niman

Cui Li,1,2,7 Dan Xu,5,7 Qing Ye,3,7 Shuai Hong,1,2,7 Yisheng Jiang,1 Xinyi Liu,1,2 Nana Zhang,3,6 Lei Shi,1 Cheng-Feng Qin,3, * and Zhiheng Xu1,4, * 1State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China 2University of Chinese Academy of Sciences, Beijing 100101, China 3Department of Virology, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China 4Parkinson’s Disease Center, Beijing Institute for Brain Disorders, Beijing 100101, China 5Institute of Life Sciences, Fuzhou University, Fuzhou 350116, China 6Guangxi Medical University, Nanning 530021, China 7Co-first author *Correspondence: [email protected] (C.-F.Q.), [email protected] (Z.X.)

Zika Virus Disrupts Neural Progenitor Development and Leads to Microcephaly in Mice http://www.cell.com/cell-stem-cell/pdfExtended/S1934-5909(16)30084-4

Weekly Brazil microcephaly cases http://portalsaude.saude.gov.br/index.php/o-ministerio/principal/leia-mais-o-ministerio/197-secretaria-svs/20799-microcefalia

Babies with microcephaly cases reach 1,326 in 24 states and the Federal DistrictUOL's in Sao Paulo 05/11/2016 13h23 Listen text 0:00 To print Report errorNacho Doce / Reuters Brazil had 1,326 cases of microcephaly or nervous system damage reported between October 2015 and May 7, according to the Ministry of Health report released on Wednesday (11). Until last week, 1,271 cases were recorded. The surge of children born with neurological problems are associated with zika epidemic virus transmitted by the mosquito Aedes aegypti. The cases of microcephaly registered in the country occurred in 484 municipalities in 24 states and the Federal District. Only Acre and Santa Catarina have no records.Most cases (1.190), however, is still concentrated in the Northeast. According to the pulp were 56 deaths recorded after childbirth or during pregnancy whose relationship with microcephaly was confirmed. There are 174 deaths under investigation. In addition, there are still 7,438 pregnant women with suspected cases and 3,433 still under investigation. Cases discarded, it was not confirmed microcephaly or where the malformation is not associated with zika, totaling 2,679 since the beginning of the investigation.Microcephaly can be caused by other diseases such as syphilis, toxoplasmosis, rubella and herpes viral. According to the ministry, 205 cases were confirmed by specific laboratory criteria for zika virus. However, the folder considers that there was infection zika most of the babies with mothers who had a final diagnosis of microcephaly. Virus causes brain cells to self-destructThe infection zika virus triggers the cells of the human brain in forming an immune response that leads to self-destruction . The discovery was made by scientists at the University of California (UC) in San Diego (USA) and published last week in the journal Cell. According to the authors of the article, the death of brain stem cells after infection is associated with microcephaly cases caused by viruses. Block the innate immune response of the brain stem cells may be an alternative for them to survive the infection, reducing the possibility of occurrence of the malformation. Previous studies with minicérebros infected zika helped establish the connection between viral infection and death of neural stem cells. The group led by Brazilian Stevens Rehen, the Federal University of Rio de Janeiro and the D'Or Institute for Research and Education (er), used the Organoids in a study published in April in the journal Science, to conclude that the zika virus actually has the ability to infect and kill human brain cells. Also in April, an American University Johns Hopkins group used the technique to prove that zika virus prefers neural stem cells. Now, the latest study added another piece to the puzzle: the role of the immune system. http://noticias.uol.com.br/saude/ultimas-noticias/redacao/2016/05/11/bebes-com-microcefalia-chegam-a-1326-casos-em-24-estados-e-no-df.htm

By Felice J. Freyer GLOBE STAFF MAY 11, 2016 Ten Massachusetts residents became infected with Zika while traveling to areas where the virus is prevalent, but no local transmission of the illness has been reported, and it’s “extremely unlikely” that will happen, a top state disease tracker told public health officials Wednesday. The virus is spread primarily by the bites of certain species of mosquitoes; doctors have identified a few cases of sexual transmission. Dr. Catherine M. Brown, deputy state epidemiologist, gave a presentation on Zika at the request of the Public Health Council, an appointed board of physicians, academics, and consumer advocates that sets health policy. Afterward, she said the state would release no information about the people who contracted Zika, including where they traveled or whether they were pregnant. The first person in the state to come down with Zika was identified in January as a Boston man. The state public health laboratory acquired the ability to test for Zika shortly after the outbreak began in South America and now processes dozens of samples a week, Brown said. Zika will hit hardest in South, where abortion, birth control are limitedThere’s little doubt: Zika is coming to the continental United States, bringing frightening birth defects. Brown emphasized that pregnant woman should avoid traveling to Zika-affected areas because the virus can cause birth defects or miscarriages. Pregnant women who travel to those areas are advised to be tested for Zika even if they have no symptoms. Otherwise, Zika is a not a big worry: 80 percent of infected people develop no symptoms, and those who get sick typically recover in two to seven days without needing treatment. Symptoms include fever, rash, joint pain, and conjunctivitis. Zika is spread chiefly by the Aedes aegypti species of mosquito, which does not live in New England. Another breed, the Aedes albopictus, can also transmit Zika and has occasionally been trapped in Massachusetts. The state has been keeping a close watch on a small commercial area in New Bedford, where albopictus mosquitoes have been breeding after being imported in discarded tires, Brown said.Because Massachusetts already tests mosquitoes for West Nile virus and Eastern equine encephalitis, Brown said, the state is well positioned to respond to emerging viruses and the arrival of new mosquito species. The state stepped up surveillance for albopictus mosquitoes in 2014, before the Zika outbreak, because the species can also carry dengue and other infections, she said. Felice J. Freyer can be reached at [email protected] Massachusetts already tests mosquitoes for West Nile virus and Eastern equine encephalitis, Brown said, the state is well positioned to respond to emerging viruses and the arrival of new mosquito species. Zika is spread chiefly by the Aedes aegypti species of mosquito, which does not live in New England. Another breed, the Aedes albopictus, can also transmit Zika and has occasionally been trapped in Massachusetts. The state has been keeping a close watch on a small commercial area in New Bedford, where albopictus mosquitoes have been breeding after being imported in discarded tires, Brown said. The state stepped up surveillance for albopictus mosquitoes in 2014, before the Zika outbreak, because the species can also carry dengue and other infections, she said. Felice J. Freyer can be reached at [email protected]. https://www.bostonglobe.com/metro/2016/05/11/zika-virus-has-infected-massachusetts-residents-who-traveled-abroad/BC7wxLABN3AxQlxhJvqbVP/story.html

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

This sonogram shows a rhesus macaque fetus 25 days after being infected. Sarah Kohn/Kathleen Antony/Saverio Capuano/Jennifer Post Zika causes microcephaly in miceBy Jon CohenMay. 11, 2016 , 1:00 PM By far the most alarming feature of the Zika virus now marching across South America and the Caribbean is its threat to fetuses. Last month the U.S. Centers for Disease Control and Prevention declared that “a causal relationship” exists between the virus and brain abnormalities in newborns—most noticeably a small head, known as microcephaly. But just how a mother’s infection harms the fetus, and how to prevent the damage, is uncertain. New animal models are now pointing to answers. Pregnant monkeys are showing hints of fetal damage. But the most dramatic results come from mice. Mouse studies published this week in Cell and its sister journal Cell Stem Cell and in Nature show precisely how the virus slows fetal growth, damages the brain, and leads to miscarriage. Two of them also prove for the first time in an animal model that Zika virus can cause microcephaly in fetuses. Together, the findings indicate that the virus by itself can wreak havoc, says Michael Diamond, a viral immunologist at Washington University in St. Louis in Missouri who led the Cell study. “Some people feel there are many cofactors like insecticides,” Diamond says. “Our study suggests at least you don’t have to invoke other things.” And by providing an animal model for the fetal damage, the studies should also ease the path for testing potential vaccines and treatments. Mice normally cannot sustain a Zika infection because the virus triggers secretion of interferons, molecules that bolster immune responses. Diamond’s lab circumvented this problem by creating female mice that had a key interferon gene knocked out; in a second experiment, they treated pregnant animals with an anti-interferon antibody. The team then injected pregnant females with a virus isolated from a person in French Polynesia; the isolate is 99% genetically similar to the one now circulating in Latin America. In the knockout mice, the virus replicated to higher levels than in those treated with the antibody, killing most of the fetuses. The researchers found high levels of Zika virus in the placentas—1000 times more than in the mother’s blood—supporting the hypothesis that the virus harms the placenta, which, in turn, cuts the blood supply to the fetus, Diamond says. Pregnant mice treated with the antibody still made enough interferon to partially control the infection and allow the pups to survive. Mirroring effects seen in humans, they were born small, a condition known as intrauterine growth restriction. In both sets of mice, the virus also turned up in fetal heads, Diamond says, suggesting that it causes brain damage directly as well as by impairing the placenta. That’s consistent with earlier in vitro findings that Zika can infect and damage human neural precursor cells. Neither set of pups developed microcephaly, which Diamond says could be because the researchers infected the mothers so early during pregnancy that not much brain development had yet occurred. The two other mouse experiments, published in Cell Stem Cell and Nature, did document microcephaly. Neither team manipulated their mice to make them more susceptible to the virus. In the Cell Stem Cell study, Zhiheng Xu of the Chinese Academy of Sciences in Beijing sidestepped the mice’s natural resistance to Zika virus by injecting a Samoan isolate directly into fetal brains. In Nature, Fernanda Cugola of the University of São Paulo in Brazil and co-workers injected a Brazilian isolate into the tails of a strain of mice that are naturally immunocompromised. Diamond notes that the Brazilian-led team injected an “astronomical amount of virus” through the intravenous route, which may have sent the virus directly to the placenta and helped dodge the antiviral immune response. Both studies found malformations associated with microcephaly, including what’s known as cortical thinning and smaller brains. The two reports also showed that Zika virus infected and damaged neuronal stem cells harvested from mice and humans. “If you see consistent phenotypes in different models, the things that are happening are probably important,” says Guo-li Ming of Johns Hopkins University School of Medicine in Baltimore, Maryland, who led the earlier studies of Zika in human neural progenitor cells. The researchers who study these various mouse models acknowledge that they differ from humans in many critical ways. “It’s very difficult to study humans directly,” Diamond notes. Yet he stresses that these mouse models give insights into pathogenesis and will allow for high-throughput screening of drugs and vaccines against the virus. Pregnant mice engineered to have higher levels of Zika virus had smaller fetuses (top) than normal dams (bottom). Miner et al., Cell165, (19 May 2016) Monkeys are naturally infected with Zika virus and are far closer to humans in many ways, and at least a half-dozen studies are underway. In an unusual twist for the primate research community, investigators from four U.S. labs have been posting data from their monkey Zika experiments on their websites in near real time, before publication. “We decided that the best thing for the community was that information be made available as widely as possible and freely available,” says David O’Connor, whose group at the University of Wisconsin, Madison, is furthest along in studying Zika infection of pregnant monkeys. One pregnant rhesus macaque that O’Connor’s group is following was 50 days postinfection at last report, and a little more than halfway through her pregnancy. Sonograms of the fetus—which are posted online—“sort of” show evidence that the head circumference is small, but O’Connor and colleagues “are not drawing too much attention to it,” he says, because it’s not that far outside of the normal range. The group will know for sure after they perform a cesarean section on the mother—which will also let them obtain the placenta, normally eaten by rhesus mothers. “I hope we can accelerate the information about what’s going on in people,” he says. O’Connor points out that Zika-infected monkeys do not perfectly reflect humans, either, and he sees the various models as complementary. “We can learn a lot from the fact that pregnancies are quick in the mice and you can do much larger experiments, but in monkeys we can do experiments that are much more relevant to human pregnancy,” he says. “Clearly, we have a lot of work to do, but these experiments are opening up the possibility that Zika’s effects during pregnancy may be much more common than we initially thought.” Posted in: HealthzikaDOI: 10.1126/science.aaf5715 Jon CohenJon is a staff writer for Science. http://www.sciencemag.org/news/2016/05/zika-causes-microcephaly-mice

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

May 10 totals:

Zika virus (ZIKV) is an arbovirus belonging to the genus Flavivirus (familyFlaviviridae) and was first described in 1947 in Uganda following blood analyses of sentinel Rhesus monkeys1. Until the twentieth century, the African and Asian lineages of the virus did not cause meaningful infections in humans. However, in 2007, vectored by Aedes aegypti mosquitoes, ZIKV caused the first noteworthy epidemic on the Yap Island in Micronesia2. Patients experienced fever, skin rash, arthralgia and conjunctivitis2. From 2013 to 2015, the Asian lineage of the virus caused further massive outbreaks in New Caledonia and French Polynesia. In 2013, ZIKV reached Brazil, later spreading to other countries in South and Central America3. In Brazil, the virus has been linked to congenital malformations, including microcephaly and other severe neurological diseases, such as Guillain–Barré syndrome4, 5. Despite clinical evidence, direct experimental proof showing that the Brazilian ZIKV (ZIKVBR) strain causes birth defects remains absent6. Here we demonstrate that ZIKVBR infects fetuses, causing intrauterine growth restriction, including signs of microcephaly, in mice. Moreover, the virus infects human cortical progenitor cells, leading to an increase in cell death. We also report that the infection of human brain organoids results in a reduction of proliferative zones and disrupted cortical layers. These results indicate that ZIKVBR crosses the placenta and causes microcephaly by targeting cortical progenitor cells, inducing cell death by apoptosis and autophagy, and impairing neurodevelopment. Our data reinforce the growing body of evidence linking the ZIKVBR outbreak to the alarming number of cases of congenital brain malformations. Our model can be used to determine the efficiency of therapeutic approaches to counteracting the harmful impact of ZIKVBR in human neurodevelopment.

Fernanda R. Cugola,Isabella R. Fernandes,Fabiele B. Russo,Beatriz C. Freitas,João L. M. Dias,Katia P. Guimarães,Cecília Benazzato,Nathalia Almeida,Graciela C. Pignatari,Sarah Romero,Carolina M. Polonio,Isabela Cunha,Carla L. Freitas,Wesley N. Brandão,Cristiano Rossato,David G. Andrade,Daniele de P. Faria,Alexandre T. Garcez,Carlos A. Buchpigel,Carla T. Braconi,Erica Mendes,Amadou A. Sall,Paolo M. de A. Zanotto,Jean Pierre S. Peron,Alysson R. Muotri& Patricia C. B. Beltrão-BragaAffiliationsUniversity of São Paulo, Department of Surgery, Stem Cell Laboratory, São Paulo, São Paulo 05508-270, BrazilFernanda R. Cugola, Isabella R. Fernandes, Fabiele B. Russo, João L. M. Dias, Katia P. Guimarães, Cecília Benazzato, Nathalia Almeida, Graciela C. Pignatari & Patricia C. B. Beltrão-BragaUniversity of California San Diego, School of Medicine, Department of Pediatrics/Rady Children’s Hospital San Diego, Department of Cellular & Molecular Medicine, Stem Cell Program, La Jolla, California 92037-0695, USAIsabella R. Fernandes, Beatriz C. Freitas, Sarah Romero & Alysson R. MuotriTismoo, The Biotech Company, São Paulo, São Paulo 01401-000, BrazilFabiele B. Russo & Graciela C. PignatariUniversity of São Paulo, Department of Immunology, Neuroimmune Interactions Laboratory, São Paulo, São Paulo 05508-000, BrazilCarolina M. Polonio, Isabela Cunha, Carla L. Freitas, Wesley N. Brandão, Cristiano Rossato,David G. Andrade & Jean Pierre S. PeronUniversity of São Paulo, Department of Radiology and Oncology, USP School of Medicine, São Paulo, São Paulo 05403-010, BrazilDaniele de P. Faria, Alexandre T. Garcez & Carlos A. BuchpigelUniversity of São Paulo, Department of Microbiology, Institute of Microbiology Sciences, Laboratory of Molecular Evolution and Bioinformatics, São Paulo, São Paulo 05508-000, BrazilCarla T. Braconi, Erica Mendes & Paolo M. de A. ZanottoInstitute Pasteur in Dakar, Dakar 220, SénégalAmadou A. SallUniversity of São Paulo, School of Arts, Sciences and Humanities, Department of Obstetrics, São Paulo, São Paulo 03828-000, BrazilPatricia C. B. Beltrão-BragaContributionsF.R.G. derived the NPCs, neurons and neurospheres, performed the viral infections and cell analyses and analysed the data. I.R.F. performed the viral infections of cells, processed and analysed infected brain organoids, prepared manuscript figures and analysed the data. F.B.R. derived the NPCs, performed immunostainings and analyses, prepared manuscript figures and analysed the data. B.C.F. revised the manuscript and with S.R. generated the organoid cultures from iPSCs and assisted with the immunofluorescence staining and experimental design. J.L.M.D. performed macroscopic and microscopic staining and analyses of the mice. K.O.P.G. performed the TEM experiments, RNA extraction and quantification and histopathological analyses. C.B. and N.S. performed RNA extraction and quantification and prepared figures. G.C.P. performed cell cultures, analysed the data and revised the manuscript. C.M.P., I.C., C.L.F., W.N.B. and C.R. performed cell death qPCR assays and flow cytometry, D.G.A performed flow cytometry staining protocols and analysed the data. C.M.P., I.C. and D.G.A. infected and observed the pregnant mice daily. C.M.P., C.L.F., I.C. and C.R. processed the mouse tissues for virus quantification and further analyses. D.P.F., A.T.G. and C.A.B. performed the CT scans and analysed and plotted the data. C.T.B. and E.A.M. performed virus amplification, titration and gene expression analysis. A.A.S. provided MR766 and YFV-17D isolates and serological reagents. P.M.A.Z. designed the experiments and revised the manuscript. J.P.S.P., A.R.M. and P.C.B.B.-B. designed the experiments, analysed the data and wrote the manuscript. Competing financial interestsThe authors declare no competing financial interests. Corresponding authorsCorrespondence to: Patricia C. B. Beltrão-Braga or Alysson R. Muotri or Jean Pierre S. Peron

The Brazilian Zika virus strain causes birth defects in experimental modelsNature (2016) doi:10.1038/nature18296Received 08 March 2015 Accepted 04 May 2016 Published online 11 May 2016http://www.nature.com/nature/journal/vnfv/ncurrent/full/nature18296.html

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

May 11, 2016 DEPARTMENT OF HEALTH DAILY ZIKA UPDATE: THREE NEW TRAVEL-RELATED CASES TODAY IN VOLUSIA AND ORANGE COUNTIES 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 three new travel-related cases today with two new cases in Volusia County and one in Orange County.The Declaration of Public Health Emergency has been amended to include Volusia County. Of the cases confirmed in Florida, five cases are still exhibiting symptoms. According to the CDC, symptoms associated with the Zika virus last between seven to 10 days. Based on CDC guidance, several pregnant women who have traveled to countries with local-transmission of Zika have received antibody testing, and of those, seven have tested positive for the Zika virus. The CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. It is recommended that women who are pregnant or thinking of becoming pregnant postpone travel to Zika affected areas. County Number of Cases (all travel related) Alachua 4 Brevard 2 Broward 15 Clay 1 Collier 1 Hillsborough 3 Lee 4 Martin 1 Miami-Dade 44 Orange 8 Osceola 4 Palm Beach 7 Pasco 1 Pinellas 1 Polk 3 Santa Rosa 1 Seminole 2 St. Johns 1 Volusia 2 Cases involving pregnant women* 7 Total 112 *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 1,666 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 the 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.Florida currently has the capacity to test 6,451 people for active Zika virus and 2,063 for Zika antibodies.Federal Guidance on Zika: According to the 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.The CDC has put out guidance related to the sexual transmission of the Zika virus. This includes the CDC recommendation that if you have traveled to a country with local transmission of Zika you should abstain from unprotected sex.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/2016/05/051116-zika-update.html

County Number of Cases (all travel related) Alachua 4 Brevard 2 Broward 15 Clay 1 Collier 1 Hillsborough 3 Lee 4 Martin 1 Miami-Dade 44 Orange 8 Osceola 4 Palm Beach 7 Pasco 1 Pinellas 1 Polk 3 Santa Rosa 1 Seminole 2 St. Johns 1 Volusia 2 Cases involving pregnant women* 7 Total 112 *Counties of pregnant women will not be shared.

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

Latest Facts and Advisories as of 5/11/2016 [ Español (PDF)]Reported cases of Zika in New York City: 78 13 of the 78 cases were pregnant at the time of diagnosis;All cases contracted Zika while visiting other countries; andAll patients have recovered.http://www1.nyc.gov/site/doh/health/health-topics/zika-virus.page

Latest Facts and Advisories as of 5/11/2016 [ Español (PDF)]Reported cases of Zika in New York City: 78 13 of the 78 cases were pregnant at the time of diagnosis;All cases contracted Zika while visiting other countries; andAll patients have recovered.

Zika virus cases in Canada, as of May 5, 2016CountryLocally acquired through sexual transmissionTravel-relatedCanada167 http://www.healthycanadians.gc.ca/diseases-conditions-maladies-affections/disease-maladie/zika-virus/surveillance-eng.php?id=zikacases#s1

Zika virus cases in Canada, as of May 5, 2016CountryLocally acquired through sexual transmissionTravel-relatedCanada167

TABLE I. Provisional cases of selected* infrequently reported notifiable diseases (<1,000 cases reported during the preceding year), United States, week ending May 7, 2016 (WEEK 18)†http://wonder.cdc.gov/mmwr/mmwr_2016.asp?mmwr_year=2016&mmwr_week=18&mmwr_table=1&request=Submit&mmwr_location= Disease Total cases reported for previous years Current weekCum 20165-year weekly average§20152014201320122011States reporting cases during current week (No.18) Anthrax-------1 Arboviral diseases ¶,**: Chikungunya virus ††-292863NNNNNNNN Eastern equine encephalitis virus---688154 Jamestown Canyon virus §§---8112223 La Crosse virus §§---55808578130 Powassan virus-107812716 St. Louis encephalitis virus--02310136 Western equine encephalitis virus-------- Botulism, total-464193161152168153 foodborne-41371542724 infant-37213512713612397 other(wound & unspecified)-502119121832 Brucellosis-273121929911479 Chancroid26012--158WA (1 ), CA (1 ) Cholera--025141740 Cyclosporiasis **1102635388784123151IA (1 ) Diphtheria--0-1-1- Haemophilus influenzae, invasive disease (age <5 yrs) ¶¶: serotype b-712740313014 nontypeable serotype166414212814111593TX (1 ) other serotype-431125266233263230 unknown serotype373418439343748NYC (1 ), FL (1 ), AZ (1 ) Hansen's disease **-1428588818282 Hantavirus Infections **: Hantavirus infection (non-HPS) ††---1NNNNNNNN Hantavirus pulmonary syndrome (HPS)-511732213023 Hemolytic uremic syndrome, post-diarrheal **4455248250329274290NY (1 ), NE (1 ), VA (1 ), ID (1 ) Hepatitis B, virus infection perinatal-8135474840NP Influenza-associated pediatric mortality **, ***361313014116052118WI (1 ), TX (1 ), NM (1 ) Leptospirosis **11003638NNNNNNNYC (1 ) Listeriosis513711756769735727870NYC (1 ), GA (1 ), FL (2 ), TX (1 ) Measles †††314818566718755220MN (2 ), TN (1 ) Meningococcal disease, invasive §§§: serogroup ACWY-324104123142161257 serogroup B1243988999110159WA (1 ) other serogroup-402225172020 unknown serogroup4665146196298260323OH (1 ), TX (1 ), CO (1 ), CA (1 ) Novel influenza A virus infections ¶¶¶-10632131314 Plague--01310443 Poliomyelitis, paralytic-----1-- Polio virus infection, nonparalytic **-------- Psittacosis **-1078622 Q fever total **:-174149168170135134 acute-133128132137113110 chronic-402136332224 Rabies, human--011216 SARS CoV-------- Smallpox-------- Streptococcal toxic shock syndrome **-975300259224194168 Syphilis, congenital ****-906485458348322360 Toxic shock syndrome (staphylococcal) **1915559716578SC (1 ) Trichinellosis **-401114221815 Tularemia-154309180203149166 Typhoid fever1847367349338354390KY (1 ) Vancomycin-intermediate Staphylococcus aureus**340417521224813482OH (1 ), VA (1 ), TX (1 ) Vancomycin-resistant Staphylococcus aureus **---1--2- Viral hemorrhagic Fevers ††††: Crimean-Congo hemorrhagic fever----NPNPNPNP Ebola hemorrhagic fever----4NPNPNP Guanarito hemorrhagic fever----NPNPNPNP Junin hemorrhagic fever----NPNPNPNP Lassa fever----1NPNPNP Lujo virus----NPNPNPNP Machupo hemorrhagic fever----NPNPNPNP Marburg fever----NPNPNPNP Sabia-associated hemorrhagic fever----NPNPNPNP Yellow fever-------- Zika ††,§§§§ Zika virus congenital infectionNANANANNNNNNNNNN Zika virus disease, non-congenital infection34520NNNNNNNNNNVA (2 ), TX (1 )[ Export This Table ] [ Next Part ] [ NNDSS Interactive Tables ] [ Mortality Interactive Tables ] -: No reported cases N: Not reportable. NA: Not Available NN: Not Nationally Notifiable. NP: Nationally notifiable but not published. Cum: Cumulative year-to-date counts. * Case counts for reporting years 2015 and 2016 are provisional and subject to change. Data for years 2011 through 2014 are finalized. For further information on interpretation of these data, seehttp://wwwn.cdc.gov/nndss/document/ProvisionalNationaNotifiableDiseasesSurveillanceData20100927.pdf. † This table does not include cases from the U.S. territories. Three low incidence conditions, rubella, rubella congenital, and tetanus, are in Table II to facilitate case count verification with reporting jurisdictions. § Calculated by summing the incidence counts for the current week, the 2 weeks preceding the current week, and the 2 weeks following the current week, for a total of 5 preceding years. Additional information is available athttp://wwwn.cdc.gov/nndss/document/5yearweeklyaverage.pdf. ¶ Includes both neuroinvasive and nonneuroinvasive. Updated weekly reports from the Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases (ArboNET Surveillance). Data for West Nile virus are available in Table II. ** Not reportable in all reporting jurisdictions. Data from states where the condition is not reportable are excluded from this table, except for the arboviral diseases and influenza-associated pediatric mortality. Reporting exceptions are available athttp://wwwn.cdc.gov/nndss/downloads.html. †† Office of Management and Budget approval of the NNDSS Revision #0920-0728 on January 21, 2016, authorized CDC to receive data for these conditions. CDC is in the process of soliciting data for these conditions (except Zika virus, congenital infection). CDC and the U.S. states are still modifying the technical infrastructure needed to collect and transmit data for Zika virus congenital infections. §§ Jamestown Canyon virus and Lacrosse virus have replaced California serogroup diseases. ¶¶ Data for Haemophilus influenzae (all ages, all serotypes) are available in Table II. *** Please refer to the MMWR publication for weekly updates to the footnote for this condition. ††† Please refer to the MMWR publication for weekly updates to the footnote for this condition. §§§ Data for meningococcal disease (all serogroups) are available in Table II. ¶¶¶ Please refer to the MMWR publication for weekly updates to the footnote for this condition. **** Updated weekly from reports to the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. †††† Please refer to the MMWR publication for weekly updates to the footnote for this condition. §§§§ All cases reported have occurred in travelers returning from affected areas, with their sexual contacts, or infants infected in utero.National Notifiable Diseases Surveillance System (NNDSS) MMWR web application provided by CDC WONDER, http://wonder.cdc.gov

Zika ††,§§§§ Zika virus congenital infectionNANANANNNNNNNNNN Zika virus disease, non-congenital infection34520NNNNNNNNNNVA (2 ), TX (1 )