When photographer Lianne Milton arrived in the urban coastal city of Recife, it had just become “ground zero” for the mosquito-borne Zika virus.

“By then, mothers were sent to their regional hospitals,” Milton told In Sight via email. “I didn’t feel this sense of panic so much as I felt a sense of anger or sadness from the mothers. There is this feeling of hopelessness, like, what am I going to do?”

Since Milton’s trip to Recife on assignment for The Washington Post, the Zika virus has been “spreading explosively” across the Americas — affecting 23 countries, World Health Organization officials said Thursday.

“Brazil is the epicenter of Zika,” The Post’s Ariana Eunjung Cha and Lena H. Sun wrote, “public health officials are investigating a link between the virus and a rare brain defect called microcephaly in infants. … Brazil’s health minister, Claudio Maierovitch, said the country is investigating 12 confirmed deaths of babies born with microcephaly for potential linkage with Zika virus infection. The country has more than 4,000 suspected cases of microcephaly. Some of those have turned out not to be microcephaly, but many of them have been confirmed through ultrasound, he said.”

In Recife, Milton accompanied patrols of soldiers and volunteers who traveled door to door testing standing water and educating residents about the virus. “When a group of 100 soldiers descends into your neighborhood, generally I think residents were suspicious,” Milton said.  “Because usually that would mean one thing, that they want something. In this case, it’s Zika that they want to get rid of.”

When Milton visited the mothers, she said that although some were gripped by a sense of hopelessness, “many were also really into the moment of learning and embracing how to raise their baby with a disability,” she said. But the biggest challenges mothers face lie ahead, Milton said.

“The most crushing aspect is that most of these babies may never have the opportunity to receive proper developmental therapy and education because access to it would be very challenging to those who live outside the city. Mothers have had to quit their jobs, a second income for the family, or quit their dreams of opening a bakery; how will they finance additional health care for their child with a disorder?” Milton wrote in the email. “I feel that their biggest challenges have yet to come.”

See more of Lianne Milton’s photos from Recife here.