niman

Sequence Map update https://www.google.com/maps/d/u/0/edit?hl=en&mid=1XSxKe6FIecV8f33cQwyc7uylxeU

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|KU758877.1|Zika virus isolate 17271 polyprotein gene, complete cds13101310100%0.0100%KU758877.1Select seq gb|KX247646.1|Zika virus isolate Zika virus/Homo sapiens/COL/UF-1/2016, complete genome13101310100%0.0100%KX247646.1Select seq gb|KU820897.2|Zika virus isolate FLR polyprotein gene, complete cds13101310100%0.0100%KU820897.2Select seq gb|KX087101.2|Zika virus strain ZIKV/Homo sapiens/PRI/PRVABC59/2015, complete genome13101310100%0.0100%KX087101.2Select seq gb|KU937936.1|Zika virus isolate ZIKVNL00013 polyprotein gene, complete cds13101310100%0.0100%KU937936.1Select seq gb|KX156776.1|Zika virus strain ZIKV/Homo sapiens/PAN/CDC-259364_V1-V2/2015, complete genome13101310100%0.0100%KX156776.1Select seq gb|KX156775.1|Zika virus strain ZIKV/Homo sapiens/PAN/CDC-259249_V1-V3/2015, complete genome13101310100%0.0100%KX156775.1Select seq gb|KX156774.1|Zika virus strain ZIKV/Homo sapiens/PAN/CDC-259359_V1-V3/2015, complete genome13101310100%0.0100%KX156774.1Select seq gb|KX087102.1|Zika virus strain ZIKV/Homo sapiens/COL/FLR/2015, complete genome13101310100%0.0100%KX087102.1Select seq gb|KU501215.1|Zika virus strain PRVABC59, complete genome13101310100%0.0100%KU501215.1Select seq gb|KX262887.1|Zika virus isolate 103451, complete genome13051305100%0.099%KX262887.1Select seq gb|KX247632.1|Zika virus isolate MEX_I_7 polyprotein gene, complete cds13051305100%0.099%KX247632.1Select seq gb|KX198135.1|Zika virus strain ZIKV/Homo sapiens/PAN/BEI-259634_V4/2016, complete genome13051305100%0.099%KX198135.1Select seq gb|KX056898.1|Zika virus isolate Zika virus/GZ02/2016 polyprotein gene, complete cds13051305100%0.099%KX056898.1Select seq gb|KU955590.1|Zika virus isolate Z16019 polyprotein gene, complete cds13051305100%0.099%KU955590.1Select seq gb|KU870645.1|Zika virus isolate FB-GWUH-2016, complete genome13051305100%0.099%KU870645.1Select seq gb|KU922960.1|Zika virus isolate MEX/InDRE/Sm/2016, complete genome13051305100%0.099%KU922960.1Select seq gb|KU922923.1|Zika virus isolate MEX/InDRE/Lm/2016, complete genome13051305100%0.099%KU922923.1Select seq gb|KU820898.1|Zika virus isolate GZ01 polyprotein gene, complete cds13051305100%0.099%KU820898.1Select seq gb|KU740184.2|Zika virus isolate GD01 polyprotein gene, complete cds13051305100%0.099%KU740184.2Select seq gb|KU761564.1|Zika virus isolate GDZ16001 polyprotein gene, complete cds13051305100%0.099%KU761564.1Select seq gb|KU497555.1|Zika virus isolate Brazil-ZKV2015, complete genome13051305100%0.099%KU497555.1Select seq gb|KU647676.1|Zika virus strain MRS_OPY_Martinique_PaRi_2015 polyprotein gene, complete cds13051305100%0.099%KU647676.1Select seq gb|KU312312.1|Zika virus isolate Z1106033 polyprotein gene, complete cds13051305100%0.099%KU312312.1Select seq gb|KX280026.1|Zika virus isolate Paraiba_01, complete genome13011301100%0.099%KX280026.1Select seq gb|KX197192.1|Zika virus isolate ZIKV/H.sapiens/Brazil/PE243/2015, complete genome13011301100%0.099%KX197192.1Select seq gb|KX059014.1|Zika virus isolate Haiti/1230/2014 NS5 gene, partial cds13011301100%0.099%KX059014.1Select seq gb|KX059013.1|Zika virus isolate Haiti/1227/2014 NS5 gene, partial cds13011301100%0.099%KX059013.1Select seq gb|KX051563.1|Zika virus isolate Haiti/1/2016, complete genome13011301100%0.099%KX051563.1Select seq gb|KU509998.3|Zika virus strain Haiti/1225/2014, complete genome13011301100%0.099%KU509998.3Select seq gb|KU991811.1|Zika virus isolate Brazil/2016/INMI1 polyprotein gene, complete cds13011301100%0.099%KU991811.1Select seq gb|KU926310.1|Zika virus isolate Rio-S1, complete genome13011301100%0.099%KU926310.1Select seq gb|KU853013.1|Zika virus isolate Dominican Republic/2016/PD2, complete genome13011301100%0.099%KU853013.1Select seq gb|KU853012.1|Zika virus isolate Dominican Republic/2016/PD1, complete genome13011301100%0.099%KU853012.1Select seq gb|KU729217.2|Zika virus isolate BeH823339 polyprotein gene, complete cds13011301100%0.099%KU729217.2Select seq gb|KU707826.1|Zika virus isolate SSABR1, complete genome13011301100%0.099%KU707826.1Select seq gb|KU501217.1|Zika virus strain 8375 polyprotein gene, complete cds13011301100%0.099%KU501217.1Select seq gb|KU501216.1|Zika virus strain 103344 polyprotein gene, complete cds13011301100%0.099%KU501216.1Select seq gb|KU365780.1|Zika virus strain BeH815744 polyprotein gene, complete cds13011301100%0.099%KU365780.1Select seq gb|KU365779.1|Zika virus strain BeH819966 polyprotein gene, complete cds13011301100%0.099%KU365779.1Select seq gb|KU365778.1|Zika virus strain BeH819015 polyprotein gene, complete cds13011301100%0.099%KU365778.1Select seq gb|KU365777.1|Zika virus strain BeH818995 polyprotein gene, complete cds13011301100%0.099%KU365777.1Select seq gb|KU321639.1|Zika virus strain ZikaSPH2015, complete genome13011301100%0.099%KU321639.1Select seq gb|KM078936.1|Zika virus strain CHI1410214 NS5 protein gene, partial cds13011301100%0.099%KM078936.1Select seq gb|KJ873160.1|Zika virus isolate NC14-03042014-3481 nonstructural protein 5 gene, partial cds13011301100%0.099%KJ873160.1Select seq gb|KJ776791.1|Zika virus strain H/PF/2013 polyprotein gene, complete cds13011301100%0.099%KJ776791.1Select seq gb|KM078961.1|Zika virus strain CHI2612114 NS5 protein gene, partial cds12971297100%0.099%KM078961.1Select seq gb|KU926309.1|Zika virus isolate Rio-U1, complete genome12961296100%0.099%KU926309.1Select seq gb|KU527068.1|Zika virus strain Natal RGN, complete genome12961296100%0.099%KU527068.1Select seq gb|KM078930.1|Zika virus strain CHI2283714 NS5 protein gene, partial cds12961296100%0.099%KM078930.1Select seq gb|KM078971.1|Zika virus strain CHI2613014 NS5 protein gene, partial cds12941294100%0.099%KM078971.1Select seq gb|KM078970.1|Zika virus strain CHI2490414 NS5 protein gene, partial cds12941294100%0.099%KM078970.1Select seq gb|KM078933.1|Zika virus strain CHI1058514 NS5 protein gene, partial cds12941294100%0.099%KM078933.1Select seq gb|KU940228.1|Zika virus isolate Bahia07, partial genome12921292100%0.099%KU940228.1Select seq gb|KU940224.1|Zika virus isolate Bahia09, partial genome12921292100%0.099%KU940224.1Select seq gb|KU729218.1|Zika virus isolate BeH828305 polyprotein gene, complete cds12921292100%0.099%KU729218.1Select seq gb|KM078929.1|Zika virus strain CHI1805214 NS5 protein gene, partial cds12921292100%0.099%KM078929.1Select seq gb|KX117076.1|Zika virus isolate Zhejiang04, complete genome12831283100%0.099%KX117076.1Select seq gb|KX253996.1|Zika virus isolate ZKC2/2016, complete genome12781278100%0.099%KX253996.1Select seq gb|KX185891.1|Zika virus isolate Zika virus/CN/SZ02/2016 polyprotein gene, complete cds12781278100%0.099%KX185891.1Select seq gb|KU963796.1|Zika virus isolate SZ-WIV01 polyprotein gene, complete cds12781278100%0.099%KU963796.1Select seq gb|KU955589.1|Zika virus isolate Z16006 polyprotein gene, complete cds12781278100%0.099%KU955589.1Select seq gb|KU820899.2|Zika virus isolate ZJ03, complete genome12781278100%0.099%KU820899.2Select seq gb|KU744693.1|Zika virus isolate VE_Ganxian, complete genome12781278100%0.099%KU744693.1Select seq gb|KU179098.1|Zika virus isolate JMB-185 nonstructural protein 5 gene, partial cds12741274100%0.099%KU179098.1Select seq gb|KF993678.1|Zika virus strain PLCal_ZV from Canada polyprotein gene, partial cds12741274100%0.099%KF993678.1Select seq gb|KU681081.3|Zika virus isolate Zika virus/H.sapiens-tc/THA/2014/SV0127- 14, complete genome12691269100%0.099%KU681081.3Select seq gb|KM851039.1|Zika virus strain SV0127/14 nonstructural protein 5 gene, partial cds12691269100%0.099%KM851039.1Select seq gb|KU866423.1|Zika virus isolate Zika virus/SZ01/2016 polyprotein gene, complete cds12601260100%0.098%KU866423.1Select seq gb|KU955593.1|Zika virus isolate Zika virus/H.sapiens-tc/KHM/2010/FSS13025, complete genome12511251100%0.098%KU955593.1Select seq gb|JN860885.1|Zika virus isolate FSS13025 polyprotein gene, partial cds12511251100%0.098%JN860885.1Select seq gb|EU545988.1|Zika virus polyprotein gene, complete cds12511251100%0.098%EU545988.1Select seq gb|KU681082.3|Zika virus isolate Zika virus/H.sapiens-tc/PHL/2012/CPC-0740, complete genome12381238100%0.098%KU681082.3Select seq gb|KM851038.1|Zika virus strain CPC-0740 nonstructural protein 5 gene, partial cds12381238100%0.098%KM851038.1Select seq gb|KJ873161.1|Zika virus isolate NC14-02042014-3220 nonstructural protein 5 gene, partial cds1227122794%0.099%KJ873161.1Select seq gb|HQ234499.1|Zika virus isolate P6-740 polyprotein gene, partial cds11301130100%0.094%HQ234499.1Select seq gb|KU985087.1|Zika virus isolate MEX/InDRE/Zika-2/2015 nonstructural protein 5 gene, partial cds1059105981%0.099%KU985087.1Select seq gb|KU556802.1|Zika virus isolate MEX/InDRE/14/2015 NS5 protein gene, partial cds1043104380%0.099%KU556802.1Select seq gb|KF268949.1|Zika virus isolate ARB15076 polyprotein gene, complete cds95595599%0.089%KF268949.1Select seq gb|KU963573.1|Zika virus isolate ZIKV/Macaca mulatta/UGA/MR-766_SM150-V8/1947 polyprotein (GP1) gene, complete cds95195199%0.089%KU963573.1Select seq gb|KU955594.1|Zika virus isolate Zika virus/M.mulatta-tc/UGA/1947/MR-766, complete genome95195199%0.089%KU955594.1Select seq gb|KU720415.1|Zika virus strain MR 766 polyprotein gene, complete cds95195199%0.089%KU720415.1Select seq dbj|LC002520.1|Zika virus genomic RNA, complete genome, strain: MR766-NIID95195199%0.089%LC002520.1Select seq gb|KF383118.1|Zika virus strain ArD157995 polyprotein gene, complete cds95195199%0.089%KF383118.1Select seq gb|HQ234498.1|Zika virus isolate MR_766 polyprotein gene, partial cds95195199%0.089%HQ234498.1Select seq gb|AY632535.2|Zika virus strain MR 766, complete genome95195199%0.089%AY632535.2Select seq gb|AF013415.1|Zika virus strain MR-766 NS5 protein (NS5) gene, partial cds95195199%0.089%AF013415.1Select seq gb|KU963574.1|Zika virus isolate ZIKV/Homo sapiens/NGA/IbH-30656_SM21V1-V3/1968 polyprotein (GP1) gene, complete cds94694699%0.089%KU963574.1Select seq gb|KF383121.1|Zika virus strain ArD158095 polyprotein gene, partial cds94694699%0.089%KF383121.1Select seq gb|KF383119.1|Zika virus strain ArD158084 polyprotein gene, complete cds94694699%0.089%KF383119.1Select seq gb|HQ234500.1|Zika virus isolate IbH_30656 polyprotein gene, partial cds94694699%0.089%HQ234500.1Select seq gb|KU232300.1|Zika virus isolate 067ZV_PEBR15 NS5 protein gene, partial cds94294272%0.099%KU232300.1Select seq gb|KU232290.1|Zika virus isolate 036ZV_PEBR15 NS5 protein gene, partial cds94094072%0.099%KU232290.1Select seq gb|KX198134.1|Zika virus strain ZIKV/Aedes africanus/SEN/DAK-AR-41524_A1C1-V2/1984, complete genome93793799%0.089%KX198134.1Select seq gb|KU955595.1|Zika virus isolate Zika virus/A.taylori-tc/SEN/1984/41671-DAK, complete genome93393399%0.089%KU955595.1Select seq gb|KU955592.1|Zika virus isolate Zika virus/A.taylori-tc/SEN/1984/41662-DAK, complete genome93393399%0.089%KU955592.1Select seq gb|KU955591.1|Zika virus isolate Zika virus/A.africanus-tc/SEN/1984/41525-DAK, complete genome93393399%0.089%KU955591.1Select seq gb|DQ859059.1|Zika virus strain MR 766 polyprotein gene, complete cds93393399%0.089%DQ859059.1Select seq gb|KU232297.1|Zika virus isolate 049ZV_PEBR15 NS5 protein gene, partial cds93193172%0.099%KU232297.1Select seq gb|KU232298.1|Zika virus isolate 050ZV_PEBR15 NS5 protein gene, partial cds92692671%0.099%KU232298.1

LOCUS KU724096 726 bp RNA linear VRL 11-JUN-2016 DEFINITION Zika virus isolate 259249_2015_Panama NS5B gene, partial cds. ACCESSION KU724096 VERSION KU724096.1 GI:998178886 KEYWORDS . SOURCE Zika virus ORGANISM Zika virus Viruses; ssRNA viruses; ssRNA positive-strand viruses, no DNA stage; Flaviviridae; Flavivirus. REFERENCE 1 (bases 1 to 726) AUTHORS Arauz,D., De Urriola,L., Jones,J., Castillo,M., Martinez,A., Murillo,E., Troncoso,L., Chen,M., Abrego,L., Armien,B., Pascale,J.M., Sosa,N., Lopez-Verges,S. and Moreno,B. TITLE Febrile or Exanthematous Illness Associated with Zika, Dengue, and Chikungunya Viruses, Panama JOURNAL Emerging Infect. Dis. 22 (8) (2016) In press PUBMED 27139219 REMARK Publication Status: Available-Online prior to print REFERENCE 2 (bases 1 to 726) AUTHORS Arauz,D. Sr., De Urriola,L., Castillo,M., Martinez,A.A., Murillo,E., Pascale,J.M., Sosa,N., Lopez-Verges,S. and Moreno,B. TITLE Direct Submission JOURNAL Submitted (17-FEB-2016) Departament of Research in Virology and Biotechnology, Gorgas Institute For Health Studies Memorial Institute, Ave. Justo Arosemena 35th Street, Panama, Panama 0816-02593, Panama COMMENT ##Assembly-Data-START## Assembly Method :: Sequencher v. 4.5 Coverage :: partial Sequencing Technology :: Sanger dideoxy sequencing ##Assembly-Data-END## FEATURES Location/Qualifiers source 1..726 /organism="Zika virus" /mol_type="genomic RNA" /isolate="259249_2015_Panama" /isolation_source="serum" /host="Homo sapiens" /db_xref="taxon:64320" /country="Panama" /collection_date="11-Dec-2015" CDS <1..>726 /codon_start=1 /product="NS5B" /protein_id="AMK26952.1" /db_xref="GI:998178887" /translation="ISRFDLENEALITNQMEKGHRALALAIIKYTYQNKVVKVLRPAE KGKTVMDIISRQDQRGSGQVVTYALNTFTNLVVQLIRNMEAEEVLEMQDLWLLRRSEK VTNWLQSNGWDRLKRMAVSGDDCVVKPIDDRFAHALRFLNDMGKVRKDTQEWKPSTGW DNWEEVPFCSHHFNKLHLKDGRSIVVPCRHQDELIGRARVSPGAGWSIRETACLAKSY AQMWQLLYFHRRDLRLMANAICSS" ORIGIN 1 attagcaggt ttgatctgga gaatgaagct ctaatcacca accaaatgga gaaagggcac 61 agggccttgg cattggccat aatcaagtac acataccaaa acaaagtggt aaaggtcctt 121 agaccagctg aaaaagggaa aacagttatg gacattattt cgagacaaga ccaaaggggg 181 agcggacaag ttgtcactta cgctcttaac acatttacca acctagtggt gcaactcatt 241 cggaatatgg aggctgagga agttctagag atgcaagact tgtggctgct gcggaggtca 301 gagaaagtga ccaactggtt gcagagcaac ggatgggata ggctcaaacg aatggcagtc 361 agtggagatg attgcgttgt gaagccaatt gatgataggt ttgcacatgc cctcaggttc 421 ttgaatgata tgggaaaagt taggaaggac acacaagagt ggaaaccctc aactggatgg 481 gacaactggg aagaagttcc gttttgctcc caccacttca acaagctcca tctcaaggac 541 gggaggtcca ttgtggttcc ctgccgccac caagatgaac tgattggccg ggcccgcgtc 601 tctccagggg cgggatggag catccgggag actgcttgcc tagcaaaatc atatgcgcaa 661 atgtggcagc tcctttattt ccacagaagg gacctccgac tgatggccaa tgccatttgt 721 tcatct

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

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ReferencesMarchette NJ, Garcia R, Rudnick A. Isolation of Zika virus from Aedes aegypti mosquitoes in Malaysia. Am J Trop Med Hyg. 1969;18(3):411-5.PMID: 4976739Grard G, Caron M, Mombo IM, Nkoghe D, Mboui Ondo S, Jiolle D, et al. Zika virus in Gabon (Central Africa)--2007: a new threat from Aedes albopictus? PLoS Negl Trop Dis. 2014;8(2):e2681. DOI: 10.1371/journal.pntd.0002681 PMID: 24516683D’Ortenzio E, Matheron S, Yazdanpanah Y, de Lamballerie X, Hubert B, Piorkowski G, et al. Evidence of Sexual Transmission of Zika Virus. N Engl J Med. 2016;374(22):2195-8. DOI: 10.1056/NEJMc1604449 PMID: 27074370Hills SL, Russell K, Hennessey M, Williams C, Oster AM, Fischer M, et al. Transmission of Zika Virus Through Sexual Contact with Travelers to Areas of Ongoing Transmission - Continental United States, 2016. MMWR Morb Mortal Wkly Rep. 2016;65(8):215-6. DOI: 10.15585/mmwr.mm6508e2 PMID: 26937739Deckard DT, Chung WM, Brooks JT, Smith JC, Woldai S, Hennessey M, et al. Male-to-Male Sexual Transmission of Zika Virus - Texas, January 2016. MMWR Morb Mortal Wkly Rep. 2016;65(14):372-4. DOI: 10.15585/mmwr.mm6514a3 PMID: 27078057Venturi G, Zammarchi L, Fortuna C, Remoli ME, Benedetti E, Fiorentini C, et al. An autochthonous case of Zika due to possible sexual transmission, Florence, Italy, 2014. Euro Surveill. 2016;21(8):30148. DOI: 10.2807/1560-7917.ES.2016.21.8.30148 PMID: 26939607European Centre for Disease Prevention and Control (ECDC). Current Zika transmission. Last updated 8 Jun 2016. Stockholm: ECDC. [Accessed 09 Jun 2016]. Available from: http://ecdc.europa.eu/en/healthtopics/zika_virus_infection/zika-outbreak/Pages/Zika-countries-with-transmission.aspx Agence de la Biomédecine. Recommandations professionnelles dans le cadre de l’épidémie de virus Zika. French. Available from: http://www.agence-biomedecine.fr/IMG/pdf/2016-003_reco_amp_et_zika_18-03-2016_.pdf Lessler JT, Ott CT, Carcelen AC, Konikoff JM, Williamson J, Bi Q, et al. Times to key events in the course of Zika infection and their implications: a systematic review and pooled analysis [Submitted]. Bull World Health Organ.2016;1. DOI: 10.2471/BLT.16.174540Turmel JM, Abgueguen P, Hubert B, Vandamme YM, Maquart M, Le Guillou Guillemette H, et al. Late sexual transmission of Zika virus related to probable long persistence in the semen. Lancet. 2016. Coelho FC, Durovni B, Saraceni V, Lemos C, Codeço CT, Camargo S, et al. Sexual transmission causes a marked increase in the incidence of Zika in women in Rio de Janeiro, Brazil. Available from:http://biorxiv.org/content/early/2016/05/26/055459 Duffy MR, Chen TH, Hancock WT, Powers AM, Kool JL, Lanciotti RS, et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med. 2009;360(24):2536-43. DOI: 10.1056/NEJMoa0805715 PMID: 19516034Atkinson B, Hearn P, Afrough B, Lumley S, Carter D, Aarons EJ, et al. Detection of Zika Virus in Semen. Emerg Infect Dis. 2016;22(5):940. DOI: 10.3201/eid2205.160107 PMID: 27088817Haneche F, Leparc-Goffart I, Simon F, Hentzien M, Martinez-Pourcher V, Caumes E, et al. Rift Valley fever in kidney transplant recipient returning from Mali with viral RNA detected in semen up to four months from symptom onset, France, autumn 2015. Euro Surveill. 2016;21(18):30222. DOI: 10.2807/1560-7917.ES.2016.21.18.30222PMID: 27172608Sow MS, Etard JF, Baize S, Magassouba N, Faye O, Msellati P, et al. , Postebogui Study Group. New Evidence of Long-lasting Persistence of Ebola Virus Genetic Material in Semen of Survivors. J Infect Dis. 2016:jiw078. DOI: 10.1093/infdis/jiw078 PMID: 27142204

Discussion and conclusionsThe finding in our study of a likely man-to-woman sexual transmission of ZIKV between two asymptomatic cases coincided with systematic virological testing in the context of ART. To date, all reported sexual transmissions implicated an index case with symptoms of ZIKV infection, either during a stay in an epidemic area or during the 2 weeks after return from such an area [3-6,10]. As up to 80% of patients infected with ZIKV remain asymptomatic, the level of sexual transmission could play a more important role than expected in the overall dynamic of ZIKV circulation [12]. This unapparent risk of transmission is of concern for pregnant women and women considering pregnancy, and highlights the need to reinforce the counselling and recommendations given to men travelling to epidemic regions and having sex with women of reproductive age. The possible sexual transmission from asymptomatic cases also increases the risk of emergence of ZIKV in Europe in areas where Ae. albopictus and Ae. aegypti are present. ZIKV sexual transmission has been reported to occur up to 41 days after the onset of symptoms of the index case and ZIVK RNA has been detected in semen samples at 62 days post-symptom onset [10,13]. Issues related to viral presence and load in semen have been recently highlighted for Rift Valley fever virus and Ebola virus [14,15], whereby questions on the potential consequences have been raised for Ebola virus, as its long-lasting persistence has been shown in semen of survivors [15]. Whether the seminal level of ZIKV RNA follows the same slow decreasing pattern than Ebola virus is not known, but can be expected. Crucial questions remain to be addressed regarding ZIKV sexual transmission. First, the prevalence of ZIKV persistence in semen needs to be clarified in large epidemiological studies. Second, describing the duration of virus persistence in semen and the dynamics of RNA viral load in semen will help decipher the virus pathophysiological cycle in the male genitourinary tract. These data are of utmost importance in order to determine the overall probability of ZIKV sexual transmission.

BackgroundZIKV is an emerging flavivirus currently responsible for a major outbreak in different areas of the world including for example South America, as well as islands of the Caribbean and the Pacific [7]. In addition to the vector-borne transmission of the virus by Ae. aegypti or Ae. albopictus, evidence of sexual transmission has been reported between symptomatic patients, from men-to-women or from men-to-men [3-6]. The interval between the onset of symptoms in the man and his partner has been observed to vary from 4 to 44 days [10]. Recently published data show a higher incidence of ZIKV infection in women of reproductive age in Brazil, suggesting a potential role for sexual transmission in the outbreak dynamic [11]. Knowledge on the maximum delay for possible sexual transmission from the time of infection, as well as knowledge of possible transmissions from asymptomatic infected individuals, are of real interest for public health in terms of establishing control measures, improving surveillance to detect the emergence of ZIKV in areas with no current circulation but where Aedes is established, and in terms of understanding the outbreak dynamic.

Description of casesA couple wishing to have children was referred to our Assisted Reproduction Treatment (ART) centre for in vitro fertilisation with donor semen (IVF-D), as the male partner had non-obstructive azoospermia. The couple presented for a first consultation in early February 2016 in preparation of an IVF-D cycle scheduled two months later. Until this time, they had planned to spend a two-week holiday in early March in the French overseas department and region of Martinique, which is an epidemic area for ZIKV [7]. On the day before the first consultation, guidelines issued by the French governmental agency regulating ART, had been released concerning ZIKV. In the case of the couple, these guidelines recommended that both partners be tested for ZIKV RNA by reverse transcription-polymerase chain reaction (RT-PCR) in blood and urine samples at least 28 days after they came back from Martinique [8]. In addition, at the same occasion and according to the guidelines, samples of the man’s seminal plasma and sperm cell suspension obtained after sperm preparation on gradient were also to be tested for ZIKV RNA by RT-PCR [8]. The couple was thus informed that the IVF-D cycle would be delayed and an appointment for the ZIKV RNA tests was scheduled 39 days after their return from the holiday (Figure). FigureTimelines showing the key dates of possible exposure to Zika virus (ZIKV) for two cases of ZIKV infection and results of ZIKV reverse transcription-polymerase chain reaction tests on blood, urine or semen, France, March–April 2016 Virological diagnosis was performed as previously described [3]. The woman tested positive for ZIKV RNA by RT-PCR in blood (i.e. serum) and urine samples. The man tested negative for ZIKV RNA in blood, but positive in urine and seminal plasma. Sperm cell suspension was not tested for ZIKV, as he was azoospermic. Serological analysis for the man indicated the presence of anti-ZIKV IgM (absence of anti-dengue IGM) and anti-flaviviruses IgG. At the time of the consultation and during the following week, both partners reported having no clinical symptoms of ZIKV infection during and after their stay in Martinique (i.e. no fever, cutaneous manifestation, arthritis, nor myalgia). As Ae. albopictus and Ae. aegypti are not established in Brittany where the patients lived, the hypothesis of a local vector-borne infection was excluded. Due to the absence of clinical symptoms, the probable date of exposure to ZIKV could not be determined from the incubation period range. Instead, we used data from a systematic review of the time of viral clearance estimating that 5% of cases will have no detectable virus in the blood by 2.4 days after infection and 95% by 18.9 days [9]. The results of the blood tests, whereby the man tested negative for the virus, while the woman tested positive, pointed to him having been infected before her. The most likely period of exposure to ZIKV for the man was during his stay in Martinique. The woman was found to be viraemic in blood 39 days after her return, which if she had been infected at any time during the holiday trip would correspond to at least 20 days longer than the maximal time of viral clearance (Figure). These data, associated with the detection of ZIKV RNA in the man’s semen, support the hypothesis of ZIKV sexual transmission from the man to the woman between day 21 and day 36 after their return from Martinique. The couple reported having several unprotected sexual intercourses after their return.

Zika virus (ZIKV) is a mosquito-borne flavivirus transmitted by Aedes species [1,2]. It is also the first flavivirus known to be sexually transmittable between symptomatic patients [3-6]. We here report a ZIKV sexual transmission in a couple returning from Martinique, whereby both partners were asymptomatic.

The current Zika virus outbreak and its potential severe health consequences, especially congenital fetal syndrome, have led to increased concern about sexual transmission, especially in pregnant women and women of reproductive age. Here we report a case of Zika virus sexual transmission, likely male-to-female, in a totally asymptomatic couple.

T Fréour 1 2 , S Mirallié 1 2 , B Hubert 3 , C Splingart 1 , P Barrière 1 , M Maquart 4 , I Leparc-Goffart 4+ Author affiliations 1. Service de médecine de la reproduction, CHU de Nantes 2. These authors contributed equally as first authors 3. Santé publique France, French national public health agency, Regional unit (Cire) Pays de la Loire, Saint-Maurice, France 4. French Armed Forces Biomedical Research Institute, Marseille, France Correspondence: Isabelle Leparc-Goffart ([email protected]) Citation style for this article: Fréour T, Mirallié S, Hubert B, Splingart C, Barrière P, Maquart M, Leparc-Goffart I. Sexual transmission of Zika virus in an entirely asymptomatic couple returning from a Zika epidemic area, France, April 2016. Euro Surveill. 2016;21(23):pii=30254. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.23.30254 Received:30 May 2016; Accepted:09 June 2016

Eurosurveillance, Volume 21, Issue 23, 09 June 2016Rapid communication SEXUAL TRANSMISSION OF ZIKA VIRUS IN AN ENTIRELY ASYMPTOMATIC COUPLE RETURNING FROM A ZIKA EPIDEMIC AREA, FRANCE, APRIL 2016 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22500

ReferencesZanluca C, Melo VC, Mosimann ALP, Santos GI, Santos CN, Luz K. First report of autochthonous transmission of Zika virus in Brazil. Mem Inst Oswaldo Cruz. 2015;110:569–72. DOIPubMedHennessey M, Fischer M, Staples JE. Zika virus spreads to new areas—region of the Americas, May 2015–January 2016. MMWR Morb Mortal Wkly Rep. 2016;65:55–8. DOIPubMedLanciotti RS, Calisher CH, Gubler DJ, Chang GJ, Vorndam AV. Rapid detection and typing of dengue viruses from clinical samples by using reverse transcriptase-polymerase chain reaction. J Clin Microbiol. 1992;30:545–51.PubMedLanciotti RS, Kosoy OL, Laven JJ, Panella AJ, Velez JO, Lambert AJ, Chikungunya virus in US travelers returning from India, 2006. Emerg Infect Dis. 2007;13:764–7. DOIPubMedAyers M, Adachi D, Johnson G, Andonova M, Drebot M, Tellier R. A single tube RT-PCR assay for the detection of mosquito-borne flaviviruses. J Virol Methods. 2006;135:235–9. DOIPubMedLanciotti RS, Kosoy OL, Laven JJ, Velez JO, Lambert AJ, Johnson AJ, Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis. 2008;14:1232–9. DOIPubMedLanciotti RS, Lambert AJ, Holodniy M, Saavedra S, Signor LD. Phylogeny of Zika virus in Western Hemisphere, 2015.Emerg Infect Dis. 2016;22:933–5. DOIPubMedThomas DL, Sharp TM, Torres J, Armstrong PA, Munoz-Jordan J, Ryff KR, Local transmission of Zika virus—Puerto Rico, November 23, 2015–January 28, 2016. MMWR Morb Mortal Wkly Rep. 2016;65:154–8. DOIPubMedLeibovitz Z, Daniel-Spiegel E, Malinger G, Haratz K, Tamarkin M, Gindes L, Microcephaly at birth—the accuracy of three references for fetal head circumference. How can we improve prediction? Ultrasound Obstet Gynecol.2015;2:23.PubMedWorld Health Organization. Guillain-Barré syndrome—Panama [cited 2016 Mar 29]. http://www.who.int/csr/don/29-march-2016-gbs-panama/en/

GenBank accession nos. KU724096–100 http://www.ncbi.nlm.nih.gov/nuccore/KU724096 GenBank: 998178886 This record has not yet been released. Please contact [email protected] with the publication details if the accession has been published.

Figure Figure. Locations in the Guna Yala region of eastern Panama with confirmed cases of Zika virus infection during November 27, 2015–January 22, 2016. Inset maps show locations of Guna Yala in Panama and of Panama in the Americas.

To the Editor: The earliest clinical cases of Zika virus infection were reported from continental South America in 2015 (1), after which the virus spread rapidly through the Americas (2). Here we describe an investigation of febrile or exanthematous illnesses for possible association with Zika, dengue, or chikungunya virus; these illnesses occurred in the Guna Yala region of eastern Panama, which borders northern Colombia (Figure). We collected and analyzed a convenience sample of 276 serum samples and 26 paired urine samples from 276 patients who sought care at clinics in Guna Yala during November 27, 2015–January 22, 2016, for reported fever or rash of <5 days’ duration in addition to 1 of the following: headache, malaise, arthralgia, myalgia, or conjunctivitis. We also collected data on clinical signs and symptoms, date of illness onset, age, sex, residence, and self-reported status of pregnancy. At first, we performed real-time reverse transcription PCR (rRT-PCR) tests specific for dengue (3) and chikungunya (4) viruses. However, because all the samples received during the week of November 27 were negative for those viruses and Zika virus was being reported in Colombia as of October 2015, we also tested the samples with a flavivirus-specific rRT-PCR (5), followed by amplicon sequencing; or with an rRT-PCR specific for Zika virus (6). Of the 276 patients whose samples were tested, 164 (60%) were female. A total of 22 (8%) samples were positive for dengue; 2 were positive for chikungunya. Of the remaining 252 patients, 50 (20%) had >1 sample that tested positive for Zika virus (50/252 serum samples, 4/26 paired urine samples). Of these 50 patients, 30 (60%) were female. Most of these patients reported illness onset during December 9–27, 2015 (Technical Appendix[PDF - 241 KB - 3 pages] Figure 1). Zika virus infection affected all age groups (median age 35 y, range 0.1–80 y). The most commonly reported signs and symptoms were fever (86%), exanthema (72%), and headache (62%). The clinical characteristics of these infections showed no statistically significant difference with those associated with dengue and chikungunya virus infections and with cases found to be negative for all 3 viruses, suggesting that the negative cases could represent Zika virus infections (Technical Appendix[PDF - 241 KB - 3 pages] Table). One of the patients with confirmed Zika virus infection reported being in her second trimester of pregnancy; she underwent a fetal ultrasound at 36 weeks’ gestation, which was interpreted as normal, and the infant was found to have no neurologic defects at birth. By using Vero E6 cells (American Type Culture Collection), we isolated Zika virus from 9 samples (8 serum, 1 urine). Phylogenetic analysis of 5 Zika virus sequences (a 428-nucleotide fragment encompassing a conserved region of the nonstructural protein 5 gene) placed these isolated (GenBank accession nos. KU724096–100) within the Asian lineage, the lineage involved in the spread of Zika virus in the Americas (Technical Appendix[PDF - 241 KB - 3 pages] Figure 2) (2,7). By using molecular methods, we confirmed diagnoses in 27% of patients during this outbreak. The distribution of positive results suggests that Zika virus was the predominant etiologic virus in this cohort, but we cannot firmly conclude this because most specimens tested negative for Zika, dengue, and chikungunya viruses. Although results from patient sampling and laboratory testing are not comparable, an assessment in Puerto Rico was able to detect Zika virus RNA by rRT-PCR or IgM by ELISA in 19% of 155 patients with suspected Zika virus infection (8). Despite the addition of IgM testing, most of the patients whose specimens were tested by rRT-PCR were negative for dengue and Zika viruses. Several reasons might exist for the high proportion of specimens testing negative for Zika virus. Viremia is often low and short-lived in persons infected with Zika virus (7); the PCR test might not be sensitive enough; some patients with Zika virus infection may have sought care after the virus had been cleared from the blood and urine; our diagnostic capacity was limited by the lack of reliable serologic tests for Zika virus; and we did not test for other viral, bacterial, or parasitic causes of fever or rash illness. The Panama Ministry of Health is following up with known pregnant women of the Guna Yala region who report Zika virus infection symptoms and is testing urine samples by using Zika virus–specific rRT-PCR within 14 days of symptom onset. Pregnant women confirmed to have Zika virus infection will receive ultrasound monitoring; however, the test has relatively low positive predictive value for detecting microcephaly (9). In Guna Yala, no symptoms of Guillain-Barré syndrome or other neurologic conditions have been detected; however, since January 2016, Zika virus has spread to other regions of Panama, and at least 1 case of Guillain-Barré syndrome has been reported (10). Our experience shows the challenge of diagnosing the causes of fever or rash by using only molecular methods, underscoring the need for diagnostic tools that are rapid and inexpensive but more sensitive and specific.

Dimelza Araúz1, Luis De Urriola1, José Jones, Marlene Castillo, Alexander Martínez, Edison Murillo, Leonidas Troncoso, María Chen, Leyda Abrego, Blas Armién, Juan M. Pascale, Néstor Sosa, Sandra López-Verges, and Brechla Moreno Author affiliations: Gorgas Memorial Institute for Health Studies, Panama City, Panama (D. Araúz, M. Castillo, M. Chen, L. Abrego, S. López-Verges, B. Moreno, A. Martinez, B. Armién, J.M. Pascale, N. Sosa); Panama Ministry of Health Department of Epidemiology, Guna Yala, Panama (L. De Urriola); Health Center Guna Yala, Guna Yala (J. Jones, E. Murillo, L. Troncoso) AcknowledgmentsWe thank the personnel of the Panama Ministry of Health for help with the epidemiologic surveillance program, all the personnel of the Gorgas Memorial Institute for Health Studies Department of Research in Virology and Biotechnology for continuous technical support, and Publio González for his assistance with the maps and graphics. This study was supported by the Gorgas Memorial Institute for Health Studies Department of Research in Virology and Biotechnology and by project 09.044.051 from the Panama Ministry of Economy and Finance (S.L.V.). A.M., B.A., J.M.P., and S.L.V. are members of Sistema Nacional de Investigación (SNI) of the Secretaría Nacional de Ciencia, Tecnología, e Innovación (SENACYT) in Panama.

Volume 22, Number 8—August 2016LetterFebrile or Exanthematous Illness Associated with Zika, Dengue, and Chikungunya Viruses, Panamahttp://wwwnc.cdc.gov/eid/article/22/8/16-0292_article

There are Now 5 Confirmed Cases of Zika in Alabama 0 0 0MORE NOW VIEWING New reports from the Alabama Department of Public Health confirm that two more cases of the Zika virus have been diagnosed in Alabama, bringing the state’s total count up to 5 cases.So far, the most recent cases were found in residents of Houston and Jefferson counties. Previously, the three other cases were found in patients in Morgan, Jefferson, and Shelby County. According to the Times Daily, the confirmed Alabama cases were all travel-related.The Zika virus is most often transmitted via bites from infected mosquitoes. However, it can also be transmitted sexually and through blood transfusions.While Zika typically manifests as a mild virus, comparable to the flu, it can cause birth defects if a mother becomes infected during pregnancy. Very recently, a child in New Jersey was born infected with the Zika virus. The baby has been diagnosed with microcephaly, a disease that causes babies to have small brains and heads. For pregnant women with Zika, microcephaly is a common birth defect.In the wake of this virus, officials across the U.S. have put out warnings –particularly for pregnant women — to protect themselves during the summer season. Preventative measures include wearing long sleeves when possible, utilizing mosquito nets and window and door screens, and EPA-approved bug spray.Researchers are also looking to the future, importing the Zika virus to the University of Honolulu in Hawaii in order to find a vaccine that can help to prevent the virus from affecting individuals bitten by infected mosquitoes. When available, vaccines are extremely effective and prevent more than 2.5 million deaths per year.But for now, there is no vaccine to speak of. That being said, pregnant women who have traveled to Zika-affected areas should be screened for the virus. Any pregnant women who exhibit the symptoms within two weeks of traveling should be evaluated at soon as possible. Women who are pregnant but do not have symptoms should get tested between two and 12 weeks after the trip. http://thelafayettesun.com/there-are-now-5-confirmed-cases-of-zika-in-alabama/

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

Fifth Imported Zika Case Confirmed in Tarrant CountyNo local transmission reported at this time June 10, 2016 (Tarrant County, TX) – Tarrant County Public Health (TCPH) has identified a fifth imported case of Zika virus in the county. TCPH reports no local transmission at this time and surveillance continues.A private laboratory received, tested and confirmed the sample.This is the first imported case with a travel history to St. Lucia. The previous cases traveled to El Salvador, Puerto Rico (2) and St. Martin. All areas have known local transmission of the disease. No other health information will be released at this time to protect the identity of the patients. Zika virus is spread to people primarily through the bite of an infected Aedes species mosquito, a known aggressive daytime biter. Sexual transmission has been reported in a small number of cases. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is typically mild with symptoms lasting no more than seven days. TCPH continues to distribute Zika Home Care Kits to Tarrant County residents being evaluated for Zika. The kit includes mosquito repellant, mosquito dunks, educational materials and other items. The kits are not being offered to the general public. Reducing mosquito breeding sites is one of the best ways residents can protect themselves and their neighbors. They should: Routinely dump standing water on their property,Overturn all small containers,Dispose of any trash or debris that can contains small amounts of water.TCPH’s Zika Hotline (817-248-6299) is available to help answer any questions residents may have about this disease. Click here for more information on Zika virus and for other useful tips. TCPH has produced a video to help residents Eliminate Mosquito Breeding Sites.

This is the first imported case with a travel history to St. Lucia. The previous cases traveled to El Salvador, Puerto Rico (2) and St. Martin. All areas have known local transmission of the disease. No other health information will be released at this time to protect the identity of the patients. http://access.tarrantcounty.com/content/main/en/public-health/news/2016/fifth-imported-zika-case-confirmed-in-tarrant-county.html?linklocation=latest-news&linkname=Fifth Imported Zika Case Confirmed in Tarrant County

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