I am Helen Branswell, an infectious diseases reporter for STAT. AMA about Zika virus and covering disease outbreaks.

I'm from Trinidad And Tobago How serious do you think the Zika Virus will be here? Everyone here is worried about it and considering we are going through rough times a Outbreak would be a horrible thing

Hi. I can't know how bad Zika will be there. But most people who contract the virus don't get sick. That's important to remember.

Hi Helen! Thanks so much for being here today. I've heard scientists say that if the surge in Zika in Brazil is connected to the cases of microcephaly, it might mean Zika rapidly evolved recently with this pathogenic symptom. What are the mechanisms by which a virus like Zika can rapidly evolve?

That's certainly one of the theories scientists are looking at to try to figure out why the virus seems to have changed. They're looking at current viruses and comparing them to viruses from years ago. How do viruses change? They mutate -- evolve.

Hello Helen! My wife and I have a trip planned to Central America (Costa Rica) in a few months and we're hoping to have kids within a year. Is it known whether a Zika infection that occurs prior to conception may affect future pregnancies? Thank you!

Hi, traveLover. The thinking is that the Zika virus doesn't last in one's system all that long. Maybe 10 days or so. At present the experts don't think getting infected in say April could affect a pregnancy that doesn't yet exist. But you should watch the CDC Zika site for information updates and speak with your doctor closer to the time if you are concerned.

How do medical/public health authorities plan to determine if microcephaly cases are indeed linked to Zika?

That's going to take time. And there won't be a moment where they say: Ah, there's the final proof. They've found traces of virus in brain tissue from 2 microcephalic babies who died after birth and from amniotic fluid and placenta from 4 women who were carrying fetuses with microcephaly. Those are really good clues infection in the mother is leading to infection in the fetus. But labs will want to confirm those results by finding this evidence in more cases. Brazil, with the help of the US CDC, will also conduct what are called case control studies. They will interview, in huge detail, women who were infected during pregnancy and who had a baby with microcephaly. They will ask about their experiences during pregnancy -- what did they eat, where did they travel, what were they exposed to? They'll ask the same questions of women who were pregnant at the same time but didn't have babies with microcephaly to see if there are obvious things that are different and they'll explore them further. This is all going to take months, unfortunately. In the mean time, authorities will be watching to see if microcephalic babies are born in other countries that are having Zika outbreaks.

Yeah, case control studies seem like the right strategy. Will they be able to supplement the participants' histories with any kind of specimen-gathering or testing? Would antibody testing (to learn about past Zika infection) be useful for a case-control study?

So currently the antibody test for Zika isn't super useful for doing the type of study you are asking about. It cross reacts with dengue, so if you get a positive result, you know the person had Zika or dengue, but you don't know which. Brazil has had a huge dengue outbreak in the past few years.

Hi Helen, How did you get your start in science reporting? What would you recommend for others that might be interested in science reporting? Are graduate degrees in journalism or science important for credentials or is it more about showing your previous work? Thanks! Edit: previous not precious

I got into journalism and science journalism by fluke. I had been a journalist for more than 20 years when the health job at my former media outlet came open. I was asked to apply. I didn't want to. Thank goodness I was talked into it. Best. Job. Ever. I don't have a graduate degree and my BA is in English lit. My path was happenstance and serendipity -- and a lot of reading!

How effective are genetically modified mosquitoes at helping eradicate the Zika virus?

I don't think anyone is realistically talking about eradicating Zika at the moment. Eradicate means to wipe off the face of the earth. Mosquito control is hugely challenging and that would not seem at this point to be a realistic goal.

It's been a long time since a Mosquito borne virus has spread across the lower 48 of the US. Dengue, Chikungunya, Malaria, etc., have not been able to get a foothold here in decades. Does the medical community believe Zika will be any different? If so, why?

Actually, you're forgetting about West Nile virus. It has taken hold since it arrived in the United States in (or around) 1999. The medical community does not currently think Zika will take root in the US. They think it will be like dengue and chikungunya here. Some travelers will bring the virus to the US and they could infect mosquitoes leading to some local spread in places where Aedes mosquitoes are found. But the CDC and others feel that there won't be prolonged or endemic spread of these viruses in the US. Air-conditioned homes and cars and screens on doors and windows help. They think it might play out like the current dengue outbreak in Hawaii. You can read about it here. http://www.statnews.com/2016/01/21/zika-dengue-fever-hawaii/

Does this virus have any ability to spread itself more rapidly than any of the other tagline viruses over the last decade (swine, bird, west nile, etc)? If so, why?

Well, mosquitoes are a pretty effective virus delivery mechanism. So this virus seems to be spreading pretty efficiently in places where people aren't immune to it and where Aedes aegypti mosquitoes exist. Bird flu viruses aren't actually well adapted to infect people - they attach to receptor cells that are common in water birds but not so common in the human respiratory tract. If you've been following the bird flu viruses you know there are some cases, but they are in the hundreds rather than the hundreds of thousands or millions, as there may be in the next year for Zika in the Americas.

Can you tell me symptoms of zica virus?

flu like symptoms, mainly. Muscle and joint aches. Fever. A raised red rash and some people get conjunctivitis -- ie pink eye. But most people who catch Zika don't get sick. 4 out of 5, the experts say.

What are some of the principal ways in which zika virus has propogated? And why suddenly just now only?

Hi. I'm not sure what you mean when you ask how it is propagated. If you mean spread, it is like this: infected person is bitten by a mosquito which becomes infected. It bites others, infecting them. And so on. This has been happened for decades in parts of the world. Equatorial Africa and Asia. But there these concerning signals of a microcephaly risk haven't been seen.

Do you think U.S. hospitals are prepared for an infectious disease outbreak? (Having, hopefully, learned from the Ebola epidemic?)

Each disease outbreak has its own characteristics and poses its own challenges. Zika doesn't spread from person to person, so it doesn't pose the risk to healthcare workers that Ebola did. But caring for babies with microcephaly or for people who develop Guillain-Barre syndrome, where those arise, will pose challenges for health systems.

Every so often I see a new headline about a way scientists are considering eradicating mosquitos. Do you think this is a realistic approach in combating these kinds of diseases?

To be honest, I don't think I know enough about what works and what doesn't with mosquito control to give you a meaningful answer. Eradicating anything is a very ambitious goal. Everyone I ask about mosquito control says it is very complex and needs to be maintained constantly and that is really tough.

Do we know how long the virus stays in the body after infection? I live in Haiti and was likely infected the beginning of December 2015 (tested positive for dengue but mild symptoms and no test for Zika done). I found out that I am pregnant January 27th. Likely only 5 weeks at this point but still need to confirm. Thanks.

Hi. Have you talked to your doctor about your situation? I think he or she would be better able to assess your situation.

It seems like every year there's a new virus that's going to kill us all -- West Nile, SARS, H1N1, and of course, Ebola. They pop up out of nowhere and then a couple years later no one even remembers the names. Are virus outbreaks like shark attacks in the summer, in that they're largely a product of media frenzy?

It's true there appear to be a steady stream of new diseases. I don't think anyone said we were all going to die from West Nile and certainly no one is saying it about Zika. When something is new and concerning, it does get a lot of coverage. We all -- scientists, public health authorities, reporters and lay folk -- readjust our thinking about how big a threat this or that disease is as more is learned about it. We're all on the learning curve at the same time when a new disease emerges.

Hi Helen, what can you tell us about the links between Zika and Guillaume Behr Syndrome? How concerned should one be about that?

Hi. It looks like the Zika virus may trigger GBS in some cases, but that's a picture that is still coming into focus. French Polynesia had a Zika outbreak in 2013-14 and they saw an increase in GBS there. Brazil is seeing more cases than usual, as is Colombia and El Salvador. Guillain-Barre syndrome, which is a progressive (and generally temporary) paralysis, can be caused by lots of different things. Some infections are known to be linked to it. So mechanistically, it seems plausible Zika infection could trigger it. But at this point it is suspected, not proven.

Hi Helen, thanks so much for doing this!

Quick question. My family is planning a trip in April/May to travel to the San Diego Zoo. I will be 5-6 months pregnant at that time. I know the Zika virus is mainly in South America right now but do you think it's best to skip that trip in my pregnant state? I would think that the zoo would be a hot spot for mosquitoes and it can get quite warm/humid in Southern California.

Thanks again!

If you are pregnant and have concerns about whether you should take a trip to any location, you should talk with your health-care provider. He or she would be the best person to advise you. But just FYI: all mosquitoes don't transmit Zika. Most mosquitoes don't transmit Zika. It's Aedes mosquitoes. Cheers!

Do you know of anyone who has suggested working on a cheap and readily available test for the virus? Surely this would be a welcome option for those in regions where the virus is most prevalent?

lots of researchers are working on or getting ready to work on better tests for Zika.

Hi Helen, this might be a little off topic but how did you start covering disease outbreaks--and how did you break into science writing in general?

Fluke in terms of science writing. SARS in terms of covering disease outbreaks. I was based in Toronto in 2003 when the city was hit by SARS. I'd never covered an outbreak before but found it fascinating. Hated what the disease did to people but loved covering the story.

Have there been any cases of microcephaly (above the background rate) reported in countries other than Brazil?

I don't know what the background rates of microcephaly are for the other countries but they would surely have some cases. The US CDC estimates there are between 2 and 12 cases per 10,000 babies born in the US. FYI, the background rates Brazil reported (ie under 175/yr for the past 5 years) are probably underestimates.

there are some long questions here so i apologize if this has been asked: what are the estimates of this disease's impact on the brazilian olympics?

I think it's too soon to say.

Is there any elevated Zika risk for people with compromised immune systems? For instance, people undergoing chemotherapy?

I haven't seen anything on that at this point. In general, people with compromised immune systems can get sicker when they contract an infection. But I don't think anyone has released any data yet on Zika infection in people with compromised immune systems. In fact, I just did a quick search of PubMed and found nothing. http://www.ncbi.nlm.nih.gov/pubmed

Do we have any existing anti viral medications out on the market which fight against Zika?

no, there aren't any antivirals that are known to be effective against Zika.

Thanks for doing this. The Zika Virus was first reported in Uganda over 60 years ago. Are modern populations in Africa currently affected or at risk? Why don't we hear any news about this outbreak there?

There is probably a lot of immunity in the populations there. The outbreak in the Americas is so explosive because no one here is immune. Assuming the virus sticks around that will change over time.