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Zika Fears Grow With Abortion Rules

Some health experts worry that the expected spread of Zika in the United States this summer, combined with tough new restrictions on abortion, could put pregnant women in a ethical quandary.

Some health experts worry that the expected spread of Zika in the United States this summer, combined with tough new restrictions on abortion, could put pregnant women in a ethical quandary.

While the disease caused by the Zika virus doesn't do much more than feel like a killer case of the flu, pregnant women are at risk for microcephaly, a birth defect that causes babies to be born with smaller heads and cognitive difficulties. Brazil has reported more than 2,500 such births linked to Zika already.

Pregnant women who have been bitten by a Zika-carrying mosquito test positive for the virus in their second trimester of their pregnancy. But microcephaly only becomes evident in the third trimester of pregnancy. Many states now prohibit abortions during this later time frame, while others make it extremely difficult at all.

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In fact, the states with the strictest laws are also those in the "Zika belt" where the disease-carrying mosquito Aedes aegypti is plentiful.

"Were going to have a summer that is full of strife over abortion," said Arthur Caplan, professor of bioethics at the New York University School of Law. "Zika may bring the issue of fetal late detection of abnormality back into the debate."

The Supreme Court recently heard a challenge to a Texas law requiring doctors performing abortions to have privileges in nearby hospitals. If the court holds the law, it could leave Texas women with a single abortion clinic. Similar laws are on the books in Alabama and Mississippi, and awaiting signatures by governors in Indiana, Florida and South Carolina.

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Those states are the same ones where the Aedes mosquitoes that carry Zika are expected to be most common this summer, according to a recent study in PLOS Currents by meteorologists at the National Center for Atmospheric Research The scientists used weather predictions to plot the spread of Aedes and found cities like Miami, New Orleans, Mobile and Houston have the greatest risk of Zika. This year's strong El Nino weather system could also mean a warmer summer, the kind that mosquitoes thrive in.

"There's no question that as soon as we see people being bitten by mosquitos and worrying that they are infected, they will realize that there options have been restricted," said Alta Charo, professor of law and bioethics at the University of Wisconsin. "Poor women in the south are going to be in a terrible position."

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In February, the Centers for Disease Control reported on the cases of nine pregnant women who have tested positive for the Zika virus.

Two of them had abortions in recent months, while two others have suffered miscarriages. One woman gave birth to an infant with serious birth defects, while two others delivered healthy infants. Two are still pregnant.

In some Latin American countries where Zika is rapidly spreading and which completely outlaw abortions, women are turning to abortion pills available from online pharmacies, according to the Washington Post.

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In the United States, Caplan said that women who find themselves infected with Zika will likely keep quiet about it in states where abortions are restricted or difficult to obtain.

"There will women who say I'm pregnant, I've got Zika and I'm going to end this pregnancy," Caplan said. "There may be some public discussion, but they won't make an issue out of it. They will be driving further, while some may be in places where they can't get to where they want to go."

Dr. Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), told Discovery News that "2015 was a very active year for protecting Americans." Indeed, there were plenty of crises and near-crises that threatened our health. Here's a sampling of six scares from 2015. In the meantime, the World Health Organization has already

issued a list of the top diseases on its watchlist

for 2016. For the second year, Ebola dominated global health issues. At the CDC, over 4,000 staff members, or 20 percent of the staff, worked on curtailing the outbreak, Frieden said. "The thing that is least well understood about Ebola is how close it became to a global catastrophe," Frieden said. "It could have been widespread in Africa for years, and it would have killed people not just from Ebola, but because health systems stop functioning." In fact, in Guinea,

more people died of malaria than Ebola

, because the country's health care system was so overloaded with Ebola patients that people with other diseases couldn't get proper treatment. "Ebola is an epidemic that not only kills but undermines others," Frieden said.

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Over 15,000 Americans died from

Clostridium difficile

(

C. difficile

) in a single year; it causes more hospital-acquired infections than any other bacteria, according to a CDC study. Not only do people often contract it when they are on antibiotics; some strains are resistant to treatment from antibiotics, making fecal transplants the leading alternative treatment. But the scariest bacteria news of 2015 might be the recent finding that a superbug gene found in China quickly infected someone in Denmark, highlighting the risk that drug-resistant bacteria pose to most modern medicine. "I'm an infectious disease physician and I have treated many people with cancer who are getting chemotherapy and have had horrible infections held in check with antibiotics," Frieden said. "If we don't have antibiotics, then cancer and other [modern medical treatments] are hanging by a thread." Waiting for a new miracle drug is a mistake, he added; it's also essential to take "better stewardship of the antibiotics we have."

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Air pollution is a silent killer, said Dr. Francesca Dominici, a professor of biostatistics at the Harvard T.H. Chan School of Public Health. But there's no escaping it. "With air, you cannot wake up one morning and say you're not going to breathe or even move somewhere with clean air," she said. "It's affecting everybody." There is an antidote, however: "If we shut down coal-fired power plants, it would save lives immediately," she said. "But it's the one thing no one is talking about." Climate change talk tends to focus on the future, what life will be like in 100 years. But there is a "health crisis happening right now," she said, and "it's crazy to think people are not doing anything about it. In a certain way, not acting on air quality and power plants is like not acting on the Ebola epidemic." When coal-fired power plants are shut down, the ambient air improves immediately, she said. Air pollution is linked to cardiovascular disease, which is the No. 1 killer in the U.S. It's also associated with lung function and cognitive issues in children.

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Although it didn't cause any deaths, the measles outbreak traced to Disneyland grabbed headlines across the country and put the debate about vaccines back in the spotlight. Many of the 147 people who fell sick were not immunized against measles, either for personal beliefs or because they were too young to get the vaccine. Vaccines in the U.S. are "underused," Frieden said. Take the HPV vaccine, which is recommended for girls and boys at age 11 or 12: according to a 2014 survey, 40 percent of girls and 60 percent of boys hadn't started the 3-shot series. "We're doing less well that Rwanda at protecting our children against HPV," he said. About 25 percent of Americans are infected with HPV, which can cause several types of cancer.

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Each year, more than 200,000 people die from preventable medical errors, killing more Americans than anything except for heart disease and cancer. "Considering we're all going to get sick at some point and need a hospital, it's hard to think we could suffer from error, and care that is not coordinated as it should be," Dominici said. Errors include everything from giving patients the wrong medication to giving premature babies too much oxygen.

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When 180 people in one small town in Indiana were infected with HIV in less than a year, it drew national attention. In a county that typically sees fewer than five cases of HIV a year, most of the new cases were linked to partners injecting the prescription opioid oxymorphone with shared syringes. Opioid pain relievers are prescribed for reducing severe pain, but "we got the risk-benefit wrong," Frieden said. "There's a short-term benefit, but in the medium- and long-term, you could die from it." The painkillers are so addictive that 1.9 million Americans live with prescription opioid abuse or dependence, and there are thousands of overdose deaths in the U.S. per year. The 2015 Indiana State Department of Health investigation reveals additional risks, including a resurgence of HIV.

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