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CDCEID journalPast IssuesApril 2015Zika Virus Infection, Philippines, 2012Zika Virus Infection, Philippines, 2012 Recommend on FacebookTweetFigure Volume 21, Number 4—April 2015LetterZika Virus Infection, Philippines, 2012Maria Theresa Alera, Laura Hermann , Ilya A. Tac-An, Chonticha Klungthong, Wiriya Rutvisuttinunt, Wudtichai Manasatienkij, Daisy Villa, Butsaya Thaisomboonsuk, John Mark Velasco, Piyawan Chinnawirotpisan, Catherine B. Lago, Vito G. Roque, Louis R. Macareo, Anon Srikiatkhachorn, Stefan Fernandez, and In-Kyu YoonAuthor affiliations: Philippines-AFRIMS (Armed Forces Research Institute of Medical Sciences), Cebu City, Philippines (M.T. Alera, J.M. Velasco, C.B. Lago);University of Toronto, Toronto, Ontario, Canada (L. Hermann); AFRIMS, Bangkok, Thailand (L. Hermann, C. Klungthong, W. Rutvisuttinunt, W. Manasatienkij, B. Thaisomboonsuk, P. Chinnawirotpisan, L.R. Macareo, S. Fernandez, I.-K. Yoon); Cebu City Health Department, Cebu City (I.A. Tac-An, D. Villa); Department of Health, Manila, Philippines (V.G. Roque, Jr.); University of Massachusetts Medical School, Worcester, Massachusetts, USA (A. Srikiatkhachorn)Main Article FigureFigure. Maximum-likelihood phylogenetic tree of fragments of Zika virus was determined using the general time-reversible plus gamma distribution plus invariable site model with 13 reference Zika virus strains from GenBank. The contig sequence, obtained from de novo assembly and blastn (http://blast.ncbi.nlm.nih.gov/Blast.cgi?PROGRAM=blastn&PAGE_TYPE=BlastSearch&LINK_LOC=blasthome), of the Philippines isolate from 2012 (GenBank accession no. KM851038; bold font) was analyzed against 8 reference strains from Africa (GenBank accession nos. KF268948, KF268949, KF268950, LC002520, AY632535, NC012532, HQ234500, HQ234501) and 5 reference strains from Asia (GenBank accession nos. KJ776791, JN860885, EU545988, HQ234499, KF993678). The year of collection is unknown for several strains from Africa. Bootstrap values >70 are indicated at nodes. Scale bar indicates nucleotide substitutions per site. The drawing is not to scale. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378478/figure/F1/

Recent PHL visitor tested positive for Zika Published March 6, 2016 5:02pmBy BIANCA ROSE DABU, GMA News A US resident who visited the Philippines last January tested positive for the Zika virus, the Department of Health (DOH) disclosed on Sunday. The DOH said the report was relayed to them by the US Center for Disease Control. The patient was described as a "non-pregnant adult" who reportedly got sick in her last week in the country. She is now back in the US, according to a report by GMA News reporter Isay Reyes.The DOH said the visitor started to exhibit symptoms of the Zika virus from January 2 to 18. After the case has been confirmed, Philippine and US authorities traced and visited the places that the patient visited and conduct the necessary measures to prevent and control the virus. The DOH gave assurances that that there is no outbreak of the Zika virus in the Philippines and there is absolutely no reason to panic. In a press conference last month, Department of Health Secretary Janette Garin said that The Research Institute for Tropical Medicine will be activating five other government hospitals and laboratories for Zika virus testing. ' The hospitals include: Baguio General Hospital, Vicente Sotto Memorial Medical Center in Cebu City, Southern Philippines Medical Center in Davao, Lung Center of the Philippines in Quezon City, and San Lazaro Hospital in Manila. While there are about 2,000 Zika virus testing kits in the Philippines, the World Health Organization recommended to avoid testing on people without symptoms and to protect existing resources while there is still an immediate need for aggressive production of Zika virus testing kits. The DOH reminds everyone of the importance of cleanliness, and has also started to coordinate with other agencies to promote cleanliness and control the population of mosquitoes—the carrier of the virus. — APG, GMA News - See more at: http://www.gmanetwork.com/news/story/558015/news/nation/recent-phl-visitor-tested-positive-for-zika#sthash.qUg9789C.dpuf

A resident of the United States has tested positive for the deadly Zika virus while staying in the Philippines last January, the Department of Health (DOH) revealed on Sunday. In a press briefing, Health Secretary Janette Garin said that the unidentified American woman stayed in the Philippines for four weeks. However, the US resident only exhibited symptoms of the virus when she was on her last week in the country. “Currently we are coordinating with US Centers for Disease Control and Prevention for the profile of the patient, including information on places she visited in the PH,” Garin said. The health official allayed fears that there is now an outbreak of the said disease in the country. “Despite reported case, there is no outbreak of Zika virus in the Philippines. There is no epidemic. The public should not panic,” she said. READ: DOH says PH still free of Zika virus Garin also asked pregnant women and those who are planning to get pregnant to exercise maximum caution to avoid contracting the virus. Zika has become an epidemic in South America last year. The virus, which is spread through mosquito bites, causes mild illness or no symptoms at all. Some pregnant women who get infected by the virus give birth to children with microcephaly. According to the World Health Organization (WHO), microcephaly is a rare condition where “a baby is born with a small head or the head stops growing after birth.” Researchers are still studying the link of the rise of microcephaly cases and the Zika virus. The WHO has declared Zika as a “global emergency.” AJH/With reports from Jocelyn Uy, Philippine Daily Inquirer Read more: http://globalnation.inquirer.net/137422/american-tested-positive-for-zika-virus-while-in-ph-doh#ixzz427YlVWJd Follow us: @inquirerdotnet on Twitter | inquirerdotnet on Facebook

US resident who visited PH tests positive for ZikaHealth Secretary Janette Garin assures the public that there is no cause for alarm as there is no epidemic Rappler.comPublished 5:38 PM, March 06, 2016Updated 5:38 PM, March 06, 20162521TwitterRedditEmail521 ZIKA THREAT. The World Health Organization recently declared the virus a global health emergency. MANILA, Philippines – A resident of the United States tested positive for the Zika virus after spending 4 weeks in the Philippines in January 2016, the Department of Health (DOH) said on Sunday, March 6. The DOH cited a report from the US-Centers for Disease Control and Prevention (US-CDC) which indicated that a non-pregnant adult showed symptoms of fever, rash, joint pain, conjunctivitis, and muscle pain during her last week of stay in the Philippines, and was confirmed to have the Zika virus upon returning to the US. Zika is a mild case of the flu transmitted by mosquito species usually found in tropical and sub-tropical regions. Though seemingly minor, however, the virus is suspected to cause serious neurological problems and birth defects in babies born to infected women. (READ: FAST FACTS: Zika virus) Philippine Health Secretary Janette Garin said they are now trying to pinpoint all the provinces the patient may have traveled to during her stay. "Currently, we are coordinating with US-CDC for the profile of the patient, including information on places she visited in the Philippines," Garin said. The health chief assured the public that there is no cause for alarm as there is no epidemic, considering that it is just the second confirmed case of Zika virus in the country. The first laboratory confirmed case was in 2012 when a 15-year-old boy tested negative for dengue and Chikungunya but positive for Zika. He recovered after 3 weeks of bed rest and medication. Zika is characterized by fever, rash, and conjunctivitis. Other symptoms include joint pain, muscle pain, headache, and vomiting. These may last for 2 to 7 days. Although most infected individuals do not manifest any symptoms, they are still capable of transmitting the infection through the bite of infected female Aedes mosquitoes, the same ones responsible for dengue and Chikungunya. Other reports also indicated that the virus could be transmitted through sexual contact and blood transfusion. The symptoms of the virus can be treated with medications for common pain and fever, rest, and water. Patients, however, are encouraged to consult the nearest health facility if symptoms persist. The Research Institute for Tropical Medicine (RITM) can test suspected cases. Zika virus kits are also available for those who want to get tested across the country. (READ: 1,000 kids available in PH for Zika virus testing) Garin advised women – pregnant or not – to take precautions to protect themselves. Breeding grounds, Garin added, should be destroyed to prevent the spread of Aedes mosquitoes. "We reiterate that cleanliness is still the key against mosquito-borne diseases. The public is reminded to be vigilant and pre-cautious in eliminating mosquito breeding places through the '4S campaign,'" she said. "The 4S means search & destroy mosquito breeding places; use self-protection measures, seek early consultation for fever lasting more than two days, and say yes to fogging when there is an impending outbreak." According to the World Health Organization (WHO), 55 countries have reported local Zika cases from January 2007 to March 2016, making it a global threat. – Rappler.com http://www.rappler.com/nation/124851-philippines-zika-virus-united-states-resident

First case of Zika virus detected in Philippines since 2012A US resident who spent four weeks in the Philippines was found to have been infected with the Zika virus, the first case in the South-east Asian country since 2012. PHOTO: AFPPUBLISHED39 MIN AGOFACEBOOKTWITTEREMAIL MANILA (AFP) - An American woman was infected with the Zika virus while visiting the Philippines, health department officials said on Sunday (March 6), the first case detected in the country for several years. Philippines Health Secretary Janette Garin said the US Centres for Disease Control and Prevention (US-CDC) had informed her that a US resident who stayed in the Philippines for four weeks in January had apparently developed symptoms in her last week before returning to America. "We were informed that shortly after returning home to the US, an evidence of Zika virus infection was detected from the patient," Ms Garin said in a statement. "Currently, we are coordinating with US-CDC for the profile of the patient, including information on places she visited in the Philippines," she said, without giving details of the patient. zikavirus5316.jpgRelated StoryExperiments show link between Zika virus and foetal brain damageHealth department officials said they still had no clue how the American was infected while in the Philippines. The only previous known case of Zika in the country was a 15-year-old boy infected in 2012. He recovered after three weeks. The mosquito-borne disease is usually not life-threatening, but has been linked to a rise in birth defects in other countries, where hundreds of babies have been born with unusually small heads in recent years. http://www.straitstimes.com/asia/se-asia/first-case-of-zika-virus-detected-in-philippines-since-2012

First Case Of Zika Virus Detected In Philippines Since 2012World | Agence France-Presse | Updated: March 06, 2016 15:20 ISTEMAILPRINTCOMMENTS The only previous known case of Zika in the country was a 15-year-old boy infected in 2012. MANILA, PHILIPPINES: An American woman was infected with the Zika virus while visiting the Philippines, health department officials said Sunday, the first case detected in the country for several years.Health Secretary Janette Garin said the US Centers for Disease Control and Prevention (US-CDC) had informed her that a US resident who stayed in the Philippines for four weeks in January had apparently developed symptoms in her last week before returning to America."We were informed that shortly after returning home to the US, an evidence of Zika virus infection was detected from the patient," Garin said in a statement. "Currently, we are coordinating with US-CDC for the profile of the patient, including information on places she visited in the Philippines," Garin said without giving details of the patient.Health department officials said they still had no clue how the American was infected while in the Philippines.The only previous known case of Zika in the country was a 15-year-old boy infected in 2012. He recovered after three weeks.The mosquito-borne disease is usually not life-threatening but has been linked to a rise in birth defects in other countries, where hundreds of babies have been born with unusually small heads in recent years.(This story has not been edited by NDTV staff and is auto-generated from a syndicated feed.)Story First Published:March 06, 2016 15:20 ISThttp://www.ndtv.com/world-news/first-case-of-zika-virus-detected-in-philippines-since-2012-1284421

American tests positive for Zika virus while in PhilippinesAries Joseph HeginaPhilippine Daily Inquirer March 6, 2016 4:18 pm MANILA - A resident of the United States has tested positive for the deadly Zika virus while staying in the Philippines last January, the Department of Health revealed on Sunday.In a press briefing, Health Secretary Janette Garin said that the unidentified American woman stayed in the Philippines for four weeks.However, the US resident only exhibited symptoms of the virus when she was on the last week of her stay in the country."Currently we are coordinating with US Centres for Disease Control and Prevention for the profile of the patient, including information on places she visited in the Philippines," Garin said.The health official allayed fears that there is now an outbreak of the said disease in the country. "Despite reported case, there is no outbreak of Zika virus in the Philippines. There is no epidemic. The public should not panic," she said.Garin also asked pregnant women and those who are planning to get pregnant to exercise maximum caution to avoid contracting the virus.Zika has become an epidemic in South America last year. The virus, which is spread through mosquito bites, causes mild illness or no symptoms at all.Some pregnant women who get infected by the virus give birth to children with microcephaly.According to the World Health Organisation (WHO), microcephaly is a rare condition where "a baby is born with a small head or the head stops growing after birth."Researchers are still studying the link of the rise of microcephaly cases and the Zika virus. The WHO has declared Zika as a "global emergency."

Zika confirmed in a United States resident who developed symptoms in the Philippines. http://www.nationmultimedia.com/breakingnews/American-tests-positive-for-Zika-virus-while-in-Ph-30280891.html

Reported first case of microcephaly linked to Zika virus in ColombiaDate Published: 4 / Mar / 2016 4:07:43 PM Photo: EFE A doctor reported on Friday the first case of microcephaly linked to Zika virus in Colombia, although the National Institute of Health said it had no information and declined to confirm. Colombia is the second country with the highest number of cases of Zika in Latin America and the Caribbean after Brazil. So far there have been 42,706 cases including 7,653 pregnant women, according to the National Institute of Health (NIH). Zika many details about the still unknown, including whether the virus -transmitido mosquito Aedes aegypti really cause microcephaly and is linked to Guillain-Barre syndrome, a rare disorder that can weaken necrológico muscles and cause paralysis. "The only infectious agent that would explain what is happening is Zika virus infection," he told Reuters Alfonso Rodriguez-Morales, a physician and researcher at the Technological University of Pereira. The case of microcephaly, a congenital defect that causes the head of the babies is abnormally small and that brain development is not complete, which can cause difficulties in intellectual and physical development, was recorded in the department of Sucre, in the northern Colombia, where 28 infected women follow with Zika was made. Rodriguez-Morales explained that the case does not prove a direct link between the virus and microcephaly, although his team ruled out other possible causes of defects of this child, including rubella, herpes, syphilis, and toxoplasmosis. Two other babies born until the time of the women involved in the study had cranial defects that are still being investigated and could so far not be linked to Zika said the doctor. The INS said it could not confirm the case because the patient samples were not sent to their laboratories. He also reported that it is currently monitoring 28 children with microcephaly potential, not all related to Zika. Rodriguez-Morales said the researchers sent the samples to the INS. The potential case was first reported by the scientific journal Nature. "We will really see the impact of Zika in newborns and pregnancy during the next two or three months," he said. Health authorities in Colombia reported last week a "probable" case of microcephaly associated with an aborted fetus Zika week. Brazil has confirmed more than 640 cases of microcephaly, and finds that most are related to infections in mothers Zika.more than 4,200 additional suspected cases are investigated. Reuters - See more at: http://www.cablenoticias.tv/vernoticia.asp?titulo=Reportan-primer-caso-de-microcefalia-vinculado-a-virus-de-zika-en-Colombia&WPLACA=66243#sthash.M5ciVjwg.dpuf

First case of microcephaly and stillbirths in VenezuelaIn a test that was made to the umbilical cord tissue doctors found genetic material Zika virus. Posted by: Drafting Sumarium on March 4, 2016 - 24:57 [email protected] @sumariumcom (Caracas, Reuters) - Doctors in Venezuela confirmed the first case of microcephaly and death of the fetus of a mother who was infected in the country with the virus Zika at the beginning of her pregnancy, she reported on Friday the International Society for Infectious Diseases. The case adds to the evidence in Brazil on the relationship between Zika and microcephaly in infants , which investigates the World Health Organization (WHO), and a report in Colombia of a "probable" case of this anomaly in the fetus of a mother interrupted her pregnancy after suffering the virus. The baby patient, 24 years old, and had no life in week 17 of gestation and presented "a diagnosis of microcephaly and severe oligoamnios" , said the medical report signed by four Venezuelan doctors. The mother showed symptoms of the virus in the first trimester of pregnancy, but at that time or the placenta or the fetus had abnormalities, the study added. The presence of dengue virus, rubella or chikungunya was discarded . The Ministry of Health in Venezuela has not yet informed about this case and did not immediately return a request for information made Reuters. In a test that was made to the umbilical cord tissue doctors found genetic material Zika virus . An official of the World Health Organization (WHO) said on Friday that there is "growing evidence" about the relationship between Zika virus and two neurological disorders microcephaly and Guillain-Barre syndrome. In early February, Venezuela reported three deaths and about 5,221 patients suspected of having the virus Zika , but doctors and non - governmental organizations believe that cases may be many more in a country suffering from an acute shortage of medicines and repellents to avoid the bite of the infected mosquito. The outbreak has been confirmed this year in Panama, Venezuela, El Salvador, Mexico, Suriname, Colombia, Guatemala and Paraguay. "In the circumstances we are living, the situation could be much more dramatic than in other countries in the region , " said Jaime Torres infectious disease specialist at an academic conference that was broadcast on the Internet in February. Torres, who participated in the study reported the first case Zika's relationship with microcephaly in Venezuela, made the warning as 60 percent of the 600,000 pregnant women do not receive adequate prenatal annual control. In most cases, the virus occurs without symptoms that cause alarm. In Venezuela abortion laws consider as illegal unless threatened the life or health of the woman, but not in the case of the baby. Category: Venezuela | Keys: Zikahttp://sumarium.com/confirman-el-primer-caso-microcefalia-y-muerte-del-feto-en-venezuela/

Microcephaly confirmed case of death of the fetus by Zika in Venezuela Mar 5, 2016 The Health Ministry has not reported on this case in Venezuela The Cooperante.- The International Society for Infectious Diseases, doctors reported that Venezuela confirmed the first case of microcephaly and death of the fetus of a mother who was infected in the country with Zika virus during pregnancy. As reported by Reuters, the baby of the patient 24, had no life at 17 weeks of gestation and the doctors was diagnosed microcephaly and oligoamnios, ie the unborn had a small amount of amniotic fluid surrounding it and protects. The mother presented the symptoms of Zika in the first trimester of pregnancy, although no changes were developed or the placenta or the fetus, the disease was detected in the umbilical cord. The Health Ministry has not reported on this case in Venezuela, although in early February, the country reported three deaths and 5,221 patients suspected of having the Zika virus, without doctors and NGOs have reflected however that may be many most cases. http://elcooperante.com/alo-luisana-medicos-confirman-primer-caso-de-microcefalia-y-muerte-de-un-feto-por-zika-en-venezuela/

FRIDAY, MARCH 4, 2016 Kathleen Haughney 03/04/2016 11:45 am Hengli Tang, professor of biological science at Florida State. Zika virus FAQ (PDF) Florida State University researchers have made a major breakthrough in the quest to learn whether the Zika virus is linked to birth defects with the discovery that the virus is directly targeting brain development cells and stunting their growth. This is the first major finding by scientists that shows that these critical cells are a target of the virus and also negatively affected by it. Hengli Tang, professor of biological science at FSU, is a lead author of the study published today (March 4) in the academic journal Cell Stem Cell. “We’re trying to fill the knowledge gap between infection and the neurological defects,” Tang said. “This research is the very first step in that, but it’s answering a critical question. It enables us to focus the research. Now you can be studying the virus in the right cell type, screening your drugs on the right cell type and studying the biology of the right cell type.” Though the Zika virus was discovered in 1947, there is very little known about how it works and its potential health implications, especially among pregnant women. Anecdotal evidence has suggested a link to microcephaly, a condition where a child is born with an abnormally small head as a result of incomplete brain development. Tang and graduate student Sarah Ogden are working to find answers about the mysterious Zika virus. Tang, along with researchers at Johns Hopkins University and Emory University, found that the virus directly targets a cell type called human embryonic cortical neural progenitors in as little as three days after being exposed to the virus. They also discovered that these infected cells replicate the Zika virus, posing potential treatment problems, and that the virus is directly interfering with cell growth and function. Some of the cells died after being infected. “Potentially, this could explain why there is a link to microcephaly, but there is a lot more work needed to show the direct causal effect,” said Guo-Li Ming, professor of neurology at Johns Hopkins University. The research took a remarkably quick path. Because of the public health implications, researchers worldwide have been working around the clock to study how the virus works and its potential targets. According to the World Health Organization, 48 countries have reported local transmission of the Zika virus. About a month ago, a research team led by Johns Hopkins University neurology Professors Hongjun Song and Ming brought neural stem cells to FSU where Tang and his graduate students infected them with the virus and began monitoring them. A few weeks later, they were transported to Emory so scientists there could analyze changes in gene expression caused by the virus. Tang had been funded by the National Institutes of Health to study the Dengue virus, which is similar to the Zika virus, and was in the unique position of already running a lab equipped to handle and study samples of the virus. Song and Ming, who went to graduate school with Tang, were experts on the neural cells that they believed the virus was targeting. The three labs will continue to collaborate and also tackle various aspects of the disease separately. Tang is investigating how it enters the cell and then how it specifically disrupts the normal cell processes. Ming is using 3D models of brains to further examine the link between the neural progenitor cells and microcephaly. And Song is investigating why the virus is going after neural progenitor cells as opposed to other cell types. Many questions still remain about the virus, but this discovery is the pivotal first step. “It’s significant because we’re literally the first people in the world to know this, to know that this virus can infect these very important cells and interfere with their function,” Tang said. “Research is rewarding in general, but when you have something this timely and this clinically relevant, it’s extra satisfying because we’ll be helping people in the long run.” Other authors on the paper are Florida State University researcher Ruth Didier and graduate students Christy Hammack, Sarah Ogden and Emily Lee; Zhexing Wen, Xuyu Qian and Kimberly Christian from Johns Hopkins University; and Yujing Li, Bing Ya, Feiran Zhang and Peng Jin from Emory University. The research was funded by Florida State University, the Maryland Stem Cell Research Fund and the National Institutes of Health. FSU makes Zika breakthrough from Florida State Universityhttp://news.fsu.edu/Top-Stories/FSU-researchers-make-important-Zika-virus-breakthrough

Venezuelan doctors confirmed case of microcephaly and death of fetusThis is the case of a patient 24, whose baby no longer had life in week 17 of gestation, as well as presenting "a diagnosis of microcephaly and severe oligoamnios" says the report.The fetus had no life in week 17 of gestation (FILE)THE UNIVERSALFriday March 4, 2016 6:47 PMCaracas.- According to a study signed by four Venezuelan doctors, was confirmed the first case of microcephaly and death of the fetus of a mother who was infected with the virus Zika at the beginning of their pregnancy. This is the case of a patient, 24 years, whose baby no longer had life in week 17 of gestation, as well as presenting "a diagnosis of microcephaly and severe oligoamnios" the report replicated by the International Society for Infectious Diseases and reviewed by Reuters. it describes the mother presented Zika virus symptoms in the first trimester of pregnancy, but at that time neither the placenta or the fetus had abnormalities. Then the possibility that it was dengue virus, rubella or chikungunya was discarded. The Ministry of Health in Venezuela has not yet informed about this case and has not responded to the request for information that raised the Reuters news agency. Earlier February, Venezuela reported three deaths and about 5,221 patients suspected of having the virus Zika. However, doctors and NGOs ensure that cases are more numerous because of the acute shortage of medicines and repellent mosquito carrying the virus afflicting the country. "In the circumstances we are living, the situation could be much more dramatic in other countries in the region ,"said infectious disease specialist Jaime Torres at an academic conference that was broadcast on the Internet in February. Torres, who participated in the study's first case reporting relationship of Zika with microcephaly in Venezuela, warned the situation because 60 percent of the 600,000 pregnant women do not receive adequate prenatal annual control. And we should mention that in most cases, the virus without symptoms that cause alarm. The World Health Organization (WHO) continues to investigate the evidence in Brazil on the relationship between Zika and microcephaly in infants. An official of the international organization reiterated Friday that there is "growing evidence" about the relationship between Zika virus and two neurological disorders microcephaly and Guillain-Barre syndrome. http://www.eluniversal.com/vida/160304/medicos-venezolanos-confirman-caso-de-microcefalia-y-muerte-de-feto

Linked to Zika with deformed baby in VenezuelaThe International Society for Infectious Diseases reported that doctors in Venezuela confirmed the first case of microcephaly of a baby whose mother was infected with the virus Zika. March 4, 2016 by Alan Lopez Section International The International Society for Infectious Diseases reported that doctors in Venezuelaconfirmed the first case of microcephaly and death of the fetus of a mother who was infected in that country with the virus Zika at the beginning of the process of pregnancy. Thus, the medical report signed by four Venezuelan doctors reported that the baby patient and had no life at 17 weeks of gestation, and it had a diagnosis ofmicrocephaly and severe oligohydramnios. The report also noted that the mother, 24 -year-old showed symptoms of the virus Zikain the first trimester of pregnancy, but at that time no alterations or the fetus or placenta were recorded, and that was ruled presence of dengue, rubella or chikungunya virus. It is noteworthy that in a test conducted to the tissue of the umbilical cord of the baby in Venezuela doctors found genetic material of the virus, in addition to this case , the evidence adds in Brazil on the relationship between the disease and microcephaly in fetuses and newborns , which is being investigated by the World Health Organization (WHO). In addition, in early February in Venezuela three deaths and five thousand 221 patients suspected of suffering were recorded virus Zika , although doctors and organizations reported that the number of cases may be much higher because this is a country that suffers from a severe shortage of medicines and repellents to prevent mosquito bites Aedes aegypti , spread of disease. http://www.sexenio.com.mx/articulo.php?id=72937

Recorded case of microcephaly in fetus by Zika virus in VenezuelaPosted by: Genesis Acevedo in News , Life and Health 3 hours ago 0 36 Views Doctors said the 24-year old patient was carrying a baby in week 17 of gestation and had no life because in the first months of gestation contracted the virus and transmitted it to the neonate Photo: AFP Friday March 4 Venezuela doctors confirmed the first case of microcephaly and death of a fetus whose mother was infected by the virus Zika, in the early months of pregnancy, said Friday the International Society for Infectious Diseases. The 24 year old patient was carrying a baby in week 17 of gestation and had no life, presenting a diagnosis of "severe microcephaly and oligoamnios" the medical report signed by four doctors. The mother showed symptoms of the virus in the first trimester of pregnancy, however at that time, neither the fetus or the placenta had some type of alterations, Reuters reported on its website. This case entitled Health, Luisana Melo, still not pronounced, like not respond to a request for information to conduct news agency. It was learned that the umbilical cord had contained genetic material Zika virus, thanks to a test that was performed to tissue. It is recalled that in the first days of February were reported in the nation three deaths and at least 5,221 cases of patients suspected of having the virus Zika, although medical and non-governmental organizations believe that there could be many more, before the crisis of shortage It presents the country. http://www.eltubazodigital.com/noticias-de-venezuela/vida-y-salud/registran-caso-de-microcefalia-en-feto-por-virus-zika-en-venezuela/

Colombia has first cases of microcephaly related zika Researchers predict that in two or three months, the country will live a wave of babies born with the virus linked problems By: AFP03/04/2016 - 19:28 | Updated on 04/03/2016 - 19:32ShareEmailGoogle+TwitterFacebookPhoto: GUGA MATOS / JC IMAGE / Estadão ContentResearchers diagnosed the first cases of birth defects related to zika babies in Colombia. According to a report published in Nature, these are indications that in two or three months the country will have a wave of children born with problems related to the virus. According to the magazine, a newborn had diagnosis of microcephaly and two abnormalities in the brain. The three had positive tests for zika. Read also: Rio Grande do Sul has 97 suspected cases of zika virus research suggests that mosquito can transmit zika Alfonso Rodriguez-Morales, president of the Colombian Collaborative League in zika who made the diagnoses, says the group is investigating other cases. For the researcher, the risk posed by zika can much lower than that of other diseases that are known to cause microcephaly, such as toxoplasmosis, rubella, but this is a preliminary estimate. The virus reached the neighboring country in September 2015 and now Colombia is the second country in number of infected, behind Brazil. Here, the first cases of zika began to be recorded in May 2015, but before that had infection reports in the Northeast. In August, neurologists Pernambuco realized the increasing number of cases of microcephaly. In November the Ministry of Health confirmed that the increase in cases of microcephaly was related to the virus. On Tuesday, the Ministry of Health report has confirmed 641 cases of microcephaly. Of these, 82 had a positive laboratory tests for infection zika. http://zh.clicrbs.com.br/rs/vida-e-estilo/vida/noticia/2016/03/colombia-tem-primeiros-casos-de-microcefalia-relacionados-ao-zika-4990487.html

REGRETTABLE! CONFIRMS FIRST CASE OF MICROCEPHALY BY ZIKA IN VENEZUELA: THE BABY DID NOT SURVIVE Friday, March 4, 2016 15:38218 The infectious disease, Jaime Torres, the Institute of Tropical Medicine (IMT) of the Central University of Venezuela (UCV), issued a report that revealed the first proven case of microcephaly in Venezuela. The victim was a baby at 17 weeks gestation in a patient 24 years old, from Maturin, Monagas state. Doctors found that the fetus was lifeless. In the 13th week of pregnancy (January 5, 2016), she presented skin rash and malaise, two characteristic symptoms of Zika, however, "... the assessment that date, including ultrasound examination revealed no alterations in amniotic fluid placenta and fetus ... "Torres said in the report. February 16 for the sonogram and reflected a severe reduction in the amount of amniotic fluid and intracerebral calcified structures, both complications associated with Zika virus. "... Practiced Serological studies ruled out the occurrence of recent infection with cytomegalovirus, rubella, dengue or chikungunya ..." reads the document. 19 of the same month the studies found fetal death in utero, diagnosed with microcephaly and decreased amniotic fluid. Thanks to the authorization granted by the baby's parents, samples from the umbilical cord, placenta and brain, were referred to the IMT and the Venezuelan Institute for Scientific Research (IVIC). "... In parallel, have been sent Confirmatory shows the National Institute of Hygiene Rafael Rangel, national reference center for diagnosis of infections Zika virus and samples for further study of histopathology and electron microscopy ... were collected," he explained the infectious disease. Initial results obtained from the test polymerase chain reaction in real-time PCR, performed blood, umbilical cord and amniotic fluid showed the presence in those tissues Zika virus's genetic material. The report also included the rubrics of the obstetrician Rafael Suarez, Nahir Martinez, belonging to the virology section of the IMT and the IVIC Dr. Zoila Moros. http://laiguana.tv/articulos/23078-confirmado-microcefalia-zika-venezuela-imt-ivic

CONFIRMS FIRST CASE OF MICROCEPHALY IN VENEZUELAMarch 4, 2016 Must HomerThis is the case of a patient 24, whose baby no longer had life in week 17 of gestation, as well as presenting "a diagnosis of microcephaly and severe oligoamnios" says the report. According to a study signed by four Venezuelan doctors, it was confirmed the first case of microcephaly and fetal death of a mother who was infected with the virus Zika at the beginning of her pregnancy. This is the case of a patient 24, whose baby no longer had life in week 17 of gestation, as well as presenting "a diagnosis of microcephaly and severe oligoamnios" the report replicated by the International Society for Infectious Diseases and reviewed by Reuters. further he discloses that the mother had symptoms of Zika virus in the first trimester of pregnancy, but at that time neither the placenta or the fetus had abnormalities. Then the possibility that it was dengue virus, rubella or chikungunya discarded. The Ministry of Health in Venezuela has not yet informed about this case and has not responded to the request for information that raised the Reuters news agency. In early February, Venezuela reported three deaths and about 5,221 patients suspected of having the virus Zika. However, doctors and NGOs ensure that cases are more numerous because of the acute shortage of medicines and mosquito repellents virus carrier afflicting the country. "In the circumstances we are living, the situation could be much more dramatic than in other countries in the region," said Jaime Torres infectious disease specialist at an academic conference that was broadcast on the Internet in February. Torres, who participated in the study reported the first case Zika's relationship with microcephaly in Venezuela, warned the situation as 60 percent of the 600,000 pregnant women do not receive adequate prenatal annual control. And it should be mentioned that in most cases the virus occurs without symptoms that cause alarm. The World Health Organization (WHO) continues to investigate the evidence in Brazil on the relationship between Zika and microcephaly in infants. An official of the international organization reiterated Friday that there is "growing evidence" about the relationship between Zika virus and two neurological disorders. Microcephaly and Guillain-Barre syndrome (ES) http://www.guayanadigital.com.ve/2016/03/04/confirman-primer-caso-de-microcefalia-en-venezuela/

They confirmed the first case of microcephaly and fetal death in MonagasMarch 4, 2016by Gabriela ZapataHealthno CommentA report infectólogo the Institute of Tropical Medicine of the Central University of Venezuela, Jaime Torres, revealed the first proven case of microcephaly in Venezuela, in the baby of a patient 24-year-old from Maturin, Monagas state. At week 17 of gestation doctors they found the fetus was dead. In the description of the case it is reported that the last menstrual period of women occurred in October 2015 and the January 5, 2016 (in the 13th week of pregnancy) presented skin rash and malaise, two characteristic symptoms of zika. "The assessment of that date, including ultrasound examination revealed no alterations in amniotic fluid, placenta and fetus" indicate in the report. On February 16 and the sonogram revealed a severe reduction in the amount of amniotic fluid and intracerebral calcified structures, both complications that have been associated with the presence of zika. "Practiced Serological studies ruled out the occurrence of recent infection with cytomegalovirus, rubella, dengue or chikungunya". Three days after studies showed fetal death in utero, diagnosed with microcephaly and decreased amniotic fluid. The baby's parents authorized that samples of umbilical cord, placenta and brain, which were referred to the IMT and the Venezuelan Institute for Scientific Research (IVIC) was studied. "In parallel, have been sent Confirmatory shows the National Institute of Hygiene Rafael Rangel, national reference center for diagnosis of infections Zika virus and samples for further study of histopathology and electron microscopy were collected," explained in the document.(The National) http://www.noticiasdeaqui.net/2016/03/04/confirmaron-primer-caso-de-microcefalia-y-muerte-fetal-en-monagas/

Colombia reports more than 47,700 Zika casesA pregnant woman holds a mosquito net in Cali, Colombia, on Feb 10, 2016.PHOTO: AFPPUBLISHED1 HOUR AGOFACEBOOK0TWITTEREMAIL BOGOTA (AFP) - Colombia has seen more than 47,700 cases of Zika, including thousands of pregnant women infected with the mosquito-borne virus, the country's National Health Institute reported Saturday. A total of 8,890 pregnant women have come down with the disease, which has been tentatively linked to a serious birth defect known as microcephaly affecting babies born to women who became infected while pregnant. Of the 47,771 cases now reported, 5,065 were registered in the last week alone. Among those, 1,237 cases were pregnant women. Although the disease's symptoms are generally mild and include low fever, headaches and joint pain, Zika's rapid spread has raised alarm in Latin America due to its association with several more serious health conditions. Apart from its links to microcephaly, an irreversible condition in which babies are born with abnormally small heads and brains, it is also suspected of causing Guillain-Barre syndrome, a neurological disorder. The virus has infected people across 282 Colombian municipalities, 67 per cent of them women. The 25 to 29 age group was the most affected, comprising about 14 per cent of cases. Clinical exams were used to identify 39,924 of the cases in Colombia. Laboratory tests confirmed 2,090 more and another 5,757 are suspected cases. Colombia has reported the largest number of cases in Latin America after Brazil, where the outbreak was first detected last year and where 1.5 million Zika cases have been reported. Health authorities project that more than 600,000 people will be infected with the Zika virus this year in Colombia. http://www.straitstimes.com/world/americas/colombia-reports-more-than-47700-zika-cases

HEALTH , 4 MAR 2016 - 5:43 PMEpidemic Colombia denies even have evidence of congenital malformations zikaColombia carried out from December 2015 follow-up of 28 cases of microcephaly to determine whether there is connection with Zika virus. By: AFP 10SHAREDTwitterFacebookGooglereviewsINSERT Colombia denied Friday still have evidence of birth defects related to Zika virus in the mother, as reported by the British journal Nature a study in the country citing. "Samples of these cases have not come to us for analysis, so we can not confirm this link , " he told AFP Martha Lucia Ospina, director of theNational Institute of Health (INS), the reference laboratory in the country endorsed internationally . Nature said Friday that a team of researchers from the Colombian Network of Partnership against Zika (Recolzika), led by Alfonso Rodriguez Morales, "diagnosed as a newborn with microcephaly and two others with congenital brain abnormalities." "All three tested positive for the presence of the Zika virus , " he added the text, specifying that the experts submitted their findings to a scientific journal. Ospina welcomed the study, but hoped that the INS obtain 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 said. Ospina said Colombia carried out from December 2015 follow - up of 28 cases of microcephaly to determine whether there is connection with Zika virus in the mother. "Some are of children born and unborn children other, but never have had so far confirmation of that relationship," said the director of the INS. In this regard, the INS said Friday on his Twitter account "that all cases of fetuses and children in study follow steps" and announced that the "process results will be communicated." Colombia, the second most affected country by the zika after Brazil, has registered 42,706 cases of this disease, 7,653 of which in pregnant women, according to the latest weekly balance INS. In Brazil, the authorities estimate that a million and a half people were infected by the zika since 2015. This week 641 cases of microcephaly and 139 infants died from this cause were reported. Microcephaly leaves irreversible sequels in the brain and its appearance is also associated with mothers who contracted syphilis, rubella or toxoplasmosis during pregnancy. The outbreak of zika, which has set off alarms about it for this potential association with birth defects could cause between three and four million patients in the Americas, according to the World Health Organization (WHO) declared a global emergency . The zika is mainly transmitted by the bite of Aedes aegypti mosquito, the same vector of dengue, and yellow fever chincunguña. We also detected the sexual transmission. His -fever symptoms, joint pain, skin rash, conjuntivitis- are mild and in 80% of cases the disease may go unnoticed. http://www.elespectador.com/noticias/salud/colombia-niega-tener-aun-pruebas-de-malformaciones-cong-articulo-620363

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DiscussionWhy does it matter if the apparent teratogenic effects of Zika virus are placentally or directly mediated? As more data are collected, we might find that either or both hypotheses prove true depending on the timing of exposure and the stage of brain development. The placental mediation hypothesis holds appeal as we can easily and non-invasively measure an early placental response, whereas we cannot easily access the embryo. The placenta is an effective broadcaster of information on placental and fetal exposures and developmental consequences.29Secreted placental molecules and vesicles can be measured in maternal circulation and used by clinicians to diagnose a fetus at risk. Real-time monitoring of changes in concentrations of secreted molecules over the first trimester, linked to imaging of the morphology of the gestational sac, could establish temporality and provide clues as to how these relationships shift before and after the onset of maternal–placental circulation. Similarly, understanding any contribution of placental inputs to the teratogenic effect might clear the path for developing pharmacological methods to block teratogenesis. In the case of West Nile virus (a mosquito-transmitted flavivirus like Zika virus), treatments to pharmacologically stimulate autophagy were effective in reducing the neurotoxic effects in non-pregnant individuals.30 While the world awaits the epidemiology and pathology of this unique viral infection to help to explain the current epidemic in Brazil, now is the time to update our thinking and approaches to studying teratology and the role of the placenta. Doing so might provide large scientific rewards for this outbreak as well as future similar epidemics. Contributors JJA conducted the literature search and drafted the manuscript. ETAM contributed unpublished data, participated in the discussion of ideas, and helped with the writing. AC contributed to the discussion of ideas and helped with the writing. RHB contributed to the discussion of ideas and the writing. Declaration of interests We declare no competing interests.

Placental mediation hypothesisAn alternative and potential complement to the previous hypothesis of direct viral effect is that the placental response is the main cause of the brain defect. If the infected pregnancy is not spontaneously miscarried, then the virus is probably disrupting molecular synthesis in the outer layers of the placenta (figure). This change might happen before 10 weeks, when primary microcephaly occurs. Disruption of placental signals to the developing brain might cause or contribute to microcephaly. A model for this type of effect has been shown in the case of murine herpesvirus, in which the fetal effects occurred in the absence of the virus.15 The investigators offered an explanation that the placental response invoked a change in the profile of inflammatory markers within fetal organs. Whether the fetus itself expressed the inflammatory molecules, or if these molecules were delivered from the placenta, is not yet clear. Primary microcephaly, which appears to be the dominant type of microcephaly described in reports from Brazil (Marques ETA, unpublished), originates during early neurogenesis. The main features are fewer neurons at birth, simpler gyral surfaces, and smaller brains.16, 17, 18, 19 Microcephaly has various biological causes; Zika virus might be correlated with a specific type but evidence to definitively know is not yet available. Without or prior to making contact with the embryo proper, the virus might be able to perturb the synthesis or secretion of molecules (ie, proteins, neuropeptides, non-coding RNAs, or cytokines) within the placental chorionic villi. The chorionic villi have greater exposure to maternal blood than the early embryo, which is embedded within two fluid sacs and shielded by two membranes from maternal (but not placental) circulation. The perturbation in the synthesis and secretion of placental molecules by Zika virus itself or by some other process as a result of Zika virus infection might be a key component of virally induced fetal defects. One theory and modest data suggest that the placenta synthesises and secretes molecules that are essential for normal fetal brain development.20 Although largely unexplored, evolutionary hypotheses might provide a theoretical basis for linking placental functions (and dysfunction) to brain development. Our group can conceptualise two scenarios that support the idea of placental mediation of Zika virus-induced microcephaly. In one scenario, a general pro-inflammatory response of the placenta might be disrupting embryonic brain development. This idea might unify the diverse maternal exposures linked to higher risk of microcephaly (eg, radiation exposure, tobacco smoke, cocaine use, cytomegalovirus, alcohol consumption, or α-haemolytic streptococci).21, 22, 23, 24, 25 In another scenario, specific molecules or pathways synthesised by the early placenta are being disrupted, such as the microcephaly genes (ie, MCPH1-12, CEP63, and CASC5). Mutations in these genes have been causally related to microcephaly.16, 18, 19 The simultaneous under or over expression of these genes in the placenta and the fetus (ie, deficient vs toxic levels of a particular protein) might contribute to fetal defects. Even though the expression of the microcephaly proteins has been characterised as intracellular, their placental analogues might be packaged and secreted within placental exosomes—an important mechanism for intercellular communication.26 Two places should be studied to identify candidate molecules in the placental and fetal tissue of Zika virus-infected pregnancies. The first is the medical literature on genetic causes of microcephaly.18, 19,27 Are these same genes causally related to microcephaly in the case of viral infection? If so, how and in which cell type are these genes being disrupted as a result of Zika virus infection? This finding could mean that the placenta, being fetal tissue, expresses the same genes but under different conditions and for different reasons. Or this finding could indicate some placental participation in these early phases of embryonic or fetal development. The second is the set of molecules causally related to Zika virus transfer across the epidermis.28 The trophoblast, like the epidermis, is an epithelial cell type. Hence, analogies might exist between genes involved in the response of the epidermis (ie, AXL, DDX58, IFIH1, and MX1) and the placental response to the virus. Inquiry into this area might uncover shared mechanisms for receptor-mediated transmission, pattern recognition, and interferon stimulation. The chorionic villi are considered to be like the skin of the placenta. These villi are the primary interface between components of maternal blood and fetal circulation.

Direct transfer hypothesisOne possibility is that the virus has neurotropic properties and, via the placenta, is directly accessing and damaging the developing brain. This hypothesis implies the presence of the virus within the embryo at the earliest developmental stages of the cerebral cortex. However, in this early period, the embryo or fetus is fairly well shielded from maternal circulation. Maternal blood flow into the placenta only begins at 10 weeks gestation (figure).1 The routes of entry for the virus would be uterine gland secretions, leakage through the trophoblastic plugs that block maternal blood flow, or diffusion of preconceptional viral concentrations into the amniotic and yolk sacs as they form. Once the virus reaches the trophoblast barrier, the virus as part of an immunocomplex with non-neutralising antibodies could be carried through the placenta with the help of Fc gamma receptors.2,3 However, this process is less likely to be the case before 16 weeks.4, 5 Similar to the dengue virus,6, 7Zika virus might work through the endoplasmic reticulum of the trophoblast to become a sort of cargo of placental exosomes. Those exosomes might then be targeting embryonic or fetal neuroepithelium. The virus could be causing localised reactions at the interface of the placenta that can allow free virus to pass through.8 Zika virus might also be transmitted through semen, potentially giving the virus access to the early embryo.9 FigureThe gestational sac in the first trimester before the onset of maternal–placental blood flow The placenta consists of the chorion and the chorionic villi which encircle the embryo and carry out synthesis and secretion of molecules that can enter into the embryo. Different scenarios include: direct transfer of free virus through the trophoblast layers, placental exosome-mediated transfer, or minimal to no transfer. View Large Image | View Hi-Res Image | Download PowerPoint SlideTissue samples at this stage are not yet available to test these assumptions directly. Most of the signs of infection in women delivering microcephalic babies in Brazil are reported from 8–16 weeks gestation (Marques ETA, unpublished),9 which could mean that the virus is reaching the fetus at a later stage in brain development, and possibly precisely at this point when maternal blood flow into the placenta begins. A recent case report presents novel cross-sectional evidence that the cause of microcephaly in a fetus was direct transfer.10 The fetus was exposed to maternal Zika virus infection late in the first trimester (based on maternal symptoms) and the authors measured higher viral titres in the brain tissue at autopsy relative to other tissues. In two cases, the viral DNA was measured in amniotic fluid at 28 weeks, but not in maternal serum or urine.11 Additional evidence for direct transfer and brain damage by Zika virus is the detection of IgM against viral antigen (but not the viral mRNA) in the cerebral spinal fluid of 30 of the 31 samples analysed of the babies born with microcephaly (Marques ETA, unpublished). Although still sparse, these data are crucial towards an understanding of the teratogenic mechanism of Zika virus. Hopefully, additional data will continue to provide answers to questions central to a complete understanding of the relationship between Zika virus and microcephaly: does the virus reach the fetal brain in all cases? Can this process be measured within the developmental timeframe that matters most for the development of primary microcephaly? Because these measurements have been made late in or at the end of pregnancy, whether the virus is able to cross the placenta in the early period, which is most relevant to the risk of microcephaly, remains unclear. The ultimate proof would be a positively correlated metric of virus exposure in maternal and fetal tissues that coincides with the timing of the fetal defect. Alternatively, a cohort analysis (currently ongoing in Brazil) can statistically confirm the temporal ordering of prenatal maternal infection, fetal brain development, and increased risk of delivering a microcephalic infant. In-vitro models in which embryonic neuronal cells are directly exposed to Zika virus might generate useful information. However, these cells might also misrepresent conditions during early pregnancy in vivo, in which the virus must traverse fluid and tissue layers to reach the developing brain. Interestingly, no information to date points to global effects of Zika virus on placental function such as smaller birth size (excluding the head), reduced trophoblast invasion (higher incidences of pre-eclampsia or growth restriction), or preterm birth—all of which are tightly linked to the health and function of the placenta. Again, this observation suggests that the virus works through a more specific molecular pathway instead of outright destruction of the placenta and fetus. The pathology of placentas infected with cytomegalovirus might offer some foresights while data for Zika virus placental pathology evolves.12, 13 The most frequent symptom in placentas infected with cytomegalovirus was chronic villitis, or wide-scale inflammation of the cell layers of the chorionic villi. The degree of placental inflammation has been correlated with the severity of the fetal effects that include microcephaly.12, 13 The placenta, through a microRNA-mediated response, might be blocking or enhancing replication of the Zika virus as has been shown with other viruses.14