Britain's health ministry will investigate how a recording of former minister Matt Hancock kissing and embracing his aide was released to the media and forced his resignation, Northern Ireland minister Brandon Lewis said on Sunday. 
 
"It is a matter I know the department of health will be looking into to understand exactly how that recording ... got out of the system," he told Sky News, adding that the ministry would be launching an internal investigation. 
 
"What Matt did was wrong, he acknowledged that, it's why he apologised immediately for his behaviour and acknowledged what he did was wrong and it's ultimately why he's taken the decision that his position was untenable and distracting from the wider work we all have to do ... to move out of the pandemic."

Meanwhile, British former finance minister Sajid Javid will replace Matt Hancock as the country's health minister, Prime Minister Boris Johnson's office said on Saturday.&nbsp;

Earlier, UK Health Secretary Matt Hancock resigned after revelation that he himself violated coronavirus restrictions during an affair with his aide. Photos apparently showing him hugging and kissing the woman were published in a section of the media.

Hancock conceded he had let the public down after The Sun newspaper published a security camera photo. The image was reportedly obtained from a whistleblower showing him with the aide in his office on May 6.

Javid had resigned as finance minister last year after he refused to fire his political advisers as demanded by Johnson.

Hancock, the frontman for Britain's response to the pandemic, particularly the vaccine roll-out, quit in a letter to Prime Minister Boris Johnson, reiterating his earlier apology.

"We owe it to people, who have sacrificed so much on this pandemic to be honest when we have let them down as I have done by breaching the guidance," he wrote.

Prime Minister Johnson said that he was 'sorry' to receive Hancock's resignation. He added that Hancock should be 'immensely proud' of his service.

Johnson had initially stood by Hancock after he admitted to have broken social distancing rules at a time when he was urging the public to stick by the measures, including curbs on funeral numbers.

Opposition parties had kept up the pressure on the government accusing it of hypocrisy over lockdown rule breaches. Many members of the public have been slapped with fines.

The main opposition Labour party said the government needed to answer questions about the undisclosed appointment of the aide, former lobbyist Gina Coladangelo, to Hancock's top advisory team.&nbsp;

Both she and Hancock are married, and first met at university.

Britain's health ministry will investigate how a recording of former minister Matt Hancock kissing and embracing his aide was released to the media and forced his resignation, Northern Ireland minister Brandon Lewis said on Sunday.

Britain's health ministry will investigate how a recording of former minister Matt Hancock kissing and embracing his aide was released to the media and forced his resignation, Northern Ireland minister Brandon Lewis said on Sunday. "It is a matter I know the department of health will be looking into to understand exactly how that recording ... got out of the system," he told Sky News, adding that the ministry would be launching an internal investigation. "What Matt did was wrong, he acknowledged that, it's why he apologised immediately for his behaviour and acknowledged what he did was wrong and it's ultimately why he's taken the decision that his position was untenable and distracting from the wider work we all have to do ... to move out of the pandemic." Meanwhile, British former finance minister Sajid Javid will replace Matt Hancock as the country's health minister, Prime Minister Boris Johnson's office said on Saturday. Earlier, UK Health Secretary Matt Hancock resigned after revelation that he himself violated coronavirus restrictions during an affair with his aide. Photos apparently showing him hugging and kissing the woman were published in a section of the media. Hancock conceded he had let the public down after The Sun newspaper published a security camera photo. The image was reportedly obtained from a whistleblower showing him with the aide in his office on May 6. Javid had resigned as finance minister last year after he refused to fire his political advisers as demanded by Johnson. Hancock, the frontman for Britain's response to the pandemic, particularly the vaccine roll-out, quit in a letter to Prime Minister Boris Johnson, reiterating his earlier apology. "We owe it to people, who have sacrificed so much on this pandemic to be honest when we have let them down as I have done by breaching the guidance," he wrote. Prime Minister Johnson said that he was 'sorry' to receive Hancock's resignation. He added that Hancock should be 'immensely proud' of his service. Johnson had initially stood by Hancock after he admitted to have broken social distancing rules at a time when he was urging the public to stick by the measures, including curbs on funeral numbers. Opposition parties had kept up the pressure on the government accusing it of hypocrisy over lockdown rule breaches. Many members of the public have been slapped with fines. The main opposition Labour party said the government needed to answer questions about the undisclosed appointment of the aide, former lobbyist Gina Coladangelo, to Hancock's top advisory team. Both she and Hancock are married, and first met at university.

UK health department to investigate leak of Hancock footage, says minister

By: Claire Snell-Rood and Cathleen Willging

Much has been made of the distress and discontent in rural areas during the 2016 U.S. presidential election. Few realise, however, this is also felt through unequal health.

Researchers call it the &ldquo;rural mortality&nbsp;penalty.&rdquo; While rates of mortality have steadily fallen in the nation&rsquo;s <a href="http://www.pnas.org/content/113/7/E815.full">urban areas</a>, they have actually climbed for rural Americans. And the picture is even bleaker for specific groups, such as rural white women and people of colour, who face persistent disparities in health outcomes. In every category, from suicide to unintentional injury to heart disease, rural residents&rsquo; health has been declining since the 1990s.

While some have blamed these gaping disparities on &ldquo;culture&rdquo; or &ldquo;lifestyle&rdquo; factors &ndash; such as a supposed fatalism or overconsumption of unhealthy products like Mountain Dew &ndash; the truth is that the biggest culprit is limited access to health care and challenging economic circumstances.

The passage of the Affordable Care Act (ACA) in 2010 began to change this as more rural Americans gained insurance coverage and the government invested more money into regional health facilities and training.

This progress is now at risk, however, as the Republican Congress inches closer to repealing Obamacare and replacing it with a feeble alternative that greatly weakens rural health care access. As researchers who study the mental and physical health of rural Americans, we believe this would have disastrous consequences.

The travails of rural America

Even as <a href="https://theconversation.com/where-is-rural-america-and-what-does-it-look-like-72045?sr=1">rural America</a> feeds the country, <a href="http://www.npr.org/sections/thesalt/2017/05/22/529493413/in-some-rural-counties-hunger-is-rising-but-food-donations-arent">hunger is on the rise</a> in rural areas.

Some <a href="https://www.iatp.org/files/258_2_98043.pdf">98 percent of rural residents</a> live in food deserts &ndash; defined as counties in which one must drive more than 10 miles to get to the nearest supermarket. This makes it challenging to maintain healthy and nutritious diets, leading to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481194/">higher rates of obesity in rural areas</a> that greatly increase the risk for diabetes, heart disease and certain cancers.

As rural workers struggle to <a href="https://www.wsj.com/articles/rural-america-struggles-as-young-people-chase-jobs-in-cities-1395890099">sustain employment</a> in a <a href="https://www.washingtonpost.com/news/wonk/wp/2016/05/22/a-very-bad-sign-for-all-but-americas-biggest-cities/?utm_term=.174ccab19701">shifting economy</a>, the increasing poverty is contributing to mental distress and <a href="http://journals.sagepub.com/doi/abs/10.1177/002204260703700302">substance use</a>. On a larger scale, the economic changes that have hit rural areas have resulted in a declining tax base, lower incomes and strained educational institutions. Together, they challenge rural residents&rsquo; health not just in the immediate term but cumulatively over their lives.

<figure class="align-center "><img alt="" src="https://cdn.theconversation.com/files/175505/width754/file-20170625-13475-1udmu6z.jpg" />
<figcaption>
&nbsp;

Like many other rural hospitals in the U.S., Evans Memorial in Claxton, Georgia, has struggled to keep its doors open while treating patients who tend to be older, poorer and often uninsured. AP Photo/Russ Bynum
</figcaption>
</figure>

Barriers to accessing health care

Yet, despite all these medical issues, rural residents have a tough time getting the health care they need.

The nature of rural employment, for example, is characterised by <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1748-0361.2005.tb00058.x/epdf">self-employment, seasonal work and lower-than-average pay</a>. This means rural workers are <a href="https://www.ruralhealthinfo.org/pdf/research_compendium.pdf">less likely to get insurance through their jobs and thus face higher premiums</a> when buying their own policies.

The lack of public transportation in most rural areas is also a major hurdle to seeing a doctor, particularly as residents <a href="https://www.ncbi.nlm.nih.gov/pubmed/16606425">have to travel much farther</a> than those in urban areas to reach health care providers.

Rural residents get most of their services through primary care providers, who take on the work of other practitioners, like behavioural health clinicians, due to longstanding specialist shortages. When handling numerous complaints during a single medical encounter, primary care providers may concentrate on the acutest health concerns of their patients, undermining the ability to diagnose all their conditions and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609543/">meaningfully discuss their larger health risks</a>, such as exercise, weight and substance use. When providers are rushed or deliver sub-par care, rural residents may wonder if seeking it out is worth the challenge, <a href="https://www.ncbi.nlm.nih.gov/pubmed/27322157">opting to struggle on their own</a>.

These and other constraints make it tougher for rural Americans to get the screenings necessary to spot serious diseases such as <a href="http://www.tandfonline.com/doi/abs/10.1300/J013v42n02_06">cancer</a> early or to maintain adequate follow-up on conditions like <a href="https://www.ncbi.nlm.nih.gov/pubmed/24183213">hearing loss</a>. Finding the regular medical care necessary to manage chronic conditions, such as diabetes, depression or opioid disorders, is even more challenging.

Rural health care has at times been <a href="https://www.ncbi.nlm.nih.gov/pubmed/18709749">characterised as patchwork</a>. In part, that&rsquo;s because the costs of sustaining health care infrastructure in rural areas<a href="https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/30/10/36/rural-health-goals-guaranteeing-a-future"> are higher</a> thanks to the large service areas, the inability to negotiate bulk pricing and lack of financial incentives to fill in provider gaps.

The ACA and the AHCA

The ACA, intended to turn this around, has in fact led to dramatic gains in insurance coverage among rural Americans.

Broadly speaking, insurance rates in rural areas <a href="http://hrms.urban.org/quicktakes/Substantial-Gains-in-Health-Insurance-Coverage-Occurring-for-Adults-in-Both-Rural-and-Urban-Areas.html">reached almost 86 percent</a> in early 2015, up from an estimated 78 percent in 2013.

In Kentucky &ndash; a state with high poverty, a large rural population (42 percent of residents) and a successful <a href="https://theconversation.com/love-it-or-hate-it-obamacare-has-expanded-coverage-for-millions-66472?sr=2">Medicaid expansion</a> initiative &ndash; <a href="http://www.cbpp.org/blog/medicaid-at-50-kentuckys-experience-highlights-benefits-of-medicaid-expansion">tens of thousands of newly insured low-income adults</a> began using preventative services after previously being unable to afford it. The state&rsquo;s uninsured fell by half and, as a result, <a href="http://content.healthaffairs.org/content/35/1/96.abstract">fewer people skipped taking their medications</a> due to financial hardships relative to other states that didn&rsquo;t expand Medicaid.

The ACA also <a href="http://www.scholarsstrategynetwork.org/brief/how-obamacare-repeal-would-harm-rural-america">strengthened rural health care institutions</a> by investing in upgrades to hospitals and clinics, preventative health programs and support for providers to stay in rural areas. While rural hospitals are often laden with the expense of providing extensive care without payment to indigent patients, rural hospitals in states that expanded Medicaid under the ACA <a href="http://www.cbpp.org/research/health/house-passed-bill-would-devastate-health-care-in-rural-america?utm_source=CBPP+Email+Updates&amp;utm_campaign=d303d5c441-EMAIL_CAMPAIGN_2017_05_16&amp;utm_medium=email&amp;utm_term=0_ee3f6da374-d303d5c441-110964945">finally was able to better balance their books when caring for this vulnerable group</a>. At the same time, the ACA supported innovative models ideal for rural areas that prioritised <a href="https://www.ncbi.nlm.nih.gov/pubmed/18709749">outreach</a>, <a href="http://content.healthaffairs.org/content/29/5/852.abstract">integration of services</a> and <a href="http://nashp.org/wp-content/uploads/2016/09/Rural-Opioid-Primer.pdf">collaboration between safety-net players</a>.

Both the <a href="https://www.washingtonpost.com/graphics/2017/politics/obamacare-senate-bill-compare/">House and Senate</a> bills to repeal and replace Obamacare would <a href="http://www.scholarsstrategynetwork.org/brief/how-obamacare-repeal-would-harm-rural-america">drastically reduce rural Americans&rsquo; insurance coverage</a> and significantly threaten the ability of <a href="http://www.npr.org/sections/health-shots/2017/06/22/533680909/republicans-proposed-medicaid-cuts-would-hit-rural-patients-hard">many rural hospitals and clinics to keep their doors open</a>. <a href="http://www.cbpp.org/research/health/house-passed-bill-would-devastate-health-care-in-rural-america">Analysts show</a> that the bill would provide insufficient tax credits to pay for rural premium costs, drastically increase the price of rural premiums and increase uncompensated care in rural hospitals.

What rural areas need from health care reform

Previous efforts at health care reform show us that rural areas are uniquely vulnerable. Efforts need to take account not only of coverage and access &ndash; as has been the focus of the current debate &ndash; but also how reform affects rural health care institutions and the larger social factors shaping overall health.

The particular economic factors affecting rural health care institutions <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415203/">make rural areas particularly vulnerable to political shifts</a> that disrupt services for existing patients and for those newly insured, creating immense challenges for rural providers. Steps that fail to account for the impact of financial hardship on these institutions not only hurt their bottom line but contribute to <a href="https://www.ncbi.nlm.nih.gov/pubmed/22229021">poor morale and workforce turnover</a> and larger-scale decisions to reduce services, which decrease their ability to address patient needs.

At the same time, commitment to improving the health of rural Americans requires attention to the so-called upstream factors shaping rural health. That means <a href="http://www.prnewswire.com/news-releases/medicaid-plays-a-more-significant-role-in-small-towns-and-rural-communities-than-in-metro-areas-300469734.html">preserving the safety net programs so vital in rural areas</a> with underemployment and low-paying jobs, <a href="http://www.soar-ky.org/about-us">strengthening rural economies</a> and investing in <a href="https://www.brookings.edu/blog/brown-center-chalkboard/2017/01/04/a-better-future-for-rural-communities-starts-at-the-schoolhouse/">high-quality education</a>.

<img alt="The Conversation" height="1" src="https://counter.theconversation.edu.au/content/78018/count.gif?distributor=republish-lightbox-basic" width="1" />If our leaders are serious about reform that will lessen the rural-urban mortality gap, they should recognise the unique needs of rural America and ensure health care policy reflects how vital access to quality care is to their financial success &ndash; not to mention their well-being.

<a href="https://theconversation.com/profiles/claire-snell-rood-378593">Claire Snell-Rood</a>, Assistant Professor of Public Health, University of California, Berkeley and Cathleen Willging, Adjunct Associate Professor of Anthropology, University of New Mexico

This article was originally published on <a href="http://theconversation.com">The Conversation</a>. Read the <a href="https://theconversation.com/ahca-would-make-rural-americas-already-distressed-health-care-worse-78018">original article</a>.

Researchers who study the mental and physical health of rural Americans, believe this repealing Obamacare would have disastrous consequences

By: Claire Snell-Rood and Cathleen Willging Much has been made of the distress and discontent in rural areas during the 2016 U.S. presidential election. Few realise, however, this is also felt through unequal health. Researchers call it the “rural mortality penalty.” While rates of mortality have steadily fallen in the nation’s urban areas, they have actually climbed for rural Americans. And the picture is even bleaker for specific groups, such as rural white women and people of colour, who face persistent disparities in health outcomes. In every category, from suicide to unintentional injury to heart disease, rural residents’ health has been declining since the 1990s. While some have blamed these gaping disparities on “culture” or “lifestyle” factors – such as a supposed fatalism or overconsumption of unhealthy products like Mountain Dew – the truth is that the biggest culprit is limited access to health care and challenging economic circumstances. The passage of the Affordable Care Act (ACA) in 2010 began to change this as more rural Americans gained insurance coverage and the government invested more money into regional health facilities and training. This progress is now at risk, however, as the Republican Congress inches closer to repealing Obamacare and replacing it with a feeble alternative that greatly weakens rural health care access. As researchers who study the mental and physical health of rural Americans, we believe this would have disastrous consequences. The travails of rural America Even as rural America feeds the country, hunger is on the rise in rural areas. Some 98 percent of rural residents live in food deserts – defined as counties in which one must drive more than 10 miles to get to the nearest supermarket. This makes it challenging to maintain healthy and nutritious diets, leading to higher rates of obesity in rural areas that greatly increase the risk for diabetes, heart disease and certain cancers. As rural workers struggle to sustain employment in a shifting economy, the increasing poverty is contributing to mental distress and substance use. On a larger scale, the economic changes that have hit rural areas have resulted in a declining tax base, lower incomes and strained educational institutions. Together, they challenge rural residents’ health not just in the immediate term but cumulatively over their lives. Like many other rural hospitals in the U.S., Evans Memorial in Claxton, Georgia, has struggled to keep its doors open while treating patients who tend to be older, poorer and often uninsured. AP Photo/Russ Bynum Barriers to accessing health care Yet, despite all these medical issues, rural residents have a tough time getting the health care they need. The nature of rural employment, for example, is characterised by self-employment, seasonal work and lower-than-average pay. This means rural workers are less likely to get insurance through their jobs and thus face higher premiums when buying their own policies. The lack of public transportation in most rural areas is also a major hurdle to seeing a doctor, particularly as residents have to travel much farther than those in urban areas to reach health care providers. Rural residents get most of their services through primary care providers, who take on the work of other practitioners, like behavioural health clinicians, due to longstanding specialist shortages. When handling numerous complaints during a single medical encounter, primary care providers may concentrate on the acutest health concerns of their patients, undermining the ability to diagnose all their conditions and meaningfully discuss their larger health risks, such as exercise, weight and substance use. When providers are rushed or deliver sub-par care, rural residents may wonder if seeking it out is worth the challenge, opting to struggle on their own. These and other constraints make it tougher for rural Americans to get the screenings necessary to spot serious diseases such as cancer early or to maintain adequate follow-up on conditions like hearing loss. Finding the regular medical care necessary to manage chronic conditions, such as diabetes, depression or opioid disorders, is even more challenging. Rural health care has at times been characterised as patchwork. In part, that’s because the costs of sustaining health care infrastructure in rural areas are higher thanks to the large service areas, the inability to negotiate bulk pricing and lack of financial incentives to fill in provider gaps. The ACA and the AHCA The ACA, intended to turn this around, has in fact led to dramatic gains in insurance coverage among rural Americans. Broadly speaking, insurance rates in rural areas reached almost 86 percent in early 2015, up from an estimated 78 percent in 2013. In Kentucky – a state with high poverty, a large rural population (42 percent of residents) and a successful Medicaid expansion initiative – tens of thousands of newly insured low-income adults began using preventative services after previously being unable to afford it. The state’s uninsured fell by half and, as a result, fewer people skipped taking their medications due to financial hardships relative to other states that didn’t expand Medicaid. The ACA also strengthened rural health care institutions by investing in upgrades to hospitals and clinics, preventative health programs and support for providers to stay in rural areas. While rural hospitals are often laden with the expense of providing extensive care without payment to indigent patients, rural hospitals in states that expanded Medicaid under the ACA finally was able to better balance their books when caring for this vulnerable group. At the same time, the ACA supported innovative models ideal for rural areas that prioritised outreach, integration of services and collaboration between safety-net players. Both the House and Senate bills to repeal and replace Obamacare would drastically reduce rural Americans’ insurance coverage and significantly threaten the ability of many rural hospitals and clinics to keep their doors open. Analysts show that the bill would provide insufficient tax credits to pay for rural premium costs, drastically increase the price of rural premiums and increase uncompensated care in rural hospitals. What rural areas need from health care reform Previous efforts at health care reform show us that rural areas are uniquely vulnerable. Efforts need to take account not only of coverage and access – as has been the focus of the current debate – but also how reform affects rural health care institutions and the larger social factors shaping overall health. The particular economic factors affecting rural health care institutions make rural areas particularly vulnerable to political shifts that disrupt services for existing patients and for those newly insured, creating immense challenges for rural providers. Steps that fail to account for the impact of financial hardship on these institutions not only hurt their bottom line but contribute to poor morale and workforce turnover and larger-scale decisions to reduce services, which decrease their ability to address patient needs. At the same time, commitment to improving the health of rural Americans requires attention to the so-called upstream factors shaping rural health. That means preserving the safety net programs so vital in rural areas with underemployment and low-paying jobs, strengthening rural economies and investing in high-quality education. If our leaders are serious about reform that will lessen the rural-urban mortality gap, they should recognise the unique needs of rural America and ensure health care policy reflects how vital access to quality care is to their financial success – not to mention their well-being. Claire Snell-Rood, Assistant Professor of Public Health, University of California, Berkeley and Cathleen Willging, Adjunct Associate Professor of Anthropology, University of New Mexico This article was originally published on The Conversation. Read the original article.

Trump's health care policy is disastrous for rural America

Florida authorities on Friday reported the first sign of local Zika transmission in the continental United States, concluding that mosquitoes likely infected four people with the virus that can cause a rare but serious birth defect. 
 
Governor Rick Scott said the state believed active transmission of the virus was occurring within an area of Miami about the size of 2.6 square kilometres. Testing showed that one woman and three men had been infected, Scott said. 
 
While health officials have yet to identify mosquitoes carrying the virus, the state has ruled out other means of transmission, including travel to another country with a Zika outbreak, and sexual contact. 
 
&quot;This means Florida has become the first state in the nation to have local transmission of the Zika virus,&quot; Scott said at a press conference. 
 
Zika appears to pose the greatest risk when it infects pregnant women, given its ability to cause microcephaly in babies, a condition defined by small head size that can lead to developmental problems. The current outbreak was first detected in Brazil last year and has since spread rapidly through the Americas. 
 
Florida Surgeon General Celeste Philip said that health officials are not advising pregnant women to move out of the suspected transmission area. 
 
&quot;We do not believe there will be ongoing transmission,&quot; Philip said at a press conference in Orlando, citing daily efforts to control the mosquito population in the area. 
 
The local health department is searching for other potential infections, with more than 2,300 people tested so far in the state, is ramping up mosquito control programs and is distributing Zika protection kits to pregnant women at their doctors&#39; offices, Florida officials said. 
 
Federal authorities have already begun to treat the Florida cases as a sign of local transmission. On Wednesday, the US Food and Drug Administration ordered blood banks in Florida&#39;s densely populated Miami-Dade County and Broward County to stop collecting blood until they can test each unit or incorporate technologies that can kill blood pathogens. 
 
Residents in the trendy Miami neighbourhood thought to harbour Zika said the local spread of the virus had been inevitable, given the large numbers of tourists from other countries with outbreaks. 
 
Damian Jose Delgado, a 35-year-old father of two, said news of Zika&#39;s arrival would make him think twice about expanding his family. 
&quot;I think I might be done having kids,&quot; Delgado said. 
 
Federal scientists kept at arm&#39;s length 
 
The state of Florida is yet to invite a dedicated team of the federal government&#39;s disease hunters to assist with the investigation on the ground, health officials told Reuters. 
 
In its plans to fight Zika nationwide, CDC stressed that such teams would help local officials track and contain the virus. Similar teams were sent to Utah earlier this month to solve how a person may have become infected while caring for a Zika-infected patient, before local officials went public with the case, and quickly joined an effort to contain an Ebola case in Dallas in 2014. 
 
&quot;Should we need additional assistance, we will reach out,&quot; Gambineri said in an email. She did not reply to questions about why the state decided not to bring in a CDC team. 
 
Coordination with the US Centers for Disease Control and Prevention since the state reported possible local Zika transmission on July 19 has been conducted largely at a distance, they said. That is surprising to some infectious disease experts, who say a less robust response could lead to a higher number of infections. 
 
CDC spokesman Tom Skinner said the agency has several teams ready for when states request help with Zika, including Florida. 
&quot;If invited, we&#39;ve got a team ready to go,&quot; he said. 
 
While Florida has a strong record of battling limited outbreaks of similar mosquito-borne viruses, including dengue and chikungunya, the risk of birth defects caused by Zika adds greater urgency to containing its spread with every available means, they say. Other states have quickly called in CDC teams to help track high-profile diseases. 
 
&quot;You only have a small window. This is the window&quot; to prevent a small-scale outbreak from spreading, said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, who expressed impatience with the pace of the Florida investigation. 
 
The current Zika outbreak was first detected last year in Brazil, where it has been linked to more than 1,700 cases of the birth defect microcephaly, and has since spread rapidly through the Americas. 
 
(Reuters) 
&nbsp;

Governor Rick Scott said the state believed active transmission of the virus was occurring within an area of Miami

Florida authorities on Friday reported the first sign of local Zika transmission in the continental United States, concluding that mosquitoes likely infected four people with the virus that can cause a rare but serious birth defect. Governor Rick Scott said the state believed active transmission of the virus was occurring within an area of Miami about the size of 2.6 square kilometres. Testing showed that one woman and three men had been infected, Scott said. While health officials have yet to identify mosquitoes carrying the virus, the state has ruled out other means of transmission, including travel to another country with a Zika outbreak, and sexual contact. "This means Florida has become the first state in the nation to have local transmission of the Zika virus," Scott said at a press conference. Zika appears to pose the greatest risk when it infects pregnant women, given its ability to cause microcephaly in babies, a condition defined by small head size that can lead to developmental problems. The current outbreak was first detected in Brazil last year and has since spread rapidly through the Americas. Florida Surgeon General Celeste Philip said that health officials are not advising pregnant women to move out of the suspected transmission area. "We do not believe there will be ongoing transmission," Philip said at a press conference in Orlando, citing daily efforts to control the mosquito population in the area. The local health department is searching for other potential infections, with more than 2,300 people tested so far in the state, is ramping up mosquito control programs and is distributing Zika protection kits to pregnant women at their doctors' offices, Florida officials said. Federal authorities have already begun to treat the Florida cases as a sign of local transmission. On Wednesday, the US Food and Drug Administration ordered blood banks in Florida's densely populated Miami-Dade County and Broward County to stop collecting blood until they can test each unit or incorporate technologies that can kill blood pathogens. Residents in the trendy Miami neighbourhood thought to harbour Zika said the local spread of the virus had been inevitable, given the large numbers of tourists from other countries with outbreaks. Damian Jose Delgado, a 35-year-old father of two, said news of Zika's arrival would make him think twice about expanding his family. "I think I might be done having kids," Delgado said. Federal scientists kept at arm's length The state of Florida is yet to invite a dedicated team of the federal government's disease hunters to assist with the investigation on the ground, health officials told Reuters. In its plans to fight Zika nationwide, CDC stressed that such teams would help local officials track and contain the virus. Similar teams were sent to Utah earlier this month to solve how a person may have become infected while caring for a Zika-infected patient, before local officials went public with the case, and quickly joined an effort to contain an Ebola case in Dallas in 2014. "Should we need additional assistance, we will reach out," Gambineri said in an email. She did not reply to questions about why the state decided not to bring in a CDC team. Coordination with the US Centers for Disease Control and Prevention since the state reported possible local Zika transmission on July 19 has been conducted largely at a distance, they said. That is surprising to some infectious disease experts, who say a less robust response could lead to a higher number of infections. CDC spokesman Tom Skinner said the agency has several teams ready for when states request help with Zika, including Florida. "If invited, we've got a team ready to go," he said. While Florida has a strong record of battling limited outbreaks of similar mosquito-borne viruses, including dengue and chikungunya, the risk of birth defects caused by Zika adds greater urgency to containing its spread with every available means, they say. Other states have quickly called in CDC teams to help track high-profile diseases. "You only have a small window. This is the window" to prevent a small-scale outbreak from spreading, said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, who expressed impatience with the pace of the Florida investigation. The current Zika outbreak was first detected last year in Brazil, where it has been linked to more than 1,700 cases of the birth defect microcephaly, and has since spread rapidly through the Americas. (Reuters)

Florida cases seen as first sign of local Zika transmission in US

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