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Colombia Sees First Zika-Linked Birth DefectsTara John @tarajohn 9:24 AM ET Luis Robayo—AFP/Getty ImagesAn official of the of Health Ministry delivers brochures with information about the Zika virus to pregnant women, on Feb. 10, 2016, in Cali, Colombia.Three newborns tested positive for the presence of the Zika virusResearchers have found the first cases of birth defects linked to the Zika virus in Colombia, which may signal the start of a wave of birth defects in the country. According to Nature,researchers have diagnosed one newborn with microcephaly and two others with congenital brain abnormalities. All three tested positive for the presence of the Zika virus. Colombia has seen the second-highest amount of confirmed Zika cases after Brazil, which has seen a marked uptick in birth defects in areas where the mosquito-borne disease is prevalent. Until now, the smaller South American country had not observed a similar increase. Colombian researchers hope to monitor pregnant women and better establish the extent of the threat posed on fetuses by the virus, an important question that scientists have not been able to answer with Brazilian data. [Nature] http://time.com/4247623/zika-virus-newborns-colombia/

First Zika-linked birth defects detected in ColombiaCases may signal start of anticipated wave of birth defects in country hit hard by Zika virus. Declan Butler04 March 2016Article toolsRights & PermissionsLuis Robayo/AFP/Getty Images Brochures with information about the Zika virus have been delivered to pregnant women in Colombia. Researchers have found Colombia's first cases of birth defects linked to the Zika virus, Nature has learned — which are likely forerunners of a widely anticipated wave of Zika-related birth defects in the country. The discovery is perhaps no surprise: the virus arrived in Colombia last September, and the country is second only to Brazil in terms of the number of people infected with Zika. But Colombian researchers hope that plans put in place to closely monitor pregnant women can help to better establish the magnitude of the threat posed to fetuses by Zika. That is a crucial question that scientists have not so far been able to answer with the data from Brazil. Related storiesSpectre of Ebola haunts Zika responseZika researchers release real-time data on viral infection study in monkeysProving Zika link to birth defects poses huge challengeMore related stories Researchers have diagnosed one newborn with microcephaly — an abnormally small head — and two others with congenital brain abnormalities, says Alfonso Rodriguez-Morales, who chairs the Colombian Collaborative Network on Zika (RECOLZIKA), which made the diagnoses. All three tested positive for the presence of Zika virus. The researchers have submitted a report of their detections to a scientific journal. Rodriguez-Morales, an infectious-diseases epidemiologist at the Technological University of Pereira in western Colombia, says that he expects to see a rise in cases of Zika-linked birth defects starting in two or three months' time. The RECOLZIKA group — a network of researchers and public-health institutions across Colombia — are already investigating a handful of other suspected cases of microcephaly, which have a possible link to Zika. The next wave?Brazil is the only country so far to report a large surge in newborns with microcephaly that coincides with outbreaks of Zika virus. By the time the alarm over a possible microcephaly link was raised there (in October 2015), Zika infections had already peaked in many parts of the country, because the virus first reached Brazil at the beginning of last year. In Colombia, by contrast, researchers detected the first Zika cases in September, and by December had set up national tracking programmes to monitor pregnant women for signs of infection, and to spot early signs of birth defects in fetuses. Since then, researchers have been waiting attentively to see whether their country might experience a similar rise in birth defects. The true size of Brazil's surge in microcephaly cases is unknown. The country's health ministry says that 5,909 suspected microcephaly cases have been registered since early November, but only 1,667 of them have been investigated so far. Of those, 1,046 have been discarded as false positives, and 625 have been confirmed. (A link with the Zika virus has been confirmed by molecular-lab tests in 82 cases.) Given that Brazil reported only 147 cases of microcephaly in 2014, the reported increase in cases since November suggests a marked rise in the number of babies born with the condition. But the 2014 figure is a “huge underestimate”, says Lavinia Schüler-Faccini, a geneticist who specialises in birth defects at the Federal University of Rio Grande do Sul, Brazil, and president of the Brazilian Society of Genetic Medicine. She says that according to the frequency of microcephaly typically observed in regions around the world, one would expect to see 300–600 cases of severe microcephaly in any given year in Brazil, and around 1,500 less-severe ones. The search for cases of microcephaly in Brazil since October is probably turning up many mild cases that previously went unnoticed — so that the reported surge looks higher than it really is. Still, Schüler-Faccini and other clinicians say there is a real problem. They have observed first-hand a marked increase in the number of unusually severe cases of microcephaly, they say. To be prepared to better interpret any imminent peak in birth defects in Colombia, RECOLZIKA plans to look at historical cases to establish a baseline for the annual numbers of birth defects in different regions. It is also setting up a study to analyse patterns in the distribution of head-circumference measurements recorded in obstetrics units regionally throughout the country, to get a better idea of the local range of normal values. Luis Robayo/AFP/Getty Images A pregnant woman holds a mosquito net — delivered by Colombia's health ministry to ward off Zika virus infection — in Santiago de Cali, Colombia. Zika's link to microcephalyIt has also not been possible so far from Brazilian data to quantify the extent to which Zika virus is linked to the rise in microcephaly. The latest data from Brazil's ministry of health show that increased cases of microcephaly and/or congenital malformations of the central nervous system are still concentrated in the northeast — raising questions as to whether other factors, perhaps specific to this region, might also be in play. Clinical evidence leaves little doubt that a link between Zika and microcephaly exists: the virus has been detected in amniotic fluid, in the cerebrospinal fluid of affected babies and in the brains of stillborn fetuses and those aborted after the detection of severe malformations during pregnancy. But there are also many other possible causes of microcephaly, including a group of infections that are collectively called STORCH (syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus infection and herpes simplex), which are known to cause birth defects. Exposure to toxic chemicals and the consumption of alcohol during pregnancy can also cause the condition. “There is a clear need for a full assessment of other detailed causes of microcephaly, such as STORCH, and even non-infectious causes,” says Rodriguez-Morales. Brazil’s health ministry has stated that it is carrying out tests for such causes, but it has not made public how many of the confirmed microcephaly cases are attributable to these. Healthy comparisonsA key question in assessing the scale of the threat that Zika may pose to fetuses is how many pregnant women infected with Zika — in particular during the first trimester, when the fetus is most vulnerable — nonetheless give birth to healthy babies. RECOLZIKA researchers hope to help to answer this through their monitoring programme. The risk posed by Zika may well be lower than that of other diseases that are known to cause microcephaly such as toxoplasmosis and rubella, says Rodriguez-Morales. That is a preliminary estimate, he says, based on back-of-the-envelope calculations of the reported numbers of confirmed cases of microcephaly and congenital disorders, compared to the number of pregnant women in regions experiencing Zika epidemics. But even if its risk does turn out to be low, Zika could still lead to many cases because a large number of pregnant women in the Americas are likely to become infected with the virus. The biggest risk to pregnant women is right now, rather than in the long term. The epidemic is sweeping so quickly through the Americas that much of the population, including young women, will become naturally vaccinated by their exposure to the virus. As population immunity increases, the Zika epidemic is likely to fade quickly, and it will become endemic with only occasional flare ups. In a modelling study posted to the preprint server bioRxiv1 on 29 February, US researchers noted that the risk of prenatal Zika virus exposure “should decrease dramatically following the initial wave of disease, reaching almost undetectable levels”. Nature doi:10.1038/nature.2016.19502 Facebook LinkedIn WeiboReferencesBewick, S., Fagan, W. F., Calabrese, J. M. & Agusto, F. Preprint at bioRxivhttp://dx.doi.org/10.1101/041897 (2016).

Researchers have diagnosed one newborn with microcephaly — an abnormally small head — and two others with congenital brain abnormalities, says Alfonso Rodriguez-Morales, who chairs the Colombian Collaborative Network on Zika (RECOLZIKA), which made the diagnoses. All three tested positive for the presence of Zika virus. The researchers have submitted a report of their detections to a scientific journal. http://www.nature.com/news/first-zika-linked-birth-defects-detected-in-colombia-1.19502

Audio http://terrance.who.int/mediacentre/presser/WHO-RUSH_Zika_update_presser_AYLWARDb_04MAR2016.mp3

Marcia CastroMarcia Castro is a founding member of the Wittgenstein Centre for Demography and Global Human Capital’s Scientific Advisory Board. At Harvard, Castro serves as a member of the Faculty Advisory Committee of the Brazil Studies Program, a member of the Brazil Studies Program Steering Group of the David Rockefeller Center for Latin American Studies (DRCLAS), and a member of the Center for Geographic Analysis (CGA) Steering Committee. Her research focuses on: the identification of social, biological, and environmental risks associated with vector-borne diseases in the tropicsmodeling determinants of malaria transmission, with particular emphasis on generating evidence for better control strategiesexpansion of the Brazilian Amazon frontier and the social and environmental impacts of large-scale development projects implemented in the regionurbanization and healthuse of spatial analysis in the Social Sciencespopulation dynamics and mortality modelsCastro has applied geographical information systems, remote sensing, and spatial statistics to her research, as well as proposed novel methods in spatial analysis. She has done extensive work in the Brazilian Amazon, and has experience working in Africa. Since 2004, she has been working on the Dar es Salaam Urban Malaria Control Program, promoting the use of environmental management approaches to improve urban health. She is currently working on a project that is measuring health, poverty and place by modeling inequalities in Accra, Ghana using RS and GIS. She is also investigating the use of remotely sensed imagery to predict urban malaria in Dar es Salaam, Tanzania. Castro is leading a project to assess the malaria poverty vicious cycle, and she started a project to propose a new methodology to assess spatio-temporal trends in a scenario of multiple control interventions. She is also working on the issues of human mobility and asymptomatic malaria infections in the Brazilian Amazon, as well as on the potential impacts of extreme climatic events on malaria transmission in the Amazon.

Ashish JhaDr Jha was a panelist in the Forum’s discussion on Telehealth. Ashish K. Jha, MD, MPH is a practicing general internist at the VA. He is a professor of Health Policy at the Harvard T.H. Chan School of Public Health and a member of the Institute of Medicine. His work has focused on four primary areas: Public reporting,Pay for performance,Health information technology,Leadership,And the roles they play in effecting the delivery of safe, effective, patient-centered care. With a strong body of analytic work on the US system, he also founded the HSPH Initiative on Global Health Quality (HIGHQ), played a key role in the WHO’s working group on patient safety research, and is leading an international HIT benchmarking effort with the OECD.

Hon. Nils Daulaire, M.D.Dr. Nils Daulaire served in the Obama Administration as Assistant Secretary for Global Affairs at the U.S. Department of Health and Human Services and as the United States Representative on the Executive Board of the World Health Organization, as well as Alternate U.S. Board Member to the Global Fund. Earlier, he served in the Clinton Administration as Deputy Assistant Administrator for Policy at the U.S. Agency for International Development. For over a decade, Dr. Daulaire was president and CEO of the Global Health Council, which led policy and advocacy efforts to improve maternal and child health, reproductive health and family planning, HIV/AIDS and infectious disease control in the poorest populations around the world. Earlier in his career, Dr. Daulaire worked for the John Snow Public Health Group, much of the time resident in Nepal where he conducted groundbreaking field research on community-based management of childhood pneumonia and vitamin A deficiency. He comes to Harvard following a year as Senior Visiting Scholar on Global Health Security at the Norwegian Institute of Public Health and previously was a clinical professor of global health at the University of Washington and visiting professor of community and family medicine at Dartmouth Medical School. He is a member of the U.S. National Academy of Medicine as well as the Council on Foreign Relations. Dr. Daulaire has worked with over 50 countries around the globe and speaks seven languages.

Anthony FauciAnthony Fauci was a panelist for the Forum discussion on Ebola. Anthony Fauci was appointed Director of NIAID in 1984. He oversees an extensive research portfolio of basic and applied research to prevent, diagnose, and treat infectious diseases such as HIV/AIDS and other sexually transmitted infections, influenza, tuberculosis, malaria and illness from potential agents of bioterrorism. NIAID also supports research on transplantation and immune-related illnesses, including autoimmune disorders, asthma and allergies. The NIAID budget for fiscal year 2013 was approximately $4.5 billion. Dr. Fauci serves as one of the key advisors to the White House and Department of Health and Human Services on global AIDS issues, and on initiatives to bolster medical and public health preparedness against emerging infectious disease threats such as pandemic influenza. He was one of the principal architects of the President’s Emergency Plan for AIDS Relief (PEPFAR), which has already been responsible for saving millions of lives throughout the developing world. Dr. Fauci also is the long-time chief of the NIAID Laboratory of Immunoregulation. He has made many contributions to basic and clinical research on the pathogenesis and treatment of immune-mediated and infectious diseases. He helped pioneer the field of human immunoregulation by making important basic scientific observations that underpin the current understanding of the regulation of the human immune response. In addition, Dr. Fauci is widely recognized for delineating the precise mechanisms whereby immunosuppressive agents modulate the human immune response. He developed effective therapies for formerly fatal inflammatory and immune-mediated diseases such as polyarteritis nodosa, granulomatosis with polyangiitis (formerly Wegener’s granulomatosis), and lymphomatoid granulomatosis. A 1985 Stanford University Arthritis Center Survey of the American Rheumatism Association membership ranked the work of Dr. Fauci on the treatment of polyarteritis nodosa and granulomatosis with polyangiitis as one of the most important advances in patient management in rheumatology over the previous 20 years. Dr. Fauci has made seminal contributions to the understanding of how HIV destroys the body’s defenses leading to its susceptibility to deadly infections. Further, he has been instrumental in developing highly effective strategies for the therapy of patients living with HIV/AIDS, as well as for a vaccine to prevent HIV infection. He continues to devote much of his research time to identifying the nature of the immunopathogenic mechanisms of HIV infection and the scope of the body’s immune responses to HIV. In 2003, an Institute for Scientific Information study indicated that in the 20-year period from 1983 to 2002, Dr. Fauci was the 13th most-cited scientist among the 2.5 to 3 million authors in all disciplines throughout the world who published articles in scientific journals during that time frame. Dr. Fauci was the world’s 10th most-cited HIV/AIDS researcher in the period from 1996 through 2006. Dr. Fauci has delivered major lectures all over the world and is the recipient of numerous prestigious awards, including the Presidential Medal of Freedom, the National Medal of Science, the George M. Kober Medal of the Association of American Physicians, the Mary Woodard Lasker Award for Public Service, the Albany Medical Center Prize in Medicine and Biomedical Research, the Robert Koch Gold Medal, the Prince Mahidol Award, and 38 honorary doctoral degrees from universities in the United States and abroad. Dr. Fauci is a member of the National Academy of Sciences, the American Academy of Arts and Sciences, the Institute of Medicine, and the American Philosophical Society, as well as other professional societies including the American College of Physicians, The American Society for Clinical Investigation, the Association of American Physicians, the Infectious Diseases Society of America, The American Association of Immunologists, and the American Academy of Allergy, Asthma & Immunology. He serves on the editorial boards of many scientific journals; as an editor of Harrison’s Principles of Internal Medicine; and as author, coauthor, or editor of more than 1,200 scientific publications, including several textbooks.

Julie SteenhuysenJulie Steenhuysen is a Health and Science Correspondent for Reuters.

SummaryWatch the live webcast here on Friday, March 4, 2016 12:30-1:30pm ET THE ZIKA CRISIS: Latest Findings Presented in Collaboration with Reuters The ongoing spread of the Zika virus — and its unconfirmed potential links to a birth defect called microcephaly — have raised worldwide alarms. This Forum will examine what we know and don’t know about the virus, drawing parallels and lessons from another disease outbreak, Ebola, that we can apply to the Zika emergency. An expert panel will discuss the current status of our understanding of the Zika virus and its health effects; containment strategies, including controlling the mosquitoes that primarily spread the virus; and feasibility of a vaccine and treatment options. Spread the word: Send our panelists questions in advance to [email protected] A live chat on The Forum’s Zika Crisis web page. Tweet us @ForumHSPH #zika Part of: Policy Controversies. Presented in Collaboration with Reuters

The Zika Crisis Latest Findings https://theforum.sph.harvard.edu/events/the-zika-crisis/

First Zika-linked birth defects detected in Colombia

http://www.nature.com/news/first-zika-linked-birth-defects-detected-in-colombia-1.19502

News Venezuela Cuba announced today the second imported case of the Zika virus, diagnosed a nurse on the island to return to the country on February 23 last from Venezuela, where paid health cooperation, said the Ministry of Public Health (MINSAP).Cuban nurse, 51, who lives in the eastern city of Manzanillo, Granma province, presented the same day 23 a 'rash (rash) skin accompanied by pruritus (itching), inflammation and pain in the left hand "and was entered two days later in the Celia Sanchez local hospital. The statement MINSAP explained that the patient had in the hospital "sampling for isolation zika" which was sent to the Institute of Tropical Medicine "Pedro Kouri" (IPK) in Havana. The laboratory IPK, a specialized diagnostic center, research and care of communicable diseases, confirmed on March 2 that the test on the Cuban patient at the time of admission "tested positive for Zika virus," he said The report. He also noted that currently the nurse diagnosed with Zika virus is "asymptomatic and in good general condition". The first case of spread of the Zika virus imported was detected on the island in a Venezuelan doctor of 28 who came to the Caribbean country last February 21 to pursue a postgraduate course in gastroenterology and is being held at IPK, as reported Wednesday MINSAP. For several weeks, Cuba is developing a program of action that includes the mobilization of 9,000 troops of the Armed Forces and 200 police with fumigation and inspections in homes and workplaces to meet the Zika virus, dengue and chikungunya. Health authorities have explained through local media that the objective of the plan is to fight the mosquito "Aedes aegypti" and "Aedes albopictus" trasmisores agents of these diseases, as both are present in several areas of the island. President of Cuba, Raul Castro, urged the Feb. 22 Cubans to take "a personal matter" fighting the mosquito that transmits these diseases in a statement entitled "Call to our people," reported in the mainstream media press the island. EFE http://gunow.co.ve/post/Cuba-diagnostica-segundo-caso-de-Zika-importado-de-Venezuela

LATIN AMERICA06:41 04.03.2016Get short URL 012000The first case of a human fetus death from microcephaly (brain damage) caused by Zika virus has been registered in Venezuela, El Nacional reports citing medical experts. © REUTERS/ PAULO WHITAKER8 Costa Rica Natives, 2 Foreigners Infected With ZikaMEXICO CITY (Sputnik) – The 24-year-old mother was infected with Zika in January, on the 13th week of her pregnancy, and her unborn baby developed microcephaly as a result and died at 17 weeks, infectologist at the Central University of Venezuela Jaime Torres revealed as cited by the Venezuelan newspaper on Thursday. The Zika virus affects primarily monkeys and humans and is transmitted by daytime-active mosquitoes. Transmission through blood transfusions and sexual intercourse has also been reported. Zika does not cause serious complications in adults, but it can lead to severe brain defects, such as microcephaly, in newborns. © AFP 2016/ MARVIN RECINOSEmerging Technologies Failing to Combat Spread of Zika Virus - ReportAt present, there is no vaccine available to treat the Zika virus. Mosquito control remains crucial to prevent its spread. The diagnosis of Zika virus infections is also very important, especially for the care and monitoring of pregnant women. According to El Nacional, the parents of the dead unborn baby have authorized that samples of umbilical cord, placenta and the fetus’s brain be used for study. The current Zika outbreak started in Brazil in the spring of 2015. It has since spread across Latin America, with cases having been reported in several European countries and the United States. Over 300 Zika virus cases and three Zika-related deaths have been confirmed in Venezuela. Read more: http://sputniknews.com/latam/20160304/1035756583/fetus-death-from-zika-caused-microcephaly-reported.html#ixzz41w4Hjfl4

Published Date: 03/03/2016 15:16:52 Subject: PRO / ESP> Zika - Venezuela: (ANZ) early infection in pregnant, microcephaly, stillborn, confirmation Archive Number:20160303.4067220 ZIKA - VENEZUELA: (ANZ) EARLY INFECTION IN PREGNANT, microcephaly, stillborn, ProMED-mail statement http://www.promedmail.org ProMED-mail is a program of theInternational Society for Infectious Diseases http://www.isid.org Date: February 3, 2016 Source: Rafael Suarez <rafaelsuarezp @ hotmail.com> [. Edited by Jaime Torres] a recent case of microcephaly associated confirmed by the zika virius during the first trimester of pregnancy, in a Venezuelan embarada infection is reported. case report : female patient, 24 years old from Maturin (Edo. Monagas). First deed, last menstrual period 14.10.2015. He presented carcacterístico morbilliform rash and malaise on January 5, 2015 (in the 13th week of gestation). Obstetric evaluation that date was normal including sonographic study revealed no alterations in amniotic fluid, placenta and fetus. In the ecosonography on February 16, 2016 severe oligoamnios, head diameter was observed in the 3rd percentile (12.8 centimeters ) and hyperechoic Images intraventricular.serological studies performed in week 17 ruled out the occurrence of recent infection with CMV, rubella, dengue and Chicungunya. at week 17 + 3 days of gestation at sonogram stillbirth was evident, diagnosed with microcephaly and oligoamnios severe. for research purposes parents authorized the study of various samples of umbilical cord, placenta and brain, which were referred to the Institutes of Tropical Medicine of the Central University of Venezuela, as the Venezuelan Institute for Scientific research (IVIC ). In parallel, they have been sent Confirmatory shows the National Institute of Hygiene "Rafael Rangel" (INHRR), national reference center for diagnosis of infections Zika virus and samples for further study of histopathology and electron microscopy were collected. The initial results PCR reaction for Zika practiced in the blood and tissue of the umbilical cord, as in the amniotic fluid, showed the presence of genetic material of the virus in these tissues. Pending the results of PCR in fetal brain parénquma and RT-PCR tests sent to reference laboratory INHRR. Dr. Rafael Suárez.Obstetra, former Professor of the Department of Gynecology and Obstetrics of the Central University of Venezuela Lic. Nahir Martinez, Section of Virology, Institute of Tropical Medicine, Central University of Venezuela Lic. Zoila Moros, Venezuelan Institute for Scientific Research Dr. Jaime R. Torres, Section of Infectious Diseases, Institute of Tropical Medicine, Central University of Venezuela Reported by: Jaime R. Torres <[email protected]> - ProMED-ESP ............. .... jt [ Thiswould be the first confirmed case of microcephaly associated with recent infection Zika virus, outside the Brazilian context. Previous 2 cases (one patient in the US and one in Slovenia, had a history of infection in Brazil during the first trimester of pregnancy. In a corresponding to a Colombian patient Bucaramanga, recently reviewed by Promed-Eng indigenous case suspect (see below) , no studies or confirmatory PCR virological infection were performed by the Zika virus, either the mother or the product of gestation. Moderator Jaime R. Torres]

Zika has been confirmed in 1st trimester infected fetus in Maturin Venezuela http://promedmail.org/direct.php?id=20160303.4067220

Match update 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|KU820899.1|Zika virus isolate ZJ03 polyprotein gene, complete cds1852518525100%0.0100%KU820899.1Select seq gb|KJ776791.1|Zika virus strain H/PF/2013 polyprotein gene, complete cds1839018390100%0.099%KJ776791.1Select seq gb|KU509998.1|Zika virus strain Haiti/1225/2014, complete genome1834518345100%0.099%KU509998.1Select seq gb|KU321639.1|Zika virus strain ZikaSPH2015, complete genome1832118321100%0.099%KU321639.1Select seq gb|KU729218.1|Zika virus isolate BeH828305 polyprotein gene, complete cds1831218312100%0.099%KU729218.1Select seq gb|KU707826.1|Zika virus isolate SSABR1, complete genome1831218312100%0.099%KU707826.1Select seq gb|KU365779.1|Zika virus strain BeH819966 polyprotein gene, complete cds1831218312100%0.099%KU365779.1Select seq gb|KU501217.1|Zika virus strain 8375 polyprotein gene, complete cds1830018300100%0.099%KU501217.1Select seq gb|KU365780.1|Zika virus strain BeH815744 polyprotein gene, complete cds1830018300100%0.099%KU365780.1Select seq gb|KU647676.1|Zika virus strain MRS_OPY_Martinique_PaRi_2015 polyprotein gene, complete cds1829418294100%0.099%KU647676.1Select seq gb|KU501216.1|Zika virus strain 103344 polyprotein gene, complete cds1829418294100%0.099%KU501216.1Select seq gb|KU365777.1|Zika virus strain BeH818995 polyprotein gene, complete cds1829418294100%0.099%KU365777.1Select seq gb|KU497555.1|Zika virus isolate Brazil-ZKV2015, complete genome182871828799%0.099%KU497555.1Select seq gb|KU527068.1|Zika virus strain Natal RGN, complete genome1828518285100%0.099%KU527068.1Select seq gb|KU820897.1|Zika virus isolate FLR polyprotein gene, complete cds1828218282100%0.099%KU820897.1Select seq gb|KU365778.1|Zika virus strain BeH819015 polyprotein gene, complete cds1828218282100%0.099%KU365778.1Select seq gb|KU312312.1|Zika virus isolate Z1106033 polyprotein gene, complete cds1828218282100%0.099%KU312312.1Select seq gb|KU501215.1|Zika virus strain PRVABC59, complete genome1827318273100%0.099%KU501215.1Select seq gb|KU761564.1|Zika virus isolate GDZ16001 polyprotein gene, complete cds1825418254100%0.099%KU761564.1Select seq gb|KU740184.1|Zika virus isolate GD01 polyprotein gene, complete cds1824518245100%0.099%KU740184.1Select seq gb|KU744693.1|Zika virus isolate VE_Ganxian, complete genome1810518105100%0.099%KU744693.1Select seq gb|KU681081.3|Zika virus isolate Zika virus/H.sapiens-tc/THA/2014/SV0127- 14, complete genome1805118051100%0.099%KU681081.3Select seq gb|JN860885.1|Zika virus isolate FSS13025 polyprotein gene, partial cds177531775399%0.098%JN860885.1Select seq gb|KF993678.1|Zika virus strain PLCal_ZV from Canada polyprotein gene, partial cds176881768898%0.099%KF993678.1Select seq gb|EU545988.1|Zika virus polyprotein gene, complete cds1760717607100%0.098%EU545988.1Select seq gb|KU681082.3|Zika virus isolate Zika virus/H.sapiens-tc/PHL/2012/CPC-0740, complete genome1744317443100%0.098%KU681082.3Select seq gb|HQ234499.1|Zika virus isolate P6-740 polyprotein gene, partial cds164331643399%0.095%HQ234499.1Select seq gb|KU720415.1|Zika virus strain MR 766 polyprotein gene, complete cds1327713277100%0.089%KU720415.1Select seq gb|HQ234498.1|Zika virus isolate MR_766 polyprotein gene, partial cds132721327299%0.089%HQ234498.1Select seq gb|KF383115.1|Zika virus strain ArB1362 polyprotein gene, complete cds1327013270100%0.089%KF383115.1Select seq gb|KF268949.1|Zika virus isolate ARB15076 polyprotein gene, complete cds1326613266100%0.089%KF268949.1Select seq gb|DQ859059.1|Zika virus strain MR 766 polyprotein gene, complete cds1326613266100%0.089%DQ859059.1Select seq gb|KF383119.1|Zika virus strain ArD158084 polyprotein gene, complete cds1325913259100%0.089%KF383119.1Select seq dbj|LC002520.1|Zika virus genomic RNA, complete genome, strain: MR766-NIID1325413254100%0.089%LC002520.1Select seq gb|KF268948.1|Zika virus isolate ARB13565 polyprotein gene, complete cds1324813248100%0.089%KF268948.1Select seq gb|KF268950.1|Zika virus isolate ARB7701 polyprotein gene, complete cds1324113241100%0.089%KF268950.1Select seq gb|HQ234501.1|Zika virus isolate ArD_41519 polyprotein gene, partial cds132141321499%0.089%HQ234501.1Select seq gb|KF383116.1|Zika virus strain ArD7117 polyprotein gene, complete cds1321213212100%0.089%KF383116.1Select seq gb|AY632535.2|Zika virus strain MR 766, complete genome1319613196100%0.089%AY632535.2Select seq gb|KF383117.1|Zika virus strain ArD128000 polyprotein gene, complete cds1314213142100%0.088%KF383117.1Select seq gb|HQ234500.1|Zika virus isolate IbH_30656 polyprotein gene, partial cds131201312099%0.088%HQ234500.1Select seq gb|KF383118.1|Zika virus strain ArD157995 polyprotein gene, complete cds1294213010100%0.088%KF383118.1Select seq gb|KF383121.1|Zika virus strain ArD158095 polyprotein gene, partial cds128551285597%0.089%KF383121.1Select seq gb|KU729217.1|Zika virus isolate BeH823339 polyprotein gene, complete cds119261692792%0.099%KU729217.1Select seq gb|KF383120.1|Zika virus strain ArD142623 nonfunctional polyprotein gene, partial sequence108681086897%0.084%KF383120.1Select seq gb|KU312314.1|Zika virus isolate Z1106031 polyprotein gene, partial cds4962496227%0.099%KU312314.1Select seq gb|KU312313.1|Zika virus isolate Z1106032 polyprotein gene, partial cds4935493527%0.099%KU312313.1Select seq gb|KU646828.1|Zika virus isolate Si322 polyprotein gene, partial cds4637463725%0.099%KU646828.1Select seq gb|KU646827.1|Zika virus isolate Si323 polyprotein gene, partial cds4628462825%0.099%KU646827.1Select seq gb|KU312315.1|Zika virus isolate Z1106027 polyprotein gene, partial cds3431343118%0.099%KU312315.1Select seq gb|KU740199.1|Zika virus isolate VE_Ganxian2016 polyprotein gene, partial cds3202320217%0.099%KU740199.1Select seq gb|DQ859064.1|Spondweni virus strain SM-6 V-1 polyprotein gene, complete cds2856419795%0.071%DQ859064.1Select seq gb|KJ634273.1|Zika virus strain CK-ISL 2014 E protein (E) gene, partial cds2695269514%0.099%KJ634273.1Select seq gb|KU686218.1|Zika virus isolate MEX/InDRE/14/2015 polyprotein gene, partial cds2042204211%0.099%KU686218.1Select seq gb|KU179098.1|Zika virus isolate JMB-185 nonstructural protein 5 gene, partial cds2008200811%0.099%KU179098.1Select seq gb|KM078936.1|Zika virus strain CHI1410214 NS5 protein gene, partial cds173717379%0.099%KM078936.1Select seq gb|KM078961.1|Zika virus strain CHI2612114 NS5 protein gene, partial cds173617369%0.099%KM078961.1Select seq gb|KM078930.1|Zika virus strain CHI2283714 NS5 protein gene, partial cds173417349%0.099%KM078930.1Select seq gb|KM078971.1|Zika virus strain CHI2613014 NS5 protein gene, partial cds173017309%0.099%KM078971.1Select seq gb|KM078970.1|Zika virus strain CHI2490414 NS5 protein gene, partial cds173017309%0.099%KM078970.1Select seq gb|KM078933.1|Zika virus strain CHI1058514 NS5 protein gene, partial cds173017309%0.099%KM078933.1Select seq gb|KM078929.1|Zika virus strain CHI1805214 NS5 protein gene, partial cds172817289%0.099%KM078929.1Select seq gb|KJ873160.1|Zika virus isolate NC14-03042014-3481 nonstructural protein 5 gene, partial cds158815888%0.099%KJ873160.1Select seq gb|KJ873161.1|Zika virus isolate NC14-02042014-3220 nonstructural protein 5 gene, partial cds140614067%0.099%KJ873161.1Select seq gb|KM851039.1|Zika virus strain SV0127/14 nonstructural protein 5 gene, partial cds137013707%0.098%KM851039.1Select seq gb|KM851038.1|Zika virus strain CPC-0740 nonstructural protein 5 gene, partial cds133313337%0.097%KM851038.1Select seq gb|KU556802.1|Zika virus isolate MEX/InDRE/14/2015 NS5 protein gene, partial cds132413247%0.099%KU556802.1Select seq gb|AF013415.1|Zika virus strain MR-766 NS5 protein (NS5) gene, partial cds1283128310%0.088%AF013415.1Select seq gb|KT200609.1|Zika virus isolate BR/949/15 NS5 gene, partial cds123612366%0.099%KT200609.1Select seq gb|KU232300.1|Zika virus isolate 067ZV_PEBR15 NS5 protein gene, partial cds121612166%0.099%KU232300.1Select seq gb|KU232290.1|Zika virus isolate 036ZV_PEBR15 NS5 protein gene, partial cds120712076%0.099%KU232290.1Select seq gb|KU232297.1|Zika virus isolate 049ZV_PEBR15 NS5 protein gene, partial cds120512056%0.099%KU232297.1Select seq gb|KU232294.1|Zika virus isolate 061ZV_PEBR15 NS5 protein gene, partial cds119811986%0.099%KU232294.1Select seq gb|KU232292.1|Zika virus isolate 054ZV_PEBR15 NS5 protein gene, partial cds119511956%0.099%KU232292.1Select seq gb|KU232298.1|Zika virus isolate 050ZV_PEBR15 NS5 protein gene, partial cds119111916%0.099%KU232298.1Select seq gb|KU232293.1|Zika virus isolate 057ZV_PEBR15 NS5 protein gene, partial cds118911896%0.099%KU232293.1Select seq gb|KU232296.1|Zika virus isolate 045ZV_PEBR15 NS5 protein gene, partial cds118711876%0.099%KU232296.1Select seq gb|KU232295.1|Zika virus isolate 068ZV_PEBR15 NS5 protein gene, partial cds118411846%0.099%KU232295.1Select seq gb|KU232288.1|Zika virus isolate 001ZV_PEBR15 NS5 protein gene, partial cds117311736%0.099%KU232288.1Select seq gb|KU232289.1|Zika virus isolate 020ZV_PEBR15 NS5 protein gene, partial cds116911696%0.099%KU232289.1Select seq gb|KU232299.1|Zika virus isolate 015ZV_PEBR15 NS5 protein gene, partial cds116611666%0.099%KU232299.1Select seq gb|KU232291.1|Zika virus isolate 051ZV_PEBR15 NS5 protein gene, partial cds116211626%0.099%KU232291.1Select seq gb|KU758878.1|Zika virus polyprotein gene, partial cds113011306%0.098%KU758878.1

Match update 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|KU820897.1|Zika virus isolate FLR polyprotein gene, complete cds1852518525100%0.0100%KU820897.1Select seq gb|KU647676.1|Zika virus strain MRS_OPY_Martinique_PaRi_2015 polyprotein gene, complete cds1843818438100%0.099%KU647676.1Select seq gb|KU509998.1|Zika virus strain Haiti/1225/2014, complete genome1839018390100%0.099%KU509998.1Select seq gb|KJ776791.1|Zika virus strain H/PF/2013 polyprotein gene, complete cds1838418384100%0.099%KJ776791.1Select seq gb|KU321639.1|Zika virus strain ZikaSPH2015, complete genome1837518375100%0.099%KU321639.1Select seq gb|KU729218.1|Zika virus isolate BeH828305 polyprotein gene, complete cds1836618366100%0.099%KU729218.1Select seq gb|KU707826.1|Zika virus isolate SSABR1, complete genome1836618366100%0.099%KU707826.1Select seq gb|KU365779.1|Zika virus strain BeH819966 polyprotein gene, complete cds1836618366100%0.099%KU365779.1Select seq gb|KU497555.1|Zika virus isolate Brazil-ZKV2015, complete genome183591835999%0.099%KU497555.1Select seq gb|KU365780.1|Zika virus strain BeH815744 polyprotein gene, complete cds1835418354100%0.099%KU365780.1Select seq gb|KU365777.1|Zika virus strain BeH818995 polyprotein gene, complete cds1834818348100%0.099%KU365777.1Select seq gb|KU312312.1|Zika virus isolate Z1106033 polyprotein gene, complete cds1834818348100%0.099%KU312312.1Select seq gb|KU501217.1|Zika virus strain 8375 polyprotein gene, complete cds1834518345100%0.099%KU501217.1Select seq gb|KU365778.1|Zika virus strain BeH819015 polyprotein gene, complete cds1834518345100%0.099%KU365778.1Select seq gb|KU527068.1|Zika virus strain Natal RGN, complete genome1833918339100%0.099%KU527068.1Select seq gb|KU501216.1|Zika virus strain 103344 polyprotein gene, complete cds1833918339100%0.099%KU501216.1Select seq gb|KU501215.1|Zika virus strain PRVABC59, complete genome1833618336100%0.099%KU501215.1Select seq gb|KU740184.1|Zika virus isolate GD01 polyprotein gene, complete cds1831818318100%0.099%KU740184.1Select seq gb|KU761564.1|Zika virus isolate GDZ16001 polyprotein gene, complete cds1830918309100%0.099%KU761564.1Select seq gb|KU820899.1|Zika virus isolate ZJ03 polyprotein gene, complete cds1828218282100%0.099%KU820899.1Select seq gb|KU744693.1|Zika virus isolate VE_Ganxian, complete genome1814118141100%0.099%KU744693.1Select seq gb|KU681081.3|Zika virus isolate Zika virus/H.sapiens-tc/THA/2014/SV0127- 14, complete genome1805118051100%0.099%KU681081.3Select seq gb|JN860885.1|Zika virus isolate FSS13025 polyprotein gene, partial cds177441774499%0.098%JN860885.1Select seq gb|KF993678.1|Zika virus strain PLCal_ZV from Canada polyprotein gene, partial cds177121771298%0.099%KF993678.1Select seq gb|EU545988.1|Zika virus polyprotein gene, complete cds1758917589100%0.098%EU545988.1Select seq gb|KU681082.3|Zika virus isolate Zika virus/H.sapiens-tc/PHL/2012/CPC-0740, complete genome1743417434100%0.098%KU681082.3Select seq gb|HQ234499.1|Zika virus isolate P6-740 polyprotein gene, partial cds164151641599%0.095%HQ234499.1Select seq gb|KF383115.1|Zika virus strain ArB1362 polyprotein gene, complete cds1331513315100%0.089%KF383115.1Select seq gb|KF268949.1|Zika virus isolate ARB15076 polyprotein gene, complete cds1331113311100%0.089%KF268949.1Select seq gb|KF268948.1|Zika virus isolate ARB13565 polyprotein gene, complete cds1331113311100%0.089%KF268948.1Select seq gb|KU720415.1|Zika virus strain MR 766 polyprotein gene, complete cds1330813308100%0.089%KU720415.1Select seq gb|KF268950.1|Zika virus isolate ARB7701 polyprotein gene, complete cds1330413304100%0.089%KF268950.1Select seq gb|HQ234498.1|Zika virus isolate MR_766 polyprotein gene, partial cds133021330299%0.089%HQ234498.1Select seq gb|KF383119.1|Zika virus strain ArD158084 polyprotein gene, complete cds1329013290100%0.089%KF383119.1Select seq dbj|LC002520.1|Zika virus genomic RNA, complete genome, strain: MR766-NIID1328613286100%0.089%LC002520.1Select seq gb|DQ859059.1|Zika virus strain MR 766 polyprotein gene, complete cds1328413284100%0.089%DQ859059.1Select seq gb|KF383116.1|Zika virus strain ArD7117 polyprotein gene, complete cds1324813248100%0.089%KF383116.1Select seq gb|HQ234501.1|Zika virus isolate ArD_41519 polyprotein gene, partial cds132321323299%0.089%HQ234501.1Select seq gb|AY632535.2|Zika virus strain MR 766, complete genome1322713227100%0.089%AY632535.2Select seq gb|KF383117.1|Zika virus strain ArD128000 polyprotein gene, complete cds1317313173100%0.088%KF383117.1Select seq gb|HQ234500.1|Zika virus isolate IbH_30656 polyprotein gene, partial cds131471314799%0.088%HQ234500.1Select seq gb|KF383118.1|Zika virus strain ArD157995 polyprotein gene, complete cds1295413022100%0.088%KF383118.1Select seq gb|KF383121.1|Zika virus strain ArD158095 polyprotein gene, partial cds128911289197%0.089%KF383121.1Select seq gb|KU729217.1|Zika virus isolate BeH823339 polyprotein gene, complete cds119301697692%0.099%KU729217.1Select seq gb|KF383120.1|Zika virus strain ArD142623 nonfunctional polyprotein gene, partial sequence108861088697%0.084%KF383120.1Select seq gb|KU312314.1|Zika virus isolate Z1106031 polyprotein gene, partial cds4962496227%0.099%KU312314.1Select seq gb|KU312313.1|Zika virus isolate Z1106032 polyprotein gene, partial cds4940494027%0.099%KU312313.1Select seq gb|KU646828.1|Zika virus isolate Si322 polyprotein gene, partial cds4673467325%0.099%KU646828.1Select seq gb|KU646827.1|Zika virus isolate Si323 polyprotein gene, partial cds4673467325%0.099%KU646827.1Select seq gb|KU312315.1|Zika virus isolate Z1106027 polyprotein gene, partial cds3434343418%0.099%KU312315.1Select seq gb|KU740199.1|Zika virus isolate VE_Ganxian2016 polyprotein gene, partial cds3205320517%0.099%KU740199.1Select seq gb|DQ859064.1|Spondweni virus strain SM-6 V-1 polyprotein gene, complete cds2852417095%0.071%DQ859064.1Select seq gb|KJ634273.1|Zika virus strain CK-ISL 2014 E protein (E) gene, partial cds2691269114%0.099%KJ634273.1Select seq gb|KU686218.1|Zika virus isolate MEX/InDRE/14/2015 polyprotein gene, partial cds2075207511%0.099%KU686218.1Select seq gb|KU179098.1|Zika virus isolate JMB-185 nonstructural protein 5 gene, partial cds2021202111%0.099%KU179098.1Select seq gb|KM078936.1|Zika virus strain CHI1410214 NS5 protein gene, partial cds175217529%0.099%KM078936.1Select seq gb|KM078961.1|Zika virus strain CHI2612114 NS5 protein gene, partial cds174817489%0.099%KM078961.1Select seq gb|KM078930.1|Zika virus strain CHI2283714 NS5 protein gene, partial cds174617469%0.099%KM078930.1Select seq gb|KM078971.1|Zika virus strain CHI2613014 NS5 protein gene, partial cds174517459%0.099%KM078971.1Select seq gb|KM078970.1|Zika virus strain CHI2490414 NS5 protein gene, partial cds174517459%0.099%KM078970.1Select seq gb|KM078933.1|Zika virus strain CHI1058514 NS5 protein gene, partial cds174517459%0.099%KM078933.1Select seq gb|KM078929.1|Zika virus strain CHI1805214 NS5 protein gene, partial cds174317439%0.099%KM078929.1Select seq gb|KJ873160.1|Zika virus isolate NC14-03042014-3481 nonstructural protein 5 gene, partial cds160216028%0.099%KJ873160.1Select seq gb|KJ873161.1|Zika virus isolate NC14-02042014-3220 nonstructural protein 5 gene, partial cds142014207%0.099%KJ873161.1Select seq gb|KM851039.1|Zika virus strain SV0127/14 nonstructural protein 5 gene, partial cds138213827%0.099%KM851039.1Select seq gb|KU556802.1|Zika virus isolate MEX/InDRE/14/2015 NS5 protein gene, partial cds134613467%0.099%KU556802.1Select seq gb|KM851038.1|Zika virus strain CPC-0740 nonstructural protein 5 gene, partial cds134613467%0.098%KM851038.1Select seq gb|AF013415.1|Zika virus strain MR-766 NS5 protein (NS5) gene, partial cds1315131510%0.088%AF013415.1Select seq gb|KU232300.1|Zika virus isolate 067ZV_PEBR15 NS5 protein gene, partial cds124012406%0.099%KU232300.1Select seq gb|KT200609.1|Zika virus isolate BR/949/15 NS5 gene, partial cds124012406%0.099%KT200609.1Select seq gb|KU232290.1|Zika virus isolate 036ZV_PEBR15 NS5 protein gene, partial cds123112316%0.099%KU232290.1Select seq gb|KU232297.1|Zika virus isolate 049ZV_PEBR15 NS5 protein gene, partial cds122912296%0.099%KU232297.1Select seq gb|KU232294.1|Zika virus isolate 061ZV_PEBR15 NS5 protein gene, partial cds122012206%0.099%KU232294.1Select seq gb|KU232292.1|Zika virus isolate 054ZV_PEBR15 NS5 protein gene, partial cds121812186%0.099%KU232292.1Select seq gb|KU232298.1|Zika virus isolate 050ZV_PEBR15 NS5 protein gene, partial cds121412146%0.099%KU232298.1Select seq gb|KU232296.1|Zika virus isolate 045ZV_PEBR15 NS5 protein gene, partial cds121112116%0.099%KU232296.1Select seq gb|KU232293.1|Zika virus isolate 057ZV_PEBR15 NS5 protein gene, partial cds121112116%0.099%KU232293.1Select seq gb|KU232295.1|Zika virus isolate 068ZV_PEBR15 NS5 protein gene, partial cds120512056%0.099%KU232295.1Select seq gb|KU232288.1|Zika virus isolate 001ZV_PEBR15 NS5 protein gene, partial cds119511956%0.099%KU232288.1Select seq gb|KU232289.1|Zika virus isolate 020ZV_PEBR15 NS5 protein gene, partial cds119111916%0.099%KU232289.1Select seq gb|KU232299.1|Zika virus isolate 015ZV_PEBR15 NS5 protein gene, partial cds118711876%0.099%KU232299.1Select seq gb|KU232291.1|Zika virus isolate 051ZV_PEBR15 NS5 protein gene, partial cds118611866%0.099%KU232291.1Select seq gb|KU758878.1|Zika virus polyprotein gene, partial cds113311336%0.099%KU758878.1

Sacramento County No local transmission of Zika infections has occurred in California. There have been three travel-associated cases of Zika virus infection in California residents in 2016 (as of 2/19/16); none of these cases were in Sacramento County residents. http://www.dhhs.saccounty.net/PUB/Documents/AZ-Health-Info/ME-zikaHPC20160223.pdf#search=zika

San Bernardino County http://www.sbcounty.gov/dph/publichealth/default.aspx No cases of Zika, Public Health continues to monitor situation Although there are no reported cases in San Bernardino County, the Department of Public Health’s Division of Environmental Health Services, the Communicable Disease Section and Public Health Laboratory are working together to make sure any suspected Zika cases are investigated and tested appropriately. READ MORE The six confirmed cases of Zika virus in California were acquired in other countries. The Zika virus is primarily transmitted to people by Aedes aegypti and Aedes albopictus mosquitoes, the same mosquitoes that can transmit dengue and chikungunya viruses. These mosquitoes are not native to California, but have been identified in 12 California counties. In San Bernardino County they were found in October of 2015, but the risk of transmission in California is still low.

Santa Barbara County Update http://cosb.countyofsb.org/zika_Virus/ Santa Barbara County has tested 5 patients for Zika virus and 2 were negative. Results are pending for other tests. http://cosb.countyofsb.org/uploadedFiles/phd/Press_Release/2016-02-19 Zika update.pdf

Long Beach City Zika tally page IS ZIKA VIRUS IN LONG BEACH?So far in the Southern California (SoCal) region, Zika virus infections have been found in a few people who were infected while travelling outside of the U.S. http://www.longbeach.gov/health/services/directory/diseases-and-other-public-health-hazards/zika-virus/

San Diego County Tally Page? http://www.sandiegocounty.gov/content/dam/sdc/hhsa/programs/phs/documents/Zika_FAQs.pdf

Orange County Tally page? http://ochealthinfo.com/phs/about/dcepi/epi/disease/zika What should Californians know about Zika? The California Department of Public Health (CDPH) is monitoring the Zika virus outbreak in Latin America closely. As of February 5, 2016, there have been six confirmed cases of Zika virus disease reported in California residents, all in travelers returning from other countries with Zika virus outbreaks. These cases occurred in 2013 (1), 2014 (3), and 2015 (2). CDPH has also been notified of one preliminary positive case of Zika for 2016. CDPH requested that health care providers voluntarily report Zika virus infections. The CDPH laboratory can provide preliminary laboratory testing and coordinate confirmatory testing, which is currently provided by the US Centers for Disease Control and Prevention (CDC).