niman

Public health responseThe national task force is leading the response to the outbreak, under the National Director of Public Health (NDPH). WHO set up an Incident Management System (IMS) to coordinate international partners’ support to the NDPH. The IMS integrates and coordinates the work of several organizations, including the Institut Pasteur of Dakar, UNICEF, Centers for Disease Control and Prevention, Medicos del Mundo and Médecins Sans Frontières. The IMS partner response to the outbreak is articulated around five pillars: strengthening surveillance, with a focus on case investigations and laboratory confirmationvaccination,vector control,case management, andsocial mobilization.As of June 10, almost half of the country had been vaccinated (10,641,209 people) and the country had received 11,635,800 vaccines. Mass vaccination campaigns have taken place in all the districts of Luanda, seven districts of Benguela, five districts of Cuanza Sul, five districts of Huambo, three districts of Huila, and two of Uige. Vaccination is ongoing in two districts of Lunda Norte and one in Zaire, all of which border DRC. Additional mass vaccination campaigns are being planned in these and other provinces, including Cuando Cubango, Cunene and Namibe. Reactive vaccination has taken place in Cafunfu town (Lunda Norte) and the city of Lubango (Huila), among others. Plans are under way to complete vaccination in areas with low vaccination coverage (so called ‘mop up’ campaigns) in Luanda and Benguela. WHO and partners are providing technical and financial support to the response. The current challenges include the need to strengthen the response to the outbreak at the provincial level and address border health issues.

On 21 January 2016, the Ministry of Health of Angola notified WHO of an outbreak of yellow fever (YF). The first case (with onset date of 5 December 2015) was identified in Viana municipality, Luanda province. As of 10 June, 3,137 suspected cases, including 345 deaths, had been reported from all the 18 provinces of Angola. A total of 847 cases had been laboratory-confirmed. The confirmed cases are from 78 districts of 16 provinces. Local transmission has been documented in 31 districts of 12 provinces (Benguela, Cuango Cubango, Cuanza Norte, Cuanza Sul, Cunene, Huambo, Huila, Luanda, Lunda Norte, Malanje, Uige, and Zaire). Luanda and Huambo remain the most affected provinces with 1,778 cases (489 confirmed) and 508 cases (126 confirmed), respectively. The other most affected provinces are Benguela (291 suspected cases), Huila (135 suspected cases), Cuanza Sul (99 suspected cases) and Uige (54 suspected cases). The majority of the cases are aged 15 to 24 years. Efforts to strengthen surveillance are ongoing, and the number of cases in the country is slowly decreasing, though new clusters of cases are being reported in new districts. The epidemiological trend and pattern show that YF virus circulation continues to extend to other provinces and the risk for exportation to other countries with close linkages to Angola still exists. The epidemiological situation in Lunda Norte is of particular concern. This province shares borders with the Democratic Republic of the Congo (DRC) and regularly experiences a high flow of people and goods in and out of DRC. To date, three laboratory confirmed cases, imported from Lunda Norte, have been reported by DRC.

Yellow fever – AngolaDisease Outbreak News 14 June 2016 http://www.who.int/csr/don/14-june-2016-yellow-fever-angola/en/

Sequences producing significant alignments:Select:AllNone Selected:0 AlignmentsDownloadGenBankGraphicsDistance tree of resultsShow/hide columns of the table presenting sequences producing significant alignmentsSequences producing significant alignments:Select for downloading or viewing reportsDescriptionMax scoreTotal scoreQuery coverE valueIdentAccessionSelect seq gb|KX253995.1|Zika virus strain ZIKV/Homo sapiens/PRI/PRI-BNI-P1/2016 polyprotein gene, partial cds681681100%0.0100%KX253995.1Select seq gb|KU724098.1|Zika virus isolate 259060_2015_Panama NS5B gene, partial cds681681100%0.0100%KU724098.1Select seq gb|KU724097.1|Zika virus isolate 259250_2015_Panama NS5B gene, partial cds681681100%0.0100%KU724097.1Select seq gb|KU724096.1|Zika virus isolate 259249_2015_Panama NS5B gene, partial cds681681100%0.0100%KU724096.1Select seq gb|KU820897.3|Zika virus isolate FLR polyprotein gene, complete cds681681100%0.0100%KU820897.3Select seq gb|KU758877.1|Zika virus isolate 17271 polyprotein gene, complete cds681681100%0.0100%KU758877.1Select seq gb|KX262887.1|Zika virus isolate 103451, complete genome681681100%0.0100%KX262887.1Select seq gb|KX247646.1|Zika virus isolate Zika virus/Homo sapiens/COL/UF-1/2016, complete genome681681100%0.0100%KX247646.1Select seq gb|KX247632.1|Zika virus isolate MEX_I_7 polyprotein gene, complete cds681681100%0.0100%KX247632.1Select seq gb|KX087101.2|Zika virus strain ZIKV/Homo sapiens/PRI/PRVABC59/2015, complete genome681681100%0.0100%KX087101.2Select seq gb|KX198135.1|Zika virus strain ZIKV/Homo sapiens/PAN/BEI-259634_V4/2016, complete genome681681100%0.0100%KX198135.1Select seq gb|KU937936.1|Zika virus isolate ZIKVNL00013 polyprotein gene, complete cds681681100%0.0100%KU937936.1Select seq gb|KX156776.1|Zika virus strain ZIKV/Homo sapiens/PAN/CDC-259364_V1-V2/2015, complete genome681681100%0.0100%KX156776.1Select seq gb|KX156775.1|Zika virus strain ZIKV/Homo sapiens/PAN/CDC-259249_V1-V3/2015, complete genome681681100%0.0100%KX156775.1Select seq gb|KX156774.1|Zika virus strain ZIKV/Homo sapiens/PAN/CDC-259359_V1-V3/2015, complete genome681681100%0.0100%KX156774.1Select seq gb|KX087102.1|Zika virus strain ZIKV/Homo sapiens/COL/FLR/2015, complete genome681681100%0.0100%KX087102.1Select seq gb|KX056898.1|Zika virus isolate Zika virus/GZ02/2016 polyprotein gene, complete cds681681100%0.0100%KX056898.1Select seq gb|KU991811.1|Zika virus isolate Brazil/2016/INMI1 polyprotein gene, complete cds681681100%0.0100%KU991811.1Select seq gb|KU985087.1|Zika virus isolate MEX/InDRE/Zika-2/2015 nonstructural protein 5 gene, partial cds681681100%0.0100%KU985087.1Select seq gb|KU955590.1|Zika virus isolate Z16019 polyprotein gene, complete cds681681100%0.0100%KU955590.1Select seq gb|KU870645.1|Zika virus isolate FB-GWUH-2016, complete genome681681100%0.0100%KU870645.1Select seq gb|KU922960.1|Zika virus isolate MEX/InDRE/Sm/2016, complete genome681681100%0.0100%KU922960.1Select seq gb|KU922923.1|Zika virus isolate MEX/InDRE/Lm/2016, complete genome681681100%0.0100%KU922923.1Select seq gb|KU820898.1|Zika virus isolate GZ01 polyprotein gene, complete cds681681100%0.0100%KU820898.1Select seq gb|KU740184.2|Zika virus isolate GD01 polyprotein gene, complete cds681681100%0.0100%KU740184.2Select seq gb|KU853013.1|Zika virus isolate Dominican Republic/2016/PD2, complete genome681681100%0.0100%KU853013.1Select seq gb|KU853012.1|Zika virus isolate Dominican Republic/2016/PD1, complete genome681681100%0.0100%KU853012.1Select seq gb|KU729217.2|Zika virus isolate BeH823339 polyprotein gene, complete cds681681100%0.0100%KU729217.2Select seq gb|KU761564.1|Zika virus isolate GDZ16001 polyprotein gene, complete cds681681100%0.0100%KU761564.1Select seq gb|KU497555.1|Zika virus isolate Brazil-ZKV2015, complete genome681681100%0.0100%KU497555.1Select seq gb|KU707826.1|Zika virus isolate SSABR1, complete genome681681100%0.0100%KU707826.1Select seq gb|KU527068.1|Zika virus strain Natal RGN, complete genome681681100%0.0100%KU527068.1Select seq gb|KU232299.1|Zika virus isolate 015ZV_PEBR15 NS5 protein gene, partial cds681681100%0.0100%KU232299.1Select seq gb|KU232298.1|Zika virus isolate 050ZV_PEBR15 NS5 protein gene, partial cds681681100%0.0100%KU232298.1Select seq gb|KU232296.1|Zika virus isolate 045ZV_PEBR15 NS5 protein gene, partial cds681681100%0.0100%KU232296.1Select seq gb|KU232295.1|Zika virus isolate 068ZV_PEBR15 NS5 protein gene, partial cds681681100%0.0100%KU232295.1Select seq gb|KU232294.1|Zika virus isolate 061ZV_PEBR15 NS5 protein gene, partial cds681681100%0.0100%KU232294.1Select seq gb|KU232293.1|Zika virus isolate 057ZV_PEBR15 NS5 protein gene, partial cds681681100%0.0100%KU232293.1Select seq gb|KU232291.1|Zika virus isolate 051ZV_PEBR15 NS5 protein gene, partial cds681681100%0.0100%KU232291.1Select seq gb|KU232290.1|Zika virus isolate 036ZV_PEBR15 NS5 protein gene, partial cds681681100%0.0100%KU232290.1Select seq gb|KU232289.1|Zika virus isolate 020ZV_PEBR15 NS5 protein gene, partial cds681681100%0.0100%KU232289.1Select seq gb|KU232288.1|Zika virus isolate 001ZV_PEBR15 NS5 protein gene, partial cds681681100%0.0100%KU232288.1Select seq gb|KU556802.1|Zika virus isolate MEX/InDRE/14/2015 NS5 protein gene, partial cds681681100%0.0100%KU556802.1Select seq gb|KU647676.1|Zika virus strain MRS_OPY_Martinique_PaRi_2015 polyprotein gene, complete cds681681100%0.0100%KU647676.1Select seq gb|KU501215.1|Zika virus strain PRVABC59, complete genome681681100%0.0100%KU501215.1Select seq gb|KU365780.1|Zika virus strain BeH815744 polyprotein gene, complete cds681681100%0.0100%KU365780.1Select seq gb|KU365779.1|Zika virus strain BeH819966 polyprotein gene, complete cds681681100%0.0100%KU365779.1Select seq gb|KU365777.1|Zika virus strain BeH818995 polyprotein gene, complete cds681681100%0.0100%KU365777.1Select seq gb|KX253994.1|Zika virus strain ZIKV/Homo sapiens/GER/GER-BNI-P2/2016 polyprotein gene, partial cds67767799%0.0100%KX253994.1Select seq gb|KU232300.1|Zika virus isolate 067ZV_PEBR15 NS5 protein gene, partial cds677677100%0.099%KU232300.1Select seq gb|KX280026.1|Zika virus isolate Paraiba_01, complete genome675675100%0.099%KX280026.1Select seq gb|KX197192.1|Zika virus isolate ZIKV/H.sapiens/Brazil/PE243/2015, complete genome675675100%0.099%KX197192.1Select seq gb|KX059014.1|Zika virus isolate Haiti/1230/2014 NS5 gene, partial cds675675100%0.099%KX059014.1Select seq gb|KX059013.1|Zika virus isolate Haiti/1227/2014 NS5 gene, partial cds675675100%0.099%KX059013.1Select seq gb|KX051563.1|Zika virus isolate Haiti/1/2016, complete genome675675100%0.099%KX051563.1Select seq gb|KU509998.3|Zika virus strain Haiti/1225/2014, complete genome675675100%0.099%KU509998.3Select seq gb|KU926310.1|Zika virus isolate Rio-S1, complete genome675675100%0.099%KU926310.1Select seq gb|KU926309.1|Zika virus isolate Rio-U1, complete genome675675100%0.099%KU926309.1Select seq gb|KU232297.1|Zika virus isolate 049ZV_PEBR15 NS5 protein gene, partial cds675675100%0.099%KU232297.1Select seq gb|KU232292.1|Zika virus isolate 054ZV_PEBR15 NS5 protein gene, partial cds675675100%0.099%KU232292.1Select seq gb|KU501217.1|Zika virus strain 8375 polyprotein gene, complete cds675675100%0.099%KU501217.1Select seq gb|KU501216.1|Zika virus strain 103344 polyprotein gene, complete cds675675100%0.099%KU501216.1Select seq gb|KU365778.1|Zika virus strain BeH819015 polyprotein gene, complete cds675675100%0.099%KU365778.1Select seq gb|KU312312.1|Zika virus isolate Z1106033 polyprotein gene, complete cds675675100%0.099%KU312312.1Select seq gb|KU321639.1|Zika virus strain ZikaSPH2015, complete genome675675100%0.099%KU321639.1Select seq gb|KM078961.1|Zika virus strain CHI2612114 NS5 protein gene, partial cds675675100%0.099%KM078961.1Select seq gb|KM078936.1|Zika virus strain CHI1410214 NS5 protein gene, partial cds675675100%0.099%KM078936.1Select seq gb|KM078933.1|Zika virus strain CHI1058514 NS5 protein gene, partial cds675675100%0.099%KM078933.1Select seq gb|KJ873161.1|Zika virus isolate NC14-02042014-3220 nonstructural protein 5 gene, partial cds675675100%0.099%KJ873161.1Select seq gb|KJ873160.1|Zika virus isolate NC14-03042014-3481 nonstructural protein 5 gene, partial cds675675100%0.099%KJ873160.1Select seq gb|KJ776791.1|Zika virus strain H/PF/2013 polyprotein gene, complete cds675675100%0.099%KJ776791.1Select seq gb|KU940228.1|Zika virus isolate Bahia07, partial genome672672100%0.099%KU940228.1Select seq gb|KU940224.1|Zika virus isolate Bahia09, partial genome672672100%0.099%KU940224.1Select seq gb|KU729218.1|Zika virus isolate BeH828305 polyprotein gene, complete cds672672100%0.099%KU729218.1Select seq gb|KU681081.3|Zika virus isolate Zika virus/H.sapiens-tc/THA/2014/SV0127- 14, complete genome672672100%0.099%KU681081.3Select seq gb|KM851039.1|Zika virus strain SV0127/14 nonstructural protein 5 gene, partial cds672672100%0.099%KM851039.1Select seq gb|KM078971.1|Zika virus strain CHI2613014 NS5 protein gene, partial cds672672100%0.099%KM078971.1Select seq gb|KM078930.1|Zika virus strain CHI2283714 NS5 protein gene, partial cds672672100%0.099%KM078930.1Select seq gb|KM078970.1|Zika virus strain CHI2490414 NS5 protein gene, partial cds668668100%0.099%KM078970.1Select seq gb|KM078929.1|Zika virus strain CHI1805214 NS5 protein gene, partial cds666666100%0.099%KM078929.1Select seq gb|KX117076.1|Zika virus isolate Zhejiang04, complete genome663663100%0.099%KX117076.1Select seq gb|KU744693.1|Zika virus isolate VE_Ganxian, complete genome663663100%0.099%KU744693.1Select seq gb|KU179098.1|Zika virus isolate JMB-185 nonstructural protein 5 gene, partial cds663663100%0.099%KU179098.1Select seq gb|KU866423.2|Zika virus isolate Zika virus/SZ01/2016/China polyprotein gene, complete cds657657100%0.099%KU866423.2Select seq gb|KX253996.1|Zika virus isolate ZKC2/2016, complete genome657657100%0.099%KX253996.1Select seq gb|KX185891.1|Zika virus isolate Zika virus/CN/SZ02/2016 polyprotein gene, complete cds657657100%0.099%KX185891.1Select seq gb|KU963796.1|Zika virus isolate SZ-WIV01 polyprotein gene, complete cds657657100%0.099%KU963796.1Select seq gb|KU955589.1|Zika virus isolate Z16006 polyprotein gene, complete cds657657100%0.099%KU955589.1Select seq gb|KU820899.2|Zika virus isolate ZJ03, complete genome657657100%0.099%KU820899.2Select seq gb|KF993678.1|Zika virus strain PLCal_ZV from Canada polyprotein gene, partial cds657657100%0.099%KF993678.1Select seq gb|KU724099.1|Zika virus isolate 259032_2015_Panama NS5B gene, partial cds64564595%0.099%KU724099.1Select seq gb|KU955593.1|Zika virus isolate Zika virus/H.sapiens-tc/KHM/2010/FSS13025, complete genome645645100%0.098%KU955593.1Select seq gb|JN860885.1|Zika virus isolate FSS13025 polyprotein gene, partial cds645645100%0.098%JN860885.1Select seq gb|EU545988.1|Zika virus polyprotein gene, complete cds639639100%1e-17998%EU545988.1Select seq gb|KU681082.3|Zika virus isolate Zika virus/H.sapiens-tc/PHL/2012/CPC-0740, complete genome636636100%1e-17897%KU681082.3Select seq gb|KM851038.1|Zika virus strain CPC-0740 nonstructural protein 5 gene, partial cds636636100%1e-17897%KM851038.1Select seq gb|KU724100.1|Zika virus isolate 259043_2015_Panama NS5B gene, partial cds58058085%9e-16299%KU724100.1Select seq gb|HQ234499.1|Zika virus isolate P6-740 polyprotein gene, partial cds576576100%1e-16094%HQ234499.1Select seq gb|KX101061.1|Zika virus isolate Bahia03, partial genome53153179%4e-14799%KX101061.1Select seq gb|KF268949.1|Zika virus isolate ARB15076 polyprotein gene, complete cds531531100%4e-14791%KF268949.1Select seq gb|KF383118.1|Zika virus strain ArD157995 polyprotein gene, complete cds513513100%1e-14190%KF383118.1Select seq gb|KF383103.1|Zika virus strain ArA986 nonstructural protein 5 gene, partial cds513513100%1e-14190%KF383103.1Select seq gb|KF383086.1|Zika virus strain ArA975 nonstructural protein 5 gene, partial cds513513100%1e-14190%KF383086.1Select seq gb|KF383121.1|Zika virus strain ArD158095 polyprotein gene, partial cds509509100%1e-14090%KF383121.1Select seq gb|KF383119.1|Zika virus strain ArD158084 polyprotein gene, complete cds509509100%1e-14090%KF383119.1Select seq gb|KF268950.1|Zika virus isolate ARB7701 polyprotein gene, complete cds50650698%2e-13990%KF268950.1Select seq gb|KF268948.1|Zika virus isolate ARB13565 polyprotein gene, complete cds50650698%2e-13990%KF268948.1Select seq gb|KU963573.1|Zika virus isolate ZIKV/Macaca mulatta/UGA/MR-766_SM150-V8/1947 polyprotein (GP1) gene, complete cds504504100%6e-13990%KU963573.1Select seq gb|KU955594.1|Zika virus isolate Zika virus/M.mulatta-tc/UGA/1947/MR-766, complete genome504504100%6e-13990%KU955594.1Select seq gb|KU720415.1|Zika virus strain MR 766 polyprotein gene, complete cds504504100%6e-13990%KU720415.1Select seq dbj|LC002520.1|Zika virus genomic RNA, complete genome, strain: MR766-NIID504504100%6e-13990%LC002520.1Select seq gb|HQ234498.1|Zika virus isolate MR_766 polyprotein gene, partial cds504504100%6e-13990%HQ234498.1Select seq gb|AY632535.2|Zika virus strain MR 766, complete genome504504100%6e-13990%AY632535.2Select seq gb|AF013415.1|Zika virus strain MR-766 NS5 protein (NS5) gene, partial cds504504100%6e-13990%AF013415.1Select seq gb|KU963574.1|Zika virus isolate ZIKV/Homo sapiens/NGA/IbH-30656_SM21V1-V3/1968 polyprotein (GP1) gene, complete cds495495100%3e-13689%KU963574.1Select seq gb|HQ234500.1|Zika virus isolate IbH_30656 polyprotein gene, partial cds495495100%3e-13689%HQ234500.1Select seq gb|DQ859059.1|Zika virus strain MR 766 polyprotein gene, complete cds495495100%3e-13689%DQ859059.1Select seq gb|KF383106.1|Zika virus strain ArA27443 nonstructural protein 5 gene, partial cds491491100%4e-13589%KF383106.1Select seq gb|KF383104.1|Zika virus strain ArA982 nonstructural protein 5 gene, partial cds491491100%4e-13589%KF383104.1Select seq gb|KF383088.1|Zika virus strain ArD30101 nonstructural protein 5 gene, partial cds491491100%4e-13589%KF383088.1Select seq gb|KX198134.1|Zika virus strain ZIKV/Aedes africanus/SEN/DAK-AR-41524_A1C1-V2/1984, complete genome486486100%2e-13389%KX198134.1Select seq gb|KU955595.1|Zika virus isolate Zika virus/A.taylori-tc/SEN/1984/41671-DAK, complete genome486486100%2e-13389%KU955595.1Select seq gb|KU955592.1|Zika virus isolate Zika virus/A.taylori-tc/SEN/1984/41662-DAK, complete genome486486100%2e-13389%KU955592.1Select seq gb|KU955591.1|Zika virus isolate Zika virus/A.africanus-tc/SEN/1984/41525-DAK, complete genome486486100%2e-13389%KU955591.1Select seq gb|KF383114.1|Zika virus strain AnD30332 nonstructural protein 5 gene, partial cds486486100%2e-13389%KF383114.1Select seq gb|KF383107.1|Zika virus strain ArA27407 nonstructural protein 5 gene, partial cds486486100%2e-13389%KF383107.1Select seq gb|KF383087.1|Zika virus strain ArD30156 nonstructural protein 5 gene, partial cds486486100%2e-13389%KF383087.1Select seq gb|KF383085.1|Zika virus strain ArD9957 nonstructural protein 5 gene, partial cds486486100%2e-13389%KF383085.1Select seq gb|KF383116.1|Zika virus strain ArD7117 polyprotein gene, complete cds482482100%2e-13288%KF383116.1Select seq gb|KF383115.1|Zika virus strain ArB1362 polyprotein gene, complete cds475475100%3e-13088%KF383115.1Select seq gb|HQ234501.1|Zika virus isolate ArD_41519 polyprotein gene, partial cds473473100%1e-12988%HQ234501.1Select seq gb|KF383113.1|Zika virus strain ArA1465 nonstructural protein 5 gene, partial cds468468100%4e-12888%KF383113.1Select seq gb|KF383098.1|Zika virus strain ArD127988 nonstructural protein 5 gene, partial cds468468100%4e-12888%KF383098.1Select seq gb|KF383097.1|Zika virus strain ArD127994 nonstructural protein 5 gene, partial cds468468100%4e-12888%KF383097.1Select seq gb|KF383089.1|Zika virus strain ArD165531 nonstructural protein 5 gene, partial cds468468100%4e-12888%KF383089.1Select seq gb|KF383117.1|Zika virus strain ArD128000 polyprotein gene, complete cds464464100%5e-12787%KF383117.1Select seq gb|KF383101.1|Zika virus strain ArD127710 nonstructural protein 5 gene, partial cds464464100%5e-12787%KF383101.1Select seq gb|KF383099.1|Zika virus strain ArD127987 nonstructural protein 5 gene, partial cds464464100%5e-12787%KF383099.1Select seq gb|KF383084.1|Zika virus strain HD78788 nonstructural protein 5 gene, partial cds455455100%3e-12487%KF383084.1Select seq gb|KU867812.1|Zika virus isolate Jiangxi.CHN/01/2016 nonstructural protein 5 gene, partial cds40140158%5e-108100%KU867812.1Select seq gb|KF383120.1|Zika virus strain ArD142623 nonfunctional polyprotein gene, partial sequence369369100%3e-9882%KF383120.1Select seq gb|KF383093.1|Zika virus strain ArD149810 nonstructural protein 5 gene, partial cds347347100%1e-9180%KF383093.1Select seq gb|KF383091.1|Zika virus strain ArD149938 nonstructural protein 5 gene, partial cds347347100%1e-9180%KF383091.1Select seq gb|KF383095.1|Zika virus strain ArD132915 nonstructural protein 5 gene, partial cds342342100%4e-9080%KF383095.1Select seq gb|KF383092.1|Zika virus strain ArD147917 nonstructural protein 5 gene, partial cds342342100%4e-9080%KF383092.1Select seq gb|KX101060.1|Zika virus isolate Bahia02, partial genome331331100%8e-8775%KX101060.1Select seq gb|KX101066.1|Zika virus isolate Bahia01, partial genome21721731%1e-52100%KX101066.1Select seq gb|FJ898456.1|Dengue virus 3 isolate DENV-3/WS/BID-V2973/1995, complete genome15215295%4e-3370%FJ898456.1Select seq gb|JQ920478.1|Dengue virus 3 isolate PF95/190795-20064 polyprotein gene, complete cds14714795%2e-3170%JQ920478.1Select seq gb|AY656170.1|Dengue virus type 3 vector p3(delta30), complete sequence14714795%2e-3170%AY656170.1Select seq gb|AY656169.1|Dengue virus type 3 vector p3, complete sequence14714795%2e-3170%AY656169.1Select seq gb|AY648961.1|Dengue virus type 3 strain Sleman/78, complete genome14714795%2e-3170%AY648961.1Select seq gb|KT831765.1|Dengue virus 1 isolate BO15/14, partial genome145145100%6e-3170%KT831765.1Select seq gb|JF262780.1|Dengue virus 4 isolate P73-1120, complete genome145145100%6e-3170%JF262780.1Select seq gb|JF262779.1|Dengue virus 4 isolate P75-514, complete genome145145100%6e-3170%JF262779.1Select seq gb|EF457906.1|Dengue virus type 4 isolate P75-215, complete genome145145100%6e-3170%EF457906.1Select seq gb|KX101064.1|Zika virus isolate Bahia11, partial genome14321731%2e-30100%KX101064.1Select seq gb|KU940227.1|Zika virus isolate Bahia08, partial genome14321731%2e-30100%KU940227.1

Sequences producing significant alignments:Select:AllNone Selected:0 AlignmentsDownloadGenBankGraphicsDistance tree of resultsShow/hide columns of the table presenting sequences producing significant alignmentsSequences producing significant alignments:Select for downloading or viewing reportsDescriptionMax scoreTotal scoreQuery coverE valueIdentAccessionSelect seq gb|KX253994.1|Zika virus strain ZIKV/Homo sapiens/GER/GER-BNI-P2/2016 polyprotein gene, partial cds807807100%0.0100%KX253994.1Select seq gb|KU724096.1|Zika virus isolate 259249_2015_Panama NS5B gene, partial cds807807100%0.0100%KU724096.1Select seq gb|KU820897.3|Zika virus isolate FLR polyprotein gene, complete cds807807100%0.0100%KU820897.3Select seq gb|KU758877.1|Zika virus isolate 17271 polyprotein gene, complete cds807807100%0.0100%KU758877.1Select seq gb|KX262887.1|Zika virus isolate 103451, complete genome807807100%0.0100%KX262887.1Select seq gb|KX247646.1|Zika virus isolate Zika virus/Homo sapiens/COL/UF-1/2016, complete genome807807100%0.0100%KX247646.1Select seq gb|KX247632.1|Zika virus isolate MEX_I_7 polyprotein gene, complete cds807807100%0.0100%KX247632.1Select seq gb|KX087101.2|Zika virus strain ZIKV/Homo sapiens/PRI/PRVABC59/2015, complete genome807807100%0.0100%KX087101.2Select seq gb|KX198135.1|Zika virus strain ZIKV/Homo sapiens/PAN/BEI-259634_V4/2016, complete genome807807100%0.0100%KX198135.1Select seq gb|KU937936.1|Zika virus isolate ZIKVNL00013 polyprotein gene, complete cds807807100%0.0100%KU937936.1Select seq gb|KX156776.1|Zika virus strain ZIKV/Homo sapiens/PAN/CDC-259364_V1-V2/2015, complete genome807807100%0.0100%KX156776.1Select seq gb|KX156775.1|Zika virus strain ZIKV/Homo sapiens/PAN/CDC-259249_V1-V3/2015, complete genome807807100%0.0100%KX156775.1Select seq gb|KX156774.1|Zika virus strain ZIKV/Homo sapiens/PAN/CDC-259359_V1-V3/2015, complete genome807807100%0.0100%KX156774.1Select seq gb|KX087102.1|Zika virus strain ZIKV/Homo sapiens/COL/FLR/2015, complete genome807807100%0.0100%KX087102.1Select seq gb|KX056898.1|Zika virus isolate Zika virus/GZ02/2016 polyprotein gene, complete cds807807100%0.0100%KX056898.1Select seq gb|KU991811.1|Zika virus isolate Brazil/2016/INMI1 polyprotein gene, complete cds807807100%0.0100%KU991811.1Select seq gb|KU985087.1|Zika virus isolate MEX/InDRE/Zika-2/2015 nonstructural protein 5 gene, partial cds807807100%0.0100%KU985087.1Select seq gb|KU955590.1|Zika virus isolate Z16019 polyprotein gene, complete cds807807100%0.0100%KU955590.1Select seq gb|KU870645.1|Zika virus isolate FB-GWUH-2016, complete genome807807100%0.0100%KU870645.1Select seq gb|KU922960.1|Zika virus isolate MEX/InDRE/Sm/2016, complete genome807807100%0.0100%KU922960.1Select seq gb|KU922923.1|Zika virus isolate MEX/InDRE/Lm/2016, complete genome807807100%0.0100%KU922923.1Select seq gb|KU820898.1|Zika virus isolate GZ01 polyprotein gene, complete cds807807100%0.0100%KU820898.1Select seq gb|KU740184.2|Zika virus isolate GD01 polyprotein gene, complete cds807807100%0.0100%KU740184.2Select seq gb|KU853013.1|Zika virus isolate Dominican Republic/2016/PD2, complete genome807807100%0.0100%KU853013.1Select seq gb|KU853012.1|Zika virus isolate Dominican Republic/2016/PD1, complete genome807807100%0.0100%KU853012.1Select seq gb|KU761564.1|Zika virus isolate GDZ16001 polyprotein gene, complete cds807807100%0.0100%KU761564.1Select seq gb|KU497555.1|Zika virus isolate Brazil-ZKV2015, complete genome807807100%0.0100%KU497555.1Select seq gb|KU232299.1|Zika virus isolate 015ZV_PEBR15 NS5 protein gene, partial cds807807100%0.0100%KU232299.1Select seq gb|KU232298.1|Zika virus isolate 050ZV_PEBR15 NS5 protein gene, partial cds807807100%0.0100%KU232298.1Select seq gb|KU232296.1|Zika virus isolate 045ZV_PEBR15 NS5 protein gene, partial cds807807100%0.0100%KU232296.1Select seq gb|KU232295.1|Zika virus isolate 068ZV_PEBR15 NS5 protein gene, partial cds807807100%0.0100%KU232295.1Select seq gb|KU232294.1|Zika virus isolate 061ZV_PEBR15 NS5 protein gene, partial cds807807100%0.0100%KU232294.1Select seq gb|KU232290.1|Zika virus isolate 036ZV_PEBR15 NS5 protein gene, partial cds807807100%0.0100%KU232290.1Select seq gb|KU232289.1|Zika virus isolate 020ZV_PEBR15 NS5 protein gene, partial cds807807100%0.0100%KU232289.1Select seq gb|KU232288.1|Zika virus isolate 001ZV_PEBR15 NS5 protein gene, partial cds807807100%0.0100%KU232288.1Select seq gb|KU556802.1|Zika virus isolate MEX/InDRE/14/2015 NS5 protein gene, partial cds807807100%0.0100%KU556802.1Select seq gb|KU647676.1|Zika virus strain MRS_OPY_Martinique_PaRi_2015 polyprotein gene, complete cds807807100%0.0100%KU647676.1Select seq gb|KU501215.1|Zika virus strain PRVABC59, complete genome807807100%0.0100%KU501215.1Select seq gb|KU232300.1|Zika virus isolate 067ZV_PEBR15 NS5 protein gene, partial cds803803100%0.099%KU232300.1Select seq gb|KX280026.1|Zika virus isolate Paraiba_01, complete genome801801100%0.099%KX280026.1Select seq gb|KX197192.1|Zika virus isolate ZIKV/H.sapiens/Brazil/PE243/2015, complete genome801801100%0.099%KX197192.1Select seq gb|KX059014.1|Zika virus isolate Haiti/1230/2014 NS5 gene, partial cds801801100%0.099%KX059014.1Select seq gb|KX059013.1|Zika virus isolate Haiti/1227/2014 NS5 gene, partial cds801801100%0.099%KX059013.1Select seq gb|KX051563.1|Zika virus isolate Haiti/1/2016, complete genome801801100%0.099%KX051563.1Select seq gb|KU509998.3|Zika virus strain Haiti/1225/2014, complete genome801801100%0.099%KU509998.3Select seq gb|KU926310.1|Zika virus isolate Rio-S1, complete genome801801100%0.099%KU926310.1Select seq gb|KU926309.1|Zika virus isolate Rio-U1, complete genome801801100%0.099%KU926309.1Select seq gb|KU729217.2|Zika virus isolate BeH823339 polyprotein gene, complete cds801801100%0.099%KU729217.2Select seq gb|KU707826.1|Zika virus isolate SSABR1, complete genome801801100%0.099%KU707826.1Select seq gb|KU527068.1|Zika virus strain Natal RGN, complete genome801801100%0.099%KU527068.1Select seq gb|KU232297.1|Zika virus isolate 049ZV_PEBR15 NS5 protein gene, partial cds801801100%0.099%KU232297.1Select seq gb|KU232293.1|Zika virus isolate 057ZV_PEBR15 NS5 protein gene, partial cds801801100%0.099%KU232293.1Select seq gb|KU232292.1|Zika virus isolate 054ZV_PEBR15 NS5 protein gene, partial cds801801100%0.099%KU232292.1Select seq gb|KU232291.1|Zika virus isolate 051ZV_PEBR15 NS5 protein gene, partial cds801801100%0.099%KU232291.1Select seq gb|KU501217.1|Zika virus strain 8375 polyprotein gene, complete cds801801100%0.099%KU501217.1Select seq gb|KU501216.1|Zika virus strain 103344 polyprotein gene, complete cds801801100%0.099%KU501216.1Select seq gb|KU365780.1|Zika virus strain BeH815744 polyprotein gene, complete cds801801100%0.099%KU365780.1Select seq gb|KU365779.1|Zika virus strain BeH819966 polyprotein gene, complete cds801801100%0.099%KU365779.1Select seq gb|KU365778.1|Zika virus strain BeH819015 polyprotein gene, complete cds801801100%0.099%KU365778.1Select seq gb|KU365777.1|Zika virus strain BeH818995 polyprotein gene, complete cds801801100%0.099%KU365777.1Select seq gb|KU312312.1|Zika virus isolate Z1106033 polyprotein gene, complete cds801801100%0.099%KU312312.1Select seq gb|KU321639.1|Zika virus strain ZikaSPH2015, complete genome801801100%0.099%KU321639.1Select seq gb|KM078936.1|Zika virus strain CHI1410214 NS5 protein gene, partial cds801801100%0.099%KM078936.1Select seq gb|KJ873161.1|Zika virus isolate NC14-02042014-3220 nonstructural protein 5 gene, partial cds801801100%0.099%KJ873161.1Select seq gb|KJ873160.1|Zika virus isolate NC14-03042014-3481 nonstructural protein 5 gene, partial cds801801100%0.099%KJ873160.1Select seq gb|KJ776791.1|Zika virus strain H/PF/2013 polyprotein gene, complete cds801801100%0.099%KJ776791.1Select seq gb|KM078961.1|Zika virus strain CHI2612114 NS5 protein gene, partial cds800800100%0.099%KM078961.1Select seq gb|KU724097.1|Zika virus isolate 259250_2015_Panama NS5B gene, partial cds79879898%0.0100%KU724097.1Select seq gb|KU940228.1|Zika virus isolate Bahia07, partial genome798798100%0.099%KU940228.1Select seq gb|KU940224.1|Zika virus isolate Bahia09, partial genome798798100%0.099%KU940224.1Select seq gb|KM078971.1|Zika virus strain CHI2613014 NS5 protein gene, partial cds798798100%0.099%KM078971.1Select seq gb|KM078930.1|Zika virus strain CHI2283714 NS5 protein gene, partial cds798798100%0.099%KM078930.1Select seq gb|KM078970.1|Zika virus strain CHI2490414 NS5 protein gene, partial cds794794100%0.099%KM078970.1Select seq gb|KM078933.1|Zika virus strain CHI1058514 NS5 protein gene, partial cds794794100%0.099%KM078933.1Select seq gb|KU729218.1|Zika virus isolate BeH828305 polyprotein gene, complete cds792792100%0.099%KU729218.1Select seq gb|KM078929.1|Zika virus strain CHI1805214 NS5 protein gene, partial cds792792100%0.099%KM078929.1Select seq gb|KX117076.1|Zika virus isolate Zhejiang04, complete genome789789100%0.099%KX117076.1Select seq gb|KU681081.3|Zika virus isolate Zika virus/H.sapiens-tc/THA/2014/SV0127- 14, complete genome789789100%0.099%KU681081.3Select seq gb|KU744693.1|Zika virus isolate VE_Ganxian, complete genome789789100%0.099%KU744693.1Select seq gb|KM851039.1|Zika virus strain SV0127/14 nonstructural protein 5 gene, partial cds789789100%0.099%KM851039.1Select seq gb|KU866423.2|Zika virus isolate Zika virus/SZ01/2016/China polyprotein gene, complete cds783783100%0.099%KU866423.2Select seq gb|KX253996.1|Zika virus isolate ZKC2/2016, complete genome783783100%0.099%KX253996.1Select seq gb|KX185891.1|Zika virus isolate Zika virus/CN/SZ02/2016 polyprotein gene, complete cds783783100%0.099%KX185891.1Select seq gb|KU963796.1|Zika virus isolate SZ-WIV01 polyprotein gene, complete cds783783100%0.099%KU963796.1Select seq gb|KU955589.1|Zika virus isolate Z16006 polyprotein gene, complete cds783783100%0.099%KU955589.1Select seq gb|KU820899.2|Zika virus isolate ZJ03, complete genome783783100%0.099%KU820899.2Select seq gb|KU179098.1|Zika virus isolate JMB-185 nonstructural protein 5 gene, partial cds783783100%0.099%KU179098.1Select seq gb|KF993678.1|Zika virus strain PLCal_ZV from Canada polyprotein gene, partial cds783783100%0.099%KF993678.1Select seq gb|KU955593.1|Zika virus isolate Zika virus/H.sapiens-tc/KHM/2010/FSS13025, complete genome771771100%0.098%KU955593.1Select seq gb|JN860885.1|Zika virus isolate FSS13025 polyprotein gene, partial cds771771100%0.098%JN860885.1Select seq gb|EU545988.1|Zika virus polyprotein gene, complete cds765765100%0.098%EU545988.1Select seq gb|KU681082.3|Zika virus isolate Zika virus/H.sapiens-tc/PHL/2012/CPC-0740, complete genome762762100%0.098%KU681082.3Select seq gb|KM851038.1|Zika virus strain CPC-0740 nonstructural protein 5 gene, partial cds762762100%0.098%KM851038.1Select seq gb|KU724098.1|Zika virus isolate 259060_2015_Panama NS5B gene, partial cds72672690%0.099%KU724098.1Select seq gb|HQ234499.1|Zika virus isolate P6-740 polyprotein gene, partial cds693693100%0.094%HQ234499.1Select seq gb|KX253995.1|Zika virus strain ZIKV/Homo sapiens/PRI/PRI-BNI-P1/2016 polyprotein gene, partial cds67767783%0.0100%KX253995.1Select seq gb|KX101061.1|Zika virus isolate Bahia03, partial genome66166182%0.099%KX101061.1Select seq gb|KU724099.1|Zika virus isolate 259032_2015_Panama NS5B gene, partial cds64164179%4e-18099%KU724099.1

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CDPH Weekly Update on Number of Zika virus Infections in California June 17, 2016 The following table provides the number of travel-associated infections with Zika virus in California residents in 2015 and 2016. CDPH is following CDC testing guidelines. This table is updated every Friday. As of June 17, 2016, there have been 60 travel-associated Zika virus infections in California. • Total infections: 60 • Cumulative number of infections in pregnant women: 15* • Cumulative number of infections due to sexual transmission: 1 Zika virus infections in California, 2015-2016§ (as of June 17, 2016) County Travel-associated ¥ Locally acquired † Alameda 5 0 Contra Costa 4 0 Los Angeles 18 0 Marin 1 0 Napa 1 0 Orange 4 0 San Bernardino 3 0 San Diego 13** 0 San Francisco 2 0 San Joaquin 2 0 San Mateo 2 0 Santa Clara 1 0 Solano 1 0 Sonoma 1 0 Yolo 2 0 Total 60 0 *Local Health Departments and CDPH are monitoring all pregnant women and their infants §Total number includes laboratory-confirmed and probable infections as defined by the CSTE Position Statement ¥ Persons exposed through travel to an affected area or contact with a traveler † Presumed local mosquito-borne transmission **Includes one non-resident https://www.cdph.ca.gov/HealthInfo/discond/Documents/TravelAssociatedCasesofZikaVirusinCA.pdf

Zika Testing Lags in a Vulnerable New York PopulationBy MARC SANTORAJUNE 17, 2016 Continue reading the main storyShare This PageShareTweetEmailMore As the Zika virus swept north from Brazil into the Caribbean, bringing with it frightening risks for pregnant women and their unborn children, United States health officials decided in February that all expectant women who had visited the countries affected should be tested for the disease. But after the guidelines were put in place, public health officials and doctors in New York City found that large numbers of women, many uninsured or low-income immigrants from the Caribbean and Latin America, were not being screened and tested in a systematic way. The problems facing the city’s health care providers in ensuring that all of those who need testing can get it illustrates the monumental challenges involved in reaching those considered most at risk. And as summer approaches, the reach of mosquitoes that carry the virus is expected to extend to Florida and other states along the Gulf of Mexico. The exact number of people missed is not known, because “nobody really keeps data on how many women who traveled to a Zika area should be tested,” said Dr. Jay Varma, deputy commissioner for disease control at the New York City Department of Health and Mental Hygiene. But officials found that a disproportionate number of those tested were from higher-income neighborhoods, compared with a smaller figure for lower-income neighborhoods with large populations of immigrants from Zika-associated places, Dr. Varma said. In February, after the new guidelines were put in place, 1,166 tests were performed in the city, 505 of them on pregnant women. But even as awareness grew about the virus and its ties to microcephaly, abnormally small heads and brain damage in infants of infected mothers, the number of tests performed fell: In March, 233 pregnant women were tested, and by May that number had edged up to only 318. The reasons for that lag are complicated, officials said, and include the absence of an effective commercial test, the resistance of doctors to performing the tests when they deem the risk minimal and a lack of resources for overwhelmed public hospitals and clinics. One of the biggest stumbling blocks arose from an effort to fix another problem: Some 70 percent of early samples sent to public health labs for testing were rendered useless, because they were mislabeled or improperly collected or handled. Doctors, therefore, were required to telephone the health department for every sample that they wanted to submit, according to Dr. Mary T. Bassett, the city health commissioner. And ordering a single Zika test in New York City requires a call that lasts, on average, 13 minutes, health officials said. The average visit to an obstetrician/gynecologist lasts only six to 15 minutes, according to studies, and the requirement set off an immediate backlash, especially in places that were already strained for resources, and where doctors felt they could not handle the burden. One doctor, who spoke on the condition of anonymity, in part, he said, because of patient confidentiality rules and in part out of fear of repercussions from his hospitals’ management, said that at the two Brooklyn hospitals with which he is affiliated, 20 percent to 25 percent of the pregnant women had a travel history that would make them eligible for testing. This would add up to hundreds of patients. For several months this spring, virtually none were being tested, he said. His account was backed up by a dozen other doctors and health care experts, who described varying degrees of noncompliance in the testing. Last week, Dr. Ramanathan Raju, the president of NYC Health & Hospitals, which operates the city’s public hospitals, collectively the largest municipal health care system in the nation, acknowledged the problem in an email sent to the staff. Dr. Raju wrote that “every provider in our health system has a duty to be vigilant” and follow guidelines from the federal Centers for Disease Control and Prevention and from the city’s health department “to screen for Zika and offer testing when appropriate.” He said in the email that the city’s public hospitals were working with the health department on an electronic system for initiating the tests. In the meantime, he warned, “In no way can we allow process issues to prevent us from meeting our responsibility to screen and offer testing in every point of entry to our system — including our emergency departments, ambulatory units and obstetrical settings.” The health department has offered to pick up all specimens submitted for testing from any practitioner or institution, and Dr. Bassett said the agency had been engaged in increased public outreach. The doctors interviewed said that recently they had seen more attention from their institutions to ensuring that testing took place. But many doctors and experts said that until testing could be made a part of routine treatment, with a commercial test available, there would be problems. “We still don’t have timely, specific and efficient tests available; there will not be a vaccine in the foreseeable future; and the public messaging is confusing,” said Dr. Irwin Redlener of Columbia University and its National Center for Disaster Preparedness. “To make matters worse, many health care providers, citing significant bureaucratic challenges, are resistant to making sure that at-risk individuals are screened appropriately. Some cities are struggling to get testing done at all, others are making due with procedures that are still, at best, a work in progress.” Dr. Bassett said that the problems were not wholly unexpected given that Zika came onto the scene so suddenly, but that testing was crucial not only for the health of the mothers and their babies but also for gaining a better understanding of the virus. Zika is transmitted by certain species of mosquito and through sex with an infected partner. Eighty percent of those who contract the virus do not show symptoms, so the safest course of action is to get tested. More people — over 200 — have tested positive for Zika in New York than in any other state. About 150 live in New York City, where tens of thousands of residents have ties to the nations of the Caribbean and Latin America. Of the confirmed cases, 19 involve pregnant women. Nationwide, the number of women infected with Zika during their pregnancies has risen to 234. There are essentially three tests used to detect the virus; doctors must send three blood and urine specimens from each patient in case multiple tests are needed. The simplest, known as a polymerase chain reaction test, can find traces of the virus in the blood up until about a week after infection, and in urine for about 10 days. The more complicated test, and the one that can be done only in public labs, looks for antibodies to the virus in the blood, and is supposed to be conducted two to 12 weeks after infection, giving the telltale antibodies time to develop. However, since Zika is in the same family of viruses as yellow fever and dengue, the tests can provide false positives if a patient has, for instance, been vaccinated for yellow fever. More detailed testing must then be performed. If an expectant mother tests positive for Zika, there is no treatment, but doctors will perform serial ultrasounds to detect problems in fetal development. Signs of birth defects are not visible until midway through the second trimester at the earliest. Microcephaly has been the most prominent birth defect associated with the disease; scientists are also looking at whether Zika might be associated with other developmental disorders which would not manifest themselves until after birth. The risk that a woman infected with Zika will pass it on to her fetus, leading to birth defects, is between 1 percent and 29 percent, according to various studies, a number that borders on useless for many practitioners and makes decisions about whether to terminate a pregnancy even more fraught. Reflecting the urgency of the situation, the World Health Organization recently suggested that millions of women in the affected countries consider delaying pregnancy. So far, all of the reported cases in the United States have been contracted elsewhere. Experts predict that by the end of the summer, there will most likely be cases of transmission by mosquito in Florida and the Gulf Coast States, further expanding the universe of people who will need testing. http://www.nytimes.com/2016/06/18/nyregion/zika-testing-lags-in-a-vulnerable-new-york-population.html?_r=1

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Zika virus outbreak global response Updated 17 June 2016 WHO/PAHO and partners have set out their strategic response to Zika which will place a greater focus on preventing and managing medical complications caused by Zika virus infection. To date, US$121.9 million are necessary to effectively implement the Zika Strategic Response Plan, July 2016 to December 2017. Read the "Strategic Response Plan"The revised Zika Strategic Response Plan includes a greater focus on preventing and managing medical complications caused by Zika virus infection and expanding health systems’ capacities for that purpose. Risk communication targeting pregnant women, their partners, households and communities will be central to prevention efforts to ensure they have the information they need to protect themselves. Other elements include integrated vector management, sexual and reproductive health counselling as well as health education and care within the social and legal contexts of each country where Zika virus is being transmitted. The plan highlights several specific characteristics of the Zika outbreak that require a collaborative, global response and support. These include: the potential for further international spread of Zika virus given the wide distribution of Aedes mosquitoes that are capable of transmitting Zika virus,the lack of population immunity in areas where Zika virus is circulating for the first time and which allows the disease to spread quickly,the absence of vaccines, specific treatments and rapid diagnostic tests, andinequalities in access to sanitation, information and health services in affected areas.http://who.int/emergencies/zika-virus/response/en/

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June 17, 2016 DEPARTMENT OF HEALTH DAILY ZIKA UPDATE: SEVEN NEW TRAVEL-RELATED CASES TODAY Contact:Communications [email protected](850) 245-4111 Tallahassee, Fla.—In an effort to keep Florida residents and visitors safe and aware about the status of the Zika virus, the Florida Department of Health will issue a Zika virus update each week day at 2 p.m. Updates will include a CDC-confirmed Zika case count by county and information to better keep Floridians prepared. There are seven new travel-related cases today with three in Miami-Dade, one in Broward, one in Orange, one in Pinellas and one involving a pregnant woman. Of the cases confirmed in Florida, 14 are still exhibiting symptoms. According to CDC, symptoms associated with the Zika virus last between seven to 10 days. CDC recommends that women who are pregnant or thinking of becoming pregnant postpone travel to Zika affected areas. According to CDC guidance, providers should consider testing all pregnant women with a history of travel to a Zika affected area for the virus. CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. Florida has been monitoring pregnant women with evidence of Zika regardless of symptoms since January. The total number of pregnant women who have been monitored is 39, with 9 having met the previous CDC case definition. County Number of Cases (all travel related) Alachua 4 Brevard 4 Broward 25 Clay 2 Collier 2 Duval 1 Escambia 1 Hillsborough 4 Lee 5 Martin 1 Miami-Dade 58 Orange 12 Osceola 6 Palm Beach 10 Pasco 2 Pinellas 5 Polk 3 Santa Rosa 1 Seminole 6 St. Johns 2 Volusia 2 Total cases not involving pregnant women 156 Cases involving pregnant women regardless of symptoms* 39 *Counties of pregnant women will not be shared. On Feb. 12, Governor Scott directed the State Surgeon General to activate a Zika Virus Information Hotline for current Florida residents and visitors, as well as anyone planning on traveling to Florida in the near future. The hotline, managed by the Department of Health, has assisted 2,077 callers since it launched. The number for the Zika Virus Information Hotline is 1-855-622-6735. All cases are travel-associated. There have been no locally-acquired cases of Zika in Florida. For more information on the Zika virus, click here. The department urges Floridians to drain standing water weekly, no matter how seemingly small. A couple drops of water in a bottle cap can be a breeding location for mosquitoes. Residents and visitors also need to use repellents when enjoying the Florida outdoors. More Information on DOH action on Zika: On Feb. 3, Governor Scott directed the State Surgeon General to issue a Declaration of Public Health Emergency for the counties of residents with travel-associated cases of Zika.There have been 21 counties included in the declaration– Alachua, Brevard, Broward, Clay, Collier, Duval, Escambia, Hillsborough, Lee, Martin, Miami-Dade, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Santa Rosa, Seminole, St. Johns and Volusia – and will be updated as needed. DOH encourages Florida residents and visitors to protect themselves from all mosquito-borne illnesses by draining standing water; covering their skin with repellent and clothing; and covering windows with screens.DOH has a robust mosquito-borne illness surveillance system and is working with CDC, the Florida Department of Agriculture and Consumer Services and local county mosquito control boards to ensure that the proper precautions are being taken to protect Florida residents and visitors.On April 6, Governor Rick Scott and Interim State Surgeon General Dr. Celeste Philip hosted a conference call with Florida Mosquito Control Districts to discuss ongoing preparations to fight the possible spread of the Zika virus in Florida. There were 74 attendees on the call.On May 11, Governor Scott met with federal leaders on the importance of preparing for Zika as we would a hurricane. Governor Scott requested 5,000 Zika preparedness kits from HHS Secretary Sylvia Burwell as well as a plan from FEMA on how resources will be allocated to states in the event an emergency is declared.On June 1, Governor Scott requested for President Obama to provide preparedness items needed in order to increase Florida’s capacity to be ready when Zika becomes mosquito-borne in our state.On June 9, Governor Scott spoke with Health and Human Services Secretary Sylvia Burwell and Centers for Diseases Control (CDC) Director Dr. Tom Frieden on Zika preparedness and reiterated the requests that he has continued to make to the federal government to prepare for the Zika virus once it becomes mosquito-borne in Florida. Governor Scott also requested that the CDC provide an additional 1,300 Zika antibody tests to Florida to allow individuals, especially pregnant women and new mothers, to see if they ever had the Zika virus.Florida currently has the capacity to test 5,829 people for active Zika virus and 1,631 for Zika antibodies.Federal Guidance on Zika: According to CDC, Zika illness is generally mild with a rash, fever and joint pain. CDC researchers have concluded that Zika virus is a cause of microcephaly and other birth defects.The FDA released guidance regarding donor screening, deferral and product management to reduce the risk of transfusion-transmission of Zika virus. Additional information is available on the FDA website here.CDC has put out guidance related to the sexual transmission of the Zika virus. This includes CDC recommendation that if you have traveled to a country with local transmission of Zika you should abstain from unprotected sex.Based on CDC guidance released, DOH will now report pregnant women with evidence of Zika virus regardless of symptoms. Prior to new guidance, CDC guidance was only to report cases of Zika if the pregnant women was symptomatic.For more information on Zika virus, click here. About the Florida Department of Health The department, nationally accredited by the Public Health Accreditation Board, works to protect, promote and improve the health of all people in Florida through integrated state, county and community efforts. Follow us on Twitter at @HealthyFla and on Facebook. For more information about the Florida Department of Health, please visit www.FloridaHealth.gov. http://www.floridahealth.gov/newsroom/2016/06/061716-zika-update.html

County Number of Cases (all travel related) Alachua 4 Brevard 4 Broward 25 Clay 2 Collier 2 Duval 1 Escambia 1 Hillsborough 4 Lee 5 Martin 1 Miami-Dade 58 Orange 12 Osceola 6 Palm Beach 10 Pasco 2 Pinellas 5 Polk 3 Santa Rosa 1 Seminole 6 St. Johns 2 Volusia 2 Total cases not involving pregnant women 156 Cases involving pregnant women regardless of symptoms* 39 *Counties of pregnant women will not be shared.

Arizona's First Zika Case Recorded in Traveler, read the news releaseTravel-associated Zika cases confirmed in Arizona: 6Arizona Arboviral Handbook for Chikungunya, Dengue, & Zika Viruses

Zika virus spreading rapidly across Puerto RicoJOHAN ORDONEZ/AFP/GETTY IMAGES Blood samples from pregnant women. By HELEN BRANSWELL @HelenBranswell JUNE 17, 2016 TwitterFacebookLinkedInEmailPrint There are alarming signs the Zika virus is spreading rapidly in Puerto Rico, the Centers for Disease Control and Prevention reported Friday. Blood banks on the island have seen a steady rise in the portion of donations that have to be rejected because they contain Zika virus. Last week, 1.1 percent of the donated units were contaminated. If that many people are infected with Zika when they go to give blood, it’s a sign of how much virus spread there is going on in Puerto Rico, CDC Director Dr. Thomas Frieden warned in an interview with STAT. ARTICLE CONTINUES AFTER ADVERTISEMENT “What this means is that pregnant women in Puerto Rico are really at risk. That’s the bottom line here,” Frieden said. “It isn’t that hundreds of thousands of people will die. That’s not what’s going to happen here,” he said. “It’s that we will have in Puerto Rico and potentially in parts of the US — in travelers and potentially even in some local transmission — we have terrible tragedies that will occur. Change people’s whole lives.” READ MOREZika in 30 seconds: What you need to know todayFrieden said the blood bank data suggests that as many as 2 percent of adults in Puerto Rico are getting infected monthly at this point — and it’s not yet high season for transmission. Activity of mosquito-spread viruses typically peaks in the summer. “If current trends continue, thousands of pregnant women will get infected with Zika,” said Frieden. “And there could be between dozens and hundreds of children with microcephaly born [there] in the next year.” The CDC estimates 25 percent of the island’s population could be infected with Zika in its first year of spread there. Puerto Rican women give birth to about 3,200 babies a year. Zika infection during pregnancy — particularly, it appears, in the first trimester — can lead to devastating birth defects. The most notable — and the one that raised suspicions that the Zika virus could affect profound damage in developing fetuses — is microcephaly, a condition where babies are born with unusually small heads and brains that are not completely formed. Over time, researchers in Brazil studying that country’s large cohort of Zika-affected newborns have reported other forms of brain damage, visual and hearing impairment, contorted limbs, and other birth defects, in what is coming to be known as congenital Zika syndrome. Frieden noted it is still not clear if children who were infected in the womb but who appear physically normal at birth will experience development delays later. That has been seen with other viruses that can cause birth defects in babies born to women infected during pregnancy. The primary focus of the CDC’s Zika response is to do all it can to reduce the risk that pregnant women will be infected. Frieden said the agency is working with local partners trying to identify effective steps that can be taken there. HUD, the US government’s department of housing and urban development, is putting screens on the windows of public housing units, he noted. Many homes in Puerto Rico don’t have screens or air conditioning — features scientists believe will lessen the risk of wide spread of Zika virus in the continental US. “We can’t make zero the number of infants who will be affected. But if we can reduce by 10 percent or 30 percent or 50 percent, we will have prevented that many tragedies. And that’s what we’re working to do,” Frieden said. Health authorities in Puerto Rico have already reported one case of microcephaly there. No details were released but the pregnancy did not go full term. Puerto Rico’s department of health reported Friday that 191 pregnant women on the island had tested positive for Zika. But a peculiarity of the disease the virus triggers means that number is almost certainly an underestimate. The majority of people who contract Zika don’t have symptoms; it’s thought only 1 in 5 do. So it’s difficult to know how many people in affected areas have been infected. Eventually scientists will do what’s called a sero-survey, taking blood samples from hundreds of people to look for the antibodies that indicate they were infected with Zika. Studies done after the chikungunya virus — also spread by Aedes mosquitoes — swept through Puerto Rico showed that after the first year the virus was there, a quarter of the population of the island had been infected. It’s too soon to do that work for Zika. Still, looking at the rate at which donated units of blood are testing positive provides a real-time hint of how many infections are taking place. In fact, the estimate it provides is on the low side, Frieden noted, because anyone infected who has symptoms would be turned away if they tried to donate blood. “It’s the closest thing we have to a real time pulse on what’s happening,” he said. “And what we’re finding is very concerning, because this is showing a steady and substantial increase in infections.” MOST POPULARHelen Branswell can be reached at [email protected] https://www.statnews.com/2016/06/17/zika-virus-spreading-rapidly-across-puerto-rico/ Follow Helen on Twitter @HelenBranswell

Zika Virus – June 17, 2016. Texas has had 44 reported cases of Zika virus disease. Of those, 43 were in travelers who were infected abroad and diagnosed after they returned home; one of those travelers was a pregnant woman. One case involved a Dallas County resident who had sexual contact with someone who acquired the Zika infection while traveling abroad. Texas Zika Cases by County: CountyCasesBexar6Collin2Dallas7Denton2Ellis1Fort Bend2Grayson1Harris13Lubbock1Tarrant4Travis2Val Verde1Williamson1Wise1Total44

ReferencesPetersen LR, Busch MP. Transfusion-transmitted arboviruses. Vox Sang 2010;98:495–503. CrossRef PubMedRasmussen SA, Jamieson DJ, Honein MA, Petersen LR. Zika virus and birth defects—reviewing the evidence for causality. N Engl J Med 2016;374:1981–7. CrossRef PubMedLanteri MC, Kleinman SH, Glynn SA, et al. Zika virus: a new threat to the safety of the blood supply with worldwide impact and implications. Transfusion 2016. Epub June 9, 2016. CrossRef PubMedBarjas-Castro ML, Angerami R, Cunha M, et al. Probable transfusion-transmitted Zika virus in Brazil. Transfusion 2016. In press.Food and Drug Administration. Recommendations for donor screening, deferral, and product management to reduce the risk of transfusion-transmission of Zika virus. Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration; 2016.http://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM486360.pdfFood and Drug Administration. FDA allows use of investigational test to screen blood donations for Zika virus. Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration; 2016.http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm493081.htmSimmons G, Brès V, Lu K, et al. High incidence of chikungunya virus frequency of viremic blood donations during epidemic, Puerto Rico, USA, 2014. Emerg Infect Dis 2016;22:1221–8. Epub April 2016. CrossRef PubMed

FIGURE. Proportion of screened blood donations reactive for Zika virus infection, by week of testing — Puerto Rico, April 3–June 11, 2016

Transfusion-transmitted infections have been documented for several arboviruses, including West Nile and dengue viruses (1). Zika virus, a flavivirus transmitted primarily by Aedes aegypti mosquitoes that has been identified as a cause of congenital microcephaly and other serious brain defects (2), became recognized as a potential threat to blood safety after reports from a 2013–2014 outbreak in French Polynesia. Blood safety concerns were based on very high infection incidence in the population at large during epidemics, the high percentage of persons with asymptomatic infection, the high proportion of blood donations with evidence of Zika virus nucleic acid upon retrospective testing, and an estimated 7–10-day period of viremia (3). At least one instance of transfusion transmission of Zika virus has been documented in Brazil after the virus emerged there, likely in 2014 (4). Rapid epidemic spread has followed to other areas of the Americas, including Puerto Rico. In February 2016, the Food and Drug Administration (FDA) issued recommendations for donor screening, donor deferral, and product management to reduce the risk for transfusion-transmitted Zika virus in the United States and its territories (5). In addition to behavioral- and health-risk questionnaires for blood donors in all areas, FDA recommends deferrals for donors in unaffected areas who recently lived in or visited an area with active mosquito-borne transmission of Zika virus. For establishments collecting blood in areas with active, local mosquito-borne transmission, such as Puerto Rico and other U.S. territories, the recommendations include discontinuing local blood collections and importing blood units from unaffected areas of the continental United States unless one of the following is implemented: 1) Zika virus screening of locally collected blood donations or 2) treatment of locally collected units with pathogen-reduction technology (FDA-approved only for plasma and apheresis platelets). In Puerto Rico, interventions initially were limited to importation of blood units from unaffected U.S. areas and to treatment of plasma and apheresis platelets with pathogen-reduction technology; no Zika virus screening test was available. On April 3, 2016, Zika virus screening of locally collected blood donations was implemented using a newly developed nucleic acid test (NAT) (cobas Zika, Roche Molecular Systems, Inc., Pleasanton, California) authorized by FDA under an investigational new drug application (IND) (6). As part of the IND, plasma samples from blood donors are screened individually, and specimens with reactive results are subjected to additional testing including an alternate NAT and immunoglobulin M serology. A blood donation with an initial reactive result by NAT is regarded as a presumptive viremic donor, indicating an infected donor, and is interdicted and removed from the blood supply. During April 3–June 11, 2016, a total of 68 (0.5%) presumptive viremic donors were identified from 12,777 donations tested. The highest weekly incidence was 1.1% for the latest week of reporting, June 5–June 11, and incidence has been increasing over time (Figure). Although the blood donor population of Puerto Rico is not intended to be statistically representative of the general population, the increasing prevalence of Zika virus nucleic acid among blood donors likely reflects an overall increase in infection incidence in the population at large. Based on data from previous outbreaks caused by arboviruses transmitted by Aedes aegypti, the high incidence often associated with these outbreaks can result in a substantial proportion of the population becoming infected. For example, chikungunya virus was introduced into Puerto Rico in 2014. Retrospective screening for chikungunya virus nucleic acid was performed on blood donations collected during June–December 2014, and the estimated detectable viremia was 0.65%, with a peak of 2.1% in October. Testing for chikungunya virus immunoglobulin M antibody of retained individual blood donation samples obtained during March 1–9, 2015, suggested that nearly 25% of the Puerto Rico population became infected during the previous year’s epidemic (7). Because viremia is only present days after acute infection, immunoglobulin M antibody can provide a more precise estimate of the burden of recent infection. The 2014–2015 chikungunya virus data suggest that detection of viremia in a relatively small proportion of blood donors each week can reflect a substantial proportion of the general population becoming infected during the course of an epidemic season. Currently, no medication or vaccine is available to treat or prevent Zika virus disease. Prevention relies on avoidance of mosquito bites, elimination of mosquito breeding sites, community mosquito control, and taking measures to prevent sexual transmission. Screening of the U.S. blood supply using nucleic acid tests has markedly reduced the risk for transfusion transmission for multiple pathogens, including for West Nile virus after it was associated with arboviral epidemics in the United States. Measures to protect the blood supply from Zika virus, including donor deferrals, laboratory screening, and pathogen reduction technology, are expected to similarly reduce the risk for transfusion transmission.

Matthew J. Kuehnert1; Sridhar V. Basavaraju1; Robin R. Moseley1; Lisa L. Pate2; Susan A. Galel2; Phillip C. Williamson3; Michael P. Busch4; Jose O. Alsina5; Consuelo Climent-Peris6; Peter W. Marks7; Jay S. Epstein7; Hira L. Nakhasi7; J. Peyton Hobson7; David A. Leiby7; Pradip N. Akolkar7; Lyle R. Petersen1; Brenda Rivera-Garcia8 1Zika virus response blood safety team, CDC; 2Roche Molecular Systems, Inc., Pleasanton, California; 3Creative Testing Solutions, Tempe, Arizona;4Blood Systems Research Institute, San Francisco, California; 5Banco de Sangre de Servicios Mutuos, San Juan, Puerto Rico; 6Banco de Sangre de Puerto Rico; 7Food and Drug Administration, Silver Spring, Maryland; 8Puerto Rico Department of Health. Corresponding author: Matthew J. Kuehnert, [email protected], 800-232-4636.

Screening of Blood Donations for Zika Virus Infection — Puerto Rico, April 3–June 11, 2016Early Release / June 17, 2016 / 65 http://www.cdc.gov/mmwr/volumes/65/wr/mm6524e2.htm?s_cid=mm6524e2_w#F1_down

A woman aborts in Galicia after detecting lesions in the fetus because of the Zika virusThis is the first case of congenital zika in Galicia - Sanidade emphasizes that the virus was infected pregnant in a country of Latin AmericaWriting / Agencies | Corunna / Santiago / Madrid 06/17/2016 | 2:41 The Ministry of health reported yesterday that Galicia has registered the first case of congenital infection Zika virus. Doctors detected abnormalities in the fetus of a pregnant during week 19 of gestation and women decidión terminate pregnancy in week 21. This is, says the department of Jesus Vazquez Almuíña of an imported case since the woman contracted the virus in a Latin American country in which he lived. The Xunta does not give more details about the patient but indicates that contracted the infection "in an area with active transmission of virus" in which "suffered in the eighth week of gestation a rash compatible with zika, but no study was done microbiological "to be in Galicia. Since Sanidade require that an ultrasound practiced in the twelfth week of pregnancy found no problems, but in the week nineteen in another similar test detected "significant abnormalities compatible central nervous system zika", which was confirmed in a subsequent analysis of RNA virus in amniotic fluid. "With the approval of the ethics committee, was performed an abortion at week 21," the Ministry of health, from which point out that "the autopsy of the fetus confirmed the importance of injuries and found viral RNA in the umbilical and brain "cord. So far the two cases of congenital fetal zika in which the Ministry of Health had brain malformations such as microcephaly. The first case was detected in early May in Catalonia. Then, the Ministry reported that despite this problem detected in the baby, the mother decided to go ahead with the pregnancy. In the second case, which was reported on June 6, although the place of residence of the mother, the pregnant woman decided to abort it was not indicated. The number of cases diagnosed in Spain of the Zika virus has risen to 145, all imported, of which twenty are pregnant women, one more than last week, according to the latest data from the Ministry of Health published Tuesday. Of the total diagnosed, 53 patients are in Catalonia, 34 in Madrid, 13 in Aragon, 10 in Castilla and Leon, six in Valencia, six in Galicia, four in Andalusia, four in the Canary Islands, three in Navarra , Balearic Islands and La Rioja, two in Asturias and Murcia, 1 in the Basque Country and another in La Mancha. Since the regional government recalled yesterday that the zika not person to person, but through two types of mosquito, which do not exist in Galicia. Therefore, the main risk of infection for a person is to travel the area where these insects do exist and that bitten by a mosquito transmitting the disease. To prevent congenital infection in pregnant women, Sanidade advised to avoid travel to affected areas.Moreover, since the sexual transmission of the virus is possible, it is recommended that men returning from affected areas condom use for 8 weeks if no symptoms and 6 months if I had symptoms. http://www.laopinioncoruna.es/sociedad/2016/06/17/mujer-aborta-galicia-detectar-lesiones/1080376.html