcephaly or brain abnormalities "is greater than we would have expected," said the CDC's Dr. Denise Jamieson.
So far, 107 travel-related Zika infections have been diagnosed in 24 states and the District of Columbia, including the pregnant woman.
WASHINGTON (AP) — The Supreme Court challenge to a Texas law that has dramatically reduced the number of abortion clinics in the state is the justices' most significant case on the hot-button issue in nearly a quarter-century.
One of this election-year term's biggest cases is being argued Wednesday before a court altered by the death of Justice Antonin Scalia. He was perhaps the most vociferous abortion opponent among the nine justices.
The Texas law has been replicated across the South and elsewhere, part of a wave of state abortion restrictions in the past five years.
States mainly led by Republicans have tried to limit when in a pregnancy abortions may be performed, restricted abortion-inducing drugs that take the place of surgery and increased standards for clinics and the doctors who work in them.
The Supreme Court case involves that last category. A Texas law enacted in 2013 requires doctors who perform abortions to have admitting privileges at nearby hospitals. It also prohibits clinics from providing abortions unless they meet the standards of outpatient or ambulatory surgical centers.
The high court has partially blocked those measures. If allowed to take full effect, all but 10 clinics in Texas would have to close. There would be no abortion providers in the state's rural areas or west of San Antonio. The only clinic in the Rio Grande Valley would be allowed to remain open on a limited basis. Before the law was passed, there were roughly 40 clinics in the state. About half have closed.
The case offers competing views of how to protect women's health. The clinics contend abortions are safer than many other medical procedures that are less stringently regulated and that the clinic regulations have only one purpose: to reduce the availability of abortions.
"These laws are tantamount to an outright ban for too many," said Amy Hagstrom Miller, chief executive of Whole Woman's Health, which operates clinics in Texas and other states.
Defenders of the laws in Texas and elsewhere argue that states have discretion to take steps to make abortions safer. Alabama and other states backing Texas told the Supreme Court that states were within their rights to apply health regulations to clinics for the sake of patients.
"Obviously I'm pro-life and I would like to limit the number of abortions, but here we were looking at women's health and safety," said Republican Gov. Robert Bentley of Alabama, a doctor who signed his state's admitting privileges law.
Texas Solicitor General Scott Keller, who will defend the law at the Supreme Court, said Texas acted in response to the high-profile case of Philadelphia abortion doctor Kermit Gosnell. He is serving a life sentence after his conviction for killing three babies born alive and for the overdose death of a woman who was a clinic patient.
A federal judge in Texas struck down parts of the law as not intended to promote women's health and clearly aimed at reducing access to abortion. But the 5th U.S. Circuit Court of Appeals in New Orleans largely accepted the state's argument.
The justices' June 2015 order putting the appellate ruling on hold at least suggests that there is a majority to cut back on the regulations. The clinics and abortion-rights groups are hoping for a ruling that might bolster challenges to other restrictions on abortion.
To prevail, they still need Justice Anthony Kennedy's vote, along with the reasonably certain votes of four more liberal justices, just as they did before Scalia's death. Kennedy was part of the 5-4 majority to reaffirm abortion rights in 1992, then wrote the court's decision in 2007 that upheld a federal law banning a certain procedure that opponents call partial-birth abortion. That was also a 5-4 split.
A broad high court ruling striking down the Texas provisions would show that the court's 1992 decision still "has some teeth in it," said Stephanie Toti, the lawyer who will argue the clinics' case.
Without Scalia, the best that supporters of these laws can hope for is a 4-4 tie, which would uphold the appeals court's endorsement of the Texas law and perhaps affect similar laws in Louisiana and Mississippi because they are part of the same judicial circuit as Texas.
A trial judge also struck down Louisiana's admitting privileges law, but the 5th Circuit has allowed Louisiana to enforce the law as the case makes its way through the courts.
Two of the state's four clinics have closed in response and a third will have to close soon, said Nancy Northup, president of the Center for Reproductive Rights. On Friday, the clinics said in an emergency appeal to the high court that only a New Orleans clinic would remain open if the state is allowed to enforce the law. They want the justices to block the ruling and let them stay open.
A split decision in the Texas case would have no effect on laws that have been blocked in Alabama and Oklahoma, among other states.
Women already make the drive from Louisiana and Mississippi to have abortions at the West Alabama Women's Center in Tuscaloosa, Alabama, said Dr. Willie Parker, who performs abortions in Alabama, Georgia and Mississippi. The Tuscaloosa clinic is Alabama's busiest. It would be among four clinics, out of five, that would have to close under the Alabama admitting privileges law, which is not in effect.
If the Texas law stands and others like it are enforced, Parker said, "it won't mean fewer unintended pregnancies. It won't mean fewer fatally flawed pregnancies. It will mean women will be left without a safe and legal means of ending pregnancy."
Ashley McGuire, a senior fellow with the anti-abortion group The Catholic Association, said the fight to limit abortions will continue no matter what the Supreme Court says. "This fight is not going away anytime soon," McGuire said.
The case is Whole Woman's Health v. Hellerstedt, 15-274.
LONDON (AP) — Scientists may have the first evidence that Zika can cause temporary paralysis, according to a new study of patients who developed the rare condition during an outbreak of the virus in Tahiti two years ago.
Zika is currently spreading with alarming speed across the Americas. The World Health Organization declared the epidemic to be a global emergency several weeks ago based on suspicions it may be behind a surge in disturbing birth defects and in Guillain-Barre syndrome, a neurological illness that mostly lasts a few weeks.
Before reaching South America last year, the mosquito-spread Zika had triggered outbreaks in the South Pacific on Yap island in Micronesia and in French Polynesia, including its largest island, Tahiti.
Researchers in Tahiti, France and elsewhere went back and analyzed blood samples from all 42 adults diagnosed with Guillain-Barre syndrome from the 2013-14 outbreak; nearly everyone showed signs of a previous Zika infection.
They were compared with patients who did not have the condition and did not have any Zika symptoms but were treated at the same hospital for other illnesses. Tests showed only half of that group of 98 had apparently been infected with the normally mild virus.
The research was published online Monday in the journal Lancet.
"The evidence that links Zika virus with Guillain-Barre syndrome is now substantially more compelling," said Peter Barlow, an infectious diseases expert at Edinburgh Napier University who was not part of the study. But he noted in a statement that more research was needed before reaching the same conclusion about the outbreak in the Americas, where local factors may be playing a role.
Zika is mostly spread by mosquito bites and in most people causes symptoms including fever, muscle pain and a rash. About 80 percent of people who catch the disease don't report any illness.
Guillain-Barre syndrome is typically seen after a viral or bacterial infection so a possible connection to Zika isn't entirely unexpected. It occurs when the body's immune system attacks the nervous system, often for unknown reasons. It can cause muscle weakness and breathing problems; about 5 percent of patients die from the disorder. Of the patients observed in Tahiti, none died and three months after leaving the hospital, about 40 percent could walk unaided.
The study also considered whether Guillain-Barre was the result of people being infected with both Zika and a related tropical disease, dengue, by comparing them with people who had Zika but no neurological symptoms. It found no hint that having dengue upped the risk.
Based on their findings, the scientists estimated that of 100,000 people with Zika, about 24 would develop Guillain-Barre syndrome. In Europe and North America, the average rate of the syndrome after infections like flu and dengue is about one to two people per 100,000.
David Smith of Australia's Curtin University said it was difficult to know exactly how often Zika causes Guillain-Barre syndrome. Smith co-authored an accompanying commentary in the Lancet.
He said in an email that because the Zika virus disappears from the body by the time patients develop neurological complications, there was only indirect evidence — via infection-fighting antibodies — that Zika caused Guillain-Barre syndrome. Zika is thought to be gone from the bloodstream after a week or so. Smith said not all of the Guillain-Barre cases in Tahiti could be blamed on Zika and that the researchers' estimate of the syndrome's incidence was probably inflated.
Still, experts predicted cases of Guillain-Barre syndrome would jump as Zika explodes in the Americas and WHO has warned the disease is likely to spread everywhere in the region except for Canada and Chile.
The study doesn't shed any light on whether Zika is also responsible for the spike in the number of babies born in Brazil with abnormally small heads, or microcephaly.
"That remains a mystery but our suspicions are very strong," said Jimmy Whitworth, a professor of infectious diseases at the London School of Hygiene and Tropical Medicine.
"Both Guillain-Barre syndrome and microcephaly are neurological conditions, but I don't think it would be the same mechanism that's causing both," he said. "There may be something slightly different happening with microcephaly."
Since the Zika outbreak in the Americas began last year, it has sparked epidemics in about 40 countries, of which eight have reported cases of Guillain-Barre syndrome possibly connected to Zika.