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ReferencesPan American Health Organization, World Health Organization. Epidemiological alert: neurologic syndrome, congenital malformations, and ZIKAV infection. Implications for public health in the Americas, 1 December 2015[cited 2016 Feb 6]. http://reliefweb.int/sites/reliefweb.int/files/resources/2015-dec-1-cha-epi-alert-zika-neuro-syndrome%2520%282%29.pdfBesnard M, Lastère S, Teissier A, Cao-Lormeau V, Musso D. Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014. Euro Surveill. 2014;19:20751. DOIPubMedDuffy MR, Chen TH, Hancock WT, Powers AM, Kool JL, Lanciotti RS, ZIKAV outbreak on Yap Island, Federated States of Micronesia. N Engl J Med. 2009;360:2536–43. DOIPubMedArzuza-Ortega L, Polo A, Pérez-Tatis G, López-García H, Parra E, Pardo-Herrera LC, Fatal sickle cell disease and Zika virus infection in girl from Colombia [letter]. Emerg Infect Dis. 2016 May [cited 2016 Feb 23]. DOIPubMedSchuler-Faccini L, Ribeiro EM, Feitosa IM, Horovitz DD, Cavalcanti DP, Pessoa A, Possible association between ZIKAV infection and microcephaly—Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65:59–62. DOIPubMedEuropean Centre for Disease Prevention and Control. Rapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome [cited 2016 Jan 31].http://ecdc.europa.eu/en/publications/Publications/zika-virus-americas-association-with-microcephaly-rapid-risk-assessment.pdfOliveira Melo AS, Malinger G, Ximenes R, Szejnfeld P, Alves Sampaio S, Bispo de Filippis A. ZIKAV intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg? Ultrasound Obstet Gynecol.2016;47:6–7 . DOIPubMedVentura CV, Maia M, Bravo-Filho V, Gois AL, Belfort R Jr. ZIKAV in Brazil and macular atrophy in a child with microcephaly. Lancet. 2016;387:228. DOIPubMedWorld Health Organization. IHR procedures concerning public health emergencies of international concern (PHEIC).2016 [cited 2016 Feb 2]. http://www.who.int/ihr/procedures/pheic/en/Cha AE, Dennis B, Murphy B. Zika virus: WHO declares global public health emergency, says causal link to brain defects ‘strongly suspected.’ Washington Post. 2016 [cited 2016 Feb 2]. https://www.washingtonpost.com/news/to-your-health/wp/2016/02/01/zika-virus-who-declares-global-public-health-emergency-given-rapid-spread-in-americas/Pan American Health Organization, World Health Organization. Countries and territories with autochthonous transmission in the Americas reported in 2015–2016 [cited 2016 Feb 26]. http://www.paho.org/hq/index.php?option=com_content&view=article&id=11603&Itemid=41696&lang=enHennessey M, Fischer M, Staples JE. ZIKAV spreads to new areas—region of the Americas, May 2015–January 2016.MMWR Morb Mortal Wkly Rep. 2016;65:55–8. DOIPubMedLive Birth Information System Brazil (SINASC). Characteristics of microcephaly and other defects. Panel 3 [cited 2016 Feb 6]. https://public.tableau.com/profile/bruno.zoca#!Cardoso CW, Paploski IA, Kikuti M, Rodrigues MS, Silva MM, Campos GS, Outbreak of exanthematous illness associated with Zika, chikungunya, and dengue viruses, Salvador, Brazil. Emerg Infect Dis. 2015;21:2274–6.DOIPubMedLive Birth Information System Brazil (SINASC). Microcephaly in Brazil, 2000–2016. Panel 2 [cited 2016 Feb 26].https://public.tableau.com/profile/bruno.zoca#!Live Birth Information System Brazil (SINASC). Live birth data for states in Brazil [cited 2016 Feb 4].http://tabnet.datasus.gov.br/cgi/tabcgi.exe?sinasc/cnv/nvBA.defMiller E, Cradock-Watson JE, Pollock TM. Consequences of confirmed maternal rubella at successive stages of pregnancy. Lancet. 1982;2:781–4. DOIPubMedBodéus M, Kabamba-Mukadi B, Zech F, Hubinont C, Bernard P, Goubau P. Human cytomegalovirus in utero transmission: follow-up of 524 maternal seroconversions. J Clin Virol. 2010;47:201–2. DOIPubMedPass RF, Fowler KB, Boppana SB, Britt WJ, Stagno S. Congenital cytomegalovirus infection following first trimester maternal infection: symptoms at birth and outcome. J Clin Virol. 2006;35:216–20. DOIPubMedVictora CG, Schuler-Faccini L, Matijasevich A, Ribeiro E, Pessoa A, Barros FC. Microcephaly in Brazil: how to interpret reported numbers? Lancet. 2016;387:621–4. DOIPubMedMinistry of Health Brazil. Monitoramento dos casos de microcefalia no Brasil [cited 2016 Feb 15].http://portalsaude.saude.gov.br/images/pdf/2016/fevereiro/12/COES-Microcefalias-Informe-Epidemiologico-12-SE-05-2016-12fev2016-13h30.pdfOduyebo T, Petersen EE, Rasmussen SA, Mead PS, Meaney-Delman D, Renquist CM, Update: interim guidelines for health care providers caring for pregnant women and women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep. 2016;65:122–7. DOIPubMedFleming-Dutra KE, Nelson JM, Fischer M, Staples JE, Karwowski MP, Mead P, Update: interim guidelines for health care providers caring for infants and children with possible Zika virus infection—United States, February 2016.MMWR Morb Mortal Wkly Rep. 2016;65:182–7. DOIPubMedFiguresFigure 1. Projection of birth months after Zika virus (ZIKAV) transmission and occurrence of microcephaly, Salvador, Bahia State, Brazil. Weekly pregnancy cohorts are based on 40-week pregnancies and monthly reports of...Figure 2. Projection of anticipated birth months after Zika virus (ZIKAV) transmission in a hypothetical country. Projected birth months for weekly pregnancy cohorts are based on 40-week pregnancies in a hypothetical...Technical Appendix. Modifiable spreadsheet for projecting periods of delivery of at-risk infants after Zika virus disease outbreaks. 52 KB Suggested citation for this article: Reefhuis J, Gilboa SM, Johansson MA, Valencia D, Simeone RM, Hills SL, et al. Projecting month of birth for at-risk infants after Zika virus disease outbreaks. Emerg Infect Dis. 2016 May [date cited].http://dx.doi.org/10.3201/eid2205. http://dx.doi.org/10.3201/eid2205.160290 DOI: 10.3201/eid2205.160290 Table of Contents – Volume 22, Number 5—May 2016

DiscussionOur projections, based on ecologic data, indicate that in Bahia State, Brazil, ZIKAV infection during the first trimester or early in the second trimester of pregnancy is temporally associated with the observed increase in infants born with microcephaly; this projection is consistent with the observed reported decline for January and February 2016. This finding adds to pathologic findings documenting ZIKAV infection in several infants with microcephaly (7,8). To create a more precise projection of when to expect the first full-term births to mothers who were infected with ZIKAV during their second trimester of pregnancy, readers can refine our model by using our modified spreadsheet tool (Technical Appendix) and local data from countries in which ZIKAV is transmitted. Understanding the timing of ZIKAV infection of pregnant women is key because the effects of ZIKAV infection on pregnancy and fetal and infant outcomes is likely to vary by gestational timing, as has been demonstrated for other congenital infections such as rubella and cytomegalovirus; transmission risk may also vary according to gestational timing (17,18). For rubella, risk for adverse fetal effects is highest during the first trimester; for cytomegalovirus, risk is highest during the first trimester but is also present after exposure during the second or third trimesters (17,19). For countries currently experiencing ZIKAV disease outbreaks, it will be several months before the first pregnancies during which ZIKAV exposure could have occurred will reach term, particularly if the critical period of pregnancy is in the first or second trimester, as our data suggest. Our hypothetical data (Figure 2) demonstrate the time between high levels of ZIKAV transmission during pregnancy and pregnancy outcomes for each weekly cohort of pregnant women. With some shifting of dates, these projections could apply to many countries in South and Central America that are currently experiencing outbreaks of ZIKAV disease. We found ecologic evidence of a temporal relationship between maternal ZIKAV infection during pregnancy and congenital microcephaly in Bahia State and the possible gestational time when risk is highest (Figure 1). This relationship does not necessarily imply causality, but it does give additional credence to the pathological findings and case reports that suggest a link between ZIKAV infection and microcephaly (1,5). Assessing this relationship in other states in Brazil or other locations would have been informative, but very limited data on the spread of ZIKAV are available. One limitation of the projections was that the estimated ZIKAV epidemic curve for Bahia State was based on Salvador, the capital city, which contains only ≈18% of the population of Bahia State. It is unknown whether the timing of the outbreak in Salvador was similar to that in the remainder of the state, which served as the basis for the microcephaly case numbers. Also, the epidemic curve for ZIKAV disease is not based solely on laboratory-confirmed cases, but rather it includes both suspected and confirmed ZIKAV cases determined primarily on the basis of clinical presentation. The microcephaly data probably include some reporting delays, especially for January and February. Moreover, these projections assume a true association between maternal ZIKAV infection and infant microcephaly; other maternal cofactors, such as other infections or environmental exposures, might account for some or all of the observed temporal relationship. The effects of the imprecision of some of the factors just described are unknown. Countries that can repeat this exercise with more precise prospective data will be better able to describe the expected critical exposure window, and if risk estimates for outcomes such as microcephaly and Guillain-Barré syndrome after ZIKAV infection become available, the expected number of individuals who will be affected during a certain period can be predicted. Some of the reported cases of microcephaly included in the graph are still being assessed, and some might not meet the final case definition for microcephaly in Brazil (i.e., head circumference <32 cm) (20); increased attention to the possible association between ZIKAV infection and microcephaly may have led to overascertainment. However, the rate of false-positive reports was lower in Bahia than in other states in Brazil (21). Data on births of infants with microcephaly were available for September 2015–February 2016, and although the data from January and February 2016 are probably not complete, they do show a decline in the number of infants born with microcephaly. Maternal–fetal transmission might result in other adverse pregnancy outcomes, and the full range of these outcomes is of interest; however, our study accounts for microcephaly only. Also, our assumption of 40-week pregnancies does not account for possible differences in gestational age or for fetal losses and miscarriages, although early case reports do not indicate high rates of prematurity (5). If infants with microcephaly were consistently born premature, the relevant exposure period would be delayed to include more of the second trimester. We assumed that the birth rates in these models remain constant throughout the year, which is not true for all locations. The data for ZIKAV infection and infants with microcephaly are based on dates of report, which are probably later than actual occurrence. Despite these limitations, our assessments provide some indication that the period of highest risk might be during the first trimester or early in the second trimester of pregnancy. This assessment can help inform public health officials about risks for microcephaly and help them plan for deliveries in areas where ZIKAV disease outbreaks occur. Conducting surveillance for microcephaly but also other pregnancy outcomes such as pregnancy loss and other birth defects will enable continued evaluation of any effects of ZIKAV disease might have on pregnancy. These data also emphasize the role of arboviral disease–tracking activities for informing public health planning. The US Centers for Disease Control and Prevention has prepared interim guidelines for US healthcare providers who care for women who are pregnant during a ZIKAV outbreak (22) as well as interim guidelines for the evaluation and testing of infants whose mothers might have been infected with ZIKAV during pregnancy (23). The consequences of ZIKAV infection during pregnancy are not fully understood. Given the growing evidence of an association with microcephaly (5,7,8), and accounting for the time lapse between ZIKAV disease outbreaks and the birth of any affected infants as highlighted here, it can be expected that the number of infants born with microcephaly and other adverse pregnancy outcomes will continue to rise. Dr. Reefhuis is a senior health scientist and team lead in the Birth Defects Branch, National Center on Birth Defects and Developmental Disabilities, at the Centers for Disease Control and Prevention in Atlanta. Her research has focused on identifying modifiable risk factors for birth defects. AcknowledgmentWe thank all members of the Pregnancy and Birth Defects Team from the 2016 Centers for Disease Control and Prevention Zika Response.

ResultsIn the city of Salvador, ZIKAV transmission was highest during March–June 2015 (Figure 1) (14). During this period, a cohort of pregnant women could have been infected with ZIKAV, and these infections would have occurred at different times during their pregnancies. The period of highest ZIKAV activity was March 22–May 31, 2015 (Figure 1) across all cohorts. Pregnancies that began during November 2014–June 2015 correspond to births anticipated during August 2015–March 2016. For pregnancies that began in December 2014 or January 2015, the highest likelihood of ZIKAV infection would have been late in the first trimester or during the second trimester of pregnancy, and these pregnancies would have resulted in term births during September and October 2015. For pregnancies that began during late February 2015–May 2015, the highest likelihood of ZIKAV infection would have been during the first trimester, and term births would have occurred during November 2015–February 2016. The increased number of reported cases of microcephaly in Bahia State began with October births; reported cases rose sharply during November 2015–January 2016. For the city of Salvador, these November 2015–January 2016 births corresponded to the highest likelihood of ZIKAV infection occurring in the first trimester or early in the second trimester of pregnancy, assuming that the date of report approximates the date of birth. There are no reports to indicate whether the city of Salvador experienced the ZIKAV disease outbreak earlier or later than the rest of Bahia State. In Country A (Figure 2), for the cohort of women whose pregnancies began in May 2015, corresponding to births during February–early March 2016, the likelihood of ZIKAV infection would have been limited to the third trimester of pregnancy. Women whose pregnancies began in July 2015 would be expected to deliver in late March and early April 2016, and risk for infection would have been highest during the second trimester. The highest likelihood of first trimester and early second trimester infection with ZIKAV infection would be among women who became pregnant during September 2015–January 2016, which corresponds to births from mid-May through early October 2016. To enable readers to project months when births with exposure in different trimesters can be expected, we developed a modifiable spreadsheet tool (Technical Appendix). Users may enter start and end dates of hypothetical outbreaks.

Methods Figure 1. Projection of birth months after Zika virus (ZIKAV) transmission and occurrence of microcephaly, Salvador, Bahia State, Brazil. Weekly pregnancy cohorts are based on 40-week pregnancies and monthly reports of infants with... Using published data for Bahia State and assuming that all pregnancies lasted 40 weeks (full term), we created figures demonstrating cohorts of pregnant women by week of delivery and then extrapolated to the beginning of pregnancy. Live-birth data from Brazil showed small differences in the proportions of infants born at full term (37–41 weeks) with microcephaly (76.7%) compared with those born at full term without birth defects (83.6%) (13). We considered the first 2 weeks of pregnancy to be the time from last menstrual period to conception (Figure 1). We also assumed the number of births to be constant across months of the year. To indicate the probable high-risk period for ZIKAV transmission, we graphed the number of reported cases of Zika disease or Zika-like illness by epidemiologic week (the standardized method to enable comparison of weeks across years). We also graphed the reported cases of microcephaly by month of report, assuming that the month of report reflected the month of birth (15). In Bahia, ≈4,000 infants are born each week (16); therefore, each bar represents ≈4,000 pregnancies. We derived epidemiologic data from a published report on exanthematous illness in the city of Salvador, Bahia State, Brazil (14). We assumed that the epidemic curve of exanthematous illness was representative of the epidemic curve of ZIKAV infection and that the epidemic curve for the city of Salvador could be extrapolated to Bahia State. Because exact numbers of cases were not available, we derived estimates from the published epidemic curve, which was sufficient to identify the period of high ZIKAV activity as being from March through June 2015. From the Live Birth Information System in Brazil (16), we obtained the monthly reports of infants born with microcephaly during August 2015–February 2016; information on births from January 2016 on were probably incomplete or were not yet available. The expected baseline prevalence of microcephaly is 6 cases per 10,000 births; for a state with 16,000 births per month, 10 cases of microcephaly would be expected each month. Figure 2. Projection of anticipated birth months after Zika virus (ZIKAV) transmission in a hypothetical country. Projected birth months for weekly pregnancy cohorts are based on 40-week pregnancies in a hypothetical country in... To project the probable timing of births with adverse effects associated with ZIKAV infection in early pregnancy, we then applied this approach to a hypothetical country. We assumed that ZIKAV transmission in Country A began on October 4, 2015, and followed the patterns that were seen in Salvador (14) and Yap Island (3). That is, we assumed that the level of transmission during October was low, during early November 2015 through mid-February 2016 was high, and from mid-February through mid-March 2016 was lower (Figure 2).

In May 2015, the World Health Organization (WHO) reported an outbreak of Zika virus (ZIKAV) disease in Brazil (1). ZIKAV is a single-stranded RNA virus spread primarily byAedes aegypti mosquitoes; maternal–fetal transmission of ZIKAV has been reported (2). ZIKAV infection is asymptomatic in many patients; when clinical illness does occur, it is generally mild, with exanthematous rash, fever, conjunctivitis, or arthralgia (3). An association with Guillain-Barré syndrome is under investigation; on rare occasion, death of patients with chronic disease has been reported (4). In October 2015, Brazil started to report higher than expected rates of microcephaly among infants born in the same states where ZIKAV outbreaks had occurred several months before (5). Laboratory tests later confirmed ZIKAV infection in several infants born with microcephaly, and several case series have reported that mothers who delivered an infant with microcephaly had experienced ZIKAV symptoms during early pregnancy (5–8). Because of the potential link between ZIKAV infection and microcephaly, on February 1, 2016, WHO declared a public health emergency of international concern (9,10). As of February 26, 2016, WHO reported 31 countries and territories (11) in the Americas in which local vectorborne transmission of ZIKAV was ongoing (12). With expanding local ZIKAV transmission and the possible link between ZIKAV infection during pregnancy and congenital microcephaly, projecting the effects of ZIKAV infections for other countries and understanding the gestational time when risk is greatest are critical. As ZIKAV has spread through the Americas, questions have arisen about the remarkably high numbers of infants with microcephaly reported in Brazil and the absence of reported microcephaly cases in some other countries where ZIKAV transmission is high. To help answer these questions, assessment of the timing of ZIKAV transmission and its relation to gestational week of pregnancy for the cohort of women who were pregnant during the outbreak is necessary. Our report illustrates the expected periods of exposure and weeks of delivery for the cohorts of pregnant women potentially infected with ZIKAV during outbreaks in Bahia State, Brazil. Public health officials and researchers in areas with local ZIKAV transmission could apply these methods to country-specific data to produce more precise models and predictions.

AbstractThe marked increase in infants born with microcephaly in Brazil after a 2015 outbreak of Zika virus (ZIKAV) disease suggests an association between maternal ZIKAV infection and congenital microcephaly. To project the timing of delivery of infants born to mothers infected during early pregnancy in 1 city in Bahia State, Brazil, we incorporated data on reported ZIKAV disease cases and microcephaly cases into a graphical schematic of weekly birth cohorts. We projected that these births would occur through February 2016. Applying similar projections to a hypothetical location at which ZIKAV transmission started in November, we projected that full-term infants at risk for ZIKAV infection would be born during April–September 2016. We also developed a modifiable spreadsheet tool that public health officials and researchers can use for their countries to plan for deliveries of infants to women who were infected with ZIKAV during different pregnancy trimesters.

Jennita Reefhuis , Suzanne M. Gilboa, Michael A. Johansson, Diana Valencia, Regina M. Simeone, Susan L. Hills, Kara Polen, Denise J. Jamieson, Lyle R. Petersen, and Margaret A. HoneinAuthor affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (J. Reefhuis, S.M. Gilboa, M.A. Johansson, D. Valencia, R.M. Simeone, K. Polen, D.J. Jamieson, M.A. Honein); Centers for Disease Control and Prevention, Fort Collins, Colorado, USA (S.L. Hills, L.R. Petersen)Suggested citation for this article

Volume 22, Number 5—May 2016ResearchProjecting Month of Birth for At-Risk Infants after Zika Virus Disease Outbreakshttp://wwwnc.cdc.gov/eid/article/22/5/16-0290_article

NY DoH published an update on Zika testing http://nj.gov/health/cd/zika/documents/lincs_mar4.pdf

Amounting to 38 diagnosed cases of Zika, including five pregnant EFEMarch 7, 2016To see photos Minister of Health duties, Alfonso Alonso, during his appearance before the media after the weekly meeting of the Steering Committee of this training today in Vitoria. EFEPlusMadrid, March 7 (EFE) .- The Ministry of Health, Social Services and Equality has risen to 38 cases diagnosed in Spain of the Zika virus, all imported, among which are five pregnant, two in Catalonia, two in Madrid and one in Galicia. According to its website the Ministry of Health, all confirmed cases so far at the National Microbiology Center of the Institute of Health Carlos III correspond to people who had traveled to affected countries, so it is imported cases. Thus, nine of the patients are in Catalonia, thirteen in Madrid, six in Castilla and Leon, two in Aragon, two in Asturias, one in Andalusia, one in Murcia, one in Valencia, one in Navarre, one in La Rioja and one in Galicia. Among the confirmed cases are five pregnant women, two more than last week. Two of them are in Catalonia, two in Madrid and one in Galicia. Health recalls that before the epidemic by Zika virus in several countries of the American continent, the Ministry, in collaboration with the Institute of Health Carlos III and the autonomous communities, has established a surveillance of imported cases of illness from this virus. https://es.noticias.yahoo.com/ascienden-38-casos-diagnosticados-zika-5-embarazadas-134222942.html

Sequence map updated https://www.google.com/maps/d/u/0/edit?mid=zv94AJqgUct4.kI8kcFySb4J0&hl=en

Sequences producing significant alignments:Select:AllNone Selected:0 AlignmentsDownloadGenBankGraphicsDistance tree of resultsShow/hide columns of the table presenting sequences producing significant alignmentsSequences producing significant alignments:Select for downloading or viewing reportsDescriptionMax scoreTotal scoreQuery coverE valueIdentAccessionSelect seq gb|KU867812.1|Zika virus isolate Jiangxi.CHN/01/2016 nonstructural protein 5 gene, partial cds10181018100%0.0100%KU867812.1Select seq gb|KU729217.2|Zika virus isolate BeH823339 polyprotein gene, complete cds10181018100%0.0100%KU729217.2Select seq gb|KU820897.1|Zika virus isolate FLR polyprotein gene, complete cds10181018100%0.0100%KU820897.1Select seq gb|KU497555.1|Zika virus isolate Brazil-ZKV2015, complete genome10181018100%0.0100%KU497555.1Select seq gb|KU707826.1|Zika virus isolate SSABR1, complete genome10181018100%0.0100%KU707826.1Select seq gb|KU527068.1|Zika virus strain Natal RGN, complete genome10181018100%0.0100%KU527068.1Select seq gb|KU647676.1|Zika virus strain MRS_OPY_Martinique_PaRi_2015 polyprotein gene, complete cds10181018100%0.0100%KU647676.1Select seq gb|KU509998.1|Zika virus strain Haiti/1225/2014, complete genome10181018100%0.0100%KU509998.1Select seq gb|KU501217.1|Zika virus strain 8375 polyprotein gene, complete cds10181018100%0.0100%KU501217.1Select seq gb|KU501216.1|Zika virus strain 103344 polyprotein gene, complete cds10181018100%0.0100%KU501216.1Select seq gb|KU501215.1|Zika virus strain PRVABC59, complete genome10181018100%0.0100%KU501215.1Select seq gb|KU365780.1|Zika virus strain BeH815744 polyprotein gene, complete cds10181018100%0.0100%KU365780.1Select seq gb|KU365779.1|Zika virus strain BeH819966 polyprotein gene, complete cds10181018100%0.0100%KU365779.1Select seq gb|KU365777.1|Zika virus strain BeH818995 polyprotein gene, complete cds10181018100%0.0100%KU365777.1Select seq gb|KJ776791.1|Zika virus strain H/PF/2013 polyprotein gene, complete cds10181018100%0.0100%KJ776791.1Select seq gb|KU761564.1|Zika virus isolate GDZ16001 polyprotein gene, complete cds10121012100%0.099%KU761564.1Select seq gb|KU740184.1|Zika virus isolate GD01 polyprotein gene, complete cds10121012100%0.099%KU740184.1Select seq gb|KU312312.1|Zika virus isolate Z1106033 polyprotein gene, complete cds10121012100%0.099%KU312312.1Select seq gb|KU321639.1|Zika virus strain ZikaSPH2015, complete genome10121012100%0.099%KU321639.1Select seq gb|KU729218.1|Zika virus isolate BeH828305 polyprotein gene, complete cds10091009100%0.099%KU729218.1Select seq gb|KU365778.1|Zika virus strain BeH819015 polyprotein gene, complete cds10091009100%0.099%KU365778.1Select seq gb|KF993678.1|Zika virus strain PLCal_ZV from Canada polyprotein gene, partial cds10091009100%0.099%KF993678.1Select seq gb|KU820899.1|Zika virus isolate ZJ03 polyprotein gene, complete cds10001000100%0.099%KU820899.1Select seq gb|KU681081.3|Zika virus isolate Zika virus/H.sapiens-tc/THA/2014/SV0127- 14, complete genome10001000100%0.099%KU681081.3Select seq gb|KU744693.1|Zika virus isolate VE_Ganxian, complete genome10001000100%0.099%KU744693.1Select seq gb|EU545988.1|Zika virus polyprotein gene, complete cds994994100%0.099%EU545988.1Select seq gb|JN860885.1|Zika virus isolate FSS13025 polyprotein gene, partial cds982982100%0.099%JN860885.1Select seq gb|KU681082.3|Zika virus isolate Zika virus/H.sapiens-tc/PHL/2012/CPC-0740, complete genome973973100%0.098%KU681082.3Select seq gb|KM851039.1|Zika virus strain SV0127/14 nonstructural protein 5 gene, partial cds95395395%0.099%KM851039.1Select seq gb|KM078971.1|Zika virus strain CHI2613014 NS5 protein gene, partial cds92892891%0.0100%KM078971.1Select seq gb|KM078970.1|Zika virus strain CHI2490414 NS5 protein gene, partial cds92892891%0.0100%KM078970.1Select seq gb|KM078961.1|Zika virus strain CHI2612114 NS5 protein gene, partial cds92892891%0.0100%KM078961.1Select seq gb|KM078936.1|Zika virus strain CHI1410214 NS5 protein gene, partial cds92892891%0.0100%KM078936.1Select seq gb|KM078933.1|Zika virus strain CHI1058514 NS5 protein gene, partial cds92892891%0.0100%KM078933.1Select seq gb|KM078930.1|Zika virus strain CHI2283714 NS5 protein gene, partial cds92892891%0.0100%KM078930.1Select seq gb|KM078929.1|Zika virus strain CHI1805214 NS5 protein gene, partial cds92892891%0.0100%KM078929.1Select seq gb|KM851038.1|Zika virus strain CPC-0740 nonstructural protein 5 gene, partial cds92692695%0.098%KM851038.1Select seq gb|KU179098.1|Zika virus isolate JMB-185 nonstructural protein 5 gene, partial cds90190189%0.099%KU179098.1Select seq gb|HQ234499.1|Zika virus isolate P6-740 polyprotein gene, partial cds901901100%0.095%HQ234499.1Select seq gb|KJ873160.1|Zika virus isolate NC14-03042014-3481 nonstructural protein 5 gene, partial cds89289287%0.0100%KJ873160.1Select seq gb|KU720415.1|Zika virus strain MR 766 polyprotein gene, complete cds79179199%0.091%KU720415.1Select seq dbj|LC002520.1|Zika virus genomic RNA, complete genome, strain: MR766-NIID79179199%0.091%LC002520.1Select seq gb|HQ234498.1|Zika virus isolate MR_766 polyprotein gene, partial cds79179199%0.091%HQ234498.1Select seq gb|AY632535.2|Zika virus strain MR 766, complete genome79179199%0.091%AY632535.2Select seq gb|KJ873161.1|Zika virus isolate NC14-02042014-3220 nonstructural protein 5 gene, partial cds78978977%0.0100%KJ873161.1Select seq gb|KF383118.1|Zika virus strain ArD157995 polyprotein gene, complete cds78778799%0.091%KF383118.1Select seq gb|KF383119.1|Zika virus strain ArD158084 polyprotein gene, complete cds78278299%0.091%KF383119.1Select seq gb|KF268949.1|Zika virus isolate ARB15076 polyprotein gene, complete cds77377399%0.091%KF268949.1Select seq gb|KF383116.1|Zika virus strain ArD7117 polyprotein gene, complete cds76976999%0.090%KF383116.1Select seq gb|HQ234500.1|Zika virus isolate IbH_30656 polyprotein gene, partial cds76476499%0.090%HQ234500.1Select seq gb|DQ859059.1|Zika virus strain MR 766 polyprotein gene, complete cds76476499%0.090%DQ859059.1Select seq gb|KF383121.1|Zika virus strain ArD158095 polyprotein gene, partial cds76276296%0.091%KF383121.1Select seq gb|HQ234501.1|Zika virus isolate ArD_41519 polyprotein gene, partial cds76076099%0.090%HQ234501.1Select seq gb|AF013415.1|Zika virus strain MR-766 NS5 protein (NS5) gene, partial cds75575595%0.091%AF013415.1Select seq gb|KF383117.1|Zika virus strain ArD128000 polyprotein gene, complete cds75175199%0.090%KF383117.1Select seq gb|KF268950.1|Zika virus isolate ARB7701 polyprotein gene, complete cds75175199%0.090%KF268950.1Select seq gb|KF268948.1|Zika virus isolate ARB13565 polyprotein gene, complete cds75175199%0.090%KF268948.1Select seq gb|KF383115.1|Zika virus strain ArB1362 polyprotein gene, complete cds71371399%0.088%KF383115.1Select seq gb|KU556802.1|Zika virus isolate MEX/InDRE/14/2015 NS5 protein gene, partial cds60160159%4e-168100%KU556802.1Select seq gb|KF383120.1|Zika virus strain ArD142623 nonfunctional polyprotein gene, partial sequence55455496%5e-15482%KF383120.1Select seq gb|KU232300.1|Zika virus isolate 067ZV_PEBR15 NS5 protein gene, partial cds50250249%3e-138100%KU232300.1Select seq gb|KU232290.1|Zika virus isolate 036ZV_PEBR15 NS5 protein gene, partial cds49749749%1e-13699%KU232290.1Select seq gb|KU232297.1|Zika virus isolate 049ZV_PEBR15 NS5 protein gene, partial cds49349349%2e-13599%KU232297.1Select seq gb|KU232298.1|Zika virus isolate 050ZV_PEBR15 NS5 protein gene, partial cds48248247%3e-13299%KU232298.1Select seq gb|KU232296.1|Zika virus isolate 045ZV_PEBR15 NS5 protein gene, partial cds48248247%3e-13299%KU232296.1Select seq gb|KU232295.1|Zika virus isolate 068ZV_PEBR15 NS5 protein gene, partial cds48248247%3e-132100%KU232295.1Select seq gb|KU232294.1|Zika virus isolate 061ZV_PEBR15 NS5 protein gene, partial cds48248247%3e-132100%KU232294.1Select seq gb|KU232293.1|Zika virus isolate 057ZV_PEBR15 NS5 protein gene, partial cds48248247%3e-13299%KU232293.1Select seq gb|KU232291.1|Zika virus isolate 051ZV_PEBR15 NS5 protein gene, partial cds48048047%1e-131100%KU232291.1Select seq gb|KU232288.1|Zika virus isolate 001ZV_PEBR15 NS5 protein gene, partial cds47947946%3e-131100%KU232288.1Select seq gb|KU232292.1|Zika virus isolate 054ZV_PEBR15 NS5 protein gene, partial cds47747747%1e-13099%KU232292.1Select seq gb|KU232289.1|Zika virus isolate 020ZV_PEBR15 NS5 protein gene, partial cds47547546%4e-130100%KU232289.1Select seq gb|KU232299.1|Zika virus isolate 015ZV_PEBR15 NS5 protein gene, partial cds47347346%1e-129100%KU232299.1

LOCUS KU867812 564 bp RNA linear VRL 04-MAR-2016 DEFINITION Zika virus isolate Jiangxi.CHN/01/2016 nonstructural protein 5 gene, partial cds. ACCESSION KU867812 VERSION KU867812.1 GI:1002876769 KEYWORDS . SOURCE Zika virus ORGANISM Zika virus Viruses; ssRNA viruses; ssRNA positive-strand viruses, no DNA stage; Flaviviridae; Flavivirus. REFERENCE 1 (bases 1 to 564) AUTHORS Gong,T., Shi,Y., Zhou,J., Xiao,F., Liu,S.W., Li,J., Xu,G., Zhang,Y., Liu,X. and Xiong,Y. TITLE Detection and genetic analysis of Zika virus from the first imported case, China from Venezuela, February 2016 JOURNAL Unpublished REFERENCE 2 (bases 1 to 564) AUTHORS Gong,T., Shi,Y., Zhou,J., Xiao,F., Liu,S.W., Li,J.X., Xu,G., Zhang,Y.N., Liu,X.Q. and Xiong,Y. TITLE Direct Submission JOURNAL Submitted (04-MAR-2016) Institute of Microbiology, Jiangxi Province Center for Disease Control and Prevention, Beijing East Road 555, Nanchang, Jiangxi 330029, China COMMENT ##Assembly-Data-START## Sequencing Technology :: Sanger dideoxy sequencing ##Assembly-Data-END## FEATURES Location/Qualifiers source 1..564 /organism="Zika virus" /mol_type="genomic RNA" /isolate="Jiangxi.CHN/01/2016" /isolation_source="serum" /host="Homo sapiens" /db_xref="taxon:64320" /country="China" /collection_date="06-Feb-2016" /note="type: Asian" CDS <1..>564 /codon_start=2 /product="nonstructural protein 5" /protein_id="AMN91947.1" /db_xref="GI:1002876770" /translation="EAEEVLEMQDLWLLRRSEKVTNWLQSNGWDRLKRMAVSGDDCVV KPIDDRFAHALRFLNDMGKVRKDTQEWKPSTGWDNWEEVPFCSHHFNKLHLKDGRSIV VPCRHQDELIGRARVSPGAGWSIRETACLAKSYAQMWQLLYFHRRDLRLMANAICSSV PVDWVPTGRTTWSIHGKGEWMTTEDMLV" ORIGIN 1 ggaggctgag gaagttctag agatgcaaga cttgtggctg ctgcggaggt cagagaaagt 61 gaccaactgg ttgcagagca acggatggga taggctcaaa cgaatggcag tcagtggaga 121 tgattgcgtt gtgaagccaa ttgatgatag gtttgcacat gccctcaggt tcttgaatga 181 tatgggaaaa gttaggaagg acacacaaga gtggaaaccc tcaactggat gggacaactg 241 ggaagaagtt ccgttttgct cccaccactt caacaagctc catctcaagg acgggaggtc 301 cattgtggtt ccctgccgcc accaagatga actgattggc cgggcccgcg tctctccagg 361 ggcgggatgg agcatccggg agactgcttg cctagcaaaa tcatatgcgc aaatgtggca 421 gctcctttat ttccacagaa gggacctccg actgatggcc aatgccattt gttcatctgt 481 gccagttgac tgggttccaa ctgggagaac tacctggtca atccatggaa agggagaatg 541 gatgaccact gaagacatgc ttgt

Jiangxi Province Center for Disease Control and Prevention has released a partial sequence, Jiangxi.CHN/01/2016, from the first reported case infected in Venezuela. http://www.ncbi.nlm.nih.gov/nuccore/KU867812 The partial sequence exactly matches many of the prior sequences from the Americas, in contrast to sequences from the serum, urine,and saliva from this patient. However,all such sequences are closely related to each other and trace back to the 2013/2014 sequences from French Polynesia.

Sequence map updated https://www.google.com/maps/d/u/0/edit?mid=zv94AJqgUct4.kI8kcFySb4J0&hl=en

Sequences producing significant alignments:Select:AllNone Selected:0 AlignmentsDownloadGenBankGraphicsDistance tree of resultsShow/hide columns of the table presenting sequences producing significant alignmentsSequences producing significant alignments:Select for downloading or viewing reportsDescriptionMax scoreTotal scoreQuery coverE valueIdentAccessionSelect seq gb|KU867812.1|Zika virus isolate Jiangxi.CHN/01/2016 nonstructural protein 5 gene, partial cds10181018100%0.0100%KU867812.1Select seq gb|KU729217.2|Zika virus isolate BeH823339 polyprotein gene, complete cds10181018100%0.0100%KU729217.2Select seq gb|KU820897.1|Zika virus isolate FLR polyprotein gene, complete cds10181018100%0.0100%KU820897.1Select seq gb|KU497555.1|Zika virus isolate Brazil-ZKV2015, complete genome10181018100%0.0100%KU497555.1Select seq gb|KU707826.1|Zika virus isolate SSABR1, complete genome10181018100%0.0100%KU707826.1Select seq gb|KU527068.1|Zika virus strain Natal RGN, complete genome10181018100%0.0100%KU527068.1Select seq gb|KU647676.1|Zika virus strain MRS_OPY_Martinique_PaRi_2015 polyprotein gene, complete cds10181018100%0.0100%KU647676.1Select seq gb|KU509998.1|Zika virus strain Haiti/1225/2014, complete genome10181018100%0.0100%KU509998.1Select seq gb|KU501217.1|Zika virus strain 8375 polyprotein gene, complete cds10181018100%0.0100%KU501217.1Select seq gb|KU501216.1|Zika virus strain 103344 polyprotein gene, complete cds10181018100%0.0100%KU501216.1Select seq gb|KU501215.1|Zika virus strain PRVABC59, complete genome10181018100%0.0100%KU501215.1Select seq gb|KU365780.1|Zika virus strain BeH815744 polyprotein gene, complete cds10181018100%0.0100%KU365780.1Select seq gb|KU365779.1|Zika virus strain BeH819966 polyprotein gene, complete cds10181018100%0.0100%KU365779.1Select seq gb|KU365777.1|Zika virus strain BeH818995 polyprotein gene, complete cds10181018100%0.0100%KU365777.1Select seq gb|KJ776791.1|Zika virus strain H/PF/2013 polyprotein gene, complete cds10181018100%0.0100%KJ776791.1Select seq gb|KU761564.1|Zika virus isolate GDZ16001 polyprotein gene, complete cds10121012100%0.099%KU761564.1Select seq gb|KU740184.1|Zika virus isolate GD01 polyprotein gene, complete cds10121012100%0.099%KU740184.1Select seq gb|KU312312.1|Zika virus isolate Z1106033 polyprotein gene, complete cds10121012100%0.099%KU312312.1Select seq gb|KU321639.1|Zika virus strain ZikaSPH2015, complete genome10121012100%0.099%KU321639.1Select seq gb|KU729218.1|Zika virus isolate BeH828305 polyprotein gene, complete cds10091009100%0.099%KU729218.1Select seq gb|KU365778.1|Zika virus strain BeH819015 polyprotein gene, complete cds10091009100%0.099%KU365778.1Select seq gb|KF993678.1|Zika virus strain PLCal_ZV from Canada polyprotein gene, partial cds10091009100%0.099%KF993678.1Select seq gb|KU820899.1|Zika virus isolate ZJ03 polyprotein gene, complete cds10001000100%0.099%KU820899.1Select seq gb|KU681081.3|Zika virus isolate Zika virus/H.sapiens-tc/THA/2014/SV0127- 14, complete genome10001000100%0.099%KU681081.3Select seq gb|KU744693.1|Zika virus isolate VE_Ganxian, complete genome10001000100%0.099%KU744693.1Select seq gb|EU545988.1|Zika virus polyprotein gene, complete cds994994100%0.099%EU545988.1Select seq gb|JN860885.1|Zika virus isolate FSS13025 polyprotein gene, partial cds982982100%0.099%JN860885.1Select seq gb|KU681082.3|Zika virus isolate Zika virus/H.sapiens-tc/PHL/2012/CPC-0740, complete genome973973100%0.098%KU681082.3Select seq gb|KM851039.1|Zika virus strain SV0127/14 nonstructural protein 5 gene, partial cds95395395%0.099%KM851039.1Select seq gb|KM078971.1|Zika virus strain CHI2613014 NS5 protein gene, partial cds92892891%0.0100%KM078971.1Select seq gb|KM078970.1|Zika virus strain CHI2490414 NS5 protein gene, partial cds92892891%0.0100%KM078970.1Select seq gb|KM078961.1|Zika virus strain CHI2612114 NS5 protein gene, partial cds92892891%0.0100%KM078961.1Select seq gb|KM078936.1|Zika virus strain CHI1410214 NS5 protein gene, partial cds92892891%0.0100%KM078936.1Select seq gb|KM078933.1|Zika virus strain CHI1058514 NS5 protein gene, partial cds92892891%0.0100%KM078933.1Select seq gb|KM078930.1|Zika virus strain CHI2283714 NS5 protein gene, partial cds92892891%0.0100%KM078930.1Select seq gb|KM078929.1|Zika virus strain CHI1805214 NS5 protein gene, partial cds92892891%0.0100%KM078929.1Select seq gb|KM851038.1|Zika virus strain CPC-0740 nonstructural protein 5 gene, partial cds92692695%0.098%KM851038.1Select seq gb|KU179098.1|Zika virus isolate JMB-185 nonstructural protein 5 gene, partial cds90190189%0.099%KU179098.1Select seq gb|HQ234499.1|Zika virus isolate P6-740 polyprotein gene, partial cds901901100%0.095%HQ234499.1Select seq gb|KJ873160.1|Zika virus isolate NC14-03042014-3481 nonstructural protein 5 gene, partial cds89289287%0.0100%KJ873160.1Select seq gb|KU720415.1|Zika virus strain MR 766 polyprotein gene, complete cds79179199%0.091%KU720415.1Select seq dbj|LC002520.1|Zika virus genomic RNA, complete genome, strain: MR766-NIID79179199%0.091%LC002520.1Select seq gb|HQ234498.1|Zika virus isolate MR_766 polyprotein gene, partial cds79179199%0.091%HQ234498.1Select seq gb|AY632535.2|Zika virus strain MR 766, complete genome79179199%0.091%AY632535.2Select seq gb|KJ873161.1|Zika virus isolate NC14-02042014-3220 nonstructural protein 5 gene, partial cds78978977%0.0100%KJ873161.1Select seq gb|KF383118.1|Zika virus strain ArD157995 polyprotein gene, complete cds78778799%0.091%KF383118.1Select seq gb|KF383119.1|Zika virus strain ArD158084 polyprotein gene, complete cds78278299%0.091%KF383119.1Select seq gb|KF268949.1|Zika virus isolate ARB15076 polyprotein gene, complete cds77377399%0.091%KF268949.1Select seq gb|KF383116.1|Zika virus strain ArD7117 polyprotein gene, complete cds76976999%0.090%KF383116.1Select seq gb|HQ234500.1|Zika virus isolate IbH_30656 polyprotein gene, partial cds76476499%0.090%HQ234500.1Select seq gb|DQ859059.1|Zika virus strain MR 766 polyprotein gene, complete cds76476499%0.090%DQ859059.1Select seq gb|KF383121.1|Zika virus strain ArD158095 polyprotein gene, partial cds76276296%0.091%KF383121.1Select seq gb|HQ234501.1|Zika virus isolate ArD_41519 polyprotein gene, partial cds76076099%0.090%HQ234501.1Select seq gb|AF013415.1|Zika virus strain MR-766 NS5 protein (NS5) gene, partial cds75575595%0.091%AF013415.1Select seq gb|KF383117.1|Zika virus strain ArD128000 polyprotein gene, complete cds75175199%0.090%KF383117.1Select seq gb|KF268950.1|Zika virus isolate ARB7701 polyprotein gene, complete cds75175199%0.090%KF268950.1Select seq gb|KF268948.1|Zika virus isolate ARB13565 polyprotein gene, complete cds75175199%0.090%KF268948.1Select seq gb|KF383115.1|Zika virus strain ArB1362 polyprotein gene, complete cds71371399%0.088%KF383115.1Select seq gb|KU556802.1|Zika virus isolate MEX/InDRE/14/2015 NS5 protein gene, partial cds60160159%4e-168100%KU556802.1Select seq gb|KF383120.1|Zika virus strain ArD142623 nonfunctional polyprotein gene, partial sequence55455496%5e-15482%KF383120.1Select seq gb|KU232300.1|Zika virus isolate 067ZV_PEBR15 NS5 protein gene, partial cds50250249%3e-138100%KU232300.1Select seq gb|KU232290.1|Zika virus isolate 036ZV_PEBR15 NS5 protein gene, partial cds49749749%1e-13699%KU232290.1Select seq gb|KU232297.1|Zika virus isolate 049ZV_PEBR15 NS5 protein gene, partial cds49349349%2e-13599%KU232297.1Select seq gb|KU232298.1|Zika virus isolate 050ZV_PEBR15 NS5 protein gene, partial cds48248247%3e-13299%KU232298.1Select seq gb|KU232296.1|Zika virus isolate 045ZV_PEBR15 NS5 protein gene, partial cds48248247%3e-13299%KU232296.1Select seq gb|KU232295.1|Zika virus isolate 068ZV_PEBR15 NS5 protein gene, partial cds48248247%3e-132100%KU232295.1Select seq gb|KU232294.1|Zika virus isolate 061ZV_PEBR15 NS5 protein gene, partial cds48248247%3e-132100%KU232294.1Select seq gb|KU232293.1|Zika virus isolate 057ZV_PEBR15 NS5 protein gene, partial cds48248247%3e-13299%KU232293.1Select seq gb|KU232291.1|Zika virus isolate 051ZV_PEBR15 NS5 protein gene, partial cds48048047%1e-131100%KU232291.1Select seq gb|KU232288.1|Zika virus isolate 001ZV_PEBR15 NS5 protein gene, partial cds47947946%3e-131100%KU232288.1Select seq gb|KU232292.1|Zika virus isolate 054ZV_PEBR15 NS5 protein gene, partial cds47747747%1e-13099%KU232292.1Select seq gb|KU232289.1|Zika virus isolate 020ZV_PEBR15 NS5 protein gene, partial cds47547546%4e-130100%KU232289.1Select seq gb|KU232299.1|Zika virus isolate 015ZV_PEBR15 NS5 protein gene, partial cds47347346%1e-129100%KU232299.1

LOCUS KU867812 564 bp RNA linear VRL 04-MAR-2016 DEFINITION Zika virus isolate Jiangxi.CHN/01/2016 nonstructural protein 5 gene, partial cds. ACCESSION KU867812 VERSION KU867812.1 GI:1002876769 KEYWORDS . SOURCE Zika virus ORGANISM Zika virus Viruses; ssRNA viruses; ssRNA positive-strand viruses, no DNA stage; Flaviviridae; Flavivirus. REFERENCE 1 (bases 1 to 564) AUTHORS Gong,T., Shi,Y., Zhou,J., Xiao,F., Liu,S.W., Li,J., Xu,G., Zhang,Y., Liu,X. and Xiong,Y. TITLE Detection and genetic analysis of Zika virus from the first imported case, China from Venezuela, February 2016 JOURNAL Unpublished REFERENCE 2 (bases 1 to 564) AUTHORS Gong,T., Shi,Y., Zhou,J., Xiao,F., Liu,S.W., Li,J.X., Xu,G., Zhang,Y.N., Liu,X.Q. and Xiong,Y. TITLE Direct Submission JOURNAL Submitted (04-MAR-2016) Institute of Microbiology, Jiangxi Province Center for Disease Control and Prevention, Beijing East Road 555, Nanchang, Jiangxi 330029, China COMMENT ##Assembly-Data-START## Sequencing Technology :: Sanger dideoxy sequencing ##Assembly-Data-END## FEATURES Location/Qualifiers source 1..564 /organism="Zika virus" /mol_type="genomic RNA" /isolate="Jiangxi.CHN/01/2016" /isolation_source="serum" /host="Homo sapiens" /db_xref="taxon:64320" /country="China" /collection_date="06-Feb-2016" /note="type: Asian" CDS <1..>564 /codon_start=2 /product="nonstructural protein 5" /protein_id="AMN91947.1" /db_xref="GI:1002876770" /translation="EAEEVLEMQDLWLLRRSEKVTNWLQSNGWDRLKRMAVSGDDCVV KPIDDRFAHALRFLNDMGKVRKDTQEWKPSTGWDNWEEVPFCSHHFNKLHLKDGRSIV VPCRHQDELIGRARVSPGAGWSIRETACLAKSYAQMWQLLYFHRRDLRLMANAICSSV PVDWVPTGRTTWSIHGKGEWMTTEDMLV" ORIGIN 1 ggaggctgag gaagttctag agatgcaaga cttgtggctg ctgcggaggt cagagaaagt 61 gaccaactgg ttgcagagca acggatggga taggctcaaa cgaatggcag tcagtggaga 121 tgattgcgtt gtgaagccaa ttgatgatag gtttgcacat gccctcaggt tcttgaatga 181 tatgggaaaa gttaggaagg acacacaaga gtggaaaccc tcaactggat gggacaactg 241 ggaagaagtt ccgttttgct cccaccactt caacaagctc catctcaagg acgggaggtc 301 cattgtggtt ccctgccgcc accaagatga actgattggc cgggcccgcg tctctccagg 361 ggcgggatgg agcatccggg agactgcttg cctagcaaaa tcatatgcgc aaatgtggca 421 gctcctttat ttccacagaa gggacctccg actgatggcc aatgccattt gttcatctgt 481 gccagttgac tgggttccaa ctgggagaac tacctggtca atccatggaa agggagaatg 541 gatgaccact gaagacatgc ttgthttp://www.ncbi.nlm.nih.gov/nucleotide/1002876769?report=genbank&log$=nucltop&blast_rank=85&RID=DUW7AA32014

HEALTH , 6 MAR 2016 - 3:02 PM First cases of microcephaly in Colombia attributed to ZikaThe disconnect between research groups studying the virus and the National Institute of Health is confusing to know if babies are born with brain abnormalities. By: Writing Health 14SHAREDTwitterFacebookGooglereviewsINSERTManuelly (baby) is part of the list of children born with microcephaly in Brazil to have been exposed to the virus during gestation Zika. / EFEA short review published in the journal Nature confirmed the first cases of birth defects related virus Zika in the country. The discovery, however, is not surprising because the virus arrived in Colombia in September last year and is the second most affected country after Brazil , with 42,706 reported cases of this disease, 7,653 of which have occurred in pregnant women, according to the latest weekly balance of the National Institute of Health (NIH). Colombian researchers Collaboration Network Colombia in Zika (RECOLZIKA) who have not yet officially published their research, they hope that plans put in place to monitor pregnant women help establish the magnitude of the threat to fetuses Zika virus. That is a crucial point that scientists in Brazil have not yet been able to respond. In Brazil, the authorities estimate that a million and a half people were infected by Zika since 2015. This week 641 cases of microcephaly and 139 infants died from this cause were reported. This disease is characterized in babies born with very small heads and because it leaves irreversible consequences in the brain. Its appearance is also associated with mothers who contracted syphilis, rubella or toxoplasmosis during pregnancy. In Colombia the recent publication confirmed that the researchers detected a newborn with microcephaly and two other children with congenital abnormalities of the brain, as told Alfonso Rodriguez-Morales, who heads RECOLZIKA and made the respective diagnoses. The three cases were positive to Zika virus presence. The problem is still confusion reigns between the connection of microcephaly and Zika. On the one hand, there is evidence that the relationship could exist because if the virus has been detected in amniotic fluid and cerebrospinal fluid of infants. But it also raises many questions, since there are other possible causes of microcephaly, including a group of infections that are called STORCH (syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus and herpes), which are known to cause birth defects, as well as exposure to toxic chemicals and alcohol consumption during pregnancy can cause disease. Compared with Brazil, the connection between Zika and birth defects remains unclear. According to the Ministry of Health of that country, 5,909 suspected cases of microcephaly have been reported since early November, but only 1,687 of them have been investigated so far. Of these, 1,046 have been discarded and 641 have been confirmed, but only 82 have had a link to the Zika virus in laboratory tests. Epidemiologist of the Technological University of Pereira, Rodriguez-Morales, told the journal he expects to see an increase in cases of birth defects linked to Zika virus within three months. Already since December Colombia makes tracking 28 cases of microcephaly to determine whether there is a link with Zika virus, he said Martha Lucia Ospina, director of the National Institute of Health told AFP.So from that date had been set up national monitoring programs to monitor pregnant women and to detect signs of infection and possible birth defects in fetuses. In order to be prepared for the increase in such cases in Colombia, RECOLZIKA plans to look historical cases and establish birth defects in the different regions. It also seeks to analyze patterns in the distribution of circumference measurements recorded in obstetric units across the country head. But confirmation of cases of microcephaly in the country has been undermined by the National Institute of Health (NIH). "Samples of these cases have not come to us for analysis, so we can not confirm that link.Some are children born and unborn children other, but never have had so far confirmation of that relationship, "said Martha Lucia Ospina, director INS. Ospina saw the study, but hoped that the entity obtaining samples for analysis. "It is true that this team wants to make a contribution to science;is respectable, but that desire can not take no research report to INS, "he concluded. In this situation Juan Manuel Anaya, a physician and professor at the Universidad del Rosario said that this controversy "is another example of the breakdown of a process that had to be led by one of the state entities (Colciencias, Ministry of Health or INS) in order to join efforts in two fundamental aspects: both important and urgent timely diagnosis and research, and in which, in both the state raja, despite their good will. " Anaya The conclusion to this story is that "there are several independent groups wanting to investigate the Zika and its complications. Why not summon them all, make a national network for diagnosis and research, and train several laboratories take exceptional measures to an exceptional situation. " http://www.elespectador.com/noticias/salud/primeros-casos-de-microcefalia-colombia-atribuidos-al-z-articulo-620584

Leia Mais:http://saude.estadao.com.br/noticias/geral,historicamente-o-brasil-nao-registrava-microcefalia--diz-vice-ministro-de-saude-da-colombia,1840461Leia Mais:http://saude.estadao.com.br/noticias/geral,historicamente-o-brasil-nao-registrava-microcefalia--diz-vice-ministro-de-saude-da-colombia,1840461 Colombia lives under fear of microcephalyNurse Jasmine Otero already got used to the new routine. Two months ago, every time a woman reaches the office of the health unit bringing a pregnancy test with positive result, the first question is: had itches, stains the body, fever? "Weight, nutrition, family diseases are no longer a priority. Now the most important is to know if they had symptoms of zika" he says. Professional works in Comuneros, one of the areas of greatest risk for the disease in Cúcuta, capital of the department Norte de Santander, bordering Venezuela, and champion city in number of cases of zika in Colombia - second in the number of cases of disease, behind only Brazil. "At least half of the population had the infection," ensures the nurse. Name and address are recorded. "If they miss appointments, an agent goes to the house to see what happened," he says. When symptoms are recent, tests to identify the presence of the virus are made. If complaints are older, blood is collected and sent to a bank, where materials of all pregnant women with complaints are stored. The hope is that this material is useful as soon as a new exam, able to identify an infection occurred more time is available. Opportunity. "We are watching these women in real time," says the director of the Departmental Institute of Cúcuta Health, Juan Alberto Bitar. "We have an opportunity here that Brazil had not." The effort is to try to collect as much information to see if the transmission from mother to baby zika can cause microcephaly - and believe Brazilian authorities. For now, they are being accompanied by about 7,000 Colombian women who showed symptoms of the virus. Only in Cúcuta are 1,117 cases - of which 119 were laboratory confirmed. "Brazil data indicate that there may be an association between zika and malformation. But this is not enough to establish causality. It is necessary to wait for other studies," said the State the Health deputy minister of Colombia, Fernando Ruiz Gómez . "We will serve as a point of comparison with Brazil. From there, there are some deductions, hypotheses. With this monitoring in Colombia, we have chances to find answers." Three studies are being done in the country, in collaboration with the American Center for Disease Control.One to identify the incidence of disease in the general population, one for the relationship between microcephaly and Zika and a third of cases of Guillain-Barre syndrome, an autoimmune disease, traditionally a result of infection by viruses and bacteria. Preliminary results of the work are expected in the first half of 2017. Although the Colombian government has recommended that women postpone pregnancy plans, wear protective screens and repellents to prevent mosquito bites, officials are careful to talk about the direct relationship with microcephaly. Gómez, for example, states that, to date, of the 11 cases of malformation suspected of being related to zika ten have been discarded and is still under investigation. An abortion was done, but the deputy minister says other strains were found not microcephaly. The day before yesterday, however, the journal Nature reported three cases of malformations which, according to Colombian scientists are reportedly linked to zika virus. The detail was sent to a British scientific journal. What then explains the increase records? "In Brazil, other factors may be related," said the deputy minister, who speaks of the possibility of underreporting - would be an old problem now reported. Another factor that could explain the increase in cases in Brazil, evaluates, would be environmental causes, including interaction with other diseases such as chikungunya and dengue. Divergence. There are, however, who think different. Ricardo Montoya Gonzales, obstetrician University Hospital Erasmo Meoz, Cúcuta, estimates that the increase in cases of malformation among infants is a matter of time. "If the pattern of Brazil is repeated, the increase will begin to be registered after April. This is the time for infected babies in the first trimester of pregnancy begin to rise." The information is the newspaper O Estado de S. Paulo. http://hypenews.in/colmbia-vive-sob-temor-da-microcefalia/ Assine o Estadão All Digital + Impresso todos os diasSiga @Estadao no TwitterLeia Mais:http://saude.estadao.com.br/noticias/geral,historicamente-o-brasil-nao-registrava-microcefalia--diz-vice-ministro-de-saude-da-colombia,1840461Assine o Estadão All Digital + Impresso todos os diasSiga @EstadaAssine o Estadão All Digital + Impresso todos os diasSiga @Estadao no TwitterLeia Mais:http://saude.estadao.com.br/noticias/geral,historicamente-o-brasil-nao-registrava-microcefalia--diz-vice-ministro-de-saude-da-colombia,1840461Assine o Estadão All Digital + Impresso todos os diasSiga @Estadao no

Colombia continues to deny the relationship between Zika and microcephaly in Brazil. http://saude.estadao.com.br/noticias/geral,historicamente-o-brasil-nao-registrava-microcefalia--diz-vice-ministro-de-saude-da-colombia,1840461

Commentary: Being Pregnant Patient No. 1 for Zika in ChicagoDebra Gittler reads to students at San Jorge School, in the middle of a coffee plantation in rural El Salvador, as part of her work with the educational organization ConTextos. She's the director of ConTextos, an educational NGO based in El Salvador. (Jim Garbarino)Debra Gittler Last week, I reached the halfway point of my pregnancy. And officially became the first high-risk pregnancy for Zika exposure in Chicago. There are five confirmed cases of Zika in Illinois and nine cases of pregnant women with Zika exposure in New York City. Sadly, one of those women just gave birth to a microcephalic baby, which means the infant's head is significantly smaller, often due to abnormal brain development. While my health care providers have gone above and beyond to monitor my — and my baby's — progress, my insurance carrier balks at covering the costs. For the past five years, I've split my time between El Salvador and Chicago. I was exposed to Zika while abroad; the virus is transmitted by infected mosquitoes living in tropical climates and through sexual contact. In January, when the Centers for Disease Control and Prevention announced possible links between Zika and fetal brain deformation, I immediately moved full-time to Chicago. The Zika virus has been linked to severe birth defects, including microcephaly, since it surfaced in Brazil about a year ago. I was the first pregnant patient with possible Zika exposure at the Erie Family Health Center and Northwestern Memorial Hospital's Prentice Women's Hospital. In December, while two months pregnant in El Salvador, two of 15 employees in my office were diagnosed with Zika. I had been doubtful about the spread of the Zika disease. Then suddenly there were two women in my own office infected with the virus. We didn't know then that the disease could become a global health threat. Days after arriving in Chicago, I was scheduled for an ultrasound. The results showed reasons for concern. Given my situation, my doctors recommended a battery of tests. Days later, the CDC announced additional protocols. I had another round of appointments. My 20-week review, a milestone for any pregnancy, now carried an added weight. I was told — again — that given my potential Zika exposure, there were reasons to be concerned for my baby's health. Erie and Prentice employees have treated me with the utmost respect. Nurses, doctors and counselors hand me tissues for tears while they review my baby's growth, constantly emphasizing how little we know about the disease. They stay on the phone and in consultations trying to understand the ever-changing CDC protocols: what tests to complete, frequency of ultrasounds, how to define risk. Now, I've been told that for me and my baby's well-being, I should have ultrasounds every two weeks. But my insurance provider refuses to cover these services. My benefits include 100 percent prenatal coverage. While doctor's visits are covered in full, the correlating ultrasounds, blood work and labs aren't included. Which raises the question: What does my insurance company think happens during a prenatal appointment? You urinate in a cup, get an ultrasound, give blood, repeat. For a pregnancy with Zika, I'll repeat these steps every two weeks. It's too bad my first pregnancy is so stressful. This should be a happy time, filled with excitement and wonder. But my experience is filled with dread, fear and lots of visits with doctors. And of course, disappointment that my insurance company refuses to cover medical services suggested by my physicians and the CDC. Zika virus in Illinois: 5 cases, all travel-relatedIf I had stayed in El Salvador, an emergency room ultrasound at an elite private hospital costs just $42. Here, my ultrasounds will cost me hundreds or thousands of dollars each, thanks to health insurance that aims to hustle me and my baby out of coverage during a high-risk, infectious disease-exposure pregnancy by one of the most frightening global health threats in recent history. I'm relieved to be back home in Chicago. And grateful for world-class doctors at world-class facilities. But my health insurance in America is just as Third World as the country where I was exposed to Zika in the first place. Debra Gittler is founder and executive director of ConTextos, an educational NGO based in El Salvador. Copyright © 2016, Chicago TribuneCommentary Opinion Healthcare Providers Zika Virus Diseases and Illnesses U.S. Centers for Disease Control and Preventionhttp://www.chicagotribune.com/news/opinion/commentary/ct-zika-chicago-patient-insurance-pregnant-perspec-0307-20160304-story.html

American tests positive for Zika virus after Philippine trip Resize Text Print Article Comments 0 Book mark article Read later list Saved to Reading List By Associated Press March 6 at 6:40 AMMANILA, Philippines — The Philippine government says an American woman who visited the country in January has tested positive for the Zika virus in the United States. Health Secretary Janet Garin said Sunday that her department was coordinating with the U.S. Centers for Disease Control and Prevention to get more information about the woman and find out where she stayed during her Jan. 2-28 visit to the Philippines. Garin said it was only the second Zika case to be reported in the Philippines and stresses that there has been no report of an outbreak, adding that the public should not be alarmed but should take steps to prevent infection. A 15-year-old boy got infected in Cebu city in the central Philippines in 2012, but recovered fully, according to the health department. https://www.washingtonpost.com/world/asia_pacific/american-tests-positive-for-zika-virus-after-philippine-trip/2016/03/06/30612b06-e390-11e5-a9ce-681055c7a05f_story.html?tid=twisira

Sequences producing significant alignments:Select:AllNone Selected:0 AlignmentsDownloadGenBankGraphicsDistance tree of resultsShow/hide columns of the table presenting sequences producing significant alignmentsSequences producing significant alignments:Select for downloading or viewing reportsDescriptionMax scoreTotal scoreQuery coverE valueIdentAccessionSelect seq gb|KU681082.3|Zika virus isolate Zika virus/H.sapiens-tc/PHL/2012/CPC-0740, complete genome14241424100%0.0100%KU681082.3Select seq gb|KM851038.1|Zika virus strain CPC-0740 nonstructural protein 5 gene, partial cds14241424100%0.0100%KM851038.1Select seq gb|EU545988.1|Zika virus polyprotein gene, complete cds13791379100%0.099%EU545988.1Select seq gb|JN860885.1|Zika virus isolate FSS13025 polyprotein gene, partial cds13611361100%0.098%JN860885.1Select seq gb|KU509998.1|Zika virus strain Haiti/1225/2014, complete genome13551355100%0.098%KU509998.1Select seq gb|KU501217.1|Zika virus strain 8375 polyprotein gene, complete cds13551355100%0.098%KU501217.1Select seq gb|KU501216.1|Zika virus strain 103344 polyprotein gene, complete cds13551355100%0.098%KU501216.1Select seq gb|KF993678.1|Zika virus strain PLCal_ZV from Canada polyprotein gene, partial cds13551355100%0.098%KF993678.1Select seq gb|KJ776791.1|Zika virus strain H/PF/2013 polyprotein gene, complete cds13551355100%0.098%KJ776791.1Select seq gb|KU497555.1|Zika virus isolate Brazil-ZKV2015, complete genome13521352100%0.098%KU497555.1Select seq gb|KU647676.1|Zika virus strain MRS_OPY_Martinique_PaRi_2015 polyprotein gene, complete cds13521352100%0.098%KU647676.1Select seq gb|KU729217.2|Zika virus isolate BeH823339 polyprotein gene, complete cds13461346100%0.098%KU729217.2Select seq gb|KU820897.1|Zika virus isolate FLR polyprotein gene, complete cds13461346100%0.098%KU820897.1Select seq gb|KU707826.1|Zika virus isolate SSABR1, complete genome13461346100%0.098%KU707826.1Select seq gb|KU501215.1|Zika virus strain PRVABC59, complete genome13461346100%0.098%KU501215.1Select seq gb|KU365780.1|Zika virus strain BeH815744 polyprotein gene, complete cds13461346100%0.098%KU365780.1Select seq gb|KU365779.1|Zika virus strain BeH819966 polyprotein gene, complete cds13461346100%0.098%KU365779.1Select seq gb|KU365777.1|Zika virus strain BeH818995 polyprotein gene, complete cds13461346100%0.098%KU365777.1Select seq gb|KU321639.1|Zika virus strain ZikaSPH2015, complete genome13461346100%0.098%KU321639.1Select seq gb|KU761564.1|Zika virus isolate GDZ16001 polyprotein gene, complete cds13421342100%0.098%KU761564.1Select seq gb|KU744693.1|Zika virus isolate VE_Ganxian, complete genome13421342100%0.098%KU744693.1Select seq gb|KU740184.1|Zika virus isolate GD01 polyprotein gene, complete cds13421342100%0.098%KU740184.1Select seq gb|KU527068.1|Zika virus strain Natal RGN, complete genome13421342100%0.098%KU527068.1Select seq gb|KU312312.1|Zika virus isolate Z1106033 polyprotein gene, complete cds13421342100%0.098%KU312312.1Select seq gb|KU729218.1|Zika virus isolate BeH828305 polyprotein gene, complete cds13371337100%0.098%KU729218.1Select seq gb|KU365778.1|Zika virus strain BeH819015 polyprotein gene, complete cds13371337100%0.098%KU365778.1Select seq gb|KU820899.1|Zika virus isolate ZJ03 polyprotein gene, complete cds13331333100%0.097%KU820899.1Select seq gb|KU681081.3|Zika virus isolate Zika virus/H.sapiens-tc/THA/2014/SV0127- 14, complete genome13331333100%0.097%KU681081.3Select seq gb|KM851039.1|Zika virus strain SV0127/14 nonstructural protein 5 gene, partial cds13331333100%0.097%KM851039.1Select seq gb|KM078936.1|Zika virus strain CHI1410214 NS5 protein gene, partial cds1312131296%0.098%KM078936.1Select seq gb|KM078961.1|Zika virus strain CHI2612114 NS5 protein gene, partial cds1310131096%0.098%KM078961.1Select seq gb|KM078930.1|Zika virus strain CHI2283714 NS5 protein gene, partial cds1308130896%0.098%KM078930.1Select seq gb|KM078971.1|Zika virus strain CHI2613014 NS5 protein gene, partial cds1305130596%0.098%KM078971.1Select seq gb|KM078970.1|Zika virus strain CHI2490414 NS5 protein gene, partial cds1305130596%0.098%KM078970.1Select seq gb|KM078933.1|Zika virus strain CHI1058514 NS5 protein gene, partial cds1305130596%0.098%KM078933.1Select seq gb|KM078929.1|Zika virus strain CHI1805214 NS5 protein gene, partial cds1303130396%0.098%KM078929.1Select seq gb|KU179098.1|Zika virus isolate JMB-185 nonstructural protein 5 gene, partial cds1294129495%0.098%KU179098.1Select seq gb|KJ873160.1|Zika virus isolate NC14-03042014-3481 nonstructural protein 5 gene, partial cds1276127694%0.098%KJ873160.1Select seq gb|HQ234499.1|Zika virus isolate P6-740 polyprotein gene, partial cds12611261100%0.095%HQ234499.1Select seq gb|KJ873161.1|Zika virus isolate NC14-02042014-3220 nonstructural protein 5 gene, partial cds1178117887%0.098%KJ873161.1Select seq gb|KU720415.1|Zika virus strain MR 766 polyprotein gene, complete cds10401040100%0.089%KU720415.1

Zika virus strain CPC-0740 nonstructural protein 5 gene, partial cdsGenBank: KM851038.1 FASTA Graphics Go to:LOCUS KM851038 789 bp RNA linear VRL 25-MAY-2015 DEFINITION Zika virus strain CPC-0740 nonstructural protein 5 gene, partial cds. ACCESSION KM851038 VERSION KM851038.1 GI:822599142 KEYWORDS . SOURCE Zika virus ORGANISM Zika virus Viruses; ssRNA viruses; ssRNA positive-strand viruses, no DNA stage; Flaviviridae; Flavivirus. REFERENCE 1 (bases 1 to 789) AUTHORS Alera,M.T., Hermann,L., Tac-An,I.A., Klungthong,C., Rutvisuttinunt,W., Manasatienkij,W., Villa,D., Thaisomboonsuk,B., Velasco,J.M., Chinnawirotpisan,P., Lago,C.B., Roque,V.G. Jr., Macareo,L.R., Srikiatkhachorn,A., Fernandez,S. and Yoon,I.K. TITLE Zika virus infection, Philippines, 2012 JOURNAL Emerging Infect. Dis. 21 (4), 722-724 (2015) PUBMED 25811410 REFERENCE 2 (bases 1 to 789) AUTHORS Alera,M.T., Hermann,L., Tac-An,I.A., Klungthong,C., Rutvisuttinunt,W., Villa,D., Thaisomboonsuk,B., Velasco,J.M., Chinnawirotpisan,P., Lago,C.B., Roque,V.G. Jr., Macareo,L.R., Srikiatkhachorn,A., Fernandez,S. and Yoon,I.-K. TITLE Direct Submission JOURNAL Submitted (02-OCT-2014) Virology, USAMC-AFRIMS, 315/6 Rajvithi Road, Bangkok 10400, Thailand COMMENT ##Assembly-Data-START## Assembly Method :: Trinity Sequencing Technology :: Illumina ##Assembly-Data-END## FEATURES Location/Qualifiers source 1..789 /organism="Zika virus" /mol_type="genomic RNA" /strain="CPC-0740" /host="Homo sapiens" /db_xref="taxon:64320" /country="Philippines" /collection_date="09-May-2012" CDS <1..>789 /note="NS5" /codon_start=1 /product="nonstructural protein 5" /protein_id="AKH87424.1" /db_xref="GI:822599143" /translation="RISRFDLENEALITNQMEKGHRALALAIIKYTYQNKVVKVLRPA EKGKTVMDIISRQDQRGSGQVVTYALNTFTNLVVQLIRNMEAEEVLEMQDLWLLRRPE KVTNWLQSNGWDRLKRMAVSGDDCVVKPIDDRFAHALRFLNDMGKVRKDTQEWKPSTG WDNWEEVPFCSHHFNKLHLKDGRSIVVPCRHQDELIGRARVSPGAGWSIRETACLAKS YAQMWQLLYFHRRDLRLMANAICSSVPVDWVPTGRTTWSIHGKGE" ORIGIN 1 cgcatcagca ggtttgatct ggagaatgaa gctctaatca ccaaccaaat ggagaaaggg 61 cacagggcct tggcattggc cataatcaag tacacatacc aaaacaaagt ggtaaaggtc 121 cttagaccag ctgaaaaagg gaagacagtt atggacatta tttcaagaca agaccaaagg 181 gggagcggac aagttgtcac ttacgctctt aatacattca ccaacctggt ggtgcagctc 241 attcggaata tggaggctga ggaagttcta gagatgcaag acttgtggct gctgcggagg 301 ccagagaaag tgaccaactg gttgcaaagc aacggatggg ataggctcaa aagaatggca 361 gtcagtggag atgattgcgt tgtgaaacca attgatgata ggtttgcaca tgccctcagg 421 ttcttgaatg atatgggaaa agttaggaag gacacacaag agtggaaacc ctcaactgga 481 tgggacaact gggaagaagt tccgttttgc tcccaccact tcaacaaact ccatcttaag 541 gacgggaggt ccattgtggt tccctgccgc caccaagatg aactgattgg ccgagcccgc 601 gtatcaccag gggcgggatg gagcatccgg gagactgctt gcctagcaaa atcatatgcg 661 caaatgtggc agctccttta tttccacaga agggacctcc gactgatggc caatgccatt 721 tgttcatctg tgccagttga ttgggttcca actgggagaa ctacctggtc aatccatgga 781 aagggagaa