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Zika Virus and Birth Defects — Reviewing the Evidence for CausalitySonja A. Rasmussen, M.D., Denise J. Jamieson, M.D., M.P.H., Margaret A. Honein, Ph.D., M.P.H., and Lyle R. Petersen, M.D., M.P.H. April 13, 2016DOI: 10.1056/NEJMsr1604338 http://www.nejm.org/doi/full/10.1056/NEJMsr1604338?query=featured_home

Zika Virus and Birth Defects — Reviewing the Evidence for CausalitySonja A. Rasmussen, M.D., Denise J. Jamieson, M.D., M.P.H., Margaret A. Honein, Ph.D., M.P.H., and Lyle R. Petersen, M.D., M.P.H. April 13, 2016DOI: 10.1056/NEJMsr1604338 Share: http://www.nejm.org/doi/full/10.1056/NEJMsr1604338?query=featured_home

CDC Declares Zika–Microcephaly Link SolidThe U.S. health agency says it is important for pregnant women to take safe sex precautions and avoid mosquito bites By Dina Fine Maron on April 13, 2016 Share on FacebookShare on TwitterShare on RedditEmailPrintShare viaGoogle+Stumble Upon A baby born with microcephaly is held by his mother as they wait to see a doctor at Oswaldo Cruz Hospital on February 1, 2016 in Recife, Brazil. For illustration purposes only.Photo by Diego Herculano/Brazil Photo Press/LatinContent/Getty ImagesThe Zika virus is causally linked to microcephaly, the birth defect that leads to abnormally small head size in infants, the U.S. Centers for Disease Control and Prevention declared Wednesday in The New England Journal of Medicine. The agency said it has not found any definitive new evidence but has weighed the accumulating data connecting the two conditions and concluded that it was solid enough to call causative. The CDC pointed to compelling evidence from Brazil that highlights a suspicious temporal relationship between pregnant mothers becoming infected with the virus and their babies being born with microcephaly or other serious brain abnormalities. Researchers from the agency also weighed the biological plausibility of the connection, evaluating studiesthat found the virus in the brain tissue of affected fetuses and infants. Another deciding factor for them was the presence of microcephaly and other brain abnormalities in fetuses or infants who had presumably encountered the virus in utero—conditions that are otherwise relatively rare in the general population. Although the agency had already issued numerous travel alerts advising pregnant women to stay away from areas with Zika transmission, until now the link between the mosquito-borne virus and and various birth defects had only been considered strong —not definitive. Stating the connection definitively, the CDC staff wrote, “might lead to improved understanding of and adherence to public health recommendations.” The CDC is not issuing any new health recommendations. Instead, it reiterated its advice that pregnant women should take steps to avoid getting bit by mosquitoes. Because Zika can also be sexually transmitted, the agency says couples should use condoms for at least six months after a male partner’s Zika symptoms arise. There is no current evidence that women can transmit the virus via sexual contact. For more on Zika, see Scientific American’s Special Report. http://www.scientificamerican.com/article/cdc-declares-zika-microcephaly-link-solid/

April 13, 2016 DEPARTMENT OF HEALTH DAILY ZIKA UPDATE: NO NEW CASES TODAY Contact:Communications [email protected](850) 245-4111 Tallahassee, Fla.—In an effort to keep Florida residents and visitors safe and aware about the status of the Zika virus, the Florida Department of Health will issue a Zika virus update each week day at 2 p.m. Updates will include a CDC-confirmed Zika case count by county and information to better keep Floridians prepared. There are no new cases today. 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, five 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 13 Clay 1 Collier 1 Hillsborough 3 Lee 4 Miami-Dade 33 Orange 5 Osceola 4 Palm Beach 4 Polk 3 Santa Rosa 1 Seminole 1 St. Johns 1 Cases involving pregnant women* 5 Total 85 *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 1,360 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 15 counties included in the declaration– Alachua, Brevard, Broward, Clay, Collier, Hillsborough, Lee, Miami-Dade, Orange, Osceola, Palm Beach, Polk, Santa Rosa, Seminole and St. Johns – 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 6,774 people for active Zika virus and 1,551 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 are examining a possible link between the virus and harm to unborn babies exposed during pregnancy.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 onFacebook. For more information about the Florida Department of Health, please visitwww.FloridaHealth.gov. http://www.floridahealth.gov/newsroom/2016/04/041316-zika-update.html

Health confirmed 1,113 cases of microcephaly in the country The cases occurred in 416 municipalities, mostly in the Northeast. Other 3836 remain under investigation and 2,066 were discardeduntil the 9th of April, were confirmed 1,113 cases of microcephaly and other nervous system disorders, suggestive of congenital infection, throughout the country. In all, reported 7,015 suspected cases since the beginning investigations, in October 2015, and 2,066 were discarded. Other 3,836 are under investigation. The information is the new epidemiological bulletin of the Ministry of Health, released on Tuesday (12), containing the information passed on by state health departments. Of the total confirmed cases, 189 had laboratory confirmation to the Zika virus. However, the Ministry of Health points out that this figure does not represent adequately the total number of cases related to the virus. That is, the folder considers that there was infection Zika most of the mothers who had babies with a final diagnosis of microcephaly. The 1,113 confirmed cases occurred in 416 municipalities located in 22 Brazilian states: Alagoas, Bahia, Ceará, Maranhão, Paraíba , Pernambuco, Piauí, Rio Grande do Norte, Sergipe, Espírito Santo, Minas Gerais, Rio de Janeiro, Amapá, Amazonas, Pará, Rondônia, Distrito Federal, Goiás, Mato Grosso, Mato Grosso do Sul, Parana and Rio Grande do Sul. already 2,066 cases were discarded because of normal examinations or submit microcefalias and / or changes in the central nervous system by an infectious causes. in the same period, there were 235 suspected deaths of microcephaly and / or alteration of the central nervous system after delivery or during pregnancy (miscarriage or stillbirth). Of these, 50 were confirmed to microcephaly and / or alteration of the central nervous system. Other 155 remain under investigation and 30 were discarded. It should be noted that the Ministry of Health is investigating all cases of microcephaly and other disorders of the central nervous system, informed by the states, and the possible relationship with the Zika virus and other congenital infections. Microcephaly may be caused by , various infectious agents beyond Zika as Syphilis, Toxoplasmosis, Other Infectious Agents, Rubella, Cytomegalovirus and Herpes Viral. The Ministry of Health advises pregnant women to adopt measures to reduce the presence of the mosquito Aedes aegypti , with the elimination of breeding sites , and protect themselves from mosquito exposure, keeping doors and closed or screened windows, wear pants and long sleeved shirts and use repellents allowed to pregnant women. Distribution of reported cases of microcephaly by UF until April 9 2016 Regions and Federative UnitsMicrocephaly cases and / or malformations suggestive of congenital infection Total acumulado1 of reported cases from 2015 to 2016 research Confirmados2,3 Descartados4 Brazil 3,836 1,113 2,066 7,015 Alagoas 74 55 136 265 Bahia 667 203 144 1,014 Ceará 254 80 117 451 Maranhão 112 84 42 238 Paraíba 388 105 364 857 Pernambuco 873 312 664 1,849 Piauí 25 72 57 154 large northern river 295 85 34a 414 Sergipe 159 31 17 207 Northeast 2,847 1,027 1,575 5,449 Holy Spirit 96 6 19 121 Minas Gerais 31 two 46 79 Rio de Janeiro 281 35 78 394 Sao Paulo 163a 0 96 259 Southeast region 571 43 239 853 Acre 23 0b 12 35 Amapá 2c 3c 0c 5c Amazon 9 two two 13 For 23 1 0 24 Rondônia 4 3 5 12 Roraima * 6 16c 0c 0c 16c Tocantins 117 0 17 134 North region 194 9 36 239 Federal district two 4 31 37 Goiás 75 9 37 121 Mato Grosso 116 15 71 202 Mato Grosso do Sul 3 two 13 18 Midwest region 196th 30 152 378 Paraná 6 two 25 33 Santa Catarina 1 0 3 4 Rio Grande do Sul 21 two 36 59 South region 28 4 64 96 Source: Health Departments of the States and the Federal District (updated data until 04/09/2016). 1 Cumulative number of reported cases that met the definition of previous operating case (33 cm), and the definitions adopted in Surveillance Protocol (the from 09.12.2015) that defined the Head circumference 32 cm for newborns with 37 or more weeks of gestation and other protocol definitions. 2 present typical changes: indicative of congenital infection, as intracranial calcification, dilatation of the ventricles brain or changes in posterior fossa and other clinical signs observed by any imaging method or identification of Zika virus in laboratory tests. 3 were confirmed 189 cases by specific laboratory criteria for Zika virus (PCR and serology technique). 4 Discarded present exams normal by presenting microcephaly and / or congenital malformations confirmed by non - infectious causes or does not meet the case definitions. a. As reported by the Epidemiological Surveillance Center "Prof. Alexandre Vranjac ", the State Secretary of Health of São Paulo, 163 cases are under investigation for congenital infection. Of these, 39 are possibly associated with infection by Zika virus, but have not yet finalized the investigation. B. Reduction in value after review and correction (typo, classification) c. Maintained the figures for the previous week Epidemiologic. By Camila Bogaz, the Agency Health Care to press (61) 3315-3435 / 3580 http://combateaedes.saude.gov.br/noticias/514-saude-confirma-1-113-casos-de-microcefalia-no-pais

Confirmed Zika Cases in Oregon, 2016As of 4/12/2016 Travel-associated cases: 6 Oregon mosquito-acquired cases: 0 Total: 6

Latest Facts and Advisories as of 4/13/2016 [ Español (PDF)]Reported cases of Zika in New York City: 33 Six of the thirty-three cases were pregnant at the time of diagnosis;All cases contracted Zika while visiting other countries; andAll patients have recovered.

Map Update https://www.google.com/maps/d/u/0/edit?hl=en&hl=en&authuser=0&authuser=0&mid=zv94AJqgUct4.kT4qLMXp3SLU

Metro Health Reports New Zika Exposure Contact: Carol Schliesinger Public Relations Manager 210-207-8172 SAN ANTONIO (Apr. 13, 2016) – The San Antonio Metropolitan Health District reports now four confirmed Zika cases. Test results from 28 individuals came back negative from the Centers for Disease Control and Prevention (CDC). There are now a total of 17 individuals under investigation for possible infection. Zika summary: 4 confirmed cases28 test result were negative17 pending investigation In accordance with CDC guidelines, gender or pregnancy status will not be released along with case information and updates in order to protect the privacy of these individuals. The four individuals with confirmed cases acquired the infection while traveling abroad. The Zika virus is part of the same family as the viruses that cause yellow fever, West Nile, Chikungunya and dengue. Zika is primarily transmitted through the bite of infected Aedes mosquitoes. It can also be transmitted from a pregnant mother to her baby during pregnancy or around the time of birth. In rare cases, it can be transmitted through sexual activity or blood transfusion. For people who get sick, the illness is usually mild. For this reason, many people might not realize they have been infected. Common symptoms include fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin 2 to 7 days after being bitten by an infected mosquito. Due to a possible link between infection during pregnancy and microcephaly in the infant, pregnant women are strongly advised to delay travel to Zika-affected areas. If travel is unavoidable they should take extra precautions to prevent mosquito bites. See your healthcare provider if you are pregnant and have traveled to a Zika-affected area within the last 12 weeks. Additionally, pregnant women and women who are considering becoming pregnant who have a sex partner living in or traveling to Zika-affected areas should: abstain from sex (vaginal, anal, or oral)or use condoms correctly and consistently for the duration of the pregnancyMen who traveled to a Zika-affected area also should: abstain from sexor use condoms correctly and consistently for three months after their returnWith no treatment or vaccine available, the only protection against Zika is to avoid travel to Zika-affected areas. If you do travel to a country where Zika is present, the CDC advises strict adherence to mosquito protection measures: Use air conditioning or window/door screensUse mosquito repellant on skin and clothing, even during the dayWear long-sleeved shirts and long pantsEmpty standing water from outdoor containers (even small containers)See your healthcare provider if you develop a fever, rash, joint pain, or red eyes within two weeks after traveling. Be sure to tell your health care provider where you traveled.

Metro Health Reports New Zika Exposure Contact: Carol Schliesinger Public Relations Manager 210-207-8172 SAN ANTONIO (Apr. 13, 2016) – The San Antonio Metropolitan Health District reports now four confirmed Zika cases. Test results from 28 individuals came back negative from the Centers for Disease Control and Prevention (CDC). There are now a total of 17 individuals under investigation for possible infection. Zika summary: 4 confirmed cases28 test result were negative17 pending investigation In accordance with CDC guidelines, gender or pregnancy status will not be released along with case information and updates in order to protect the privacy of these individuals. The four individuals with confirmed cases acquired the infection while traveling abroad. http://www.sanantonio.gov/Health/News/NewsReleases/TabId/1626/ArtMID/9362/ArticleID/7219/Metro-Health-Reports-New-Zika-Exposure.aspx

Sequences producing significant alignments:Select:AllNone Selected:0AlignmentsDownloadGenBankGraphicsDistance 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|KU978616.1|Zika virus isolate Dominican_Rep-Rus-2-2016 polyprotein gene, partial cds883883100%0.0100%KU978616.1Select seq gb|KU963796.1|Zika virus isolate SZ-WIV01 polyprotein gene, complete cds877877100%0.099%KU963796.1Select seq gb|KU955589.1|Zika virus isolate Z16006 polyprotein gene, complete cds877877100%0.099%KU955589.1Select seq gb|KU926310.1|Zika virus isolate Rio-S1, complete genome877877100%0.099%KU926310.1Select seq gb|KU866423.1|Zika virus isolate Zika virus/SZ01/2016 polyprotein gene, complete cds877877100%0.099%KU866423.1Select seq gb|KU820899.2|Zika virus isolate ZJ03, complete genome877877100%0.099%KU820899.2Select seq gb|KU729218.1|Zika virus isolate BeH828305 polyprotein gene, complete cds877877100%0.099%KU729218.1Select seq gb|KU707826.1|Zika virus isolate SSABR1, complete genome877877100%0.099%KU707826.1Select seq gb|KU527068.1|Zika virus strain Natal RGN, complete genome877877100%0.099%KU527068.1Select seq gb|KU501215.1|Zika virus strain PRVABC59, complete genome877877100%0.099%KU501215.1Select seq gb|KU365780.1|Zika virus strain BeH815744 polyprotein gene, complete cds877877100%0.099%KU365780.1Select seq gb|KU365779.1|Zika virus strain BeH819966 polyprotein gene, complete cds877877100%0.099%KU365779.1Select seq gb|KU365777.1|Zika virus strain BeH818995 polyprotein gene, complete cds877877100%0.099%KU365777.1Select seq gb|KU312312.1|Zika virus isolate Z1106033 polyprotein gene, complete cds877877100%0.099%KU312312.1Select seq gb|KJ776791.1|Zika virus strain H/PF/2013 polyprotein gene, complete cds877877100%0.099%KJ776791.1Select seq gb|KU509998.2|Zika virus strain Haiti/1225/2014, complete genome874874100%0.099%KU509998.2Select seq gb|KU991811.1|Zika virus isolate Brazil/2016/INMI1 polyprotein gene, complete cds874874100%0.099%KU991811.1Select seq gb|KU940228.1|Zika virus isolate Bahia07, partial genome874874100%0.099%KU940228.1Select seq gb|KU926309.1|Zika virus isolate Rio-U1, complete genome874874100%0.099%KU926309.1Select seq gb|KU853013.1|Zika virus isolate Dominican Republic/2016/PD2, complete genome874874100%0.099%KU853013.1Select seq gb|KU853012.1|Zika virus isolate Dominican Republic/2016/PD1, complete genome874874100%0.099%KU853012.1Select seq gb|KU729217.2|Zika virus isolate BeH823339 polyprotein gene, complete cds874874100%0.099%KU729217.2Select seq gb|KU744693.1|Zika virus isolate VE_Ganxian, complete genome874874100%0.099%KU744693.1Select seq gb|KU501217.1|Zika virus strain 8375 polyprotein gene, complete cds874874100%0.099%KU501217.1Select seq gb|KU501216.1|Zika virus strain 103344 polyprotein gene, complete cds874874100%0.099%KU501216.1Select seq gb|KU365778.1|Zika virus strain BeH819015 polyprotein gene, complete cds874874100%0.099%KU365778.1Select seq gb|KU321639.1|Zika virus strain ZikaSPH2015, complete genome874874100%0.099%KU321639.1Select seq gb|KU940224.1|Zika virus isolate Bahia09, partial genome868868100%0.099%KU940224.1Select seq gb|KU870645.1|Zika virus isolate FB-GWUH-2016, complete genome868868100%0.099%KU870645.1Select seq gb|KU820898.1|Zika virus isolate GZ01 polyprotein gene, complete cds868868100%0.099%KU820898.1Select seq gb|KU740184.2|Zika virus isolate GD01 polyprotein gene, complete cds868868100%0.099%KU740184.2Select seq gb|KU761564.1|Zika virus isolate GDZ16001 polyprotein gene, complete cds868868100%0.099%KU761564.1Select seq gb|KU497555.1|Zika virus isolate Brazil-ZKV2015, complete genome868868100%0.099%KU497555.1Select seq gb|KU955590.1|Zika virus isolate Z16019 polyprotein gene, complete cds865865100%0.099%KU955590.1Select seq gb|KU922960.1|Zika virus isolate MEX/InDRE/Sm/2016, complete genome865865100%0.099%KU922960.1Select seq gb|KU922923.1|Zika virus isolate MEX/InDRE/Lm/2016, complete genome865865100%0.099%KU922923.1Select seq gb|KU820897.1|Zika virus isolate FLR polyprotein gene, complete cds865865100%0.099%KU820897.1Select seq gb|KU647676.1|Zika virus strain MRS_OPY_Martinique_PaRi_2015 polyprotein gene, complete cds865865100%0.099%KU647676.1Select seq gb|KU681081.3|Zika virus isolate Zika virus/H.sapiens-tc/THA/2014/SV0127- 14, complete genome859859100%0.099%KU681081.3Select seq gb|KU740199.1|Zika virus isolate VE_Ganxian2016 polyprotein gene, partial cds85785799%0.099%KU740199.1Select seq gb|KU955593.1|Zika virus isolate Zika virus/H.sapiens-tc/KHM/2010/FSS13025, complete genome841841100%0.098%KU955593.1Select seq gb|JN860885.1|Zika virus isolate FSS13025 polyprotein gene, partial cds841841100%0.098%JN860885.1Select seq gb|KU681082.3|Zika virus isolate Zika virus/H.sapiens-tc/PHL/2012/CPC-0740, complete genome838838100%0.098%KU681082.3Select seq gb|KF993678.1|Zika virus strain PLCal_ZV from Canada polyprotein gene, partial cds838838100%0.098%KF993678.1Select seq gb|KU872850.1|Zika virus isolate Dominican Rep-Rus-2016, NS2 partial cds81481493%0.099%KU872850.1Select seq gb|KU940227.1|Zika virus isolate Bahia08, partial genome803803100%0.096%KU940227.1Select seq gb|EU545988.1|Zika virus polyprotein gene, complete cds792792100%0.096%EU545988.1Select seq gb|HQ234499.1|Zika virus isolate P6-740 polyprotein gene, partial cds765765100%0.095%HQ234499.1

LOCUS KU978616 489 bp RNA linear VRL 09-APR-2016 DEFINITION Zika virus isolate Dominican_Rep-Rus-2-2016 polyprotein gene, partial cds. ACCESSION KU978616 VERSION KU978616.1 GI:1013874324 KEYWORDS . SOURCE Zika virus ORGANISM Zika virus Viruses; ssRNA viruses; ssRNA positive-strand viruses, no DNA stage; Flaviviridae; Flavivirus. REFERENCE 1 (bases 1 to 489) AUTHORS Karan,L.S., Fedorova,M.V., Grigorieva,Y.E., Zhurenkova,O.B., Koval,M.V., Voldokhina,A.V. and Shipulin,G.A. TITLE Direct Submission JOURNAL Submitted (25-MAR-2016) Central Research Institute of Epidemiology, Novogireevskaya Str., 3A, Moscow 111123, Russia COMMENT ##Assembly-Data-START## Sequencing Technology :: Sanger dideoxy sequencing ##Assembly-Data-END## FEATURES Location/Qualifiers source 1..489 /organism="Zika virus" /mol_type="genomic RNA" /isolate="Dominican_Rep-Rus-2-2016" /isolation_source="urine" /host="Homo sapiens" /db_xref="taxon:64320" /country="Russia" /collection_date="22-Mar-2016" /note="genotype: Asian" CDS <1..>489 /note="NS2a-NS2b" /codon_start=1 /product="polyprotein" /protein_id="AMU04544.1" /db_xref="GI:1013874325" /translation="LLALASCLLQTAISALEGDLMVLINGFALAWLAIRAMVVPRTDN ITLAILAALTPLARGTLLVAWRAGLATCGGFMLLSLKGKGSVKKNLPFVMALGLTAVR LVDPINVVGLLLLTRSGKRSWPPSEVLTAVGLICALAGGFAKADIEMAGPMAAVGLLI VSY" ORIGIN 1 ctgctggcct tggcctcgtg tcttttgcaa actgcgatct ccgccttgga aggcgacctg 61 atggttctca tcaatggttt tgctttggcc tggttggcaa tacgagcgat ggttgttcca 121 cgcactgata acatcacctt ggcaatcctg gctgctctga caccactggc ccggggcaca 181 ctgcttgtgg cgtggagagc aggccttgct acttgcgggg ggtttatgct cctctctctg 241 aagggaaaag gcagtgtgaa gaagaactta ccatttgtca tggccctggg actaaccgct 301 gtaaggctgg tcgaccccat caacgtggtg ggactgctgt tgctcacaag gagtgggaag 361 cggagctggc cccctagcga agtactcaca gctgttggcc tgatatgcgc attggctgga 421 gggttcgcca aggcagatat agagatggct gggcccatgg ccgcggtcgg tctgctaatt 481 gtcagttachttp://www.ncbi.nlm.nih.gov/nuccore/KU978616.1

Central Research Institute of Epidemiology has released partial Zika sequence from urine collected Mar 22, 2016, Dominican_Rep-Rus-2-2016.

TABLE I. Provisional* cases of selected† infrequently reported notifiable diseases (<1,000 cases reported during the preceding year), United States, week ending April 9, 2016 (WEEK 14) Disease Total cases reported for previous years Current weekCum 20165-year weekly average§20152014201320122011States reporting cases during current week (No.14) Anthrax-------1 Arboviral diseases ¶,**: Chikungunya virus ††-211804NNNNNNNN Eastern equine encephalitis virus---688154 Jamestown Canyon virus §§---8112223 La Crosse virus §§---55808578130 Powassan virus---7812716 St. Louis encephalitis virus--01910136 Western equine encephalitis virus-------- Zika virus ¶¶1316042NNNNNNNNMD (1 )

Zika virus ¶¶1316042NNNNNNNNMD (1 ) http://wonder.cdc.gov/mmwr/mmwr_2016.asp?mmwr_year=2016&mmwr_week=14&mmwr_table=1&request=Submit&mmwr_location=

April 13, 2016Congress Approves Bill to Spur Zika TreatmentsFrom Life Sciences Law & Industry Report FREE TRIAL By Jeannie Baumann April 12— Legislation (S. 2512) to accelerate development of countermeasures to combat the Zika virus passed the House April 12, clearing the way for approval by the White House. The bill, which would add the Zika virus to the list of diseases that are eligible for the Food and Drug Administration's priority review voucher program, passed the Senate in mid-March . The priority review voucher program allows the developer of a vaccine or treatment for a qualifying tropical disease to receive a voucher for FDA priority review for a second product of its choice. The House passed S. 2512 by voice vote. “The Zika virus is spreading rapidly, and to fight back, we need to make sure we have the necessary tools to prevent and treat the disease,” Sen. Al Franken (D-Minn.), the bill's primary sponsor, said in an April 12 statement. “Our bipartisan bill will encourage innovators to help stop the virus in its tracks, and I’m very pleased that we got the measure across the finish line. This is an important step to combat Zika, and I look forward to President Obama signing it into law.” NIH Still Needs MoneyBut the Zika priority review bill is moving forward as Republican appropriators have pushed back on President Barack Obama's separate request for $1.9 billion in supplemental spending to combat the Zika virus—which includes about $130 million for the National Institutes of Health to carry out work on vaccine development. Appropriators in both the House and the Senate called on the White House to re-purpose Ebola dollars. The White House transferred $589 million, which includes about $40 million in funding for Zika . But Anthony S. Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, said during a White House press conference April 11 that the stopgap funding isn't enough. “If we don't get the money that the president has asked for, we're not going to be able to take it to the point where we've actually accomplished what we need to do,” Fauci said. “The money that's being transferred over from the Ebola account will help bring us a little bit further, but it's still not what we want. When the president asked for $1.9 billion, we needed $1.9 billion.” More DangerousThe Zika virus has been spreading throughout the Americas and has primarily caused alarm for its link to serious birth defects. Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention, said April 11 that the latest research indicates the virus is even more dangerous than previously known. During the same press conference where Fauci spoke, she said the virus is linked to a broader set of complications in pregnancy, not just microcephaly but also prematurity, eye problems and some other conditions. She also said the Aedes aegypti mosquito that spreads the virus is now present in about 30 states, instead of the dozen or so that had been previously identified. Phyllis Arthur, managing director for infectious diseases and diagnostic products for the Biotechnology Innovation Organization, told Bloomberg BNA that the supplemental funding and the priority review voucher programs are interconnected and complementary incentives to spur development of vaccines for the benefit of the public health. BIO has endorsed S. 2512. Fauci has told lawmakers during Zika hearings that the NIH's job is to “de-risk” the chances that a vaccine is safe and effective by conducting or funding much of the early phase testing that allows the private sector to come in and conduct the clinical trials that will develop the drug. He told Bloomberg BNA in previous statements the NIH can't move the vaccine forward to the safety and efficacy testing stage without the supplemental money. NIH Director Francis S. Collins also told Bloomberg BNA that the stopgap money wasn't enough to develop a vaccine. BIO's Arthur told Bloomberg BNA if the NIH isn't able to get enough money to get to phase II testing, “I think we get stuck.” “If indeed the money comes to NIH and BARDA [more slowly], that is how slow the development will go,” she said, referring to theBiomedical Advanced Research and Development Authority. “It’s pivotal for both NIH and BARDA to have the funds they need to carry forward at least the phase II work, if not beyond because otherwise, it’s going to take a lot longer. A lot of the companies doing the initial work are the smaller biotechs. Those companies aren’t going to be able to find private capital to be able to go forward and do phase II and phase III trials. This doesn’t mean there’s not a partner on the other side. But you’ve got to get over the phase II hump.” A spokeswoman for the House Appropriations Committee told Bloomberg BNA that the committee's position remains unchanged from an April 6 statement in favor of repurposing Ebola dollars for the Zika virus. “It is quickest and most effective to use existing funds for these response activities now. If additional resources are needed, they can be considered in the FY 2017 Appropriations process,” the House aide told Bloomberg BNA April 12. But when asked during the White House press conference what happens if the stopgap funding runs out, Fauci replied, “Hopefully that will never happen, but we'll have to start raiding other accounts, and very important research on other diseases is going to suffer and suffer badly. So, I almost can't imagine that will happen.” To contact the reporter on this story: Jeannie Baumann in Washington [email protected] To contact the editor responsible for this story: Brian Broderick [email protected] For More InformationMore information on the bill is availablehttps://www.congress.gov/bill/114th-congress/senate-bill/2512. http://www.bna.com/congress-approves-bill-n57982069788/

HOUSTON, TX - The Zika virus needs to be taken seriously! “Everything we look at with this virus seems to be a bit scarier than we originally thought,” expressed Dr. Anne Schuchat, Principal Deputy Director with the Center for Disease Control. New information is out daily. Not only is Zika a problem in the first trimester of pregnancy, but potentially throughout the entire pregnancy. And while the virus is linked to microcephaly in babies, infected adults can also develop nerve conditions similar to multiple sclerosis. Here in Houston, we now have our 7th case of Zika. Kathy Barton, Chief of Public Affairs with Houston Health Department, explains that, “This was an older gentleman, between the ages of 65-70 who had traveled to El Salvador during the Christmas holidays.” The seven infected here in Houston had all traveled to either Central America or South America. None of them were pregnant, nor have they faced any nerve conditions. Just because we haven’t had transmission of Zika in Houston yet, doesn’t mean it can’t happen. “We certainly have aedes aegypti mosquitoes in Houston, and we’re encouraging people to reduce the breeding opportunities around their homes and to protect themselves,” says Barton. http://cw39.com/2016/04/12/7th-houston-zika-virus-infection-new-threats-discovered/'

Map Update https://www.google.com/maps/d/u/0/edit?hl=en&hl=en&authuser=0&authuser=0&mid=zv94AJqgUct4.kT4qLMXp3SLU

Friday, April 8, 2016 http://www.houstontx.gov/health/Epidemiology/Zika_Virus.html GenderAge RangeTravel HistoryTravel MonthConfirmation DateCase Status by CDCFemale60-64Colombia11/1512/22/2015Confirmed PositiveMale35-39Honduras12/1501/28/2016Confirmed PositiveFemale40-45Honduras12/151/29/2016Confirmed PositiveFemale0-10Honduras1/162/22/2016Confirmed PositiveFemale45-50Guatemala1/162/25/2016Confirmed PositiveFemale60-64El Salvador11/152/26/2016Confirmed PositiveMale65-70El Salvador11/15-01/20162/29/2016Confirmed Positive

Friday, April 8, 2016 http://www.houstontx.gov/health/Epidemiology/Zika_Virus.html GenderAge RangeTravel HistoryTravel MonthConfirmation DateCase Status by CDCFemale60-64Colombia11/1512/22/2015Confirmed PositiveMale35-39Honduras12/1501/28/2016Confirmed PositiveFemale40-45Honduras12/151/29/2016Confirmed PositiveFemale0-10Honduras1/162/22/2016Confirmed PositiveFemale45-50Guatemala1/162/25/2016Confirmed PositiveFemale60-64El Salvador11/152/26/2016Confirmed PositiveMale65-70El Salvador11/15-01/20162/29/2016Confirmed Positive

Zika Virus – April 13, 2016. Texas has had 29 confirmed cases of Zika virus disease. Of those, 28 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 – 3Dallas – 5Denton – 1Fort Bend – 2Grayson – 1Harris – 11Tarrant – 3Travis – 2Wise – 1