RIO DE JANEIRO—The dengue-like Zika virus has been linked for the first time to cases of babies being born with small heads, or microcephaly, Brazil’s government said.

Scientists studying a surge of such cases in northeastern Brazil found the presence of the virus in the blood of a baby born with birth defects in Ceara state, the government said. The girl died.

The link to Zika “is an unprecedented situation in the global scientific community,” the Health Ministry said in a statement released Saturday.

Researchers with the U.S. Centers for Disease Control and Prevention will soon travel to Brazil at the government’s request to study the link between the rare neurological condition and the virus.

Brazilian health officials believe pregnant women are more vulnerable to developing fetuses with microcephaly if they are infected with Zika in their first trimester. This year, the ministry has reported 739 cases of babies born with microcephaly in nine states that have been hit by Zika infections, while last year the same region reported only 45.

“Research on the subject should continue to clarify issues such as how it is transmitted, what it does to the body, how the fetus gets infected and the time of greatest vulnerability for pregnant women,” the ministry’s statement said.

Microcephaly “usually reflects an underlying reduction in the size of the brain,” according to the CDC. The disorder can affect motor skills and cause mental retardation.

The same mosquito that carries the dengue virus, Aedes aegypti, is also responsible for spreading Zika, a disease that until now was known as a mild version of dengue with symptoms such as fever, rash and joint pain.

Outbreaks of Zika have occurred in Africa, Southeast Asia and the Pacific Islands. The virus isn’t found in the U.S., but cases of Zika have been reported in returning travelers, according to the CDC.

In its statement, Brazil’s Health Ministry reported two other deaths associated with the Zika virus not involving microcephaly. The victims were an adult male who suffered from lupus and a 16-year-old girl.

SÃO PAULO—Brazil is in the grips of yet another crisis: a fast-spreading virus some health officials are linking to thousands of cases of infant brain damage and 40 related deaths this year.

Health authorities have declared a national emergency as they battle the Zika virus, a mosquito-borne pathogen that has been detected across much of South America’s largest country.

Symptoms include fever, rashes, headaches, joint aches and vomiting, lasting from a few days to about a week. The virus is rarely lethal, and it is usually treated with bed rest and liquids.

Health officials believe the virus this year alone is responsible in Brazil for an explosion of cases of microcephaly, an extremely rare condition in which babies are born with shrunken skulls because their brains aren’t growing properly. But they say microcephaly hasn’t been linked to Zika virus outbreaks before.

On Tuesday, Brazil’s Health Ministry released figures showing that as of Saturday, the number of suspected Zika-related microcephaly cases had climbed to 2,782, a surge of nearly 16% from the previous week. The number of confirmed deaths shot up to 40 from 29 over the period. By comparison, Brazil had 147 cases of microcephaly for all of 2014.

“This is probably the largest outbreak of Zika ever recorded,” said Ann Powers, acting chief of the arboviral diseases branch at the Atlanta-based Centers for Disease Control and Prevention. “There’s a lot of concern about what it means, what the implications are, and what we can potentially do for containment and control.”

There are multiple potential causes of microcephaly in gestating babies, including genetic abnormalities, exposure to toxins and maternal alcohol abuse. Dr. Powers said there is a “suggestive” link between microcephaly and Zika, but said the connection couldn’t be confirmed until additional studies have been performed.

No vaccine exists to combat the Zika virus. Alarmed health and government officials are mobilizing communities nationwide to battle mosquitoes and have enlisted the help of international health agencies, including the World Health Organization and the CDC.

Brazilian government officials are dispatching army troops and other crews to drain water-logged areas and search out and eradicate larvae-filled water supplies. The state of São Paulo, Brazil’s most populous, has assembled a medical task force to coordinate diagnosis and treatment efforts.

With its introduction into Brazil and other countries in the Americas, including Colombia, El Salvador and Mexico, Zika is following a pattern similar to other mosquito-borne viruses that are riding speedily to new parts of the world.

The virus is carried by the Aedes aegypti and Aedes albopictus species, the same mosquitoes that transmit dengue and a similar disease, chikungunya. Those mosquitoes populate the southern U.S., Caribbean, Central and South America, Dr. Powers said.

The size of the Brazilian outbreak may be the reason health authorities are finding unusual neurological symptoms and disorders for the first time, she said.

Another reason may be a mutation in the virus, she said, adding that scientists are studying genetic sequences to look at whether changes have occurred that could lead to these disorders.

Still, chikingunya isn’t circulating widely on its own in the U.S. and any Zika outbreaks in the U.S. would be limited, Dr. Powers said, because the mosquitoes that carry it aren’t present year-round.

“This is a very good example of how something found in the past in one location can really turn out to be a problem in another,” she said.

Chikungunya, an infection that causes fever and severe, lasting joint pain, has long circulated in Africa, Asia and parts of Europe, but didn’t reach the Americas until 2013, when public health authorities found evidence of transmission in the Caribbean.

Since then, chikungunya has swept through the Americas.

“It does seem to be following a pattern similar to chikungunya,” Dr. Powers said of Zika.

With the Southern Hemisphere’s summer vacation season now under way and the nation gearing up for an influx of tourists for the 2016 Olympic Games in Rio de Janeiro, some Brazilian officials say they fear the infection rate could surge in coming months.

The Zika virus first surfaced in Africa in the late 1940s, and has hopscotched to Southeast Asia, the Western Pacific and more recently to Latin America. Exactly how it reached Brazil, why it is spreading so fast and how it became such a threat to developing fetuses isn’t yet understood. Brazilian health officials don’t know the exact number of adults infected with the Zika virus because the vast majority of them don’t receive hospital treatment.

What is clear is that Brazil’s mosquito population has surged over the past few years, paradoxically, as a result of a record drought that has hit the nation’s northeast and southeast. As water supplies dried up, anxious residents began storing emergency water supplies in swimming pools, plastic jugs and other containers, creating a huge stock of mosquito-breeding areas.

The Brazilian government’s infectious-disease officials are well-regarded throughout the region. But with the country mired in its worst economic crisis since the Great Depression and the nation’s capital transfixed by a massive corruption scandal and impeachment proceeding against President Dilma Rousseff, some worry that the nation isn’t mobilizing fast enough to battle the quick-moving epidemic.

Osmar Terra, a medical doctor, former state health secretary and current federal legislator from the southern state of Rio Grande do Sul, said he believes Brazil could have as many as 100,000 cases of infection in 2016 if emergency measures aren’t taken soon.

“This is an unprecedented human tragedy,” said Dr. Terra, who based his projections on his handling of the outbreak of the H1N1 virus in 2009. “We need a crisis cabinet” to deal with the situation.

Dr. Terra favors using drones to detect pools and hidden water supplies, allowing authorities to enter private homes without permission to search for stored water, and even urging women to delay pregnancy.

Other health professionals are giving some of the same advice. Experts say the Zika virus can be passed through a pregnant woman’s placenta to her fetus, with the greatest danger occurring during the first trimester.

Thomaz Gollop, a professor of genetic medicine at the University of São Paulo, is recommending his female patients under the age of 35 to wait a few more months this year before getting pregnant.

“Having a child is a lifelong commitment,” Dr. Gollop said.

Microcephaly cases with suspected links to the Zika virus have been reported in 19 of Brazil’s 26 states as well as the federal district of Brasília, the nation’s capital. But its effects are being felt most keenly in poor, northeastern states including Pernambuco, Paraíba, Ceará and Bahia.

Jussara Araujo, health secretary of Itapetim, in Pernambuco, said in a phone interview that the town had recorded 11 suspected cases of Zika-related microcephaly since October. But because the municipality of 13,800 lacks adequate medical infrastructure, pregnant mothers suspected of being infected had to be taken to the state capital of Recife, about 220 miles away.

“We are very saddened,” Ms. Araujo said. “We have no experts to handle it.”

One of those expectant mothers is Jackeline Palmeira de Araujo, a 26-year-old farmer who is 39 weeks’ pregnant. She said she is avoiding stagnant water, covering up with extra clothing and getting regular ultrasounds to check on her gestating daughter.  So far, everything is normal. But, “I am very scared,” Ms. Palmeira de Araujo said.

• Clinical Management :   An estimated 80% of Zika infections are asymptomatic, and most of the remainder are self-limited. No specific antiviral treatment is available and care is supportive, with symptoms usually resolving within 7 days.1 Severe GBS cases can require intensive care, including mechanical ventilation.OnJanuary 19, the CDC issued new guidelines for pregnant women with suspected or proven Zika virus infection, including an algorithm for offering laboratory testing. (Diagnostic testing is not optimal because antibody tests could cross-react, giving false-positive results due to other flavivirus infections.)Commercial tests are unavailable, but the CDC and several state laboratories have testing capability. Pregnant women with laboratory evidence of Zika virus in serum or amniotic fluid should consider serial fetal ultrasounds every 3 to 4weeks.

• Accelerated Research and Development. When Zika infection was seen as usually asymptomatic and self-limited, researchers had little incentive to develop reliable countermeasures. The emerging data on fetal complications,4 however, have altered this equation, with research on new vaccines becoming urgent. Similarly, understanding which individuals are at increased risk of GBS could allow specific antiviral treatment. A safe and effective Zika virus vaccine is probably 3 to 10 years away even with accelerated research.The National Institutes of Health launched a Zika vaccine initiative in late 2015, and Brazil has expedited vaccine development. Vaccines against yellow fever and Japanese B encephalitis have been licensed for decades, and Brazil, Mexico, and the Philippines approved the first dengue vaccine in 2015.

• Public Health Emergency Declarations. A national declaration of a public health emergency can focus political attention, while financing a surge in resources. Public health agencies also have increased authority during public health emergencies. Brazil, for example, proactively declared a public health emergency in November 2015.4 Countries experiencing major Zika virus outbreaks with possible neurological, autoimmun and congenital malformation associations could invoke heightened emergency powers.

World Health Organization Leadership :

• The World Health Organization (WHO) Ebola Panel in July 2015 said that urgent warnings “either did not reach senior leaders or senior leaders did not recognise their significance.”

• By many accounts the agency’s failure to act decisively cost thousands of lives.7 Despite internal reforms, however,WHO is still not taking a leadership role in the Zika pandemic. On January 18, WHO said it is “supporting countries to control Zika,” citing the need for surveillance, laboratories, vector control, and clinical care. Yet, the global dimensions of Zika are quite clear, with fresh urgency as the 2016 Olympics in Rio de Janeiro loom.

• Despite the global threat, the WHO director-general has not convened an IHR Emergency Committee to advise countries on critical issues such as vector control, health system preparedness, travel advisories, and avoiding punitive measures. An emergency committee should be convened immediately to advise the director-general about the conditions necessary to declare a Public Health Emergency of International Concern (PHEIC). The very process of convening the committee would catalyze international attention, funding, and research. While Brazil, PAHO, and the CDC have acted rapidly, WHO headquarters has thus far not been proactive, given potentially serious ramifications.

• Convening an emergency committee does not mean that the director-general should declare a PHEIC. WHO, for example, convened an emergency committee on 10 occasions to review global data on the Middle East respiratory syndrome (MERS). Yet the emergency committee has not advised to declare a PHEIC for MERS but has offered detailed recommendations to guide member states. The director-general has the sole authority under the IHR to convene an emergency committee, and she is uniquely empowered to declare a PHEIC subject to the committee’s advice.

• The director-general was widely criticized for waiting 4 months after the first cross-border transmission of Ebola before declaring a PHEIC.8,9 A key lesson learned from that searing experience was the need for an intermediate-level response to emerging crises, thus avoiding overreaction while still galvanizing global action. Functionally, the director-general could achieve a similar result by convening an emergency committee on Zika virus. The international community cannot afford to wait for WHO to act.

In her first major address on the Zika outbreak, the head of the World Health Organization, Dr. Margaret Chan, said the mosquito-borne virus has gone from being "a mild threat to one of alarming proportions." Chan spoke Thursday in Geneva.

The apparent link between Zika and severe birth defects in children in Brazil still hasn't been definitively proven but Chan says the threat is so high that she's calling for an emergency committee to advise her on "the appropriate level of international concern and for recommended measures that should be undertaken in affected countries and elsewhere." There's no vaccine or treatment for Zika. Chan says eliminating mosquito breeding grounds is one of the most important defenses against the disease.

"We really need to concentrate on mosquito control," Chan said in a briefing to the Executive Committee of the WHO.

The Zika virus was first detected in the Americas in May 2015 in Brazil. It has since spread in Chan's words "explosively" to 22 countries and territories in the hemisphere. There have also been a handful of cases in the mainland United States, but all of those have been in people who recently returned from Zika-affected areas.

"Arrival of the virus in some places," Chan says, "has been associated with a steep increase in the birth of babies with abnormally small heads and in cases of Guillain-Barre syndrome [a neurological condition]."

Another top official at the briefing, Dr. Marcos Espinal, the director of Communicable Diseases and Health Analysis at the WHO's Pan American Health Organization, noted that those neurological conditions have so far only been found in Brazil. Espinal said this raises the possibility that other factors in addition to Zika may be causing the severe health problems. Some researchers have wondered whether someone who gets infected with Zika and dengue at the same time, for instance, may suffer worse effects.

Chan and WHO were sharply criticized for moving too slowly to address the 2014 Ebola outbreak in West Africa. Some public health experts say the world's health agency has not been moving fast enough on Zika. Georgetown professors [Lawrence Oglethorpe Gostin (born 1949)] and [Dr. Daniel Richard Lucey (born 1955)], writing this week in JAMA, said, "WHO headquarters has thus far not been proactive, given potentially serious ramifications."

Chan's emergency committee is meeting on Monday to determine what measures should be taken both in the affected countries and elsewhere to address the outbreak.

Dr. Espinal said the virus is expected to spread to other parts of the world where dengue — which is spread by the same mosquito — is also present.

He added that he expects this outbreak to grow from the current estimate of 1 million cases to 3 to 4 million cases before it's brought under control.

Because symptoms are typically mild, the severity of the threat has not been established. But as Chan said in the briefing in Geneva: "Questions abound. We need to get some answers quickly."

As public health officials warn that the Zika virus is swiftly spreading across the Americas, the search is on to develop a vaccine to halt the disease, which could infect as many as four million people by the end of the year and has been linked to severe birth defects.

But even as a host of companies have announced plans to develop a vaccine, disease experts say it could be years — maybe as long as a decade — before an effective product makes its way to the public. Not only are scientists still learning about the virus, which until recently was viewed as relatively benign, but any vaccine must go through rigorous testing to ensure that it is safe and effective.

“It’s very important for people to be realistic,” said Dr. Jesse Goodman, a professor of medicine and infectious disease at Georgetown University, who between 2003 and 2009 was the director of the center at the Food and Drug Administration that approves vaccines. “It is a complex process, and for Zika, it hasn’t been on the map until this exploded in Brazil.”

Researchers are not only exploring ways to develop a vaccine but are also hoping to create a rapid test that would detect the presence of the virus’s antibodies.

But for both the vaccine and test research, experts say most drug companies have been reluctant to invest in drugs or treatments for diseases in the developing world unless they see a financial reward.

Brazil has been grappling with the virus since the first case appeared in May 2015, and it has since spread to more than 20 other countries in the region, according to the World Health Organization, which on Thursday rang an alarm about the disease. Public health officials are particularly worried that Zika leads to a condition known as microcephaly, in which infants are born with abnormally small heads and damaged brains. Although researchers have not conclusively identified Zika as the cause, the number of babies born in Brazil with microcephaly has risen sharply along with the spread of the virus. Zika was first identified in 1947 in Uganda, but it rose to international attention in 2007, when an outbreak was identified in the Pacific islands.

Two major vaccine makers, the British company GlaxoSmithKline and Sanofi Pasteur, a French manufacturer, said this week that they were looking into the feasibility of developing a Zika vaccine by building on previous successes with other diseases.

GlaxoSmithKline developed a vaccine for Ebola, which showed success in early clinical trials and is still being tested. Last year, Sanofi received approvals for the world’s first vaccine for dengue, which is closely related to Zika. However, Sanofi sounded a note of caution this week, even as it said it would look into a Zika vaccine. “There are too many unknowns about Zika to reliably judge the ability to research and develop a vaccine effectively at this time,” it said in a statement.

A handful of smaller companies have also said they are working on Zika vaccines, some on more aggressive timelines. One team, a collaboration between [Inovio Pharmaceuticals, Incorporated], the South Korean company [GeneOne Life Science, Inc.] and academic researchers in Canada and the United States, has said its product could be ready for emergency use by this fall. Two other companies, Hawaii Biotech and the [Protein Sciences Corporation], also announced plans for a Zika vaccine.

Meanwhile, public health officials said government researchers were working on at least two approaches to a vaccine and hoped to begin testing one of them in early clinical trials by the end of this year. That approach is a DNA vaccine method, which creates virus-like particles when it is placed into cells. The method was tried in a vaccine for West Nile, a related virus, and was found to be safe in early trials, but never progressed because the National Institutes of Health couldn’t find a company willing to develop it further, said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at the N.I.H.

Researchers will try the same approach with Zika by inserting a Zika gene into the same platform, in place of the West Nile gene. “I do not anticipate that we will have any problem partnering with pharmaceutical companies now,” he told reporters Thursday, referring to Zika.

Dr. Fauci added, however, “While these approaches are promising, it is important to understand that we will not have a widely available, safe and effective Zika vaccine this year and probably not even in the next few years.”

In a telephone interview Friday, Dr. Fauci said several factors could affect how long it would take for a vaccine to be approved, including how rampantly the disease spreads. A fast-moving disease, for example, would more quickly permit researchers to see if the vaccine is working.

Dr. Fauci said researchers were also eager to develop a rapid test to assess whether a person had been infected with Zika, to help pregnant women, in particular, find out if they have had the disease. A majority of people who are infected with Zika do not show any symptoms, and existing tests only seek out the active virus, which lasts in the body only for a short time. An easier-to-use test that looks for antibodies specific to Zika would be more useful, Dr. Fauci said, and he said academic researchers and some companies were exploring this avenue.

But even if the vaccine shows early success, drug companies — which have the capacity to manufacture large quantities of the product — must take an interest, he said, noting that earlier efforts to develop vaccines for West Nile and chikungunya, a related disease, have failed for lack of interest on the part of drug makers.

“It wasn’t perceived as a big economic boon for them to do that,” he said Friday.

Public health advocates have long criticized pharmaceutical companies for failing to invest in remedies for diseases that primarily afflict people in developing countries or ones that do not have a reliable market.

“What the private sector is most interested in are developing treatments for diseases that are known, common and predictable,” said [Lawrence Oglethorpe Gostin (born 1949)], a Georgetown law professor who co-wrote an article this week in the medical journal JAMA calling on officials to aggressively combat Zika. He has called for more public-private partnerships to give pharmaceutical companies better incentives to develop treatments for neglected diseases.

“Most of these diseases are unpredictable,” he said. “They’re sporadic, often they flare up in poor countries, and then they go away.”

Others said the Zika outbreak should be a lesson to public health officials not to ignore low-profile diseases. “We need to have better tools for these diseases,” said Dr. Carolina Batista, the Latin America medical manager for the Drugs for Neglected Diseases initiative, who is based in Brazil. “We should not wait for the crisis to come and then start.”  

Every time there is a major infectious disease outbreak that scares us — Ebola in West Africa in 2014, Middle East Respiratory Syndrome (MERS) on the Arabian Peninsula in 2012 and in South Korea in 2015, and now the Zika virus in South and Central America and the Caribbean — government leaders, the public and the news media demand explanations, guidance and predictions, and often express indignation that not enough was done to prevent it. Today everyone is asking about Zika: How did this crisis happen, and what do we need to do to make it go away? We immediately forget about the outbreak that came before it, and don’t plan for the ones we know are on the horizon. Almost no one wants to talk about Ebola or MERS now, or what we have or haven’t done to try to prevent an ugly recurrence.

When it comes to diseases, we have a very short attention span, and we tend to be reactive, rather than proactive. Instead of devoting ourselves to a comprehensive plan to combat microbial threats, we scramble to respond to the latest one in the headlines. There are lessons from previous infectious disease outbreaks that could and should have left us much better prepared than we are.

First, the mosquito that transmits this disease, the species Aedes aegypti, has never been more numerous or lived in more locations. Think of Aedes aegypti as the Norway rat of mosquitoes; it has evolved to live in close quarters with humans, and the trash that humans create. This is quite different from most other species of mosquitoes, like the ones that transmit West Nile virus, which tend to lay their eggs in marshes, rice fields, ditches, the edges of streams and small, temporary rain pools.

The world has changed dramatically in the past 40 years with regard to increasing the habitat for Aedes aegypti breeding. An explosion of plastic and rubber solid waste now litters virtually all parts of the globe, particularly in the developing world. Non-biodegradable containers, used tires and discarded plastic bags and wrappers — whether in the backyard, a roadside ditch or an abandoned lot — make ideal habitats for these mosquitoes to lay their eggs. All they need is a little rainfall.

This species is currently present in 12 states in the United States, mostly in the Southeast. But its close cousin, Aedes albopictus, known as the Asian tiger mosquito, came to the United States in the 1980s and is now in some 30 states, including the entire Eastern Seaboard up to New York City. For now, fortunately, this species does not appear to be a significant factor in the transmission of Zika to humans. What we in North America have to worry about is whether the Asian tiger mosquito can become a more effective transmitter of the virus to humans. If that happened, we would face a very serious risk of an outbreak here.

One of the solutions to this problem is called “vector control.” It involves both eliminating the places where these mosquitoes breed, or chemically treating those sites, and spraying chemical insecticides to kill adult mosquitoes, or at least keep them away from where humans live, work and play. We must clean up the garbage to have any hope of reducing Zika infections in humans.

From the 1950s through the 1970s, there was a major initiative to eradicate Aedes aegypti from the Americas by public health organizations, nonprofits and national governments. It almost succeeded. In part, that was because eliminating these mosquitoes’ breeding sites was much simpler before the spread of plastic and rubber waste. But governments and nonprofit agencies decided too early that the job had been done, and dismantled these programs to save money. Now the mosquito is back.

This is not new science or new policy. Now we’ve got an outbreak on our hands, and although the symptoms of Zika itself are absent to mild for most, for some there can be devastating consequences to infection. An increasing number of infected women have given birth to babies with microcephaly, which causes small heads and brain damage. We’re learning that Zika can lead to Guillain-Barré syndrome, a dangerous autoimmune disorder that can cause paralysis. Some believe we need more scientific data to confirm these more severe manifestations. I don’t agree; I believe the evidence is already compelling.

We shouldn’t have needed thousands of babies born with severe birth defects or people of all ages developing life-threatening autoimmune paralysis to remind us that mosquitoes pose a serious health threat. Dengue viruses, which are also transmitted by these two mosquito species, caused 2.3 million cases of dengue fever and far more serious dengue hemorrhagic fever in 2013 in the same countries in the Americas that have been, or will be, affected by Zika. These included more than 37,000 severe illnesses and 1,300 deaths. And yet these numbers hardly raised an eyebrow in the United States. If we had paid more attention then, we might be more prepared now.

Zika is here to stay in the Western Hemisphere; it will be part of life for many years to come. Even if we make vector control efforts a major initiative, it will only reduce, but not eliminate, the risk of Zika. What we need next, urgently, is a vaccine.

Some critics are suggesting that such vaccine research for Zika should have been done years ago, but this isn’t entirely fair. It was only in the past two years that there was any indication this virus could cause serious human disease. Now we have to catch up. But it’s going to be complicated. If Guillain-Barré syndrome is indeed caused by the patient’s immune response to the virus, as happens with other infectious diseases, could the vaccine itself put us at risk? This will take careful research to determine. And it will take time.

The point is, we should have anticipated that the large increase in mosquitoes would create a major health crisis. Just as we should have anticipated that a deadly hemorrhagic disease caused by the Ebola virus would emerge one day from the remote forests and threaten the vast slums of the rapidly growing megacities of Africa. We should now anticipate that the MERS virus will result in more deadly outbreaks outside of the Arabian Peninsula, as it did in Seoul, South Korea. We should anticipate that viruses such as Venezuelan equine encephalitis may spread from their jungle homes and be even more deadly than Zika.

Even more than these viruses, we should be afraid of a planet-wide catastrophe caused by influenza. The best way to avert a pandemic is to develop a game-changing universal influenza vaccine. All these crises are largely predictable and we can do much in advance to lessen the effects and diminish the spread. And believe me, the cost of acting now will be infinitely less than the cost of not acting in the long run.

The World Health Organization and its director general, Dr. Margaret Chan, were right to declare the Zika virus an international public health emergency, even if its suspected link to severe birth defects has not been proved. The mosquito-borne disease is a serious threat: It is usually so mild as to be undetectable in adults, yet as it has exploded across South and Central America it has been followed by a surge in babies born with underdeveloped heads, a condition called microcephaly.

The emergency designation will galvanize coordinated international monitoring and action of the sort that was tragically missing in the first months of the Ebola pandemic. The W.H.O.’s decision, however, could reduce travel to affected countries, which would be an economic burden. Brazil, where Zika made its first major appearance in the Western Hemisphere last May, is especially fearful that visitors will stay away from the Olympic Games in August. It cannot let that prevent it from being completely transparent about this serious threat and the steps it is taking to protect people.

In Latin America, where many nations outlaw abortion, some governments have advised that pregnancies be delayed, which can create only greater anxiety for women who have sadly limited control over such decisions.

All of this adds urgency to the work of medical researchers investigating any possible link between microcephaly and Zika infection, for which there is no cure. And it puts a heavy responsibility on the W.H.O. and institutions like the Centers for Disease Control and Prevention and the Pan American Health Organization to give clear and realistic guidance on how to avoid infection. The C.D.C. has issued a list of countries pregnant women should try to avoid visiting and has advised travelers on how to protect against mosquito bites.

Fighting Zika will not be easy. Like Ebola, it is nurtured by heat, humidity and poverty, conditions that can be intensified by globalization and global warming. Unlike Ebola, Zika is primarily spread by a mosquito, the Aedes aegypti, which is rampant in hot climates. The risk of a major outbreak in the United States is low because of effective mosquito-control programs and air-conditioning.

A vaccine or an effective treatment is still a long way off. Immediate responses, like increasing access to birth control and abortion, face stiff legal and cultural resistance in the affected region. That leaves mosquito control as the most effective weapon available now. One method being tried in Brazil is to release Aedes mosquitoes that are genetically modified to produce self-destroying offspring.

These and other measures should gain momentum now that Zika has been declared an emergency. That is essential not only to protect women and their babies, but also for improving the global response to other obscure germs waiting their turn in some hot, humid place.

In a small, first-floor office on the University of Minnesota campus, Jill DeBoer plans for worst-case scenarios.  DeBoer, the director of the Academic Health Center’s Office of Emergency Response, has bookshelves holding binders filled with detailed response plans — “playbooks” — for every disease that has been a threat to students since the team organized in 2004. 

DeBoer said similar groups formed nationwide after the anthrax attacks following 9/11, but those groups have shifted in recent years to prepare for more than bioterrorism — be it a case of meningitis on campus, a bridge collapse or something that hasn’t yet been seen. 

The AHC-OER is now forming a Zika virus playbook, DeBoer said. The team has sent information and travel warnings to all University students studying in affected countries. 

“The first partner we call is the GPS Alliance because often these infectious disease issues start off in other countries, and so with H1N1, with Ebola, with Zika, that’s our first call,” DeBoer said.

There’s a specially tailored response team for every scenario, she said. The size of the team varies with the scope of the threat, ranging from a handful of people to more than 50. Each team member has two backups.

DeBoer said the AHC-OER works with the Minnesota Department of Health — which has its own emergency team — and monitors the spread of diseases around the world.    “We have to be prepared for anything,” she said. “I feel our response system should be able to coordinate and respond to almost anything.”

School of Public Health and Medical School professor [Dr. Michael Thomas Osterholm (born 1953)], who is also the director of the University’s Center for Infectious Disease Research and Policy, addressed global infectious disease preparedness in a lecture last week. 

“The next pandemic is going to happen,” he said at the talk. “It could happen tomorrow; it could be happening today.”

[Dr. Michael Thomas Osterholm (born 1953)] said no group is ready for the next pandemic because global systems are disjointed and broken.   “There are so many holes in this ship,” he said at the lecture. “Even if we bail it out as much as we can with all our strength, we might still be sinking.”

[Dr. Michael Thomas Osterholm (born 1953)] said influenza is the biggest threat, and when — not if — an outbreak happens in Minnesota, there won’t be enough vaccines to go around, he said.  “Today, many of our key drug producers are offshore. If we have a pandemic that interrupts travel and trade, that will be a challenge,” he said. “I don’t care how prepared you are at a state level, if you have a vaccine or not makes all the difference.”

University biochemistry junior Melanie Raphael attended the lecture and said she was worried that people know too little about the importance of vaccines.

She said college students lack awareness of diseases that threaten other parts of the world.  “It took me a while to even hear about [the Zika virus],” Raphael said. “Here in college, we are kind of isolated from the rest of the world.” 

Infectious diseases can come to the U.S. from other parts of the world through travel, like what’s happened with the Zika virus, said MDH infectious disease epidemiologist Richard Danila.     “We are always on the lookout for the next big event, whether that’s an influenza virus or a pandemic like Zika,” he said.

When a new disease makes headlines, it’s hard for scientists to prevent misinformation in the media, Danila said. 

MDH strategically shares information with Minnesotans to control panic due to bad information, said Cheryl Petersen-Kroeber, deputy director of MDH Emergency Preparedness and Response.   “Epidemiologists base their decisions on the science they have at the time,” Petersen-Kroeber said. “Sometimes it’s hard because the science is always changing.”

When the Pan American Health Organization put out an alert last May about the first confirmed cases of Zika virus infection in Brazil, the news barely registered. After all, compared with other mosquito-borne viruses, such as potentially life-threatening dengue and yellow fever, Zika seemed pretty harmless. Only 20% of people infected with Zika even become ill, and their symptoms tend to be mild—fever, rash, joint pain, and conjunctivitis.

But in January, nine months after the organization raised the alarm, doctors in Brazil reported a disturbing trend that coincided with Zika’s spread across the country. Since October 2015, more than 4,000 babies in Brazil had been born with abnormally small heads and brains—a rare condition known as microcephaly. Although further analysis lowered that figure by 462 cases, the sharp rise nonetheless has experts worried that Zika could be to blame. For comparison, Brazil reported just 147 cases of microcephaly in 2014.

Zika is also being blamed for an uptick in cases of Guillain-Barré syndrome, a potentially life-threatening disorder in which the body’s immune system attacks the central nervous system and causes paralysis. As with microcephaly, the evidence connecting Zika and Guillain-Barré is still circumstantial. Nevertheless, the link is strong enough for the World Health Organization to declare the Zika outbreak a public health emergency of international concern.

Margaret Chan, WHO’s director-general, said earlier this month that the virus is “spreading explosively” through the Americas, with cases of active virus transmission in at least 26 countries and territories in the Americas. Panic over the virus has prompted health officials in some countries to take the drastic measure of advising women to delay pregnancy for months or longer. In El Salvador, Deputy Health Minister Eduardo Espinoza asked women to avoid becoming pregnant until 2018.

With Zika making headlines for the past month, scientists have been scrambling to get a handle on the virus. Industry, government, and academic scientists have all announced efforts to develop and test treatments and vaccines. But the path ahead for these researchers is long and full of pitfalls. Even though Zika has been around for almost 70 years, surprisingly little is known about the virus and its basic biology. A PubMed search for “Zika virus” turns up mostly case studies.

What we do know is that Zika is a flavivirus, a member of the same family as dengue, yellow fever, and West Nile virus. Zika is primarily transmitted via bites from infected mosquitoes, but in recent weeks doctors have reported that the virus can be sexually transmitted as well.

It was first identified in a monkey in Uganda’s Zika forest in 1947, but only a handful of human Zika cases were reported until a 2007 outbreak in Micronesia’s Yap Island. An outbreak in French Polynesia followed six years later. Last November officials in that country reexamined the cases of microcephaly that followed the outbreak. Before the outbreak, about one case of microcephaly was reported each year. In 2014–15, officials found 17 cases of fetuses and infants with “central nervous system malformations,” which includes microcephaly.

As the case connecting Zika to serious health effects builds, the world would love a vaccine or treatment for the virus. But because so few have studied Zika, drug developers currently have few tools to work with. For example, there’s no commercially available, U.S. Food & Drug Administration-approved test to screen for Zika virus.

Tracking Zika in people is hard because it’s difficult to determine that they’re infected with Zika and not a related flavivirus or that they’re not infected with more than one virus, says Priscilla L. Yang, a flavivirus expert at Harvard Medical School. Simultaneous infection with Zika and another virus could cause health effects that haven’t been seen before.

Scientists can use polymerase-chain-reaction-based methods to distinguish Zika from other flaviviruses. But those tests are accurate only during the short window patients still have the virus in their system—about seven days after infection. By the time a patient has symptoms that warrant a visit to the doctor, the virus is no longer circulating in their bloodstream, Yang notes.

Another option is to look for antibodies against the virus. But Zika and dengue are closely enough related that antibodies to Zika also recognize dengue and vice versa. Making a definitive diagnosis based on antibodies is possible but becomes time-consuming and laborious, Yang says.

For scientists who have compounds that might be effective against Zika, actually testing them has been tough. “We have small molecules that seem to be broadly acting against dengue and West Nile virus,” Yang says. “We want to test them, but getting access to the live virus has been hard.” She’s heard that certain labs known to have the Zika virus have been bombarded with hundreds of requests from researchers.

Even if someone manages to access the live virus and can find a compound that kills it in cells, the researcher will hit another roadblock: To date, no one has published practical animal models of Zika virus to screen potential therapies against. Yang points to a paper from the 1970s in which scientists did an intracranial injection of Zika virus in newborn mice, but she notes that is a poor model because many small molecules can’t slip past the blood-brain barrier.

“We’re basically starting from scratch on this one, unfortunately,” says [Sina A Bavari (born 1959)], chief scientific officer (CSO) at the U.S. Army Medical Research Institute of Infectious Diseases. Bavari and colleagues are currently working with pharma companies to see if they have any compounds that inhibit Zika replication in cells.

They’re primarily interested in compounds that have passed the hurdles of Phase I or Phase II clinical trials but are sitting idle for business reasons. That’s because it can take upward of a year and a half just to get a new compound ready for Phase I. “My worry is that by the time we get something out the door, this outbreak will have already burned out,” Bavari says.

Scientists are also grappling with this question: If only 80% of people infected with Zika have symptoms, who would get the treatment? The most vulnerable patients are pregnant women, but Bavari points out, there’s a high bar when it comes to approving a medication that can be given to them. “They don’t even want to drink caffeine,” he says.

Other scientists are working to develop a vaccine against the Zika virus. Earlier this month President Barack Obama said he would ask Congress for $1.8 billion to combat Zika at home and abroad. Of those funds, $200 million would be used for vaccine development. The U.S. National Institute of Allergy & Infectious Diseases, Sanofi Pasteur, and [NewLink Genetics Corporation] are among the heavy hitters in the vaccine field who’ve said they’ll step up to the plate.

Even so, it could take three to five years before a vaccine is ready, experts say. [Dr. Thomas Patrick Monath (born 1940)], CSO of [NewLink Genetics Corporation]'s infectious disease division, led that firm’s efforts to develop an Ebola vaccine and was CSO at Acambis, where he worked on vaccines for dengue and yellow fever. Monath tells C&EN he thinks a large field trial of 10,000 to 20,000 people across multiple sites will be necessary to determine efficacy once a Zika vaccine is developed. “Only after those trials would you contemplate doing studies in pregnant women,” he says.

Monath also says because so many people who are infected with Zika never show any symptoms, it is more difficult to determine whether the vaccine has actually prevented infections. Still, he thinks a large enough trial should be conclusive.

But some scientists say the emphasis on vaccines is misplaced. “We just don’t know enough about Zika virus right now to run around and vaccinate people,” Bavari says. “Understanding the immunopathology and immunology behind it would be really prudent before starting a full vaccination program.”

Harvard’s Yang says developing a vaccine for every emerging virus is impractical. “Vaccines are, for the most part, specific. You have one virus, and you have one vaccine for it,” she explains. “I don’t think we’ll ever have the luxury of enough resources to get a vaccine against every single possible emerging virus or enough time to do it in a reactive way.”

One area that’s not getting as much attention, she says, is development of broadly acting antivirals that could keep a virus in check while the immune system fights it off. Classical antivirals go after a single viral enzyme, but viruses are quick to develop resistance to them. “If people could identify targets that have the potential to be effective against multiple viral pathogens, it could be game-changing,” Yang says.

[Dr. Hugh Alexander "H. Alex" Brown Jr. (born 1960)], a Vanderbilt University professor who works on antivirals, agrees. “There are so many viruses out there. We need to be working on a much more broad-spectrum approach to infectious disease,” he says. “If we can develop more tools to combat broad categories of viruses, I think we would be much better off than we are today.”  [ Note - [Dr. Hugh Alexander "H. Alex" Brown Jr. (born 1960) passed July 25, 2017 ]

In the meantime, scientists agree that the research community needs to be more organized if it’s going to have a real shot at combating Zika. Yang thinks the first steps should be figuring out how to get the necessary reagents to the labs that need them and agreeing on standards so they can compare results and learn from each other’s work. “If you actually want to have some sort of impact, we all need to work together,” she says. In an encouraging sign, earlier this month, major scientific institutions and top research journals agreed to share data relevant to Zika virus.

Bavari agrees scientists need to be better at organizing their efforts, but he has doubts about the direction the community is taking. “The outbreak is moving so quickly that I am worried people will jump and we won’t do the correct research,” he says. 

Recalcitrant Mosquito Blamed For Zika’s Spread

With a treatment or vaccine for Zika potentially years away, countries are relying on mosquito control to curb the virus’s spread. Aedes aegypti mosquitoes, which inhabit tropical and subtropical regions, have been named as the culprit in transmitting the virus.

But getting rid of Aedes aegypti is extremely difficult because the mosquitoes don’t seem to be affected by most spraying regimens, says Joseph M. Conlon, an entomologist and technical adviser to the American Mosquito Control Association. According to Conlon, Aedes aegypti feed during the day, but pesticides must be sprayed at dawn or dusk. Also, mosquitoes like to come indoors to feed. So, unless pesticides are sprayed inside homes, chances are good they’re not getting to the insects.

These mosquitoes are very small, and you can’t feel the bites. “Oftentimes you don’t even know you’ve been bitten,” Conlon says.

To get rid of the biting bugs, it’s critical to eliminate any standing water. “I’ve seen Aedes aegypti breeding in discarded soda bottle caps,” Conlon says. “They’re survivors.”

Despite Aedes aegypti’s survival skills, the mosquitoes actually have a fairly limited flight range of about 150 meters. That has made some scientists suspect that because Zika has spread so quickly, the more common Culex mosquito may be transmitting the virus as well. The theory is currently being investigated.

“If that is true, that brings this to a whole different level,” Conlon says. Culex mosquitoes have a much larger range, he notes, but they can usually be controlled through common mosquito abatement programs. ◾

WASHINGTON — Public health officials used their strongest language to date in warning about a Zika outbreak in the United States, as the Obama administration lobbied Congress for $1.9 billion to combat the mosquito-borne virus.

"Most of what we've learned is not reassuring," said [Dr. Anne Schuchat (born 1960)], the principal deputy director of the Centers for Disease Control and Prevention. "Everything we look at with this virus seems to be a bit scarier than we initially thought.

As summer approaches, officials are warning that mosquito eradication efforts, lab tests and vaccine research may not be able to catch up. There are 346 cases of Zika confirmed in the continental United States — all in people who had recently traveled to Zika-prone countries, according to the most recent CDC report. Of those, 32 were in pregnant women, and seven were sexually transmitted.

But in Puerto Rico, the Virgin Islands and American Samoa, the virus is now being transmitted locally. Of the 354 cases in the territories, only three are travel-related, and 37 involved pregnant women.

Schuchat said the virus has been linked to a broader array of birth defects throughout a longer period of pregnancy, including premature birth and blindness in addition to the smaller brain size caused by microcephaly. The potential geographic range of the mosquitoes transmitting the virus also reaches farther northward, with the Aedes aegypti species present in all or part of 30 states, not just 12. And it can be spread sexually, causing the CDC to update its guidance to couples.

And researchers still don't know how many babies of women infected with Zika will end up with birth defects, or what drugs and vaccines may be effective.

"This is a very unusual virus that we can't pretend to know everything about it that we need to know," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "I'm not an alarmist and most of you who know me know that I am not, but the more we learn about the neurological aspects, the more we look around and say this is very serious."

That assessment, delivered to reporters at the White House on Monday, comes the week after the White House informed Congress it was moving more than $510 million previously earmarked to combat Ebola in Africa with Zika prevention efforts closer to home.

"What I've done is take money from other areas of non-Zika research to start. We couldn't just stop and wait for the money," Fauci said. "When the president asked for $1.9 billion, we needed $1.9 billion."

As Congress stalls funding, White House will move Ebola funds to Zika

White House press secretary Josh Earnest said the newest warning "hopefully serves as motivation for members of Congress to pay attention to this important topic."

But congressional Republicans accused the White House of trying to "politicize" Zika. "We’re glad the administration has agreed to our request to use existing Ebola funds to address the Zika epidemic," said Doug Andres, a spokesman for House Speaker Paul Ryan, R-Wis. "If additional Zika resources are needed those funds could and should be addressed through the regular appropriations process."

But Democrats said the potential human toll of the virus can't wait on the budget cycle.

“Down the road we'll find a vaccine. Down the road we will be able to manage this problem," said Sen. Bill Nelson, D-Fla., on the floor of the Senate Monday. "But in the meantime there's a great deal of trauma (and) some extraordinary heartbreak to some families.”

Zika has been known to exist since 1947, but was long considered to be a minor disease that causes only mild illness.

Late last year, Zika became linked to a dramatic increase in Brazil of microcephaly, a birth defect in which babies are born with abnormally small heads. If Zika’s role in causing birth defects is confirmed, it would be the first mosquito-borne illness to cause microcephaly, and the first infectious cause of microcephaly to be identified in more than 50 years, according to the CDC.

Doctors have known for years that Zika virus is associated with Guillain-Barre syndrome, in which the body attacks its own nerves, causing paralysis.

But a study released Monday also links Zika to a second autoimmune disorder called acute disseminated encephalomyelitis. It resembles multiple sclerosis and involves a swelling of the brain and spinal cord. New studies also show that the Zika virus appears to hone in on brain cells and kill them.

The Centers for Disease Control announced Monday it was providing $3.9 million in emergency Zika funding to Puerto Rico. saying the number of cases there is doubling every week and could reach into the hundreds of thousands. The money will go to increased laboratory capacity.

"We are quite concerned about Puerto Rico, where the virus is spreading throughout the island," Schuchat said. "We think there could be hundreds of thousands of cases of Zika virus in Puerto Rico and perhaps hundreds of affected babies."

Confirming the worst fears of many pregnant women in the United States and Latin America, U.S. health officials said Wednesday there is no longer any doubt the Zika virus causes babies to be born with abnormally small heads and other severe brain defects.

Since last year, doctors in Brazil have been linking Zika infections in pregnant women to a rise in newborns with microcephaly, or an unusually small skull. Most outside experts were cautious about drawing such a connection. But now the U.S. Centers for Disease Control and Prevention says enough evidence is in.

"There is no longer any doubt that Zika causes microcephaly," CDC Director [Dr. Thomas Randall Frieden (born 1960)] said. The CDC said it is also clear that Zika causes other serious defects, including damaging calcium buildups in the developing 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 amniotic fluid of microcephaly babies.

The CDC and other health agencies have been operating for months on the assumption that Zika causes brain defects, and they have been warning pregnant women to use mosquito repellent, cover up, avoid travel 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 precautions. Some experts hope it will change public thinking about Zika the way the 1964 surgeon general's report convinced many Americans that smoking causes lung cancer.

"We've been very careful over the last few months to say, 'It's linked to, it's associated with.' We've been careful 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 Organization has made similar statements recently. A WHO official applauded the CDC report.

"We feel it's time to move from precautionary language to more forceful language to get people to take action," said Dr. Bruce Aylward, who is leading WHO's Zika response.

The CDC announced its conclusion in a report published online by the New England Journal of Medicine.

Zika has been sweeping 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 onset of mosquito season this spring and summer.

Public health authorities have mounted aggressive 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, discarded 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 fetal deaths and devastating birth defects, mostly in Brazil, where the Health Ministry said Tuesday that 1,113 cases of microcephaly have been confirmed since October.

So far, there have been no documented Zika infections in the U.S. caught from mosquitoes. Nearly 350 illnesses in the 50 states were reported as of last week, all linked to travel to Zika outbreak regions. Thirty-two of the victims were pregnant.

The CDC report comes at a time when health officials have been begging Congress to approve an emergency $1.9 billion in supplemental funding to fight Zika internationally and prepare for its spread in the U.S. Earlier Wednesday, top House Republicans said they will probably grant a portion of that, but probably not until September.

As the microcephaly cases rose in Latin America, a number of theories circulated through the public. Some claimed the cause was a vaccine given to pregnant women. Some suspected a mosquito-killing larvicide, and others wondered whether genetically modified mosquitoes were to blame.

Investigators gradually cast those theories aside and found more and more circumstantial evidence implicating Zika. CDC officials relied on a checklist developed by a retired University of Washington professor, [Dr. Thomas Hill Shepard (born 1923)], who listed seven criteria for establishing if something can be called a cause of birth defects.

Among other things, researchers found that the spike in microcephaly in Brazil involved women who were infected with Zika during the first or second trimester of pregnancy. They also discovered more direct evidence in the form of the virus or its genetic traces.

"In the case of Zika, if you get live virus from spinal fluid from microcephalic kids, that's pretty damn good evidence," [Dr. Thomas Hill Shepard (born 1923)] said in an interview.

Researchers still don't have some of the evidence they would like. For example, there are no published studies demonstrating Zika causes such birth defects in animals. There is also a scarcity of high-quality studies that have systematically examined large numbers of women and babies in a Zika outbreak area.

"The purist will say that all the evidence isn't in yet, and they're right," the WHO's Aylward said, "but this is public health and we need to act."

The hope is that the public will start paying closer attention. [...]

The test was approved under an emergency authorization from the Food and Drug Administration and will be made widely available to physicians as early as next week, according to Quest Diagnostics, which created it.

The Zika blood test, which must be administered within seven days of the onset of symptoms, is expected to hasten diagnosis. Currently, doctors have to coordinate with public health officials to have an analysis run at government labs, which has created a backlog. It can take two to three weeks for results, according to OC Health Care Agency.

“What this means is it broadens access by patients and physicians to quality testing in the United States as well as Puerto Rico,” said Wendy H. Bost, director of corporate communications for Quest.

The New Jersey-based testing giant employs 44,000 people, including 650 medical doctors and experts. The company reported $1.86 billion in revenue in the first quarter.

Most health insurance plans should cover the cost of the blood test. The patient list price is $500, while uninsured patients will pay $120, according to Bost.

The vast majority of people infected with Zika, which is most commonly spread by tropical mosquitoes, don’t get very sick. But it can be dangerous for the fetus of an infected pregnant woman.

The virus can cause birth defects, including microcephaly, which can cause abnormally small heads and brains. It’s also “very likely” the virus is causing paralysis in some adults, according to the Centers for Disease Control and Prevention.

Orange County has reported infestations of the tropical mosquitoes, but health officials have warned a Zika outbreak here is unlikely. The virus has spread rapidly across the Western Hemisphere, starting with an outbreak in May in Brazil. This week Brazilian officials reported the number of children born with microcephaly remained stable at 4,908.

Puerto Rico on Friday reported the first U.S. Zika-related death in a 70-year-old man who died in February. Authorities said the man recovered from the first Zika symptoms, then suffered internal bleeding from a related autoimmune condition. Colombia reported three similar deaths.

The first case of Zika in Orange County was reported in March when a Costa Mesa man in his 40s picked up the virus while traveling in Central America, then returned home. He did not become seriously ill and recovered by the time testing confirmed he had Zika.

“Not that many months ago, Zika was seen as a far-off tropical disease,” said Dr. Matthew Zahn, the top epidemiologist with the Health Care Agency. “Now it’s closer to home.”

The authorization from the FDA allows for testing at dozens of Quest labs, but so far the San Juan Capistrano location should meet demand when the test becomes available next week

BALTIMORE — Leave it to the youngest person in the lab to think of the Big Idea.

Xuyu Qian, 23, a third-year graduate student at Johns Hopkins, was chatting in late January with Hongjun Song, a neurologist.

Dr. Song was wondering how to test their three-dimensional model of a brain — well, not a brain, exactly, but an “organoid,” essentially a tiny ball of brain cells, grown from stem cells and mimicking early brain development.

“We need a disease,” Dr. Song said.

Mr. Qian tossed out something he’d seen in the headlines: “Why don’t we check out this Zika virus?”

Within a few weeks — a nanosecond compared with typical scientific research time — that suggestion led to one of the most significant findings in efforts to answer a central question: How does the Zika virus cause brain damage, including the abnormally small heads in babies born to infected mothers?

The answer could spur discoveries to prevent such devastating neurological problems. And time is of the essence. One year after the virus was first confirmed in Latin America, with the raging crisis likely to reach the United States this summer, no treatment or vaccine exists.

“We can’t wait,” said Dr. Song, at the university’s Institute for Cell Engineering, where he and his wife and research partner, Dr. Guo-Li Ming, provided a pipette-and-petri-dish-level tour. “To translate our work for the clinic, to the public, normally it takes years. This is a case where we can make a difference right away.”

The laboratory’s initial breakthrough, published in March with researchers at two other universities, showed that the Zika virus attacked and killed so-called neural progenitor cells, which form early in fetal development and generate neurons in the brain.

In April, the team and other collaborators published a study in the journal Cell showing that this assault by Zika resulted in undersize brain organoids: Damaged progenitor cells created fewer neurons, leading to less brain volume.

That may explain the smaller brains and heads, a condition called microcephaly, of some babies exposed to Zika during pregnancy.

“I think they’ve nailed it,” said Dr. Eric Rubin, a professor of immunology and infectious diseases at Harvard. “That is totally consistent with the pathology that has been seen in the kids that died or the aborted fetuses. ”

The experiments here suggest other worrisome aspects of Zika infection: that even low doses of the virus for short periods can cause damage and that it is most dangerous in the first trimester of pregnancy but can also be harmful in the second.

“The really sad news is not only can the virus infect neural progenitor cells, but it turns them into a factory,” Dr. Song said.

“The cells produce more virus and they actually can spread it,” said Dr. Ming, adding that infected cells appear to create a “bystander effect,” releasing chemicals as they die that damage or kill neighboring uninfected progenitor cells.

And the organoid results contain a frightening hint of why Zika is also associated with adult neurological disorders, including Guillain-Barré syndrome, a temporary paralysis. Dr. Song said they found that Zika infection is “even worse” in glial cells, which support and insulate neurons and are present throughout life, not just in fetal development.

But there is much more to learn, and the collaboration catalyzed by a remark from a junior scientist now includes nine labs at six sites across the country.

Among them is a specialized lab at the National Center for Advancing Translational Sciences (Ncats), which is testing drugs on neural progenitor cells, hoping to find compounds that can stop the virus. Rapidly testing thousands of compounds in varying doses, the lab has already zeroed in on a promising candidate. If the drug succeeds in further testing, it could allow scientists to skip much of the safety evaluation necessary for creating new drugs or vaccines.

Many other researchers are also rushing to understand how Zika wreaks its damage. Teams in Brazil and at the University of California, San Diego have also found that the virus attacked neural progenitor cells and shrank brain organoids. The San Diego team reported that Zika overactivated a molecule that normally protects against viruses, and the excess activity seems to switch on genes that galvanize progenitor cell destruction.

A Rush of Research

In Rio de Janeiro, Stevens Rehen, a neuroscientist at D’Or Institute for Research and Education, said the Brazilian team was also testing drugs, seeking one that blocked the Zika virus. But they can test only those approved in Brazil; importing drugs from elsewhere involves weeks of red tape. “The idea is to be fast,” Dr. Rehen said.

At the University of Pittsburgh, Carolyn Coyne, a microbiologist, and Dr. Yoel Sadovsky, an obstetrician and microbiologist, are investigating how the virus enters the placenta. They determined that Zika does not infect trophoblasts, placental cells that protect against most viruses.

But there could be other routes: Does the virus sneak in through breaks in the lining? Does it hide in “Trojan horse” cells? Does it piggyback on antibodies from related infections, like dengue?

“Going through the placenta is not the only way to infect a fetus,” Dr. Sadovsky said.

Separately, scientists at other institutions, including Vanderbilt; the University of California, San Francisco; and Washington University in St. Louis, are examining questions like how the immune system recognizes the virus.

“We don’t know enough,” said Sara Cherry, a microbiologist at the University of Pennsylvania, who is also testing drugs already approved for other diseases, investigating their effects on cells from the placenta and blood-brain barrier.

“We don’t understand necessarily why Zika infection of the brain leads to particular cell deaths. Also, there may be different populations that are more or less sensitive to the virus.”

Indeed, Dr. Rubin, of Harvard, said, “It wouldn’t be surprising if the virus had to get to a specific kind of cell in the placenta, or that cell had to be in a specific phase in its growth cycle to get infected.”

Meanwhile, Dr. Ming and Dr. Song continue to explore. They are investigating which snippet of Zika’s genetic material is its lethal weapon, and are comparing Zika-infected brain organoids to tissue from a fetus aborted by a pregnant woman with Zika.

Experiments from all these labs will provide clues, Dr. Rubin said. But they will not tell the whole story. “In a person, it’s way more complicated,” he said.

Dr. Song and Dr. Ming, both 46, met as high school classmates in Wuhan, China. Now at the Institute for Cell Engineering, their offices are both on the seventh floor “She has the better view,” Dr. Song said.

“No, it’s the same,” assured Dr. Ming.

Longtime collaborators, “we do argue, but eventually we will come to an agreement,” she said. In their labs, students, like their two teenage children, “know when to go to me and when to go to her,” Dr. Song said.

Their son Max, 17, is an adjunct lab member of sorts, and his artwork mapping the Zika virus’s international journey graces the cover of the journal that published his parents’ first Zika study, Cell Stem Cell.

By February, the couple was puzzling over how to study the Zika virus when they had no samples of it; even if they could get some, their lab did not have university approval to work with Zika.

Then Dr. Song received an email from his friend Hengli Tang, a virologist at Florida State University. Since meeting as graduate students, they had vacationed and celebrated holidays together, but never worked together.

Dr. Tang studied H.I.V. and hepatitis C, and recently had equipped his lab to study dengue, a cousin of the Zika virus that is carried by the same type of mosquito. So when the Zika epidemic erupted in South America, it seemed a natural focus.

As a virus guy, Dr. Tang is comfortable with frightening pathogens. At gatherings with other researchers, he laughed, “We always start with, like: ‘What virus are you? I’m herpes.’”

But the brain was terra incognita, and Dr. Tang figured he needed a brain guy to support his Zika research grant application. “Who do I know in neuro?” he asked himself.

He emailed Dr. Song. Seconds later, the phone rang.

“He said, ‘I didn’t read the email, I just saw Zika and called,’” Dr. Tang recalled. “He was all excited and said, ‘We were just discussing where to find Zika, because we have the perfect system to study Zika.’”

The next day, neural cells were winging their way to Dr. Tang’s lab in Florida, packed in vials in ice, the first of many rapid-fire FedEx exchanges. (At one point, FedEx temporarily interrupted the breakneck pace by delaying a shipment, questioning whether the unit of measurement, milliliters, was correct, Dr. Tang said.) The Johns Hopkins researchers sent four kinds of cells: two types of stem cells, which can be turned into other human cell types; neurons; and neural progenitor cells.

A Scramble for Samples

Dr. Song and Dr. Ming were betting the Zika virus targeted neural progenitor cells; they had long studied microcephaly cases unrelated to the Zika virus and knew progenitor cells were damaged in those cases.

They sent cells derived from two people, one healthy and one with schizophrenia, because those were the cells they had, and they wondered if schizophrenia would yield different results. It didn’t.

It takes years to learn to handle these finicky cells. Dr. Tang had no such experience, so a Johns Hopkins postdoctoral student, Zhexing Wen, immediately flew to Florida to help. Later, Xuyu Qian did, too.

To obtain samples of the Zika virus, Dr. Tang had to scramble. His usual supplier, a nonprofit tissue bank, was back-ordered till July, but finally a commercial source sold him a paltry two milliliters of Zika for $300 each. That was not nearly enough to test on the Johns Hopkins cells. So Dr. Tang had to propagate the virus, eventually producing 800 milliliters.

To do so, he wanted to mimic the journey the virus takes from animals to humans. First, he grew it in monkey cells, then in mosquito cells.

The first strain was from Africa, where Zika was identified in 1947. While quite similar to the Brazilian strain, Asian strains are closer, so he eventually obtained a Cambodian strain and another strain from the current epidemic in Puerto Rico. In the lab’s experiments, different strains have yielded similar results.

Because the students in his lab are young women, Dr. Tang opted for safe-handling precautions beyond those normally required for Zika.

He was not expecting much from the first experiments adding Zika to the four types of cells. “To be honest, this was supposed to be a pilot study,” he said. “We had no idea whether, first of all, the virus would even infect these cells.”

But within a week, the results were striking. The virus attacked neural progenitor cells much more aggressively than the neurons or stem cells.

“I was overwhelmed,” Dr. Song said.

Suddenly they had a likely answer to “one of the very first questions people want to know,” Dr. Tang said.

The results suggested that the Zika virus was most dangerous in the first trimester, when most progenitor cells form. In those cells, the infection increased activity of an enzyme, caspase-3, which signals and also contributes to the death of cells, Dr. Ming said.

Dr. Rehen, the Brazilian neuroscientist working on similar research, described caspase-3 as a sort of smoking gun.

“If you see someone dead in the street, the person could be killed by a knife or by a car,” he said. “If you see caspase is involved, you can see that the weapon was a knife. The killer uses the knife; the killer is the Zika.”

In healthy humans, this and other enzymes contribute to “programmed cell death,” necessary so cells do not divide or grow endlessly, like cancerous cells. But kill too many cells or at the wrong time, and development goes awry, drastically.

Quickly, the Johns Hopkins researchers found their cellphones buzzing as other scientists saw ways to build on their results.

“There’s so many emails I can’t keep track,” Dr. Song said. “It’s, ‘I’m missing this piece, can you send me that?’ or ‘I don’t understand this part.’”

But the first experiments lacked a crucial element, they knew. They were done on cells in plates, in 2-D. How would Zika work in 3-D, in a more complex, more brainlike experiment?

Enter the brain organoids, spheres at most the size of a BB, containing stem cells differentiated into most types of brain cells. As they grow, they mimic fetal brain development; a 100-day-old organoid resembles the late second trimester of pregnancy, Dr. Ming said.

They shipped organoids to Dr. Tang in Florida, a task made easier because three high school students, including Max, had spent summer internships designing miniature spinning bioreactors, used to incubate organoids. Constructed with 3-D printed parts, they were smaller than standard bioreactors and cheaper to use because they needed less cell-growing material.

Meanwhile, after the March finding, the Ncats lab in Rockville, Md., sprang into action. Wei Zheng, who runs the lab, part of the Therapeutics for Rare and Neglected Diseases program, said the fact that Zika increased the caspase-3 enzyme gave him a way to test drugs on cells infected with Zika.

First, search for drugs that block the spike in caspase-3. Then, weed out those drugs that are toxic to the cells themselves. Finally, see if any remaining drugs prevented the Zika virus from killing cells.

Dr. Zheng noted that Zika took about three days to kill its progenitor cell victims, and did not kill all of them. If it did, he said, “you wouldn’t see a baby” at all.

It is possible, though, Dr. Ming said, when Zika strikes very early in pregnancy, it destroys so many cells that miscarriage results.

A Possible Testing Gold Mine

Ncats has perhaps the world’s largest collection of drugs and compounds, some half a million. During a recent visit, an employee who goes by the name Pepper showed how samples are fetched from glass-walled carousels by giant yellow robotic arms in a meticulously programmed ballet resembling an albatross love dance.

Many of the compounds are untested in people. But one collection contains about 2,800 drugs approved in the United States or other countries. Another library holds about 2,000 compounds that have been through some human safety testing.

Those libraries are potential gold mines. If safety-tested compounds block Zika in laboratory cells, they can be tested in people faster than new drugs or vaccines.

“We want to focus on the drugs that are immediately useful in people with the disease,” said Dr. Christopher Austin, the director of Ncats, noting that similar drug-testing was done with Ebola, yielding some compounds that are in clinical trials now.

The Johns Hopkins researchers needed time to grow more neural progenitor cells, but Dr. Zheng started anyway, first on brain tumor cells he infected with Zika. Three compounds seemed effective - a caspase inhibitor, a Russian antidepressant, and a common vitamin - so he whisked them to other researchers to try.

After receiving progenitor cells, he started again. He found 173 drugs blocked caspase-3 increase, about three dozen did so without harming cells, and one — just one — prevented the Zika virus from killing cells. That drug, which he declined to identify, is not approved but has undergone safety testing and is in a clinical trial with cancer patients, he said.

He sent the drug to Johns Hopkins, where early testing is yielding similar results. But even if results are replicated in mice and humans, hurdles remain, including determining if it is safe for pregnant women and deciding who to treat, since many women infected with Zika have had healthy babies

Also, a drug that can “save the cells after they’re infected” is not the real prize, Dr. Song said. “The best drug would actually prevent the cells from being infected in the first place.”

[...]  Now, think of Zika. Before this year, very few people had ever even heard of the Zika virus. Now, practically everyone in the world knows about Zika and believes that the primary cause of babies being born with shrunken heads (microcephaly) and brain damage in Brazil is that their mothers were bitten by the Zika-carrying mosquito while they were pregnant.

Why does everyone believe that? Because public health officials at the U.S. Centers for the Disease Control and Prevention (CDC) and National Institutes of Health (NIH) say so.1 Forget that these federal health agencies have provided no solid scientific evidence of a causal relationship. That’s beside the point. It’s the CDC and NIH.

We are being asked to overlook the fact that the theory that Zika causes microcephaly has all sorts of gaping holes in it and2 that there are at least three reports or studies by organizations in Latin America, which have raised serious questions about the Zika-microcephaly link. These independent sources either have proposed another cause of the microcephaly cases in Brazil or have failed to determine a causal link between Zika and brain disorders.3 4 5

Because the CDC and NIH have proclaimed it so, the Zika virus has been accepted to be one of the greatest threats to humanity in a long time. Last year, Zika was an obscure and relatively harmless virus known to produce no symptoms in the vast majority of those who contracted it or only very mild symptoms in a minority of those infected. CDC officials said so.

Most people infected with Zika virus won’t even know they have the disease because they won’t have symptoms. The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache.2

The illness is usually mild with symptoms lasting for several days to a week. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. For this reason, many people might not realize they have been infected.6

In a few short months, however, Zika has suddenly been transformed into a cause  célèbre—the source of tremendous fear and angst for the public. So, naturally, Zika has now become an industry, and it will later become a market. The key product in this nascent industry will be vaccines.

But first come the players—the companies that will develop, produce, market and sell the vaccines. Then, come the financiers—that, in addition to pharmaceutical companies themselves, include governments, private investors and international organizations that will front the money for the development work in the hope of either earning spectacular profits or a miraculous solution to a perceived a health crisis.

There are no shortage of players. Why? Because Zika is a new industry, and new industries represent commercial opportunities. Money. The U.S. government has offered to jumpstart the industry by proposing $1.9 billion for Zika research.7

The World Health Organization (WHO) has set up a UN Zika Response Multi-Partner Trust Fund (MPTF) to ” finance critical unfunded priorities in the response to the Zika outbreak.”8 The WHO announced on February 17, 2016 that it would seek $56 million from its member countries to help combat Zika. Included in those funds would be money to “fast-track” the development of vaccines.9 

Even wealthy philanthropists like Microsoft co-founder Paul Allen are doing their part to spur on this new industry. On February 19, 2016, Mr. Allen announced two grants worth more than $2 million, aimed at fighting Zika. Of the total, $1.5 million will go to the American Red Cross in support of efforts to “control the mosquitoes that transmit the virus and educate the public in Brazil and other Latin American countries.” The remaining $550,000 will go to Chembio Diagnostics Systems, Inc. of Medford, NY to “develop a suite of rapid tests to quickly diagnose Zika and differentiate it from diseases with similar symptoms.”10 

It is a given that wherever there is plenty of money up for grabs, the politicians will get involved to try and funnel some of it to their constituencies. For example, U.S. Senator Charles Schumer of New York has been pushing hard for Congress to approve the $1.9 billion request for Zika research. Sen. Schumer is hoping some of those funds will go to SUNY Upstate Medical University in Syracuse, NY.

Referring to the $1.9 billion request, Sen. Schumer said:

We need to get this done as soon as possible so that institutions like SUNY Upstate can use their expertise to help stem the spread of Zika. … If you care about this country, if you care about the safety of pregnant mothers, if you care about stemming this horrible disease, pass this emergency bill that will let institutions like SUNY Upstate help us understand, treat and prevent Zika.11 

The race is on to develop vaccines against Zika. It seems that almost daily the media is highlighting a new company or institution that is entering the race. Thus far, there are at least 18 competitors around the world.12 For example, there is Brazil’s own renowned Butantan Institute in São Paulo and NIH in Bethesda, MD.12 There is  Bharat Biotech International Pvt. Ltd. of Hyderabad, India; Sanofi SA of Paris, France; Inovio Pharmaceuticals, Inc. of Plymouth Meeting, PA; NewLink Genetics Corp. of Ames, IA; and Scripps Research Institute of  La Jolla, CA.13

There is Johnson & Johnson, Inc. of New Brunswick, NJ; Merck & Co. of Kenilworth, NJ; Pfizer, Inc. of New York City, NY; and possibly Takeda Pharmaceutical Company Ltd. of Osaka, Japan.14 There’s Protein Sciences Corp.15 of Meriden, CT and GeneOne Life Science, Inc. of Seoul, South Korea and possibly GlaxoSmithKline plc of London, UK.16 And just last month, Immunovaccine Inc. of Halifax, Nova Scotia, Canada and defense engineering firm Leidos, Inc. of Reston, VA announced a collaborative agreement on Zika vaccine research.17 There are others, and there will likely be many more in the years to come.

It seems everybody wants in on the action. It is exciting to be one of the early pioneers in a brand new industry with lots of growth potential, particularly when it has such strong government support and when the prospects for mandated use of the vaccines are so promising… for the industry, that is. There is already talk about Zika being with us forever and becoming one of those things against which we will routinely vaccinate.

Once Zika virus arrives in the United States, it will be here to stay. Leading experts now predict that the mosquito-borne disease will become a constant low-level threat that Americans will need to be vaccinated against routinely—as we do now for rubella, a virus that, like Zika, causes birth defects.18

What is important to understand is that once you create a profitable industry, there is seldom any turning back. It’s here to stay, until it is no longer profitable.

A special live episode of the popular science podcast This Week in Virology at the headquarters of the American Society for Microbiology. Podcast host Vincent Racaniello will hold a conversation with four leading experts on flaviviruses to discuss what we know about the emerging pathogen Zika virus and the state of ongoing research.

Guests

• [Dr. Michael S. Diamond (born 1964)]  :  Professor of Medicine, Molecular Microbiology, Pathology & Immunology  ,  Associate Director, Center for Human Immunology and Immunotherapy Programs   ,   Washington University in St. Louis

  • • The research in the Diamond laboratory focuses on the interface between viral pathogenesis and the host immune response for several globally important mosquito-borne human pathogens, including West Nile, Dengue, Zika, and Chikungunya viruses. We are interested in defining mechanisms of innate immune restriction and viral immune evasion as well as developing animal models of pathogenesis. We also study the structural and molecular bases of antibody-mediated protection of flaviviruses and alphaviruses, with a goal of identifying broadly neutralizing antibodies and their respective epitopes.

• Michaela U. Gack, PhD  :   Associate Professor of Microbiology  ,   The University of Chicago

  • • Dr. Gack’s research focuses on understanding how the intricate interplay between viruses and the host's immune system impacts the outcome of viral infection and disease. Understanding host-virus interactions at a molecular level is an essential step in developing safe and effective antivirals and vaccines. A long-term goal of her research is to identify the strategies employed by viral pathogens – influenza virus, dengue virus and several tumor viruses – to escape cell-intrinsic immune responses. She is also identifying and functionally characterizing novel host factors that play important roles in the antiviral immune defense.

• Laura Kramer, PhD  :  Director of the Arbovirus Laboratory  ,  Wadsworth Center  ,   New York State Department of Health ;   Professor ,  School of Public Health ,  State University of New York, Albany

  • • The research program of the Arbovirus Laboratories focuses on basic and applied field and laboratory studies examining how the interactions between arthropod vectors, viruses, and vertebrate hosts are affected by biotic and abiotic factors; and how these interactions impact the intensity of viral transmission, and subsequently viral evolution and adaptation. Dr. Kramer is also a Virology moderator for ProMED mail, an emerging diseases early warning alert under the umbrella of the International Society of Infectious Diseases.

• Charles M. Rice, PhD  :   Maurice R. and Corinne P. Greenberg Professor in Virology ,  The Rockefeller University

  • • In the Laboratory of Virology and Infectious Disease, Dr. Rice is interested in understanding how viruses propagate, ways in which they interact with host cells, and how they cause disease. He is one of the world's most accomplished virologists and a prominent figure in research on members of the Flaviviridae including hepatitis C virus (HCV). His laboratory, as well as others, developed cell culture infectious systems for HCV that drastically increased our ability to study this important pathogen.

When 80 motivated and innovative students from five universities work together, novel ideas will emerge. The first [U] Invent produced 12 solutions to combat the spread of the Zika virus through educational and conceptual solutions. More than $4,000 in award funds and an opportunity for two students from a winning team to meet with the Centers for Disease Control and Prevention (CDC) was presented to the students.

Innovate Against Zika is the first [U] Invent program implementing the highly successful Aggies Invent model which gives students 48 hours to collaborate in teams solving identified design challenges related to a specific topic. The students have complete access to the Engineering Innovation Center (EIC) and topic experts throughout the innovation competition. 

“It was great having other universities participate in the first [U] Invent,” said Rodney Boehm, associate professor of practice.  “All of the students blended into tight teams and it allowed us to show how we innovate at Texas A&M University.”

The Texas A&M University College of Engineering and The Zika Foundation partnered to host Innovate Against Zika with the goal of applying new discoveries about the Zika mosquito using trans-discipline expertise to halt the spread of the Zika virus through the rapid development and implementation of low-cost, sustainable solutions. Student teams chose from one of three tracks for their needs statement: vector (mosquito) control, immune households or community resiliency and sustainability.

“This weekend opened my eyes to the ability for people to pull themselves together for a common cause,” said Garrett Harmon. “It’s really motivating to me to think more about my education and what I’m doing now so I can have a great effect of people in the future.”

Innovate Against Zika was stacked with 20 of the brightest researchers in the fields of public health, entomology, chemistry, architecture, engineering and biotechnology to guide and advise the students throughout the weekend. Some of the mentors and presenters included Dr. R. Ulrich Bernier, the acting national program leader and research chemist with the USDA’s Agricultural Research Service, whose efforts are focused on surveillance and control of the vector(s) responsible for pathogen transmission; [Dr. Michael Vincent Callahan (born 1962)], a physician scientist board certified in internal medicine, infectious disease, tropical medicine (DTM&H) and mass casualty care and a clinical and research faculty member at Massachusetts General Hospital/Harvard Medical School; and Josue Young, a researcher in the Medical Entomology Department at the Gorgas Memorial Institute in Panama City, Panama.

“Control of Zika is a problem-rich issue,” said [Dr. Michael Vincent Callahan (born 1962)]. “We therefore are compelled to bring this challenge to a solution-rich setting where new answers can be identified. This is the first time engineers, architects and urban planners have been given complete access to Zika-mosquito experts. We believe this event has identified new solutions to this growing global problem.”

The first-place team, awarded $1,000, was SWATeam. The team developed an app that engages young people in games to find mosquito areas, provides education and allows the community to learn more about Zika. The team consisted of two Texas A&M students — Kendra Mack, from biomedical sciences and Ankita Brahmaroutu from the college of medicine — and five University of Texas students —Jason He, electrical engineering; Annabel Wang, Ishani Chakravarty, and Justin Zhong, chemical engineering; and Zhra Biabani, economics.

The Bucket List team took second place and was awarded  $750. This team developed a Zika protection kit that is contained in a mosquito trap to form a multi-dimensional solution. The members of this team included Kedar Balakrishna, Diego Garcia, Austin Lu, Liana Polikaitis and Ashley Tucker, biomedical engineering; Jessica Lee, biomedical science; and Megan Rodriguez, nuclear engineering.

The third-place team, awarded $500, developed an education program in a pictogram that would be attached to rain barrels currently being distributed by non-governmental organizations worldwide. The Persistent Pictogram team consisted of three Texas A&M students, Mo Adesanmi, chemical engineering, Clare Elizondo, biomedical science and Jane Frederick, biomedical engineering; two Wichita State University students, Hannah Hund, biomedical engineering and LaRissa Lawrie, strategic communications; and Stephanie Strong, chemistry and biology from East Carolina University.

[...]  The CDC showed its interest in Innovate Against Zika by offering to bring two members from the winning team to Atlanta to present the team’s innovation to the Zika response team, speak with its technology transfer experts and tour its insectary.   [...]

Moderna is edging toward a total $2 billion in funding after just 5 years of life after announcing a major new funding round--which coincides with a potential $125 million BARDA grant to help fund its mRNA Zika vaccine research. First, to its latest funding round that officially closed today with $474 million in the kitty. Specific names were not given, but the Cambridge, MA-based biotech and 2013 Fierce 15 company said that this latest equity financing included “strong support from existing institutional investors” as well as “world-class strategic pharmaceutical partners … and new institutional investors from the United States, Europe and Asia.” Moderna did not reveal in its PR or to FierceBiotech who these investors are. It also remained schtum on its highly anticipated IPO plans. “Our focus over the coming year will be to continue advancing our pipeline into the clinic,” the company said. [...]  “We currently have two Phase I clinical studies underway and anticipate moving additional programs into the clinic by the end of this year. We continue to evaluate the public markets and will look to go public at a time that makes sense for the company.” “Moderna is, yet again in its short 5 years, accelerating its expansion and entering a new growth phase,” said Stéphane Bancel, CEO of the biotech. “We are pivoting toward a new chapter in our company’s history, and we feel privileged to deploy our substantial capital resources to advance our mission to deliver on the promise of mRNA therapeutics as an entire new class of medicines.” The cash will be used to push on with its development work and bring preclinical candidates into the lab, as well as building a new GMP manufacturing facility--all the while committing $100 million a year as a consistent investment pot for its mRNA technology platform. Moderna currently has around $1.4 billion in cash on its balance sheet and the potential for over $230 million of extra funds from grants funnelled through a number of charitable and government bodies, including the Bill & Melinda Gates Foundation and BARDA--the U.S. government’s emergency health department. And it is BARDA that today has also given $8 million upfront to Moderna--with the potential for a total $125 million if development goes well--for early-stage work on its Zika messenger RNA (mRNA) vaccine. The vax is currently preclinical with the work being undertaken by Valera, Moderna’s infectious disease-focused venture, but the biotech is planning to submit an IND with the FDA by year’s end that will allow it to start human testing. Under the funding deal, the initial $8 million will support a Phase I study, toxicology studies, vaccine formulation and manufacturing, with an extra $117 million earmarked to support Phase II and Phase III, as well as large-scale manufacturing. The company told FierceBiotech that based on the funding from BARDA, it shouldn’t need to add too much of its own cash to the development program: “We anticipate the award will fund the bulk of our development and manufacturing for the vaccine,” the biotech said. It said that much of the work will be done internally, but it will call on its existing collaboration with CRO Charles River Laboratories to “support GLP toxicology studies and a collaboration with PPD to support Phase I and Phase II studies.” “We believe our mRNA vaccine technology offers potential advantages in efficacy, speed of development, and production scalability and reliability, which may position Moderna as a leader in preparing for and responding to infectious disease threats, such as Zika, that place millions of people at risk around the world,” Bancel said of its BARDA funding. “We feel a tremendous sense of responsibility to advance our Zika mRNA vaccine as quickly as possible, and we are thankful to BARDA for its commitment to support and help expedite our development efforts. We plan to initiate a Phase I study within the next several months.” Moderna already has several early-stage mRNA infectious disease vaccine studies ongoing in the U.S. and Europe, having dosed around 250 healthy human volunteers to date. The company says it plans to publish its first set of clinical data from its first Phase I next year. BARDA is not however putting all of its eggs in one basket, having last week announced it was also paying out $19.8 million upfront and more than $300 in total to Japanese pharma Takeda for its Zika vaccine work as the transmission of the virus continues its spread across the Americas, Africa and Asia. The deal is a similar one for both companies, although Takeda is in line for a larger funding pot, with its work also preclinical with plans for a Phase I before 2017. Sanofi ($SNY), GlaxoSmithKline ($GSK), India’s Bharat Biotech and Inovio Pharmaceuticals ($INO) are also all working on versions of their own vaccine for the virus that is believed to cause microcephaly in newborns. These players have taken several different approaches to the vaccine, with Inovio using a DNA vaccine while Takeda is looking at an inactivated Zika virus rather than the more common attenuated-virus approach. Moderna will use its mRNA approach, saying in a statement that it will deliver mRNA to the body’s cells, which, in turn, produce antigenic proteins as if the body was infected by a virus. “These antigenic proteins are identified and remembered by the immune system. When a person is exposed to the pathogen in the future, the body is able to recognize it as foreign and mounts an immune response, including production of antibodies that can help to destroy the pathogen.” Moderna says that, to its knowledge, “we are the only company developing a Zika vaccine that uses mRNA to drive cellular protein expression directly.” It has split its development programs down into a series of ventures focused on cancer, infectious diseases, rare diseases, and personalized cancer vaccines. The biotech already has a number of major backers and deals with Big Pharma, including AstraZeneca ($AZN), Alexion ($ALXN), Merck ($MRK) and Vertex ($VRTX).

Dr. Michael Callahan is CEO and co-founder of the Zika Foundation. He is a highly respected “physician scientist”,  who is board-certified in internal medicine, infectious disease, tropical medicine and mass casualty care, and is on both the clinical and research faculty at Massachusetts General Hospital/Harvard Medical School.

Dr. Callahan has clinical appointments globally, including in Thailand, Indonesia, Panama, and Nigeria. From 2005-2012, Dr. Callahan established Prophecy, the first rapid deployment clinical research capability for catastrophic infectious diseases outbreaks, such as Ebola.

Dr. Callahan has served as special advisor on infectious disease to two presidents, the Secretaries of Defense and of Health and Human Services, and  the Office of the Commissioner of the FDA. Dr. Callahan has been deployed to 7 mass casualty disease outbreaks, including Ebola, Marburg, H5N1 and H7N9 bird flu, and MERS. He used his experience with dengue to launch the Zika Foundation, where he is accelerating sustainable and low-cost interventions to protect women and men from Aedes mosquitos, which transmit dengue, chikungunya and the Zika virus.  His mission is to ensure that the 64 million pregnancies that occur every year in the tropical Americas are kept safe from Zika, and to prevent the epidemic of paralytic Guillain-Barre Syndrome that may well occur in southern nations over the next five years.

The interview that you're about to see challenges our basic understanding of the Zika virus. Dr. Callahan reveals, for example, that new research clearly demonstrates that Zika virus can have long-term neurological effects in adults. He discusses how the aerial spraying efforts, so common in South Florida, are actually ineffective and inappropriate for targeting the specific mosquito that transmits the virus.

However, Dr. Callahan does provide us with some very important, and actionable, tools for reducing our risk of contracting Zika, both in terms of what we can do to reduce the prevalence of the Aedes mosquito and also how we can protect ourselves day-to-day.

It's clear that we have to rewrite the book as it pertains to our understanding of mosquitoes, specifically as it relates to the Aedes mosquito that serves as the carrier of the Zika virus. Unlike what we’re used to, this mosquito lives indoors, and, according to Dr. Callahan, is actually able to watch our eyes to determine when is the best time to inflict its bite.

Dr. Callahan explores the effectiveness of various insect repellents and even touches upon his research dealing with genetically modified male mosquitoes in an attempt to limit the reproduction of the mosquito that carries this threatening virus.

BARRANQUILLA, Colombia — This tropical city on the Caribbean coast may hold the answer to one of the deeper mysteries of the Zika epidemic: Why has the world’s second-largest outbreak, after Brazil’s, produced so few birth defects?

In Brazil, more than 2,000 babies have been born with microcephaly, abnormally small heads and brain damage caused by the Zika virus. In Colombia, officials had predicted there might be as many as 700 such babies by the end of this year. There have been merely 47.

The gap has been seen all over the Americas. According to the World Health Organization, the United States has 28 cases — almost all linked to women infected elsewhere. Guatemala has 15, and Martinique has 12.

Had the rest of the Americas been as affected as northeastern Brazil, a tidal wave of microcephaly would be washing over the region. Most experts say that will not happen, but they are at a loss as to why.

Discovering what stopped microcephaly in Colombia may help other countries tamp down the epidemic’s worst effects.

There are some obvious differences between Colombia’s epidemic and Brazil’s. The population here is less than a quarter that of Brazil, and almost half of its residents live at higher altitudes, where mosquitoes are rarer.

And Zika circulated silently for much longer in Brazil. The virus arrived there by early 2014, and not in Colombia until late 2015. Having just fought a severe chikungunya epidemic in 2014, Colombia was more ready than Brazil to send forth the anti-mosquito battalions.

But all that does not seem sufficient to explain the disparity. Increasingly, there is evidence for two other possibilities.

Pregnant women here, alerted to the tragedy unfolding in Brazil, may have sought abortions in greater numbers, officials say. Others seem to have heeded the government’s controversial advice to delay pregnancy altogether.

Dr. Miguel Parra-Saavedra, the director of maternal-fetal medicine at the Cedifetal Clinic in Barranquilla and one of the country’s leading high-risk pregnancy specialists, is among the experts who suspect many pregnant women in Colombia, alarmed by news reports, sought ultrasounds and aborted deformed fetuses.

Some of his own patients have done so.

Dr. Parra-Saavedra heads a study of Zika-related birth defects in cooperation with the Centers for Disease Control and Prevention. In the course of the research thus far, he has diagnosed 13 cases of fetal microcephaly.

Four of the mothers terminated their pregnancies immediately, he said. Another four, and possibly a fifth, sought abortions but were turned down by their health insurance companies.

Only four patients, Dr. Parra-Saavedra said, deliberately chose to have their babies.

Among those who tried to have an abortion was Zuleima, a 37-year-old mother of two healthy daughters.

When she and her husband Jaime, 47, an unemployed mine-machinery operator, learned that their unborn daughter was microcephalic, they requested what is here called “pregnancy interruption.”

Abortion is legal in Colombia to protect a mother’s health, and the health ministry considers a severely deformed baby a threat to maternal mental well-being.

But Zuleima — who asked that the couple’s surnames not be used because some relatives opposed abortion — was already 31 weeks pregnant.

While the abortion law does not specify which week is too late, her insurer balked, she said, saying it needed time to decide whether to pay for the procedure.

“There were papers and papers to fill out, and the company didn’t say no and didn’t say yes,” she recalled. “They said, ‘We’ll call you later.’”

“They never did — and then it was too late. I had to have the baby.”

She spoke as she nursed her newborn daughter, Milagros. Standing behind her, Dr. William O. Contreras, a neurosurgeon, said in English that Milagros had no frontal lobes and that the connection between her two brain hemispheres was abnormally small.

“When this happens,” he said, “there is no intelligence, no coordination, no attention, no initiative, no calculation — and no memories at all.”

Dr. Fernando Ruiz, Colombia’s vice minister for public health, also says that it is “very possible” that abortions lowered the microcephaly rate here.

“Colombia has some of the most progressive laws and regulations in South America,” he said in an interview. With gynecologists alert to the threat, he said, many women had ultrasounds early enough to made decisions.

Even a very small increase in the abortion rate could account for a sharp reduction in microcephaly.

Just 320 legal abortions were officially reported in Colombia in 2011, according to the Guttmacher Institute, a New York-based research organization supporting abortion rights. Yet the institute estimates that there actually were 400,400 abortions each year in Colombia.

In this country, most abortions are not performed in clinics by vacuum aspiration, but are induced by misoprostol, a drug that causes strong contractions, said Dr. Guido Parra Anaya, the director of the Procrear assisted fertility clinic in Barranquilla.

Any doctor can prescribe the drug, and none are legally obligated to report it.

Misoprostol also is commonly given out by illegal providers here, according to the Guttmacher Institute. Frequently, women are told to take the pills and go to a hospital when heavy bleeding starts, as if they had had a miscarriage. Colombian hospitals treat an estimated 93,000 women a year for postabortion complications.

In July, Dr. Martha Lucia Ospina, the director of Colombia’s National Institutes of Health, reported that fetal deaths reported as miscarriages on death certificates had increased by 8 percent. The numbers have begun returning to normal only recently.

In Brazil, by contrast, abortion is permitted only in cases of rape or incest or to save the mother’s life, and illegal abortions are hard to get because the police, under pressure from evangelical Christians in Brazil’s Congress, began cracking down on clandestine clinics a decade ago.

Also, because the microcephaly surge in Brazil appeared with no warning, even women who might have risked illegal abortions had no time to receive ultrasounds.

In Colombia, women now normally have three ultrasounds during a pregnancy. The increased screening has made for hard choices.

Microcephaly can also be caused by other viruses or genetic mutations, but the Zika virus causes unprecedented levels of brain damage.

“In my 22 years as an ultrasound physician, I have never seen microcephaly like this,” Dr. Parra-Saavedra said. “The heads are much smaller, to a severe degree.”

Although pockets of dead cells that foreshadow microcephaly may appear earlier, fetal heads do not become unmistakably small until early in the third trimester.

Health insurers, financially struggling here, are reluctant to approve late abortions because they must pay for neonatal intensive care if the child is born alive.

For mothers, the diagnosis is understandably difficult. By the third trimester, fetuses on ultrasounds look much like newborn babies, not like embryos.

The first scans of Kiara Munoz’s son, Juan Diego, were normal. By the time his microcephaly was evident, she was in her seventh month and could see his face clearly.

“The gynecologist said I could terminate, and I cried,” said Ms. Munoz, who is 18 but looks 15. “It was very hard because the baby was so big. My husband and I decided to keep him. I am hoping for a miracle.”

Colombia’s Zika epidemic peaked in February and was declared over in late July. Many women who became pregnant during that time are still due to give birth, so more microcephaly cases may appear.

But they will still be far fewer than originally predicted.

Dr. Ruiz said that based on Brazil’s experience, he had expected to see 700 cases of Zika-related microcephaly this year. Now, he expects 100 to 250 at most.

In December, Dr. Ruiz asked women in Colombia to delay pregnancies, and he says he believes many did so, although he cannot prove it yet.

A drop in the birthrate would indicate that many women heeded the advice, but the national health statistics office takes 18 months to tally up each year’s birthrate.

In some Latin American countries, suggestions from health ministers that women delay pregnancy met harsh resistance — both from the Roman Catholic Church and from women’s groups complaining that there was too little access to contraception.

El Salvador faced a backlash when it asked women to stop having children for two years. But Colombia’s health ministry asked women to delay for only six to eight months while officials watched how the epidemic unfolded. Some women found that sensible.