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Maria G. Teixeira, PhD, Maria da Conceição N. Costa, PhD, Wanderson K. de Oliveira, MD, Marilia Lavocat Nunes, MSc, and Laura C. Rodrigues, PhDMaria G. Teixeira and Maria da Conceição N. Costa are with Instituto de Saúde Coletiva–Universidade Federal da Bahia, Salvador, Brazil. Wanderson Kleber de Oliveira and Marilia Lavocat Nunes are with Ministry of Health, Brasilia, Brazil. Laura C. Rodrigues is with London School of Hygiene and Tropical Medicine, London, England. Correspondence should be sent to Laura Rodrigues, London School of Hygiene and Tropical Medicine Keppel St, London WC1E 7HT, England (e-mail: [email protected]). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link.CONTRIBUTORS All authors have seen and approved the content and have contributed significantly to the work. M. G. Teixeira, L. C. Rodrigues, and M. C. N. Costa wrote the first draft of the article and all authors read and contributed to successive drafts before approving the final version. Peer Reviewed Read More: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303113

Maria G. Teixeira, Maria da Conceição N. Costa, Wanderson K. de Oliveira, Marilia Lavocat Nunes, and Laura C. Rodrigues. The Epidemic of Zika Virus–Related Microcephaly in Brazil: Detection, Control, Etiology, and Future Scenarios. American Journal of Public Health: April 2016, Vol. 106, No. 4, pp. 601-605.doi: 10.2105/AJPH.2016.303113 Accepted on: Feb 3, 2016 The Epidemic of Zika Virus–Related Microcephaly in Brazil: Detection, Control, Etiology, and Future Scenarios http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303113

ABSTRACT Objectives. To provide an initial description of the congenital syndrome presumably associated with infection by Zika virus compared with other syndromes including congenital infections of established etiologies. Methods. We provide an overview of a published case series of 35 cases, a clinical series of 104 cases, and published and unpublished reports of clinical and laboratory findings describing cases diagnosed since the beginning of the epidemic of microcephaly in Brazil. Results. About 60% to 70% of mothers report rash during pregnancy; mainly in the first trimester. Principal features are microcephaly, facial disproportionality, cutis girata, hypertonia/spasticity, hyperreflexia, and irritability; abnormal neuroimages include calcifications, ventriculomegaly, and lissencephaly. Hearing and visual abnormalities may be present. Conclusions. Preliminary data suggest that severe congenital abnormalities are linked to Zika virus infection. Cases have severe abnormalities, and although sharing many characteristics with congenital abnormalities associated with other viral infections, abnormalities presumably linked to the Zika virus may have distinguishing characteristics. These severe neurologic abnormalities may result in marked mental retardation and motor disabilities for many surviving offspring. Policy Implications. Affected nations need to prepare to provide complex and costly multidisciplinary care that children diagnosed with this new congenital syndrome will require. Read More: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303115

Demócrito de Barros Miranda-Filho, PhD, Celina Maria Turchi Martelli, PhD, Ricardo Arraes de Alencar Ximenes, PhD, Thalia Velho Barreto Araújo, PhD, Maria Angela Wanderley Rocha, MsC, Regina Coeli Ferreira Ramos, MsC, Rafael Dhalia, PhD, Rafael Freitas de Oliveira França, PhD, Ernesto Torres de Azevedo Marques Júnior, PhD, and Laura Cunha Rodrigues, PhDDemócrito de Barros Miranda-Filho, Ricardo Arraes de Alencar Ximenes, Maria Angela Wanderley Rocha, and Regina Coeli Ferreira Ramos are with the University of Pernambuco, Recife, Brazil. Celina Maria Turchi Martelli, Rafael Dhalia, Rafael Freitas de Oliveira França, and Ernesto T. A. Marques Júnior are with The Research Center Aggeu Magalhães (CPqAM)/Oswaldo Cruz Foundation (Fiocruz), Recife. Thalia Velho Barreto Araújo and Ricardo Arraes de Alencar Ximenes are with the Federal University of Pernambuco, Recife. Laura Cunha Rodrigues is with the London School of Hygiene and Tropical Medicine, London, UK. Correspondence should be sent to Demócrito de Barros Miranda-Filho Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE, Brazil. CEP: 50100130 (e-mail: [email protected]). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link.CONTRIBUTORS D. B. Miranda-Filho, C. Maria Turchi Martelli, R. Arraes de Alencar Ximenes, T. Velho Barreto Araújo, and L. Cunha Rodrigues contributed to the concept and design or analysis and interpretation of data. All of the authors contributed to the drafting or revision of the article and approved the final version. Peer Reviewed Read More: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303115

Demócrito de Barros Miranda-Filho, Celina Maria Turchi Martelli, Ricardo Arraes de Alencar Ximenes, Thalia Velho Barreto Araújo, Maria Angela Wanderley Rocha, Regina Coeli Ferreira Ramos, Rafael Dhalia, Rafael Freitas de Oliveira França, Ernesto Torres de Azevedo Marques Júnior, and Laura Cunha Rodrigues. Initial Description of the Presumed Congenital Zika Syndrome. American Journal of Public Health: April 2016, Vol. 106, No. 4, pp. 598-600.doi: 10.2105/AJPH.2016.303115 Accepted on: Feb 3, 2016 Initial Description of the Presumed Congenital Zika Syndrome http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303115

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The Acute Disease Service (ADS) of the Oklahoma State Department of Health (OSDH) has received confirmation that three state residents acquired Zika during international travel to countries experiencing local transmission of the virus. These are the first laboratory confirmed cases of the virus in Oklahoma. The OSDH ADS will post weekly Zika case statistics each Thursday by 10:00 a.m. https://www.ok.gov/health/Disease,_Prevention,_Preparedness/Acute_Disease_Service/Disease_Information/Zika_Virus.html

https://www.ok.gov/health/Disease,_Prevention,_Preparedness/Acute_Disease_Service/Disease_Information/Zika_Virus.html The Acute Disease Service (ADS) of the Oklahoma State Department of Health (OSDH) has received confirmation that three state residents acquired Zika during international travel to countries experiencing local transmission of the virus. These are the first laboratory confirmed cases of the virus in Oklahoma. The OSDH ADS will post weekly Zika case statistics each Thursday by 10:00 a.m.

Zika Virus – March 10, 2016 Texas has had 22 confirmed cases of Zika virus disease. 21 were in travelers who were infected abroad and diagnosed after they returned home. 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 – 4Fort Bend – 1Harris – 10Tarrant – 2Travis - 2

Fourth imported case of Zika virus detected in CubaAccording to a press release from the Ministry of Public Health (Minsap), a fourth imported case of Zika virus has been detected in Cuba Author: ministerio salud publica | [email protected] march 10, 2016 09:03:49 The fourth imported case of Zika virus has been detected, corresponding to a 30 year old computer engineer from the city of Las Tunas, who arrived in the country from Venezuela (Caracas) on March 5, 2016. The patient is a resident at the University of Computer Sciences, where she works. The day after her arrival, she presented symptoms including headache, back pain, a rash on her face and torso, as well as a mild burning sensation when urinating, for which she was admitted to the Pedro Kouri Institute of Tropical Medicine (IPK), where a test for Zika was undertaken that same day. On March 8, the IPK laboratory confirmed that the Real-Time PCR test conducted on admittance to hospital had proven positive for the Zika virus. The patient remains hospitalized and is showing signs of good health, with a rash. Related informationSecond imported case of Zika virus detected in CubaThird imported case of Zika virus detected in Cubahttp://en.granma.cu/cuba/2016-03-10/fourth-imported-case-of-zika-virus-detected-in-cuba?utm_source=twitterfeed&utm_medium=twitter

Two pregnant women in Norway test positive for Zika virusHealth officials are investigating whether the mosquito-borne virus is linked to birth defects in the children of women who caught the virus while pregnant.Share on Facebook AP By: Staff The Associated Press Published on Thu Mar 10 2016STOCKHOLM — Health authorities in Norway say two pregnant women have tested positive for the zika virus after travelling in Latin America. The Norwegian Institute of Public Health on has recently tested dozens of people for the virus, mostly pregnant women. Jon Arne Roettingen told reporters Thursday that so far three tests came back positive. He said two of them were pregnant women and one was a man. All had visited areas affected by the virus in Latin America. Roettingen could not say whether the virus had affected the pregnancies of the infected women in any way but said they were being closely monitored by health care personnel. Health officials are investigating whether the mosquito-borne virus is linked to birth defects in the children of women who caught the virus while pregnant. http://www.metronews.ca/news/world/2016/03/10/2-pregnant-women-in-norway-test-positive-for-zika-virus.html?cq_ck=1457622801582

Zika VirusDiscovered in Uganda in 1947, Zika virus is a member of the flavivirus family. Other flaviviruses include dengue, yellow fever, and West Nile Virus. Like its relatives, Zika virus is primarily transmitted to humans through the bite of infected Aedes aegyptimosquitoes. In some circumstances that are not yet understood, the virus may also be transmitted from an infected pregnant woman to her baby during pregnancy or, rarely, around the time of birth. Spread of the Zika virus through blood transfusion and sexual contact have been reported. Most people who become infected with Zika virus do not become sick. For the 20 percent of people who do become sick, the illness is generally mild with symptoms that include fever, rash, joint pain or conjunctivitis (red eyes) and lasts several days to a week. A biting Aedes aegypti mosquito, which is responsible for transmitting Zika virus. Credit: CDCZika virus has circulated in areas of Africa and Southeast Asia, but was not known to cause large outbreaks. In 2007, it caused an outbreak in a new region, Yap Island in Micronesia. In 2013, the virus caused an even larger outbreak in French Polynesia. In May 2015, the Pan American Health Organization issued an alert regarding the first confirmed Zika virus infection in Brazil. Since that time, Brazil and other countries and territories in Central and South America, as well as the Caribbean (including Puerto Rico and the U.S. Virgin Islands) have experienced ongoing Zika virus transmission. In the continental United States, there has been no local Zika transmission via infected mosquitoes to date, but there have been cases of individuals infected with the Zika virus through travel to affected countries and one reported case of sexual transmission from a returning traveler. There have been reports of a serious birth defect of the brain called microcephaly in some babies born to mothers infected with Zika virus during pregnancy. Microcephaly is a condition in which a baby’s head is abnormally small and can be associated with incomplete brain development. Currently, it is unclear what link if any Zika infection may have to microcephaly. International research organizations are investigating. There have also been reports of Guillain-Barré syndrome (GBS) in some countries where Zika transmission is occurring. GBS is a rare autoimmune disorder in which damaged nerve cells cause muscle weakness and, sometimes, paralysis. Most people do recover from GBS, but some have permanent damage and, in rare cases, GBS leads to death. It is not known if Zika virus infection causes GBS, and the U.S. Centers for Disease Control and Prevention (CDC) is working to answer this important question. NIAID Zika Virus ResearchNIAID is working with its partners in government, academia and the pharmaceutical and biotechnology industries to better understand Zika virus, the disease it causes, and ways to combat it. Specifically, NIAID is accelerating research in areas such as the natural history of the disease, basic research on the Zika virus, how it causes disease (called pathogenesis), diagnostics to rapidly determine if someone is or has been infected with Zika and to distinguish from other flaviviruses, as well as treatments and vaccines. Transmission electron micrograph of Zika virus. Credit: CDCAlthough Zika virus is new to the Western Hemisphere, NIAID scientists and grantees have long studied Zika relatives, such as dengue and West Nile Virus. Those studies provide a springboard to accelerate investigations of Zika and may yield good approaches to developing therapeutics and vaccines that will combat Zika virus. On Jan. 22, 2016, NIAID issued a call to the research community highlighting its interest in funding research on Zika virus, including: Developing sensitive, specific, and rapid clinical diagnostic tests for Zika virusCreating treatments for Zika virus and broad spectrum antiviral drugs that would be effective against multiple flavivirusesDeveloping and testing vaccines to protect against Zika virus infection and advancing new vaccination strategiesConducting basic research to understand Zika virus infection, replication, pathogenesis, and transmission, as well as the biology of the mosquito vectorsDeveloping animal models that mimic Zika virus infection in people, so that researchers can investigate the progression of diseasePursuing studies on the evolution and emergence of Zika virus, including the identification of factors that affect host-range and virulencePerforming surveillance studies of the distribution and natural history of Zika virus andEvaluating the relative immune responses to Zika and other flaviviruses that may occur in the same geographical regions (especially dengue and yellow fever virus).Additionally, on Feb. 5, 2016, NIH published a notice to the research community seeking to fund studies designed to investigate how Zika virus infection affects reproduction, pregnancy and the developing fetus. Zika Virus Vaccine ResearchNIAID is actively working on vaccine candidates to prevent Zika virus infection. Fortunately, NIAID scientists had already created vaccine platforms for other flaviviruses that can be used as a starting point for a Zika vaccine. Specifically, NIAID is currently pursuing several vaccine approaches: A DNA-based vaccine that uses a strategy similar to an investigational flavivirus vaccine for West Nile Virus. That vaccine, which was developed by scientists at NIAID’s Vaccine Research Center, was found to be safe and induced an immune response when tested in a phase 1 clinical trial.A live-attenuated (live but weakened virus, so that it cannot cause disease) investigational Zika vaccine building on a similar vaccine approach for the closely-related dengue virus.An investigational Zika vaccine that uses a genetically engineered version of vesicular stomatitis virus---an animal virus that primarily affects cattle. VSV was successfully used in an investigational Ebola vaccine tested by NIAID. This vaccine approach is at an early stage with plans underway to evaluate the Zika vaccine candidate in tissue culture and animal models.It is possible that an investigational Zika vaccine will be ready to enter early-stage human trials in 2016. An early-stage trial would examine whether an experimental vaccine is safe and generates immune responses in vaccinated volunteers. Zika Virus Treatment ResearchNIAID used its existing antiviral drug screening program for other flaviviruses, such as dengue West Nile, yellow fever, and Japanese encephalitis to create a test that could examine drug compounds for potential antiviral activity against Zika virus. It is also looking at antivirals with activity against hepatitis C, which is not a flavivirus but is closely related. NIAID will make this test available to the research community and will soon test several antiviral compounds with activity against other flaviviruses to determine if they are effective against Zika virus. The goal is to develop a broad-spectrum antiviral drug that could be used to treat a variety of flaviviruses, including Zika. Related LinksZika Virus Health Information Resources—Disaster Information Resource Center, National Library of Medicine, NIH CDC Information on Zika Virus Notice of NIAID's Interest to Highlight High-Priority Zika virus (ZIKV) Research Areas Zika Virus Infection and Zika-Associated Fetal Infection/Microcephaly (article in Harrison’s Principles of Internal Medicine online, coauthored by NIAID Director Anthony S. Fauci, M.D., and Dr. David M. Morens)—Feb. 8, 2016 Media Advisory: NIH Seeks Research Applications to Study Zika in Pregnancy, Developing Fetus—Feb. 5, 2016 Dengue Vaccine Enters Phase 3 Trial in Brazil—Jan. 14, 2016 Zika Virus in the Americas---Yet Another Arbovirus Threat (commentary in the New England Journal of Medicine, co-authored by NIAID Director Anthony S. Fauci, M.D., and Dr. David Morens)—Jan. 13, 2016 Last Updated February 25, 2016 Last Reviewed February 05, 2016 https://www.niaid.nih.gov/topics/zika/Pages/default.aspx

Norwegian pregnant woman tested positive for zikavirusetThree Norwegians totally infected by the virus.ANDERS HOLTH [email protected] LERAAN [email protected] 10 March 2016 , 12 noon: 58 TELL US IN 2400 BER PREGNANT EXPOSE TRAVEL: Maria was born with a deformed brain, probably as a result of her mother being stung by mosquitoes and infected her with zikaviruset. Video: NTB Scanpix At least one pregnant woman in Norway tested positive for zikaviruset, according to Public Health (FHI). A total of 50 samples have been analyzed since they foster medical centers began offering testing in this country in February.- There have been people who have been out and pregnant women have investigated them when they come to Norway. Three people have tested positive.At least one of them is pregnant, said Dr. Jorgen Bjørnholt in FHI to Dagbladet. NIPH has made travelwhere they discourage pregnant women to travel to areas where they risk being infected by zikavirus. - But this is not something that is transmitted further in Norway. The women have been infected abroad and do not spread further. It is a disease that is transmitted through mosquitoes. If a man is infected, the virus can survive in the semen and handed over, says Bjørnholt Dagbladet.http://www.dagbladet.no/2016/03/10/nyheter/innenriks/zikaviruset/zikafeber/43467780/

Zika fourth case in CubaIn this article: Cuba , Health , ZikaMarch 10, 2016 | + | Information note by the Ministry of Public Health the fourth imported case of patient confirmed with virus Zika, which corresponds to a computer, natural engineer of the city and province of Las Tunas, 30 years old, who arrived in the country from Venezuela (Caracas) on 05 Diagnosed / 03/2016, resident at the University of Computer Science, where he works. Begins the day after his arrival with symptoms of headache, back pain, rash on the face and trunk, as well as discreet burning when urinating, which is entered in the IPK, performing sampling for isolation Zika that day. The March 8 reported by the laboratory of the Institute of Tropical Medicine, the real-time PCR performed on the patient at the time of admission, is positive for Zika virus. It now remains hospitalized in good general condition and rash.

Cuba has reported its 4th Zika case in a traveler returning from Venezuela. http://www.cubadebate.cu/noticias/2016/03/10/cuarto-caso-de-zika-en-cuba/#.VuFnkUIrKds

Norsk pregnant woman has tested positive for ZikaNorwegian Institute of Public Health announced that three people have tested positive for zikaviruset. At least one of them is a pregnant woman, reports several media. - Three have tested positive, says chief physician Jørgen Bjørnholt according to NRK. http://www.svd.se/norsk-gravid-kvinna-har-testat-positivt-for-zika/om/varlden

Registration Date: 09/03/2016 18:03:00 the amended 09/03/2016 19:03:59 thehttp://portalsaude.saude.gov.br/index.php/cidadao/principal/agencia-saude/22554-saude-investiga-4-231-casos-de-microcefaliaREPORT CARDHealth investigated 4,231 cases of microcephalyIt has been confirmed 745 cases of microcephaly and other nervous system disorders, suggestive of congenital infection. Other 1,182 cases were discarded The Ministry of Health is investigating 4,231 suspected cases of microcephaly and other nervous system disorders, suggestive of congenital infection. Cases already analyzed, 745 were confirmed and 1,182 discarded.Since the beginning of the investigation have been reported 6,158 suspected cases of microcephaly. Data from epidemiological report from the Ministry of Health are sent weekly by the state departments of Health and were closed on Saturday, March 05. The 745 confirmed cases occurred in 282 municipalities located in 18 Brazilian states: Alagoas, Bahia, Ceará, Maranhão, Paraíba, Pernambuco, Piauí, Rio Grande do Norte, Sergipe, Espírito Santo, Minas Gerais, Rio de Janeiro, Pará, Rondônia , Goiás, Mato Grosso, Mato Grosso do Sul and Rio Grande do Sul. the 1,182 cases were classified discarded because they had normal exams, or submit microcefalias and / or changes in the central nervous system by an infectious causes. The 6,158 cases reported since the beginning of the investigation, are distributed in 1,179 municipalities, from all regions of the country. Most were registered in the Northeast (4,827 cases, which corresponds to 80%), and the state of Pernambuco is the federation of the unit with the highest number of cases are still being investigated (1214). Next are Bahia (609), Paraíba (447), Rio de Janeiro (289), Rio Grande do Norte (278) and Ceará (252). 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 can be caused by various infectious agents beyond Zika as Syphilis, Toxoplasmosis, Other Infectious Agents, Rubella, Cytomegalovirus and Herpes Viral. Until March 5, there were 157 suspected deaths of microcephaly and / or alteration of the central nervous system after birth or during pregnancy (miscarriage or stillbirth). Of these, 37 were confirmed to microcephaly and / or alteration of the central nervous system. Another 102 are still under investigation and 18 were discarded. Of the total confirmed cases of microcephaly, 88 tested positive for Zika. In these cases, specific laboratory test was used to 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. To date, signaled to the Ministry of Health to indigenous circulation of Zika virus 22 Brazilian states: Goiás, Minas Gerais, Federal District, Mato Grosso do Sul, Roraima, Amazonas, Pará, Rondônia, Mato Grosso, Tocantins, Maranhão, Piauí, Ceara, Rio Grande do Norte, Paraiba, Pernambuco, Alagoas, Bahia, Espirito Santo, Rio de Janeiro, São Paulo and Paraná. Distribution of reported cases of microcephaly by UF until March 5, 2016 Regions and Federative Units Microcephaly cases and / or malformations suggestive of congenital infection Cumulative total of reported cases from 2015 to 2016 research confirmed discarded Brazil 4,231 745 1,182 6,158 Alagoas 95 30 104 229 Bahia 609 156 98 863 Ceará 252 41 70 363 Maranhão 143 32 26 201 Paraíba 447 71 308 826 Pernambuco 1,214 241 267 1,722 Piauí 65 50 24 139 large northern river 278 78 27 383 Sergipe 162 26 13 201 Northeast 3,265 725 937 4,927 Holy Spirit 78 3 9 90 Minas Gerais 27 1 43 71 Rio de Janeiro 289 two 4 295 Sao Paulo 137 0 44 181 Southeast region 531 6 100 637 Acre 26 0 0 26 Amapá 0 0 0 0 Amazon 8 0 0 8 For 17 1 0 18 Rondônia 6 two 3 11 Roraima 14 0 0 14 Tocantins 108 0 17 125 North region 179 3 20 202 Federal district 11 0 20 31 Goiás 84 6 14 104 Mato Grosso 123 3 52 178 Mato Grosso do Sul 9 1 5 15 Midwest region 227 10 91 328 Paraná two 0 17 19 Santa Catarina 1 0 1 two Rio Grande do Sul 26 1 16 43 South region 29 1 34 64 By Camila Bogaz, Health Agency Service: (61) 3315.3580

Brazil Releases New Figures on Zika CasesMarch 09, 2016, 08:45:00 PM EDT By Dow Jones Business NewsComment Shutterstock photoSÃ O PAULO—The Brazilian government released new figures Wednesday showing the number of suspected and confirmed cases of babies born with undersized skulls and brains continues to rise. Brazil's health ministry released figures confirming 104 additional cases of infants born with the congenital abnormality called microcephaly in the past week. Since Oct. 22, when reporting microcephaly became obligatory in Brazil, there have been a total of 745 confirmed microcephaly cases, the ministry said. Lab testing has confirmed the presence of the mosquito-borne Zika virus in 88 of those cases so far. For male babies, the new measure will be 31.9 centimeters or less; for females it will be 31.5 cm or less. Previously, the ministry standard was 32 centimeters or less for both male and female newborns. The ministry's decision is aimed at reducing the number of false positives when diagnosing suspected microcephaly cases. Reporting and testing has been hampered, in part, because of different measuring standards globally. Some health authorities and researchers have been calling for the adoption of a uniform international standard. "The change is in line with the recommendation recently announced by the World Health Organization, and aims to standardize the references to all countries, valid for babies born at 37 or more weeks of gestation," the Brazilian ministry said in a statement. Although the link between Zika and microcephaly hasn't been scientifically proven, many doctors, researchers and health authorities in Latin America, the U.S. and elsewhere regard it as increasingly probable. Earlier this week, World Health Organization officials said there is gathering evidence of a link between microcephaly and the Zika virus, which has swept across the Americas in recent months. Of the 6,158 cases initially suspected to be Zika-related microcephaly reported in Brazil since October, a total of 1,182 have been rejected, either because tests showed they weren't microcephaly at all or they were microcephaly caused by other factors. Microcephaly can have many causes, including toxins, various infectious agents such as syphilis and rubella, or maternal alcohol or drug abuse. A total of 4,231 suspected microcephaly cases are still being investigated, up from 4,222 cases under investigation last week. Between last Oct. 22 and March 5, there have been 157 suspected microcephaly-related infant deaths nationwide in Brazil. Of these, a total of 37 have been confirmed as related to microcephaly or some other alteration of the nervous system, the ministry said. Eighteen deaths have been ruled unrelated to microcephaly, and 102 cases are still under investigation. Wednesday's new figures buttressed remarks made Tuesday evening in Geneva by Dr. Margaret Chan, director-general of the World Health Organization, and David Heymann, chair of WHO's emergency committee on Zika. The international health organization on February 1 declared Zika and its suspected side effects, including microcephaly and the neurological disorder Guillain-Barré syndrome, to constitute a global health emergency. Ms. Chan and Mr. Heymann acknowledged that although there still is no definitive scientific proof of the Zika- microcephaly link, they reiterated previous assertions made by WHO officials and other international health authorities that signs of a causal connection between the virus and microcephaly are mounting. The WHO is advising pregnant women to avoid traveling to areas of countries where Zika is prevalent, although Ms. Chan emphasized that it is incumbent on each individual woman to make her own decision. The WHO also is advising pregnant women to practice abstinence or safe sex, so as to prevent possible transmission of the Zika virus through intercourse. The organization's emergency committee also is urging "intensified" research into the suspected links between Zika, microcephaly and a host of other neurological disorders. Write to Rogerio Jelmayer at [email protected] and Reed Johnson at [email protected] Read more: http://www.nasdaq.com/article/brazil-releases-new-figures-on-zika-cases-20160309-01174#ixzz42V79srDU

Since Oct. 22, when reporting microcephaly became obligatory in Brazil, there have been a total of 745 confirmed microcephaly cases, the ministry said. Lab testing has confirmed the presence of the mosquito-borne Zika virus in 88 of those cases so far.Read more: http://www.nasdaq.com/article/brazil-releases-new-figures-on-zika-cases-20160309-01174#ixzz42V68aufk

¶¶ This table does not include cases from the U.S. territories. There may be some delay between identification of a case and reporting to CDC. All cases reported are travel related. 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.

Disease Total cases reported for previous years Current weekCum 20165-year weekly average§20152014201320122011States reporting cases during current week (No.09) Anthrax-------1 Arboviral diseases ¶,**: Chikungunya virus ††-10772NNNNNNNN Eastern equine encephalitis virus--0688154 Jamestown Canyon virus §§---8112223 La Crosse virus §§---52808578130 Powassan virus---6812716 St. Louis encephalitis virus---1910136 Western equine encephalitis virus-------- Zika virus ¶¶-160033NNNNNNNN

Tomorrow's MMWR for week 9 cites 193 Zika cases in the United States. http://wonder.cdc.gov/mmwr/mmwr_2016.asp?mmwr_year=2016&mmwr_week=09&mmwr_table=1&request=Submit&mmwr_location=

Test results pending in Travis County for Zika virusBy Sophia BeausoleilPublished: March 9, 2016, 8:47 pmClick to share on Twitter (Opens in new window) Click to share on Google+ (Opens in new window) 1Share on Facebook (Opens in new window)1 Click to share on Pinterest (Opens in new window) Related CoverageRain leads to concern about Zika virus First confirmed case of Zika virus in Travis County AUSTIN (KXAN) — The Austin/Travis County Health and Human Services Department (A/TCHHSD) says 29 people Travis County are awaiting test results to find out whether they have the Zika Virus. Dr. Philip Huang, Medical Director and Health Authority for A/TCHHSD, said 18 of those tests are for pregnant women. “CDC recommends that pregnant women who are considering travel in any of the areas that have active transmission for where Zika is spreading that they continue postponing that travel,” said Dr. Huang during a city of Austin Health and Human Services Committee netting at city hall, Wednesday afternoon. The virus has spread across Central and South America and is linked to Congenital Microcephaly, a condition which causes a baby to have a tiny head and brain damage. Guillain-Barre syndrome has also been reported in patients after infection, according to the health and human services department. Zika is found in Aedes aegypti mosquitoes. An insect which is known for spreading other diseases like West Nile virus and dengue according to A/TCHHSD. The department says the mosquito that carries Zika is endemic to Central Texas. There are no current cases of the mosquito carrying the Zika virus in Central Texas. The way people are getting infected are by traveling to those effected regions and getting bitten. Experts also say the virus is spread through sexual transmission an blood. According to Huang, in Travis County as of March 3, they’ve sent specimens form 45 people for Zika virus testing. They’ve received eleven results which included two positives. A man and woman contracted the virus while traveling in Colombia, according to A/TCHHSD. The nine others turned back negative, including those of five pregnant women. Officials are still waiting for 29 more results but five additional specimens were not able to be tested. Symptoms from the virus include: FeverRashJoint painConjunctivitisThere are no vaccines or cures. Huang said the best thing people can do is protect themselves by wearing long sleeve shirts, Deet insect repellent, removing standing water and being mindful during the daytime, because the mosquitoes bite during the day as well.

The Austin/Travis County Health and Human Services Department (A/TCHHSD) says 29 people Travis County are awaiting test results to find out whether they have the Zika Virus. Dr. Philip Huang, Medical Director and Health Authority for A/TCHHSD, said 18 of those tests are for pregnant women. http://kxan.com/2016/03/09/test-results-pending-in-travis-county-for-zika-virus/