I've been meaning to post an update since I saw this on my local Houston TV news last week. The reporter included a quick flash of the CDC's recently revised map showing the estimated range of the Aedes aegypti mosquito now may cover most of the southern Continental US, from the San Francisco Bay Area, down the coast and across the Desert Southwest, as far north as somewhere near Kansas City, along the Ohio River region, then through West Virginia and Maryland to the East Coast past New York City on even into a bit of Connecticut. (See first attached image or click to view a better size; unfortunately the archaic code used on the Message Board does not allow resizing inline images.)

They include a second map for the Aedes albopictus mosquito, seldom mentioned before in publicity about Zika. Although it has a broader range than A. aegypti, the page explains it is less likely than the more well-known one to spread tropical diseases to humans.

The maps are not meant to show risk for disease, the likelihood that these mosquitoes will spread viruses, nor the numbers of locations of mosquitoes.

Quartz has more analysis of the maps, linking to a study on PLOS which attempts to model the spread of A. aegypti through the year including peak Summer months. There are many maps, including this eye-catching one based on their model comparing mosquito abundance in January and July. The size of the city-based circles is based on average monthly arrivals from countries with Zika travel advisories at the time. (See second attached image or click to see a better size.)

Because we in Greater Houston have seen cases of mosquito-borne dengue and chikungunya, local officials are preparing the public. From the local story:

Seeing the photo on NPR's Houston Prepares Now For Zika's Potential Arrival This Summer and reading their coverage of Houston's challenge, you see what we face.

I'll let you click on the NPR link to see one of the images of poverty here, similar to sections of pre-Katrina New Orleans or worse. It is stressed that besides Houston being a "gateway city" in many ways and having many mosquitoes, Zika "is a disease of poverty." We're not talking about River Oaks and the Galleria here, although even some more relatively affluent parts of the city may have open ditches instead of storm drains, not to mention a landscape full of bayous.

Similar statements and news coverage has been taking place in and about shiny sexy Miami, which also has pockets of poverty.

I was prompted to go ahead and put this on the site this evening because it was the lead story on NBC Nightly News: Zika Virus Is Scary and We Need Money to Fight It, Officials Say In this, Dr. Anthony Fauci - many of us remember him from the early HIV studies - of the NIH and Dr. Anne Schuchat of the CDC appeared at the daily White House briefing to bolster the Administration's request to Congress for additional funding to study and fight Zika.

And by the way, Fiji was added to the CDC's Zika Travel Information, where several other places in the Pacific Ocean appear, and Vietnam now has had at least two cases, possibly mosquito-borne. The story also mentions cases in Bangladesh, South Korea, Thailand and China.

The CDC says (from today's wording on their site), "The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito. 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. Once a person has been infected, he or she is likely to be protected from future infections."

It is, however, not the most frequent cases, the ones with few or no symptoms, but the others that prompt public health officials, doctors, and researchers to a call to action. This includes not only, as we discussed above, the many cases of microcephaly, the far fewer cases of Guillain-Barré Syndrome (GBS) in adults, but also evolving knowledge about how Zika affects the body.

Another story today was There's More Evidence Zika Goes Straight to the Brain, with meningitis and encephalitis previously mentioned. This one describes one study of developing brain cells affected by Zika having their growth slowed 40% and another study of patients with Zika who developed acute disseminated encephalomyelitis, an inflammation of the brain and spinal cord described as being similar to multiple sclerosis, "but it's usually temporary - although the recovery can take months." Additional cases of GNS were also documented.

And now let's talk about sex. Today's CDC wording has this about sexual transmission of Zika:

• Zika virus can be spread by a man to his sex partners.
• In known cases of sexual transmission, the men developed Zika virus symptoms. From these cases, we know the virus can be spread when the man has symptoms, before symptoms start and after symptoms resolve.
• In one case, the virus was spread a few days before symptoms developed.
• The virus is present in semen longer than in blood.

There also was Updated Guidance for Prevention of Sexual Transmission of Zika Virus issued March 25 which states (among many things), "This guidance defines potential sexual exposure to Zika virus as any person who has had sex (i.e., vaginal intercourse, anal intercourse, or fellatio) without a condom with a man who has traveled to or resides in an area with active Zika virus transmission."

Further down we see, "All reported cases of sexual transmission involved vaginal or anal sex with men during, shortly before onset of, or shortly after resolution of symptomatic illness consistent with Zika virus disease. It is not known whether infected men who never develop symptoms can transmit Zika virus to their sex partners. Sexual transmission of Zika virus from infected women to their sex partners has not been reported. Sexual transmission of many infections, including those caused by other viruses, is reduced by consistent and correct use of latex condoms."

And yet even further down are the CDC's "Recommendations for men and their nonpregnant sex partners.

Men and their nonpregnant sex partners (couples) who want to reduce the risk for sexual transmission of Zika virus should use condoms consistently and correctly during sex or abstain from sex. Based on expert opinion and limited but evolving information about the sexual transmission of Zika virus, the recommended duration of consistent condom use or abstinence from sex depends on whether men had confirmed infection or clinical illness consistent with Zika virus disease and whether men are residing in an area with active transmission..."

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