Scientists develop fluid-filled artificial womb to help premature babies

An artists impression shows a lamb inside a fluid-filled womb-like bag known as an extra-uterine support device developed by the Children's Hospital of Philadelphia.MANDATORY CREDIT Children's Hospital of Philadelphia handout via REUTERS

By Kate Kelland

LONDON, (Reuters) – Scientists in the United States have developed a fluid-filled womb-like bag known as an extra-uterine support device that could transform care for extremely premature babies, significantly improving chances of survival.

In pre-clinical studies with lambs, the researchers were able to mimic the womb environment and the functions of the placenta, giving premature offspring a crucial opportunity to develop their lungs and other organs.

Around 30,000 babies in the United States alone are born critically early – at between 23 and 26 weeks of gestation, the researchers told reporters in a telephone briefing.

At that age, a human baby weighs little more than 500 grams, its lungs are not able to cope with air and its chances of survival are low. Death rates are up to 70 percent and those who do survive face life-long disability.

“These infants have an urgent need for a bridge between the mother’s womb and the outside world,” said Alan Flake, a specialist surgeon at the Children’s Hospital of Philadelphia who led the development of the new device.

His team’s aim, he said, was to develop an extra-uterine system where extremely premature babies can be suspended in fluid-filled chambers for a vital few weeks to bring them over the 28-week threshold, when their life chances are dramatically improved.

It could take up to another 10 years, but by then he hopes to have a licensed device in which babies born very prematurely are given the chance to develop in fluid-filled chambers, rather than lying in incubators being artificially ventilated.

“This system is potentially far superior to what hospitals can currently do for a 23-week-old baby born at the cusp of viability,” Flake said. “This could establish a new standard of care for this subset of extremely premature infants.”

The team spent three years evolving their system through a series of four prototypes – beginning with a glass incubator tank and progressing to the current fluid-filled bag.

Six preterm lambs tested in the most recent prototype were physiologically equivalent to a 23- or 24-week-gestation human baby and were able to grow in a temperature-controlled, near-sterile environment, Flake said.

The scientists made amniotic fluid in their lab and set up the system so that this flowed into and out of the bag.

Lung development in fetal lambs is very similar in humans, said fetal physiologist Marcus Davey, who worked on team.

“Fetal lungs are designed to function in fluid. We simulate that environment … allowing the lungs and other organs to develop while supplying nutrients and growth factors,” he said.

Flake said the success of the system, details of which were published on Tuesday in the journal Nature Communications, was due to its mimicking life in the uterus as closely as possible.

It has no external pump to drive circulation, because even gentle artificial pressure can fatally overload an underdeveloped heart, and there is no ventilator, because the immature lungs are not yet ready to breathe air.

Instead, the baby’s heart pumps blood via the umbilical cord into a low-resistance oxygenator that acts as a substitute for the placenta in exchanging oxygen and carbon dioxide.

Flake’s team plans to refine the system further and then downsize it for human infants, who are around a third of the size of the lambs used in the study.

(Editing by Tom Heneghan)

Aleppo air strike kills 14 members of one family

A damaged site is pictured after an airstrike in the besieged rebel-held al-Qaterji neighbourhood of Aleppo, Syria October 14, 2016. REUTERS/Abdalrhman Ismail

BEIRUT (Reuters) – Fourteen members of the same family were killed in an air strike in rebel-held eastern Aleppo on Monday, emergency service workers said, as the Syrian government pursued its Russian-backed campaign to capture opposition-held areas of the city.

A list of the dead published by the Civil Defence included several infants, among them two six-week old babies and six other children aged eight or below. The Civil Defence identified the jets as Russian. The attack hit the city’s al-Marjeh area.

The Civil Defence is a rescue service operating in rebel-held areas of Syria. Its workers are known as “White Helmets”.

The campaign has killed several hundred people since it started last month after the collapse of a truce brokered by Russia and the United States. The Syrian Observatory for Human Rights said it had documented the deaths of 448 people in air strikes in eastern Aleppo since then, including 82 children.

Syrian and Russian militaries say they only target militants.

People remove belongings from a damaged site after an air strike Sunday in the rebel-held besieged al-Qaterji neighbourhood of Aleppo, Syria

People remove belongings from a damaged site after an air strike Sunday in the rebel-held besieged al-Qaterji neighbourhood of Aleppo, Syria October 17, 2016. REUTERS/Abdalrhman Ismail

 

Since the campaign was announced on Sept. 22, the government has captured territory from rebels to the north of the city, and also reported advances in the city itself which rebels have in turn said they have mostly repelled.

A Syrian military source said the army had targeted terrorists in three areas of Aleppo on Monday, killing seven of them. The government refers to all rebel fighters as terrorists.

The Observatory said 17 more people were killed in attacks by Russian jets on Sunday night in the al-Qarterji district of rebel-held Aleppo. That included five children, it said.

The monitoring group also said it had recorded the deaths of 82 people including 17 children in government-held areas of western Aleppo as a result of rebel shelling.

(Reporting by Tom Perry and Ellen Francis; Editing by Louise Ireland)

Doctors say Haiti ripe for large Zika outbreak, virus under: reported

Residents in Haiti

By Makini Brice

PORT-AU-PRINCE (Reuters) – Posters warning of the dangers of Zika only reached Haiti’s health ministry in August, six months after the country reported an outbreak, in one example of delayed prevention efforts that have health experts worried a “large epidemic” is looming.

Gabriel Thimothe, a senior health ministry official, said the public service posters would be distributed to hospitals and airports shortly, but that health funding had been cut this year and foreign aid was sparse to fight the mosquito-borne virus that can cause severe birth defects.

Zika infections in pregnant women have been shown to cause microcephaly – a defect in which babies’ heads and brains are undersized – as well as other brain abnormalities.

Widespread fumigation that has limited the virus’ spread in other Caribbean nations such as Cuba only began in Haiti last month. Publicity campaigns have been all but invisible and hospital workers were on strike for much of the year.

“We’re expecting a large epidemic but we don’t know when it will occur,” said Jean-Luc Poncelet, the World Health Organization’s representative in Haiti. “There is under-reporting.”

Such an epidemic could severely strain Haiti’s fragile healthcare system, battered by an earthquake in 2010 that killed 300,000, and still struggling with a cholera epidemic that has sickened nearly 800,000 people.

WHO data show 5,000 suspected cases have been reported in more prosperous neighbor Dominican Republic, which shares the island of Hispaniola with Haiti and has a similar population and climate. Haiti by contrast, has reported 3,000 suspected cases, according to numbers shared by the U.S. Centers for Disease Control and Prevention.

That makes Haiti’s Zika infection rate about 30 per 100,000 people, compared to 82 per 100,000 in Brazil, where the connection between Zika and microcephaly was first detected, and 50 per 100,000 in Dominican Republic

The connection between Zika and microcephaly first came to light last fall in Brazil, which has since confirmed more than 1,800 cases of microcephaly.

RAINY SEASON

In the Dominican Republic there were spikes in infections in March and May, broadly coinciding with rainy seasons on both sides of the island, a time when mosquitoes and diseases they carry normally flourish. In Haiti, the number of cases reported each week generally dropped from February through the rains.

A long strike by medical residents at most public hospitals coincided with that decline, raising the question of whether there were fewer infections or a lack of health workers available to register cases.

A Zika task force, which includes the government and non-governmental organizations, was formed in May, Thimothe said. Several U.S. health officials in Haiti told Reuters that the United States provided $3 million in August to combat Zika in the country, money that was initially intended to be deployed against Ebola in West Africa.

Thimothe said the impact of an explosion of microcephaly cases would be devastating, but denied the condition was more widespread than thought, even though many Haitian women give birth at home rather than in clinics.

His position is supported by WHO data through June, which did not show an uptick in microcephaly or Guillain-Barre syndrome, a neurological disorder that can cause temporary paralysis and has also been linked to Zika.

But Louise Ivers, the senior health and policy advisor for Partners in Health, which along with Haitian organization Zanmi Lasante runs a hospital in the central town of Mirebalais, said she had seen at least 12 cases this year of Guillain-Barre, normally a rare condition.

The same hospital registered two microcephaly cases, including one confirmed to be linked to Zika, this summer.

“Maybe we are too late for prevention. Maybe we just have to manage the consequences,” Ivers said. “This could just be the tip of the iceberg.”

(Additional reporting by Joseph Guyler Delva; Editing by Frank Jack Daniel and Alistair Bell)

U.S. fights Zika mosquitoes with limited arsenal

Zika virus kit

By Julie Steenhuysen

(Reuters) – Over Wynwood, the Miami neighborhood where Zika gained a foothold in the continental United States, low flying planes have been spraying naled, a tightly controlled pesticide often used as a last resort. It appears to be working, killing at least 90 percent of the target mosquitoes.

Across the Biscayne Bay in Miami Beach, wind and high-rise buildings make aerial spraying challenging. So, the effort in the popular tourist destination has focused on ground-sprayed pyrethroids – pesticides that are safer but don’t always work.

The arrival in Florida of Zika, a virus that can cause a crippling birth defect known as microcephaly, has drawn into focus the limitations of the U.S. mosquito control arsenal.

Larvicides reduce future populations relatively safely. But for use against the mature mosquitoes that spread disease, only two classes of pesticides are approved. Each has drawbacks.

Organophosphates, such as naled, are effective. But there are strict controls to limit risk. Pyrethroids are safer but have been used so much that mosquitoes, in many places, are immune.

“That’s really the weak link in much of the United States,” said Michael Doyle, director of the Florida Keys Mosquito Control District. “We’re kind of caught off guard.”

DENGUE PREVIEW

Doyle led a 2009 effort against a dengue outbreak in South Florida, the first in the United States in nearly a century. Authorities threw everything they had at the Aedes aegypti, the same mosquito that carries Zika: backpack fogging, door-to-door yard inspections looking for watery breeding sites and larvicide spraying.

Still, 88 people were infected before the virus was brought under control more than two years later, and there continue to be sporadic cases in Florida.

The outbreak highlighted gaps in the mosquito control arsenal that remain, according to pesticide makers, abatement officials and entomologists. Few companies make pesticides for use in public health outbreaks, a niche market that is expensive to get into, has a limited upside and varies season to season.

Safety testing a new pesticide can cost up to $250 million and take 10 years, said Karen Larson, vice president of regulatory affairs at privately held Clarke Mosquito.

As long as a product remains on the market, companies must continue testing for unforeseen side effects, an expense that some makers have blamed for decisions to abandon products.

“There’s not a lot of profit,” Larson said.

Sales of the Dibrome brand of naled have been estimated at $12 million a year. By comparison, total crop pesticide sales for some companies can exceed $500 million in a single quarter.

Bayer, Dow Chemical, BASF and other agricultural pesticide makers “are not interested in going after a $20 million or $30 million a year market,” said William A. Kuser, investor relations director at Dibrome maker American Vanguard Corp.

The U.S. Environmental Protection Agency has approved several new pesticides in recent years. But it has received few requests for using them against mosquitoes, said Jim Jones, Assistant Administrator for the agency’s Office of Chemical Safety and Pollution Prevention.

“Although it’s of critical importance, the amount one can sell is small and it’s variable, which makes it difficult for business planning,” Jones said. “You can go many years without having much of a market at all, then suddenly, whether it’s because of a nuisance outbreak of mosquitoes or something like West Nile or Zika, the market grows significantly.”

Abatement authorities have pressed for help with the cost of developing mosquito control pesticides. The 1996 U.S. Food Quality Protection Act includes a provision for subsidies to defray the expense of safety testing, but Congress has never funded it.

RISK AND RESISTANCE

At least 49 cases of locally transmitted Zika infections have been reported in Florida, most in Wynwood and Miami Beach. Most people have no symptoms or mild illness.

Because of the microcephaly link, efforts are focused on preventing infection among pregnant women.

In Wynwood, the campaign began with pyrethroids, synthetic versions of a chemical derived from chrysanthemums. Amid signs of resistance, authorities switched to naled.

Developed as nerve agents, organophosphates, at high doses, can cause nausea, convulsions and death. They can be toxic to wildlife, including bees. The EPA considers naled safe at permitted ultra-low concentrations, and it is sprayed annually over 16 million acres in the United States.

But it is banned in Europe, where the risk is seen as unacceptable. In the U.S. territory of Puerto Rico, where Zika is widespread, the governor prohibited naled amid protests over safety concerns.

Although naled killed more than 90 percent of mosquitoes in traps set in Wynwood, the Aedes aegypti’s resilience remains a concern.

“This is truly the cockroach of mosquitoes,” said Tom Frieden, director of the U.S. Centers for Disease Control and Prevention.

DROPPING PESTICIDES

CDC entomologist Janet McAllister said pyrethroid resistance typically is limited by the mosquito’s small range. When resistance to one pyrethroid develops, another often works.

Still, she said, “we would love to see additional classes of insecticides available because, even in places that may have an effective tool today, that doesn’t mean it is going to last down the road.”

The EPA can fast-track its evaluation of new pesticides and expand the use of old ones. In response to Zika, it expedited new uses for pesticide-treated bed nets and mosquito traps.

Still, development of pesticides is painstaking. Even if the EPA speeds up its evaluation, required safety data can take years to collect. And the expense of ongoing safety testing has prompted companies to drop products.

Bayer CropScience, for example, told distributors it dropped the pyrethroid resmethrin in 2012, rather than do additional testing. Clarke Mosquito gave up temephos, a larvicide, six years ago, because of costs, Larson said.

That decision led to stockpiling in southwest Florida, said Wayne Gale, director of the Lee County Mosquito Control District.

“We purchased just about every bit,” he said.

(Reporting by Julie Steenhuysen; Editing by Michele Gershberg and Lisa Girion)

Zika virus findings show hearing loss to some babies

An Aedes aegypti mosquito is seen inside a test tube as part of a research on preventing the spread of the Zika virus and other mosquito-borne diseases at a control and prevention center in Guadalupe,

CHICAGO (Reuters) – A study in Brazil of 70 babies whose mothers had confirmed Zika infections found that nearly 6 percent had hearing loss, adding a new complication to the list of ills the virus can cause when women are infected during pregnancy.

The Brazilian study, published on Tuesday in the U.S. Centers for Disease Control and Prevention’s weekly report on death and disease, confirmed less rigorous reports of deafness among infants born to mothers with Zika infections.

The finding is part of an effort to fully characterize the harm caused by the Zika virus during pregnancy. The virus is best known for causing the severe birth defect microcephaly, characterized by undersized heads and underdeveloped brains. But other studies have shown that Zika can cause other brain abnormalities, vision problems and joint deformities.

In the latest study, a team led by Dr. Marli Tenório and Dr. Ernesto Marques of the Oswaldo Cruz Foundation in Pernambuco, Brazil, examined records from 70 infants with microcephaly whose mothers had laboratory-confirmed Zika infections during pregnancy.

They found that nearly 6 percent had hearing loss without any other plausible cause.

Several other viral infections during pregnancy can cause hearing loss, including rubella and cytomegalovirus, or CMV, infections. The current study adds Zika infection to that list.

Scientists say Zika should now be considered a risk factor for hearing loss, and children who were exposed during pregnancy but have normal hearing at birth should be screened regularly for delayed or progressive hearing loss.

The connection between Zika and microcephaly first came to light last fall in Brazil, which has since confirmed more than 1,800 cases of microcephaly.

(Reporting by Julie Steenhuysen; Editing by Jonathan Oatis)

Twelve premature babies killed in Bagdad hospital fire

An Iraqi woman stands in front of a maternity ward after a fire broke out at Yarmouk hospital in Baghdad

By Maher Nazeh

BAGHDAD (Reuters) – Twelve prematurely born babies were killed in a fire that broke out in the early hours of Wednesday on a maternity ward in a Baghdad hospital and was probably caused by an electrical fault, Iraqi authorities said.

Eleven or twelve other babies and 29 women were rescued from the Yarmuk hospital’s maternity ward and transferred to other hospitals, Hani al-Okabi, an MP who previously managed a health directorate in Baghdad, told journalists after visiting the hospital and talking to the management.

Firefighters and hospital staff took about three hours to put out the blaze that engulfed the ward, according to one medic. Yarmuk is a main hospital on the western side of the capital, with emergency care facilities among others.

“My son’s birth was difficult,” Shaima Hussein, one of the babies’ mothers, told Reuters TV at the gate of the hospital. She said she was not given a chance to rescue her newborn.

“I came with milk powder for him, and then this happened … they shut the electricity and the doors,” she said.

Hassan Omar said he was upset that the hospital would not give him information about his twins other than that he may have to have DNA checks to see if they were among the dead.

“I went to the other hospital, they are not there, so where are they?” he said.

The incident is likely to intensify public accusations of state corruption and mismanagement.

Pictures posted on social media showed the hospital in a state of neglect, with cockroaches crawling out from between broken tiles, dustbins overflowing with rubbish, dirty toilets and patients lying on stretchers in the courtyard.

The relative of a patient who died recently in the hospital from meningitis said he saw cockroach crawling along the tube of an oxygen mask.

“It was so dirty,” he said. “We had to bring our own bed sheets.”

Thirteen years after the U.S.-led invasion that toppled Saddam Hussein, the oil-rich country still suffers a shortage of electricity, water, schools and hospitals.

Prime Minister Haider al-Abadi has been trying for more than two years to tackle corruption in Iraq, which ranks 161 out of 168 on Transparency International’s Corruption Index, but has faced resistance from much of the political elite.

Corruption has exacerbated the effects on the economy of a sharp decline in oil revenue caused by falling crude prices and the costs of fighting Islamic State, the hardline group that has controlled large parts of northern and western Iraq since 2014.

(Additional reporting by Maher Chmaytelli; Editing by Louise Ireland)

Doctors devise care plan for babies as Zika threat looms in U.S.

mosquito under microscope

By Julie Steenhuysen

CHICAGO (Reuters) – As U.S. public health officials try to determine whether Zika has arrived in the country, doctors are establishing guidelines on how to care for the rising number of babies whose mothers were infected with the virus during pregnancy.

Florida said it is investigating two possible cases of Zika not related to travel to an area where Zika is active, raising the possibility of the first incidence of local transmission of the mosquito-borne virus.

On Thursday, the Florida Department of Health said it was investigating a non travel-related case of Zika in Broward County, marking the second such case. Florida has asked the U.S. Centers for Disease Control and Prevention to assist in its investigation that must also rule out sexual transmission.

So far, 400 pregnant women in the continental United States have evidence of Zika infection, up from 346 from a week ago, the CDC reported on Thursday. All of those were related to travel or sex with an infected person who had traveled.

Three more babies have been born in the United States with birth defects linked to Zika infections in their mothers, bringing the total to 12, CDC said.

Zika has been proven to cause microcephaly, a severe birth defect marked by small head size and undersized brains that requires a complex network of care providers and social workers to treat and provide support to parents.

But microcephaly is just the tip of the iceberg, according to experts speaking at a CDC-sponsored workshop on Thursday. They said many babies exposed in utero who appear normal at birth may have developmental problems down the road, including hearing and vision problems.

For example, babies born without a functional sucking reflex may never develop the ability to swallow and will need to be fed through a feeding tube. These infants will have a higher risk of pneumonia, said Dr. Edwin Trevathan, a pediatrician and child neurologist at Vanderbilt University Medical Center.

Less obvious damage to structures on only one side of the brain may cause seizure disorders that do not appear until adolescence, Trevathan said.

Pediatric experts at the workshop are reviewing the potential consequences of Zika infection and plan to make recommendations on ways to treat Zika-exposed infants.

The connection between Zika and microcephaly first came to light last fall in Brazil, which has now confirmed more than 1,600 cases of microcephaly that it considers related to Zika infections in the mothers.

FLORIDA PROBE

The recommendations come as Florida officials investigate what may be the first cases of Zika in the continental United States caused by the bite of a local mosquito.

Florida officials will not elaborate on how a resident of Miami was infected and whether the first case under investigation was related to mosquitoes.

“We continue to investigate and have not ruled out travel or sexual transmission at this time,” Florida spokeswoman Mara Gambineri said in an email on Thursday. However, she said the state still suspects the case is not related to travel to a Zika-infected area.

The White House on Wednesday released a statement saying President Barack Obama had spoken to Florida Governor Rick Scott regarding a suspected case of mosquito transmission of Zika and promised more money to fight the virus.

At the Zika workshop, Dr. Marc Fischer, chief of surveillance and epidemiology activity at the arboviral diseases branch of the CDC, said the agency has worked with state health departments to establish strategies to identify possible local transmission in the United States.

“When and if there is a case of local transmission, we work with local health departments to identify additional cases to define the geographic scope of the outbreak,” he said.

That includes surveying households and neighbors within a 150-yard radius around the residence of the person who has Zika.

“That’s basically the flying radius of the vector mosquitoes,” he said.

According to the U.S. Zika response plan, Zika local transmission is defined as two or more cases not due to travel or sex with an infected person that occur in a one-mile diameter over the course of a month.

CDC has given Florida $2 million for Zika preparedness, and on Thursday awarded another $5.6 million to assist the state with Zika as part of an additional $60 million in Zika funds to states announced on Thursday. U.S. lawmakers so far have not approved any of the White House’s $1.9 billion request for Zika.

CDC plans to award another $10 million to states and territories on Aug. 1 to speed identification of microcephaly and other birth defects linked to Zika.

(Additional reporting by Bill Berkrot in New York; Editing by Bernard Orr)

CDC monitoring 320 U.S. pregnant women with Zika

A woman looks at a Center for Disease Control (CDC) health advisory sign about the dangers of the Zika virus as she lines up for a security screening at Miami International Airport in Miami, Florida, U.S., May 23, 2016. REUTERS/Carlo Allegri

WASHINGTON (Reuters) – The U.S. Centers for Disease Control and Prevention said on Thursday that it is monitoring 320 U.S. pregnant women with laboratory evidence of Zika virus infection, up from 287 women a week earlier.

However, the number of babies born in the United States with birth defects linked to Zika infection in mothers during pregnancy, or lost pregnancies linked to the virus, remained unchanged from last week’s report at 7 and 5, respectively, according to a CDC registry created last month.

The registry compiles poor outcomes of pregnancies with laboratory evidence of possible Zika virus infection in the 50 states and the District of Columbia. The latest figures are as of June 30.

Zika has caused concern throughout the Americas due to an alarming rise in cases of the birth defect microcephaly and other severe fetal brain abnormalities linked to the mosquito-borne virus reported in Brazil, the country hardest hit by the outbreak. Infants with microcephaly are born with abnormally small heads and may experience potentially disabling developmental problems.

Brazil has confirmed more than 1,600 cases of microcephaly linked to Zika.

All reported U.S. cases of Zika have so far involved people who traveled to areas with a current outbreak, but health experts have warned that local transmission cases are likely to occur in the coming weeks during summer mosquito season. Gulf Coast states, such as Florida and Texas, are seen as particularly vulnerable.

The virus can also be transmitted via unprotected sex with an infected man.

(Reporting by David Morgan in Washington and Bill Berkrot in New York)

Health agency reports U.S. babies with Zika-related birth defects

Mosquito under microscope, studying Zika

By Bill Berkrot

(Reuters) – Three babies have been born in the United States with birth defects linked to likely Zika virus infections in the mothers during pregnancy, along with three cases of lost pregnancies linked to Zika, federal health officials said on Thursday.

The six cases reported as of June 9 were included in a new U.S. Zika pregnancy registry created by the Centers for Disease Control and Prevention. The agency said it will begin regular reporting of poor outcomes of pregnancies with laboratory evidence of possible Zika virus infection in the 50 states and the District of Columbia.

Zika has caused alarm throughout the Americas since numerous cases of the birth defect microcephaly linked to the mosquito-borne virus were reported in Brazil, the country hardest hit by the current outbreak. The rare birth defect is marked by unusually small head size and potentially severe developmental problems.

The U.S. cases so far involve women who contracted the virus outside the United States in areas with active Zika outbreaks, or were infected through unprotected sex with an infected partner. There have not yet been any cases reported of local transmission of the virus in the United States. Health experts expect local transmission to occur as mosquito season gets underway with warmer weather, especially in Gulf Coast states, such as Florida and Texas.

The CDC declined to provide details of the three cases it reported on Thursday, but said all had brain abnormalities consistent with congenital Zika virus infection. Two U.S. cases of babies with microcephaly previously were reported in Hawaii and New Jersey.

The poor birth outcomes reported include those known to be caused by Zika, such as microcephaly and other severe fetal defects, including calcium deposits in the brain indicating possible brain damage, excess fluid in the brain cavities and surrounding the brain, absent or poorly formed brain structures and abnormal eye development, the CDC said.

“The pattern that we’re seeing here in the U.S. among travelers is very similar to what we’re seeing in other places like Colombia and Brazil,” Dr. Denise Jamieson, co-leader of the CDC Zika pregnancy task force, said in a telephone interview.

Authorities in Brazil have confirmed more than 1,400 cases of microcephaly in babies whose mothers were exposed to Zika during pregnancy.

Lost pregnancies include miscarriage, stillbirths and terminations with evidence of the birth defects. The CDC did not specify the nature of the three reported lost pregnancies, citing privacy concerns about pregnancy outcomes.

The CDC established its registry to monitor pregnancies for a broad range of poor outcomes linked to Zika. It said it plans to issue updated reports every Thursday intended to ensure that information about pregnancy outcomes linked with the Zika virus is publicly available.

The CDC said the information is essential for planning for clinical, public health and other services needed to support pregnant women and families affected by Zika.

“We’re hoping this underscores the importance of pregnant women not traveling to areas of ongoing Zika virus transmission if possible, and if they do need to travel to ensure that they avoid mosquito bites and the risk of sexual transmission,” Jamieson said.

(Reporting by Bill Berkrot; Editing by Will Dunham)

Congress eyes $1 billion to aid at-risk families

Neonatal Therapeutic Unit at Cabell Huntington Hospital

By Duff Wilson and John Shiffman

WASHINGTON (Reuters) – Key members of the U.S. Congress said Friday they had reached a compromise to shift more than $1 billion to try to keep struggling families together, including those with babies born dependant on opioids.

The proposal is driven in part by an opioid crisis that threatens thousands of families. The bill would allow mental health, substance abuse and parenting assistance whenever a child is deemed at “imminent risk” of entering foster care. The measure also offers support for relatives who unexpectedly assume responsibility for a child when a parent cannot.

Under current law, such funds may only be spent after a child enters foster care. A spokesman for the Child Welfare League of America, John Sciamanna, called the proposed change “a landmark…, potentially historic.”

The legislation involves more than $1 billion over 10 years. Related opioid bills have not included funding.

“This bill would make a historic shift in child welfare funding by offering a way for moms and dads to get help and treatment rather than pitching in only after children are removed from home,” said Sen. Ron Wyden, the ranking Democrat on the Senate Finance Committee.

The bill is a compromise between four powerful members of Congress: Wyden; the Senate Finance committee’s Republican chair, Orrin Hatch of Utah; the Republican chair of the House Ways & Means Committee, Kevin Brady of Texas; and the ranking Democrat on Ways & Means, Sander Levin of Michigan.

The plan offers “bipartisan solutions for families and children affected by the opioid addiction crisis,” Hatch said in a statement.

In December, a Reuters investigation revealed that at least 110 babies had died since 2010 after being born opioid-dependent and sent home with parents ill-prepared to care for them. No more than nine of the 50 U.S. states followed a federal law requiring them to help those newborns, the news agency found.

In response to the Reuters series, the U.S. Department of Health and Human Services asked all states to report by June 30 whether and how they are following the existing law, known as the Child Abuse Prevention and Treatment Act. In May, the House passed legislation to improve safety planning for children born dependent on opioid drugs.

Reanne Pederson of Devils Lake, N.D., one of the women portrayed in the Reuters series who accidentally smothered her newborn in bed while on drugs, said she was happy to hear about new funding possibilities.

“It’s important to me that moms who are struggling with addiction get help,” she said.

(Editing by Ronnie Greene)