Dengue Zika Chikungunya Cuba
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    Obama May Meet Zika Head On in Cuba
    White House Letter
    By GARDINER HARRIS FEB. 15, 2016

    WASHINGTON — As the White House considers a historic visit by President
    Obama to Cuba this year, a concern beyond the political and diplomatic
    hurdles has arisen: the Zika virus.

    Mr. Obama has said he would “very much” like to visit Cuba before the
    end of his presidency, and aides have hinted that a visit could come as
    soon as next month. But disease experts say Zika’s imminent arrival in
    Cuba is almost certain, although the island nation has yet to officially
    report cases of locally acquired Zika infection.

    “Zika will be all over the Caribbean by the end of February, and almost
    certainly that includes Cuba,” said Dr. Peter Hotez, the dean of the
    National School of Tropical Medicine at the Baylor College of Medicine.
    In other words, it is possible that Mr. Obama could arrive in the middle
    of an epidemic.

    Dr. Hotez also said the disease would soon become endemic in Peru, where
    Mr. Obama will travel in November for the Asia-Pacific Economic
    Cooperation summit meeting.

    Experts generally agree that since the Zika and dengue viruses are
    spread by the same mosquito, wherever the dengue virus is endemic in the
    Western Hemisphere — including Cuba and Peru — the Zika virus will soon
    be as well.

    “It’s only a matter of time,” said Dr. James Kazura, the director of the
    Center for Global Health and Diseases at Case Western Reserve University.

    Presidential overseas visits are highly choreographed trips that involve
    hundreds of aides, security personnel and reporters, including many who
    have recently had children or are considering the prospect. The main
    worry about the Zika virus is its potential link to microcephaly, a
    condition that causes babies to be born with unusually small heads and,
    in the vast majority of cases, damaged brains.

    “The good news is this is not like Ebola — people don’t die of Zika,”
    Mr. Obama said in a recent interview with Gayle King of CBS. “A lot of
    people get it and don’t even know that they have it. What we now know,
    though, is that there appears to be some significant risk for pregnant
    women or women who are thinking about getting pregnant.”

    So far these risks have yet to alter schedules at the White House.

    “Over all, the president is not changing travel plans based on Zika,”
    said Peter Boogaard, a White House spokesman.

    Neither are other senior officials in the administration. Treasury
    Secretary Jacob J. Lew traveled in January to Puerto Rico to discuss
    solutions to the island’s debt problems, and Vice President Joseph R.
    Biden Jr. intends to be in Mexico this month for economic talks. Both
    places have Zika infections.

    Other top officials will continue to visit Latin America, and a large
    delegation from the administration still plans to travel in August to
    the Olympics in Rio de Janeiro. Brazil is ground zero for the epidemic.

    But there have been a handful of assignment changes at the State
    Department and Pentagon because of the Zika epidemic, officials said.
    Six State Department employees and 14 family members who are pregnant
    and assigned to American Embassies in countries affected by Zika have
    chosen to leave their posts, Mark C. Toner, a State Department
    spokesman, said Friday.

    At the Pentagon, a pregnant spouse of a service member assigned to
    United States Southern Command, which includes South and Central
    America, transferred out of the region three weeks sooner than
    previously scheduled because of Zika, said Maj. Adrian J. T.
    Rankine-Galloway, a Defense Department spokesman.

    The White House has coped with worse. In October 2014, as near-panic
    about the Ebola epidemic in West Africa convulsed the country, Mr. Obama
    invited to the White House Nina Pham, one of two Dallas nurses infected
    with the disease while treating an infected man in Dallas.

    Officials quietly asked for confirmation from top health experts that
    Ms. Pham was no longer infectious. Reassured, Mr. Obama hugged Ms. Pham
    in the Oval Office, an expression of confidence in officials’ grasp of
    the science of the disease. Mr. Obama later invited to the White House
    health officials who had helped battle the disease in West Africa.

    Zika is far less dangerous than Ebola, particularly for Mr. Obama. Most
    infections go unnoticed. Those sickened usually suffer little more than
    a flat pinkish rash, bloodshot eyes, fever, joint pain and headaches
    that pass after a few days. In addition to its possible link to
    microcephaly, the virus can in rare circumstances cause Guillain-Barré
    syndrome, when the body’s immune system attacks part of the peripheral
    nervous system and causes paralysis, which is usually temporary,
    sometimes life-threatening and almost always terrifying.

    But the science of Zika is far from settled. Zika has been found in
    saliva and urine, and Brazilian researchers recently warned that it
    might have the potential to spread through kissing. The virus may remain
    in a man’s semen for months, and officials have confirmed cases of its
    being transmitted by sex.

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