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As cases and alarm grow, researchers seek ways to understand and stop Zika

Alarm over the Zika virus is rising as cases surge in the United States and warmer weather looms, bringing with it mosquito season.

After the U.S. Centers for Disease Control and Prevention officially confirmed the link this week between the mosquito-borne virus and birth defects, the push intensified further for a drug to prevent or treat infections.

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Almost 350 cases of Zika have been confirmed in the United States, including eight in Maryland, and researchers nationally and locally are exploring everything from the makeup of the virus to pharmaceuticals to stop its spread.

"I started three weeks ago," said Matthew Frieman, an associate professor of microbiology and immunology at the University of Maryland School of Medicine. "In less than a year, six to nine months, this could end with a drug that works in mice."

Frieman is among the many researchers across the country waiting for approval of $1.9 billion in emergency Zika research funding requested by the White House in February but stalled in Congress. Earlier this month, the Obama administration authorized the CDC and the National Institutes of Health to use more than $500 million mostly intended for Ebola research for Zika preparation and research, and legislation passed this week in Congress to provide incentives for pharmaceutical companies to work on a vaccine.

Frieman squeezed funds from existing grants to get started on his Zika study but plans to rely on an online crowd-sourcing site for scientists called experiment.com for an experiment that will scan existing drugs for one that may prevent Zika infections.

He is using a testing method he created for other infectious diseases such as SARS, MERS and influenza. Those studies are ongoing, but all have identified U.S. Food and Drug Administration-approved drugs that show promise in the lab.

Frieman said little is known about Zika, considered until last year to cause only benign infections. Most people don't even know they are sick. Once Brazilian health authorities linked the virus to microcephaly last year and cases began to skyrocket, the World Health Organization declared it a global health emergency.

Researchers are beginning to make some inroads. Purdue University researchers, for example, said last month that they had decoded the virus' structure, information that could help in development of antiviral treatments and vaccines, officials there said. Researchers from the University of California, Los Angeles said Thursday that they found the virus easily mutates, which may help explain how it has evaded the body's immune response and become such a threat.

CDC researchers said more research is needed to determine the extent of the effects from Zika and what can be done to stop the infections.

"It is now clear that the virus causes microcephaly," said Dr. Tom Frieden, the CDC director, during a news conference Wednesday to report that Zika is a definitive cause of microcephaly and announce a paper in the New England Journal of Medicine outlining the research.

"We are also launching further studies to determine whether children who have microcephaly born to mothers infected by the Zika virus is the tip of the iceberg of what we could see in damaging effects on the brain and other developmental problems," he said.

The CDC officials wouldn't officially say Zika causes Guillain-Barre syndrome, a rare neurological disorder that can cause paralysis, but confirmed that the link is still strongly suspected.

Without many answers, public health officials have been working to inform the public about Zika prevention. The Maryland Department of Health and Mental Hygiene said Thursday that it would hold a town hall meeting for agency employees April 20 and partner with local health departments on activities for the public April 24-30.

"The Zika virus — though a virus whose symptoms tend to be mild and whose infections generally pass from a person in about seven days — remains a serious public health concern because it causes birth defects and can be sexually transmitted," state Health Secretary Van T. Mitchell said in a statement. "We want to make sure the general public remains well-informed on steps to take to minimize chances of infection."

The advice is primarily aimed at pregnant women and those planning to become pregnant, though CDC officials said not all pregnant women infected with Zika will have babies with a birth defect. The CDC affirmed previous guidance to avoid mosquito bites and avoid travel to places with active spread of Zika, largely in South and Central America. The U.S. territory of Puerto Rico has become a new hot spot, with hundreds of Zika cases reported, the agency said.

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Nearly all of the cases in the United States were identified in travelers, including all eight in Maryland. Seven of the U.S. cases were sexually transmitted; 32 were in pregnant women.

The American College of Obstetricians and Gynecologists said it encourages women to abide by the CDC advice, and officials also made the case for more research.

"The message of the CDC paper underscores the importance of ongoing research into this outbreak," Dr. Mark S. DeFrancesco, the group's president, said in a statement. "We once again encourage Congress to act swiftly to pass emergency funding to enhance our public health preparedness and enable America's researchers to lead the charge in the development of a vaccine or treatment for this virus. Ongoing support for Zika virus research will protect American families and, indeed, families around the world."

That's why Frieman is turning to crowdfunding to jump-start his research, which uses ordinary baker's yeast, the kind found in the grocery store and used to make bread or beer.

He breaks down viruses into proteins that as a whole make the virus function. Each protein — eight for Zika — is infused into the yeast to see which inhibit the yeast's growth. Then drugs are mixed in to see which restore the yeast's growth to normal. Frieman plans to test 14,000 drugs.

Those that work will be infused in the whole live virus to see if the results are the same. The drugs that slow growth again can then be tested in animals to see if they stop infections. Frieman said the simple yeast study is likely to identify drugs that seem to prevent infections in the lab, though he's less sure about animal tests.

"With every virus — flu, SARS, chikungunya — we've always found drugs that worked in the petri dish," he said. "The harder step is getting them to work in animals. We may need chemists and pharmacologists to develop better versions of the drugs."

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