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Zika Virus New Hampshire Summary Report January 11, 2016 – May 27, 2016 ZIKA VIRUS TESTING SUMMARY Number of people tested 195 Total # of pending results 13 Total # of negative results 246 Total # of positive results 4 ZIKA VIRUS CASE SUMMARY Female Pregnant Female Not pregnant Male TOTAL Number of Zika Virus Cases in NH 2 1 1 4

Zika Virus – May 31, 2016. Texas has had 36 confirmed cases of Zika virus disease. Of those, 35 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. Case counts by county: Bexar – 3 Collin – 1 Dallas – 6 Denton – 2 Fort Bend – 2 Grayson – 1Harris – 13 Tarrant – 3 Travis – 2 Val Verde – 1 Williamson – 1 Wise – 1

May 31, 2016 DEPARTMENT OF HEALTH DAILY ZIKA UPDATE: NO NEW CASES TODAY Contact:Communications OfficeNewsMedia@flhealth.gov(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 no new cases today. Of the cases confirmed in Florida, five cases 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 37, with 9 having met the previous CDC case definition. County Number of Cases (all travel related) Alachua 4 Brevard 3 Broward 17 Clay 2 Collier 2 Hillsborough 3 Lee 5 Martin 1 Miami-Dade 48 Orange 10 Osceola 5 Palm Beach 7 Pasco 1 Pinellas 4 Polk 3 Santa Rosa 1 Seminole 3 St. Johns 2 Volusia 2 Total cases not involving pregnant women 123 Cases involving pregnant women regardless of symptoms* 37 *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 1,885 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 19 counties included in the declaration– Alachua, Brevard, Broward, Clay, Collier, 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.Florida currently has the capacity to test 6,216 people for active Zika virus and 1,904 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 Friday, DOH will now report pregnant women with evidence of Zika virus regardless of symptoms. Prior to Friday, 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/2016/05/053116-zika-update.html

Pennsylvania Blood Tests Submitted for Zika TestingInformation updated Mondays at 2 p.m.CDC Confirmed Cases: 19Pending Test Results: 178 Last update: 05/31/2016

Travel-associated Zika cases confirmed in Arizona: 4Arizona Arboviral Handbook for Chikungunya, Dengue, & Zika VirusesArizona's First Zika Case Recorded in Traveler, read the news release

ReferencesFaye O, Freire CCM, Iamarino A, et al. Molecular evolution of Zika virus during its emergence in the 20th century. PLoS Negl Trop Dis 2014;8:e2636.CrossRef PubMedHayes EB. Zika virus outside Africa. Emerg Infect Dis 2009;15:1347–50. CrossRef PubMedFood and Drug Administration. Zika virus emergency use authorization. Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration; 2016. http://www.fda.gov/MedicalDevices/Safety/EmergencySituations/ucm161496.htmCDC. Interim guidance for Zika virus testing of urine—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:474. CrossRef PubMedBingham AM, Cone M, Mock V, et al. Comparison of test results for Zika virus RNA in urine, serum, and saliva specimens from persons with travel-associated Zika virus disease—Florida, 2016. MMWR Morb Mortal Wkly Rep 2016;65:475–8. CrossRef PubMedLanciotti RS, Kosoy OL, Laven JJ, et al. Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis 2008;14:1232–9. CrossRef PubMedCDC. Revised diagnostic testing for Zika, chikungunya, and dengue viruses in US public health laboratories. http://www.cdc.gov/zika/pdfs/denvchikvzikv-testing-algorithm.pdfCalisher CH, Karabatsos N, Dalrymple JM, et al. Antigenic relationships between flaviviruses as determined by cross-neutralization tests with polyclonal antisera. J Gen Virol 1989;70:37–43. CrossRef PubMedPetersen EE, Polen KND, Meaney-Delman D, et al. Update: interim guidelines for health care providers caring for pregnant women and women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:315–22. CrossRef PubMedSimeone RM, Shapiro-Mendoza CK, Meaney-Delman D. Possible Zika virus infection among pregnant women—United States and territories, May 2016. MMWR Morb Mortal Wkly Rep 2016;65:514–9.World Health Organization. Dengue guidelines for diagnosis, treatment, prevention and control, 2009. Geneva, Switzerland: World Health Organization; 2009. http://apps.who.int/iris/bitstream/10665/44188/1/9789241547871_eng.pdfDuffy MR, Chen TH, Hancock WT, et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med 2009;360:2536–43. CrossRefPubMedMusso D, Nhan T, Robin E, et al. Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013 to February 2014. Euro Surveill 2014;19:20761. CrossRef PubMedMusso D, Roche C, Nhan TX, Robin E, Teissier A, Cao-Lormeau VM. Detection of Zika virus in saliva. J Clin Virol 2015;68:53–5. CrossRef PubMedPrince HE, Tobler LH, Yeh C, Gefter N, Custer B, Busch MP. Persistence of West Nile virus–specific antibodies in viremic blood donors. Clin Vaccine Immunol 2007;14:1228–30. CrossRef PubMedRoehrig JT, Nash D, Maldin B, et al. Persistence of virus-reactive serum immunoglobulin M antibody in confirmed West Nile virus encephalitis cases. Emerg Infect Dis 2003;9:376–9. CrossRef PubMedWhitehead SS, Blaney JE, Durbin AP, Murphy BR. Prospects for a dengue virus vaccine. Nat Rev Microbiol 2007;5:518–28. CrossRef PubMedBusch MP, Kleinman SH, Tobler LH, et al. Virus and antibody dynamics in acute West Nile virus infection. J Infect Dis 2008;198:984–93. CrossRefPubMedPoland JD, Calisher CH, Monath TP, Downs WG, Murphy K. Persistence of neutralizing antibody 30–35 years after immunization with 17D yellow fever vaccine. Bull World Health Organ 1981;59:895–900. PubMedHalstead SB, Rojanasuphot S, Sangkawibha N. Original antigenic sin in dengue. Am J Trop Med Hyg 1983;32:154–6. PubMedJohnson BW, Kosoy O, Martin DA, et al. West Nile virus infection and serologic response among persons previously vaccinated against yellow fever and Japanese encephalitis viruses. Vector Borne Zoonotic Dis 2005;5:137–45. PubMedCouncil of State and Territorial Epidemiologists. Zika virus disease and congenital Zika virus infection interim case definition and addition to the Nationally Notifiable Diseases list. Atlanta, GA: Council of State and Territorial Epidemiologists; 2016.https://www.cste2.org/docs/Zika_Virus_Disease_and_Congenital_Zika_Virus_Infection_Interim.pdfMartin DA, Muth DA, Brown T, Johnson AJ, Karabatsos N, Roehrig JT. Standardization of immunoglobulin M capture enzyme-linked immunosorbent assays for routine diagnosis of arboviral infections. J Clin Microbiol 2000;38:1823–6. PubMed

TABLE. Interpretation of results of antibody testing for suspected Zika virus infection*,†,§,¶,** — United States, 2016Zika virus and dengue virus IgM ELISAZika virus PRNTDengue virus PRNTInterpretationPositive or equivocal (either assay)≥10<10Recent Zika virus infectionPositive or equivocal (either assay)<10≥10Recent dengue virus infectionPositive or equivocal (either assay)≥10≥10Recent flavivirus infection; specific virus cannot be identifiedInconclusive in one assay AND inconclusive or negative in the other≥10<10Evidence of Zika virus infection; timing cannot be determinedInconclusive in one assay AND inconclusive or negative in the other<10≥10Evidence of dengue virus infection; timing cannot be determinedInconclusive in one assay AND inconclusive or negative in the other≥10≥10Evidence of flavivirus infection; specific virus and timing cannot be determinedAny result (either or both assays)<10<10No evidence of Zika virus or dengue virus infectionPositive for Zika virus AND negative for dengue virusNot yet performedPresumptive recent Zika virus infectionPositive for dengue virus AND negative for Zika virusNot yet performedPresumptive recent dengue virus infectionPositive for Zika virus AND positive for dengue virusNot yet performedPresumptive recent flavivirus virus infectionEquivocal (either or both assays)Not yet performedEquivocal resultsInconclusive in one assay AND inconclusive or negative in the otherNot yet performedInconclusive resultsNegative for Zika virus AND negative for dengue virusNot indicatedNo evidence of recent Zika virus or dengue virus infectionAbbreviations: ELISA = enzyme-linked immunosorbent assay; IgM = immunoglobulin M antibodies; PRNT = plaque reduction neutralization test. *For persons with suspected Zika virus disease, Zika virus real-time reverse transcription–polymerase chain reaction (rRT-PCR) should be performed on serum specimens collected <7 days after onset of symptoms, and on urine specimens collect <14 days after onset of symptoms. †In the absence of rRT-PCR testing, negative IgM or neutralizing antibody testing in specimens collected <7 days after illness onset might reflect collection before development of detectable antibodies and does not rule out infection with the virus for which testing was conducted. §Zika IgM positive result is reported as “presumptive positive” to denote the need to perform confirmatory PRNT. ¶Report any positive or equivocal IgM Zika or dengue results to state or local health department. **To resolve false-positive results that might be caused by cross-reactivity or nonspecific reactivity, presumptive positive Zika IgM results should be confirmed with PRNT titers against Zika, dengue, and other flaviviruses to which the person might have been exposed. In addition, equivocal and inconclusive results that are not resolved by retesting also should have PRNT titers performed to rule out a false-positive result.

Management of Persons with Suspected Zika or Dengue Virus InfectionAll patients with clinically suspected dengue virus infection should receive appropriate management to reduce the risk for hemorrhagic complications (11). Symptomatic and asymptomatic pregnant women with serologic or molecular evidence of recent Zika virus infection should be evaluated and managed for possible adverse pregnancy outcomes and reported to the U.S. Zika Pregnancy Registry or the Puerto Rico Zika Active Pregnancy Surveillance System (9,10). Among persons for whom serologic testing is unable to determine the most recent infecting flavivirus, an epidemiologic link to a laboratory-confirmed case of dengue or Zika virus disease can be considered in determining the most likely infecting virus (22). In addition, data on the epidemiology of viruses known to be circulating at the location of exposure and clinical features of these viral infections should be considered. If serologic testing is inconclusive or there is evidence of recent infection with either Zika or dengue virus, patients should be clinically managed for both infections because they might have been infected with either virus. Health care providers with questions about test result interpretation should consult with state or local public health authorities for assistance.

Interpretation of Zika Virus Testing ResultsFor persons with suspected Zika virus disease, a positive rRT-PCR result confirms Zika virus infection, and no antibody testing is indicated (3,4,7). However, because of the decline in the level of viremia over time and possible inaccuracy in reporting of dates of illness onset, a negative rRT-PCR result does not exclude Zika virus infection. Therefore, serum IgM antibody testing for Zika and dengue virus infections should be performed if rRT-PCR is negative. For serum specimens collected <7 days after onset of symptoms, the combination of a negative rRT-PCR result and negative IgM antibody testing suggests that there was no recent infection. However, a negative IgM antibody test, in the absence of rRT-PCR testing, might reflect specimen collection before development of detectable antibodies and does not rule out infection with the viruses for which testing was performed. For specimens collected from 7 days to 12 weeks after onset of symptoms, a negative IgM antibody result to both Zika and dengue viruses rules out recent infection with either virus. If either the Zika or dengue virus IgM antibody testing yields positive, equivocal, or inconclusive results, PRNTs against Zika and dengue viruses (or other flaviviruses endemic to the region where exposure occurred) should be performed. A PRNT using a 90% cutoff value with a titer ≥10 (the typical starting serum dilution used to establish the presence of virus-specific neutralizing antibodies) against Zika virus, together with negative PRNTs (i.e., <10) against other flaviviruses is confirmatory for recent infection with Zika virus (Table). A PRNT titer ≥10 for both Zika and dengue virus (or another flavivirus) provides evidence of a recent infection with a flavivirus but precludes identification of the specific infecting virus. A negative PRNT against Zika virus in a specimen that is collected >7 days after illness onset rules out Zika virus infection. For specimens collected <7 days after onset of symptoms, the combination of a negative rRT-PCR and a PRNT titer <10 suggests that there was no infection with Zika virus. However, in the absence of rRT-PCR testing, a PRNT titer <10 might reflect specimen collection before development of detectable neutralizing antibodies and does not rule out infection with the viruses for which testing was conducted. Without confirmatory PRNTs, it is not possible to determine whether a presumptive positive IgM antibody result against Zika virus reflects recent flavivirus infection or a false-positive result. For asymptomatic pregnant women residing in an area with local Zika virus transmission, IgM testing should be performed upon initiation of prenatal care, mid-second trimester, and if any fetal abnormalities are detected during ultrasound evaluation (9). For asymptomatic pregnant women with a history of travel to areas where ongoing Zika virus transmission is occurring, Zika virus antibody testing should be performed on specimens collected 2–12 weeks post travel (9). Results are interpreted as for symptomatic persons. If a serum specimen was collected >12 weeks after travel, although IgM might still be present, it is possible that antibody levels have dropped below the detectable limit. Performing routine PRNTs for women in this group is not recommended because any result other than a PRNT titer <10 for Zika virus could represent infection with or vaccination against a flavivirus at any time in the past and does not provide specific evidence of Zika virus exposure during pregnancy.

CDC Zika Virus Diagnostic TestsThe Food and Drug Administration (FDA) has issued an Emergency Use Authorization for the CDC Zika IgM Antibody Capture Enzyme-Linked Immunosorbent Assay (Zika MAC-ELISA) for antibody testing (3). This assay has been introduced and is being used in qualified public health and Department of Defense laboratories in the United States. The Zika MAC-ELISA is used for the qualitative detection of Zika virus IgM antibodies in serum or cerebrospinal fluid collected from persons meeting the clinical and epidemiologic criteria for suspected Zika virus disease (3,22). Results are reported as positive (termed “presumptive positive” to denote the need to perform a confirmatory PRNT), equivocal, negative, or inconclusive (i.e., results uninterpretable because of high background optical density). To resolve false-positive results that might be caused by cross-reactivity or nonspecific reactivity, presumptive positive results should be confirmed with PRNT against Zika, dengue, and other flaviviruses to which the person might have been exposed (3,23). In addition, equivocal and inconclusive results that are not resolved by retesting also should have PRNT performed to rule out a false-positive result.

Zika Virus Antibody TestingAn enzyme-linked immunosorbent assay (ELISA) can be used to detect anti-Zika virus IgM antibodies in serum or cerebrospinal fluid; however, the Zika virus IgM ELISA can provide false-positive results because of cross-reacting IgM antibodies against related flaviviruses or nonspecific reactivity. The plaque reduction neutralization test (PRNT) measures virus-specific neutralizing antibody titers and should be performed against various related flaviviruses to rule out false-positive ELISA results. In primary flavivirus infections (i.e., the first time a person is infected with a flavivirus), PRNT also can be used to identify the infecting virus. Usually, this is determined with a neutralizing antibody titer ≥4-fold higher than titers against cross-reacting flaviviruses. Based on earlier flavivirus research and limited preliminary data specific to Zika virus, the historical use of a 4-fold higher titer by PRNT might not discriminate between anti-Zika virus antibodies and cross-reacting antibodies in all persons who have been previously infected with or vaccinated against a related flavivirus (i.e., secondary flavivirus infection) (20,21). Because of the importance of appropriate clinical management of Zika and dengue virus infections, and the risk for adverse pregnancy outcomes in women infected with Zika virus during pregnancy, a conservative approach to the interpretation of antibody test results is now recommended to reduce the possibility of missing the diagnosis of either infection (9,11).

Zika Virus Infection and Immune ResponseMost Zika virus infections are asymptomatic (12). Viremia is expected to occur from several days before illness onset until a week after illness onset (6,13,14). Zika virus–specific IgM antibodies develop during the first week of illness (5,6). Data on duration of IgM antibody persistence following Zika virus infection are limited. However, IgM antibodies against West Nile virus, a closely related flavivirus, have been detected in asymptomatic, infected blood donors for at least 3 months after their viremic donation, and almost half of tested patients with West Nile virus neuroinvasive disease had detectable serum IgM antibodies >1 year after illness onset (15,16). Neutralizing antibodies to Zika virus develop shortly after IgM antibodies and consist primarily of IgG antibodies. Neutralizing antibodies are expected to persist for many years after flavivirus infections and are believed to confer prolonged, possibly lifelong, immunity (17–19). In persons previously infected with a flavivirus or vaccinated against yellow fever, Japanese encephalitis, or tick-borne encephalitis, subsequent exposure to a related flavivirus can result in a rapid and brisk rise in neutralizing antibodies against multiple flaviviruses (20). In addition, the neutralizing antibody titer against a flavivirus to which the person previously was exposed might be higher than the titer against the virus with which they were most recently infected (20). For example, a person who was previously infected with dengue virus or who received yellow fever vaccine might respond with high levels of neutralizing antibodies against those viruses when later infected with Zika or West Nile viruses. When performing serologic testing, the presence of these neutralizing antibodies against multiple flaviviruses can preclude conclusive determination of which flavivirus was responsible for the recent infection.

SummaryWhat is already known about this topic? Zika virus is a mosquito-borne flavivirus closely related to dengue, West Nile, Japanese encephalitis, and yellow fever viruses. Diagnostic testing for Zika virus infection can be accomplished using both molecular and serologic methods. However, results of Zika virus antibody testing can be difficult to interpret because of cross-reactivity with related flaviviruses, which can preclude identification of the specific infecting virus, especially when the person previously was infected with or vaccinated against a related flavivirus. What is added by this report? For persons with suspected Zika virus disease, a positive real-time reverse transcription–polymerase chain reaction (rRT-PCR) result confirms Zika virus infection, but a negative result does not exclude infection. In these cases, antibody testing can identify additional recent Zika virus infections. If immunoglobulin (Ig) M test results are positive, equivocal, or inconclusive, performing a plaque reduction neutralization test (PRNT) is needed to confirm the diagnosis. However, recent evidence suggests that a 4-fold higher titer by PRNT might not discriminate between anti-Zika virus antibodies and cross-reacting antibodies in all persons who have been previously infected with or vaccinated against a related flavivirus. Thus, a more conservative approach to interpreting PRNT results is now recommended to reduce the possibility of missing the diagnosis of either Zika or dengue virus infection. What are the implications for public health practice? All patients with clinically suspected dengue should receive appropriate management to reduce the risk for hemorrhagic medical complications. Pregnant women with laboratory evidence of a recent Zika virus infection or flavivirus infection should be evaluated and managed for possible adverse pregnancy outcomes and reported to the appropriate Zika virus pregnancy registry. Health care providers should consult with state or local public health authorities for assistance in interpreting test results.

Ingrid B. Rabe, MBChB1; J. Erin Staples, MD, PhD1; Julie Villanueva, PhD1; Kimberly B. Hummel, PhD1; Jeffrey A. Johnson, PhD1; Laura Rose; MTS1; Susan Hills, MBBS1; Annemarie Wasley, ScD1; Marc Fischer, MD1; Ann M. Powers, PhD1 1Zika virus response epidemiology and laboratory teams, CDC. Corresponding author: Ingrid B. Rabe, irabe@cdc.gov, 970-221-6400.

Zika virus antibody testing and interpretation of results — United States, 2016Zika virus is closely related to other flaviviruses including dengue, West Nile, Japanese encephalitis, and yellow fever viruses. Diagnostic testing for Zika virus infection can be accomplished using both molecular and serological methods. Real-time reverse transcription-polymerase chain reaction (rRT-PCR) is the preferred test for Zika virus infection because it can be performed rapidly and is highly specific. However, because of transient and low levels of viremia, a negative rRT-PCR result does not exclude infection. Zika virus antibody test results can be difficult to interpret because of cross-reactivity with other flaviviruses, which can result in the inability to determine the specific infecting virus, especially when the person previously was infected with or vaccinated against a related flavivirus. This is important because the results of Zika and dengue virus testing will guide clinical management. Pregnant women with evidence of Zika virus infection should be evaluated and managed for possible adverse pregnancy outcomes and be reported to the Zika virus pregnancy registry established by CDC for clinical follow-up. All patients with suspected dengue should have proper clinical management to reduce the risk of medical complications and death. If serologic testing indicates recent flavivirus infection that could be caused by either Zika or dengue virus, patients should be clinically managed as if they have been infected with either virus.

Interim Guidance for Interpretation of Zika Virus Antibody Test ResultsEarly Release / May 31, 2016 / 65 http://www.cdc.gov/mmwr/volumes/65/wr/mm6521e1.htm?s_cid=mm6521e1_w

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Baby dies in Barranquilla with microcephaly apparently related to maternal zikaBy Web Redaccionhace 3 horas FacebookTwitter The doctor Oscar Osorio confirmed the death of a baby who was born with microcephaly and whose mother had symptoms of the Zika virus. The baby's death was recorded Saturday. He was born on May 26 to 28 weeks gestation and there was need for tracheostomy and ventilator. Osorio reported that another baby with microcephaly and maternal history of zika also under study. The child was born on May 25 to 36 weeks gestation and has evolved very well. The Metropolitan University researcher declared awaiting the results of laboratory at the National Institute of Health to confirm the incidence of zika in 2 cases of microcephaly.

Baby dies in Barranquilla with microcephaly apparently related to maternal zika The doctor Oscar Osorio confirmed the death of a baby who was born with microcephaly and whose mother had symptoms of the Zika virus. The baby's death was recorded Saturday. He was born on May 26 to 28 weeks gestation and there was need for tracheostomy and ventilator. http://emisoraatlantico.com.co/local/muere-barranquilla-bebe-microcefalia-relacionada-al-parecer-zika-materno/

OverviewThe primary transmission route of Zika virus is via the Aedes mosquito. However, mounting evidence has shown that sexual transmission of Zika virus is possible and more common than previously assumed. This is of concern due to an association between Zika virus infection and adverse pregnancy and fetal outcomes, including microcephaly, neurological complications and Guillain-Barré syndrome. The current evidence base on Zika virus remains limited. This guidance will be reviewed and the recommendations updated as new evidence emerges. Related linksAll publications, technical guidances on Zika virusZika virus and potential complications

Prevention of sexual transmission of Zika virusInterim guidanceShare PrintAuthors: World Health Organization Publication detailsNumber of pages: 5 Publication date: Updated 30 May 2016 Languages: English WHO reference number:WHO/ZIKV/MOC/16.1 Rev.1 http://who.int/csr/resources/publications/zika/sexual-transmission-prevention/en/

This is an interim report on the WHO-led global response to the emerging threat posed by Zika virus. It summarises the background to the Strategic Response Framework and Joint Operations Plan published in February 2016, provides an update on some key activities conducted by WHO and its partners since, and sets out the current funding gap for critical activities until the end of June 2016, as well as the approach to setting a new strategy from July 2016 onwards.