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Web Briefing for Media – The Zika Virus: What’s Next in the U.S. and Abroad?Feb 17, 2016 The rapid spread of the Zika virus in the Latin America and the Caribbean region, the appearances of cases of Zika in the United States, and the association between Zika infection and serious birth defects has generated attention and concern among the public, policymakers, and the media. The WHO declared the cluster of birth defects associated with the virus represents a public health emergency of international concern. President Obama requested $1.8 billion in funding from Congress to combat the virus at home and abroad. What have scientists and researchers discovered about the health consequences of the virus? How are Zika-affected countries responding to its spread and what more can be done? What challenge does Zika present for women in countries that have limited contraceptive and reproductive health care access? What impact could Zika have in the United States? How can the U.S. contribute to the global response? To address these and other questions, the Kaiser Family Foundation held an interactive web briefing exclusively for journalists on Wednesday, February 17, at 12:30 p.m. ET. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases; Tom Frieden, Director of the Centers for Disease Control and Prevention; and Jen Kates, Foundation Vice President and Director of Global Health & HIV Policy, provided insights and answered questions. The majority of the web briefing was devoted to a question-and-answer session with journalists. http://kff.org/global-health-policy/event/february-17-web-briefing-for-media-the-zika-virus-whats-next-in-the-u-s-and-abroad/?utm_campaign=KFF-2016-GHP-Zika-Web-Briefing&utm_content=28954720&utm_medium=social&utm_source=twitter

HUM worker dies from Guillain-Barre syndromePaulina Chirinos / Maracaibo / [email protected]://www.laverdad.com/zulia/90327-trabajador-del-hum-muere-por-guillain-barre.htmlFamily denounced the lack of input into the emergency HUM. Jorge La Cru, 51, was hospitalized with bodily pain, numbness in their limbs and coordination problems. He died of respiratory failure Family demand answers to the health authorities. (Photo: Gabriela Sanz) "His picture was complicated and died," were the words of the doctor. Jorge La Cruz, worker at University Hospital in Maracaibo (HUM), lying in the emergency medical center after six days of fighting Guillain-Barre syndrome, allegedly associated with the zika and identified by health authorities as "neurological complication" . For five years he was a worker of HUM. He was in charge of cleaning from emergence to the morgue. Berceles Pelufo wife reported that her late husband from his youth was "like an oak", being more agile and faster than his crew. December 26 La Cruz had to leave the task of stretchers quarter morgue, to his surprise a tide of mosquito flew to meet him. When he got home his family saw red marks on your skin. Two days later, bone pain and fear arose appeared "to be zika". Two days of rest and pain medication, they returned to normal worker. Berceles remember doctors CDI Santa Rosa had advised him to rest, eat soup and coconut water. New Year their woes were forgotten. 2016 came and discomfort of Jorge reappeared. January 2 muscle pain came on the scene along with numbness in the soles of the feet, hands and face. For the January 9 La Cruz complained of pain in the back that was becoming more "unbearable" that day entered the HUM of sound mind and the ability to walk. Guillain-Barre syndrome Maria Hernandez, daughter of affected, explained that after physical examinations were the doctor's diagnosis, "Mr. has Guillain-Barré but it is an expensive treatment.You can only deal with immunoglobulin and we do not have here in the hospital. They have to find a way to get it. " His wife in the midst of despair listened as the doctor requested solutions and medicines, "each solution cost thousand Bolivars and my husband needed eight daily". He told how his father worsened by the lack of immunoglobulin, "doctors told us that soon would arrive medicine but never". Les was given a certificate signed and stamped on recyclable paper with the diagnosis of GBS to request to transfer medicine from the border "for" to be able to afford it. The only option left was plasmapheresis, but could not be implemented because La Cruz had high blood pressure, "does not tell us anything, and took too long to tell us we should give plasmapheresis". On the morning of January 11 doctors announced that La Cruz had to be intubated. Anger, fear and bewilderment accompanied their relatives to the hospital management to claim medications and appropriate care. The principal's secretary gave them an answer to their cries: "no guarantee you worry us all." grief Jorge La Cruz breathed his last at age 51 on Thursday, January 14th at 3:00 am in the emergence of HUM no family around. She had a respiratory arrest. Teary-eyed Mrs. Berceles mourns the death of her husband. "He was not so bad when he arrived. Had we explained early on what our options were. And today happened to my husband, it can happen to anyone. We do not want to continue going health authorities have to take action. " The death certificate was issued on January 14 and says the cause of death "febrile illness" when in previous reports had been diagnosed as Guillain-Barre syndrome. Family members are a grief and a question: "How many people must die before action is taken?" Maria Hernandez, daughter of Jorge, "They're letting people die. On the seventh floor emergency and even we saw four patients die daily. They can not afford to care for them. "

Second confirmed death from Guillain-Barre syndromeNancy Pino died in the HUC. His family did not find 35 bottles of immunoglobulin to prevent a heart attack 54Send by mailPrintRectifyISAYEN HERRERAJANUARY 28, 2016 - 12:01 AM On Tuesday at 6:00 pm Nancy Pino died, 66 years old, diagnosed with Guillain-Barre since 9 January.Pino is the second person to die from this disease began to have an upturn in the country for 4 weeks, total 85 cases and is presumed to be a complication resulting zika. Pino started having fever, rashes and muscle pain, virus-like symptoms. Three days later he was paralyzed limbs and stopped talking. She was taken to Hospital Peripheral Car and a private clinic, but not accepted for lack of supplies. The third health center where he arrived was the University Hospital of Caracas, where he was admitted to intensive care. They were asked to family 35 vials immunoglobulin to start treatment, but only found 15. The Guillain-Barre syndrome treated with immunoglobulin was produced in the state-owned Quimbiotec, which stopped producing due to lack of foreign exchange. The family asked for help in Miraflores, where they were referred to the Autonomous Service of Pharmaceutical Elaborations (Sefar). There just brushed them 5 bottles. Another 10 containers were achieved in hospitals in the interior, but did not complete the treatment. The first case of death from Guillain-Barre syndrome was confirmed on January 14 at the University Hospital of Maracaibo. There Jorge La Cruz, 51, was hospitalized on 9 January and died six days later. Also failed immunoglobulin. On 21 January President of the IVSS, Carlos Rotondaro, committed to health activists in two months to reach 4,000 units immunoglobulin the country. Pregnant guessing. In Concepción Palacios Maternity two women with similar symptoms to those of zika . Their blood samples were sent to the National Institute of Hygiene and confirmation is expected.Another woman in the same place diagnosed with malaria. Another complication that can arise from the virus is the birth of children with microcephaly (malformation that causes the head of a child is smaller than normal) to mothers who acquired the disease within 3 months of pregnancy. In Venezuela, there are three women in evaluation for malformation in babies. Several US airlines have offered flight changes or refunds of tickets to pregnant women who had planned to travel to Caribbean and Latin American countries affected by the virus, including Venezuela http://www.el-nacional.com/sociedad/Van-fallecidos-Guillain-Barre_0_786521565.html

Doctors say upsurge in sometimes fatal paralysis condition may be linked to ZikaCases of Guillain-Barre are on the rise in the countries hardest hit by the virus.7 hours ago 10,310 Views 4 Comments Share Tweet Email10Zuleidy Balza, left, sits with her mother Zulay Balza who's recovering from Guillain-Barre syndrome.Image: Associated Press THE DOCTOR TAPS Zulay Balza’s knees with a hammer and she doesn’t feel a thing. She can’t squeeze his outstretched fingers or shut her eyelids. Her face is partially paralysed. “The weakness started in my legs and climbed upward. The face was last. After three days, I couldn’t walk,” said Balza, 49. “My legs felt like rags.” Balza is a patient at the public University Hospital in Cucuta, at the epicentre of the Colombian outbreak of the mosquito-borne Zika virus. Only Brazil has more cases. Two weeks ago, she came under assault by Guillain-Barre, a rare and sometimes fatal affliction that is the Western world’s most common cause of general paralysis. Alarm over the Zika epidemic spreading across the Americas has been chiefly over birth defects, but frontline physicians believe a surge in Guillain-Barre cases may also be related. Motor skills The World Health Organisation says Guillain-Barre cases are on the rise in Brazil, Colombia, El Salvador, Suriname and Venezuela, all hit hard by Zika, though a link remains unproven. The auto-immune disorder historically strikes only one or two people in 100,000. About one in 20 of those cases ends in death, and it is frightful. “I thought my body was going to explode,” said Balza, sitting on her hospital bed and apparently over the worst. Guillain-Barre attacks skeletal muscular nerves as if they were a foreign enemy. Fine motor skills rapidly erode, arms and legs tingle and weaken to numbness. Patients lose their balance, their speech. In rare cases, they require ventilators to stay alive. The syndrome typically strikes after a bacterial or viral infection, such as influenza, HIV or dengue, though its cause can’t always be determined. Zulay Balza fails to close her eyes as neurologist Jairo Lizarazo tests her facial muscles.Source: Ricardo Mazalan/AP Dr Jairo Lizarazo, the neurologist treating Balza, has seen cases increase more than tenfold since December — 30 cases in all — in this muggy city bordering Venezuela. Like Balza, many patients never showed the characteristic symptoms of Zika — fever, rashes, joint pain and conjunctivitis. Four in five don’t. He’s convinced the virus boosts susceptibility to Guillain-Barre. “It’s an epidemiological association,” said Lizarazo. “We don’t know exactly how it works. But it’s there, for sure.” Only explanation Associated cases confirmed or suspected based on clinical evidence number in the hundreds. Guillain-Barre cases believed to be linked to the virus have killed three people in recent weeks in Colombia and health officials have attributed another three Guillian-Barre deaths in Venezuela to suspected Zika infections. WHO said Zika has been confirmed present in apparently just one Guillain-Barre death, in the northwestern Venezuela state of Zulia in January. Dr Maria Lucia Brito Ferreira, chief neurologist at Hospitalda Restauracao in Recife, Brazil, said she hopes to get laboratory confirmation this month that nine Guillain-Barre deaths recorded there in the past year were Zika-related. Cases of Guillain-Barre in Colombia — about 450 annually before Zika struck — were up nearly threefold in the past month and a half. El Salvador has reported 118 cases since November, nearly as many as previously seen in a year. “The only explanation is the Zika virus,” said Deputy Health Minister Eduardo Espinoza. Dr. Osvaldo Nascimento, a leading Rio neurologist, estimates Brazilian cases of Guillain-Barre are up fivefold. Reporting is not compulsory, so the government’s partial figure of 1,868 cases requiring hospitalization last year is a sketchy parameter. An upsurge in Guillain-Barre was documented in 2013 during a major Zika outbreak in French Polynesia, with a study finding cases up twentyfold. WHO said all 42 cases recorded in the Pacific archipelago tested positive for Zika as well as dengue fever, which is also currently present in Colombia, Venezuela, Brazil and other Zika-affected countries. Government funding Antibodies for the dengue and chikungunya viruses, which are far more debilitating than Zika, are often being found in infected patients. That is making establishing a direct Zika-Guillain-Barre link more complicated. Like Zika, both viruses are transmitted by the Aedes aegypti mosquito and could also trigger Guillian-Barre, experts say. Source: Ricardo Mazalan/AP Under normal circumstances, eight in 10 patients nearly fully recover from Guillian-Barre, though it sometimes takes months. Data on Guillain-Barre is scant in most of the developing world. Of 18 countries participating in a clinical study launched by Dutch physicians in 2012, only two are in Latin America: Mexico and Argentina. Brazil just joined. Across the region, investigators were simply unable to get government funding to participate, said Dr Ken Gorson, a Tufts University neurologist and president-elect of an international foundation that combats Guillain-Barre. Poorer countries were ill-prepared to manage the crisis. Colombia’s National Health Institute is overwhelmed with a weeks-long backlog in completing tests for Zika. Deaths The three Guillain-Barre deaths that the country’s Health Ministry attributed to Zika on5 February have not yet been confirmed by laboratory tests, said spokesman Ricardo Amortegui. Nor have the three deaths in the Venezuelan state of Lara announced last week. One Guillian-Barre fatality in Colombia suspected of being linked to Zika was a 51-year-old man from the Caribbean island of San Andres, who died in November, said Rita Almanza, epidemiology chief in Medellin. The others were a 45-year-old man and a 41-year-old woman flown from Turbo on the Caribbean coast who died in Medellin in February. Guillain-Barre grabbed hold of Nancy Pino in neighbouring Venezuela with devastating effect. The 68-year retired school administrator developed fever, rashes and muscle pain while celebrating Christmas with her family in the hot lowland state of Anzoategui. She recovered quickly. Days later, her hands and feet started to go numb. Her tongue felt like it was asleep. She stopped eating. The family rushed her to a Caracas hospital. She could barely walk. Bedridden, she lost the ability to talk and soon, to breathe. Doctors attached her to a respirator. “It was so quick,” daughter Nihara Ramos said between sobs. “It was like a flame consuming her from the bottom up.” Doctors diagnosed Guillain-Barre with a spinal tap — they assumed she had Zika earlier — and suggested that the relatives obtain immunoglobulin, an expensive treatment that pools healthy antibodies from hundreds of donors. Gorson said it costs $15,000-$45,000 in the United States. The family, straight-jacketed by Venezuela’s economic crisis, couldn’t find or afford enough. In less than three weeks, a woman who once bounded up seven flights of stairs to her apartment was dead. http://www.thejournal.ie/zika-paralysis-2606558-Feb2016/?utm_source=shortlink

Ecuador recorded 51 cases of Zika and take measures to combat the diseaseBY EFE. - Updated February 19, 2016 at: 7:56 pm Straddle the transmitter is the same as zika spread dengue and chikungunya, Aedes aegypti. (SHUTTERSTOCK) BREAKING NEWS8:08 a.m. Junior Diaz started as a starter against Bayern Munich8:40 PM Forest fires leave desolate over 285 hectares7:56 PM Ecuador recorded 51 cases of Zika and take measures to combat the disease7:19 PM At least 50 dead in bombing of the US against the Islamic State in Libya6:26 PM Women's National Team Costa Rica says goodbye to Olympic dream after falling 3-1 to Canada6:22 PM Do not be late to the classic, no threat of early goals6:06 PM Umberto Eco, 1932-2016: Intellectual epic5:59 PM Countries agree on a work plan to conserve sharks and rays5:40 PM 'To Kill a Mockingbird': the novel that changed the outlook on race in America5:26 PM Costa Rica asked to judge Nicaragua held by slaughter in Matapalo5:18 PM Hospital San Juan de Dios makes improvements in nutrition service4:52 PM Chatarrero killed by two bullets in Limón4:26 PM Miami police union called for a boycott concert Beyoncé4:20 PM South African Iain Don-Wauchope won The Coastal Challenge and is the king of the forest policy3:47 PM Mobile World Congress expected to visit 95,0003:46 PM crucial round of primaries and Clinton Trump United States3:45 PM Emma Watson is removed from the film for a year to focus on feminism3:41 PM Authorities stop sign replaced by a genuine home in Barrio Escalante3:32 PM Incofer intervene four points of the railway line from April3:20 PM Baby survived slaughter family left the hospitalPLUS MORE ON THIS TOPICNEWSWorld Bank expects "modest" impact of zika in the economy of Latin America and the CaribbeanNEWSGuillain-Barré syndrome increases in countries with zikaTAGSECUADORZIKAMEASURES SIGN UP FOR EVENING EDITION And receive daily updates SUBMIT I accept terms and conditions SEE OTHER NEWSLETTERSQuito. The Ministry of Public Health of Ecuador announced Friday a new case of zika in the city of Guayaquil, with totaling 51 cases detected in the country. He also said preparing for March 1 volunteer work in Quechua to combat the disease in the city of Buenos Aires. The Health Minister Margarita Guevara, speaking to reporters, said the management undertaken by the Government to address the emergency situation created by the presence of the mosquito Aedes aegypti, the transmitter of the disease, and dengue and chikungunya. LEA: Guillain-Barré syndrome increases in countries with zika "By working together the various public institutions, Zika virus has not infected a number of people, as happened in other countries in the region," said the minister, insisting that remain active plans to combat the illness. He added that by March is planned to carry out a cleaning Guayaquil, in order to prevent the proliferation of mosquito breeding sites. Zika virus currently circulating in much of Latin America and the Caribbean, and while causes mild symptoms in most infected, the great fear has to do with his alleged connection with cases of microcephaly and neurological syndrome Guillain Barré. READ: World Bank expects "modest" impact on the economy zika Latin America and the Caribbean On February 11, the Ministry of Health reported that fifty people, including two pregnant women, were infected by the virus Zika in Ecuador and, of these, 16 were imported cases. He also reported that some 64,000 people were part of the brigades to combat the disease, which had joined the Armed Forces personnel. The Ministry urged people to go to health centers and avoid self-medication, if you have symptoms of the disease include fever, red spots on the skin, joint pain, red eyes and malaise. http://www.nacion.com/mundo/latinoamerica/Ecuador-registra-medidas-enfrentar-enfermedad_0_1543645740.html

Of the 462 cases confirmed on 6 February, 421 had radiological findings compatible with a congenital infection and 41 had laboratory confirmation of Zika virus infection

China confirms 3rd case of Zika virusSource: Xinhua | February 20, 2016, Saturday | PRINT EDITIONCHINA yesterday confirmed a third imported Zika case, nine days after its first, according to the National Health and Family Planning Commission. The 38-year-old male patient developed a fever after returning on Monday to Yiwu in east China’s Zhejiang Province from Fiji and Samoa. The man, who said he had been bitten by mosquitoes, was quarantined and confirmed as being infected with the Zika virus yesterday. His temperature is now normal and his condition has improved, the commission said. Symptoms of the Zika virus, which spreads to people through mosquito bites, include fever, joint pain, a rash, conjunctivitis, headache and muscle pain. Disease prevention experts said the risk of the spread of the virus from this case is low due to the current low temperature which inhibits mosquito activity. http://www.shanghaidaily.com/national/China-confirms-3rd-case-of-Zika-virus/shdaily.shtml

Ontario has first confirmed case of ZikaPerson travelled to South America, where there has been an explosion of Zika infections since first cases began showing up in Brazil last May.Share on Facebook HANDOUT / TNS Zika virus is primarily spread through mosquitoes. By: Rob Ferguson Queen's Park Bureau, Published on Fri Feb 19 2016Ontario has its first confirmed case of the mosquito-borne Zika virus as the winter vacation season to warmer climes hits high gear. The patient, a woman who is not pregnant and whose identity and condition are not being released for privacy reasons, had recently returned from a trip to Colombia. “On Tuesday, Public Health Ontario received positive test results” for the patient, said Dr. David Williams, the province’s chief medical officer of health. “The risk to Ontarians remains very low, as the mosquitoes known to transmit the virus are not established in Canada and not well suited to our climate,” Williams said in a statement late Friday afternoon. Zika cases have soared in Caribbean countries, Mexico, South and Central America since the first instances were revealed in Brazil last May. As many as 4,400 babies in Brazil have been born with microcephaly, in which babies have abnormally small heads and brains, to women who may have been bitten by mosquitoes carrying the virus. On Feb.1, the World Health Organization a global health emergency over an outbreak of birth defects and neurological disorders linked to the fast-spreading Zika epidemic, in a move that reflects the extraordinary circumstances surrounding a virus that causes no symptoms in the vast majority of cases. The Public Health Agency of Canada issued its first travel notice in mid-January following other confirmed cases of Canadians returning from Central and South America with Zika. Although the Zika virus is not transmitted by the type of mosquitoes in Canada because of its cold climate, Williams and Health Minister Eric Hoskins warned last month that there is “ongoing risk” to Ontarians travelling to affected areas in tropical parts of the Americas and the Caribbean. They urged travellers to “take protective measures to prevent mosquito bites” and said women who are pregnant or thinking about becoming pregnant should consider postponing trips to Zika-prone countries. The news about the Ontario case comes as insect scientists at Brock University in St. Catharines have received a shipment of the virus to test whether mosquitoes native to Canada could become infected with the pathogen and potentially transmit it to humans. Brock is the only university in the country with a high-level containment lab that includes and insectary, allowing the testing to be conducted safely. First discovered in Uganda in 1947, Zika is spread mainly by the Aedes aegypti, a mosquito that bites mostly in the daytime and is found in every country in the Americas except Canada and continental Chile. Until lately, experts thought Zika caused only mild symptoms, including fever, joint pain and rashes with the majority of infected people showing no symptoms at all. Williams urged any Ontarians who have been to Zika-prone areas and are exhibiting similar symptoms to be checked out by a doctor. But the virus has now spread very rapidly to 24 countries and territorites in less than a year and has been associated with an alarming surge in neurological disorders such as microcephaly. The virus has also been linked to Guillain-Barré syndrome, a potentially fatal autoimmune disorder that can cause temporary paralysis, with increased numbers of cases being reported in Brazil, El Salvador, and French Polynesia, which experienced a Zika outbreak in 2013 and 2014. However, it could take months or years to prove whether Zika is directly causing either Guillain-Barré or microcephaly. http://www.thestar.com/news/canada/2016/02/19/ontario-has-first-case-of-zika-virus-in-person-who-travelled-to-colombia.html

PAHO Audio on Feb 18 presser https://unfoundation.app.box.com/audio2016/1/6632107101/54033244773/1

Ontario confirms its first case of Zika virusIn this Feb. 11, 2016, file photo, Aedes aegypti mosquitoes float in a mosquito cage at a laboratory in Cucuta, Colombia. (THE CANADIAN PRESS / AP-Ricardo Mazalan) 35 35 0 The Canadian Press Published Friday, February 19, 2016 4:57PM EST TORONTO -- Ontario's chief medical officer of health says the province has its first confirmed case of Zika virus in a person who had travelled to Colombia. Dr. David Williams says the risk to Ontarians remains "very low, as the mosquitoes known to transmit the virus are not established in Canada and are not well-suited to our climate." There has been an explosion of Zika infections in South and Central America, Mexico and the Caribbean since the first cases began showing up in Brazil last May. RELATED STORIESCan scientists ever prove Zika virus is causing birth defects?Zika virus shipped to Canada, to test native mosquito infectabilityUN: Zika virus will be 'way down' before Rio hosts OlympicsA small number of cases have previously been reported in Canada -- in British Columbia, Alberta and Quebec -- in travellers who have returned home infected. Most people who contract the infection have no symptoms, but some experience fever, joint pain, rash and red eyes. However, the virus has been potentially linked in Brazil to more than 4,400 cases of abnormally small heads in infants born to women who may have been infected while pregnant, as well as cases of Guillain-Barre syndrome, a neurological condition that can cause muscle weakness or even partial paralysis. http://www.ctvnews.ca/health/ontario-confirms-its-first-case-of-zika-virus-1.2785395

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

Statement from Chief Medical Officer of Health on Zika Virus February 19, 2016 4:30 P.M.Ministry of Health and Long-Term Care Today, Dr. David Williams, Chief Medical Officer of Health, issued the following statement: "Ensuring that Ontarians are fully informed about emerging and infectious diseases such as Zika virus is a priority. Together with the Public Health Agency of Canada, Public Health Ontario, the U.S. Centers for Disease Control and Prevention, the World Health Organization and other national and international partners, our ministry has been monitoring and assessing Zika virus. On Tuesday, Public Health Ontario received positive test results for Zika virus for an individual who had travelled to South America. This is the first confirmed case of Zika virus infection in Ontario. From the beginning of the outbreak in Central and South America, we have taken steps to ensure our health system and our partners are prepared should a returning traveller be suspected of having the virus. That includes working with the Public Health Agency of Canada to ensure that individuals presenting with symptoms are tested as quickly as possible. We have also been working closely with health professionals and labs in Ontario to ensure that they have the most up to date information about the virus and how to care for individuals concerned about possible exposure. Any individuals who have traveled to countries affected by Zika virus and are concerned that they might have contracted Zika virus should speak with their health-care provider, who can advise them if they need to be tested. Zika testing is currently being performed by Public Health Ontario and the National Microbiology Laboratory in Winnipeg. The risk to Ontarians remains very low, as the mosquitoes known to transmit the virus are not established in Canada and are not well-suited to our climate. Current evidence suggests that Zika virus is likely to persist and spread in the Americas and the South Pacific. Ontarians travelling to regions affected with Zika virus should protect themselves by taking protective measures to prevent mosquito bites and consult their health care provider before traveling. It is recommended that pregnant women and those considering becoming pregnant discuss their travel plans with their health care provider to assess their risk and consider postponing travel to areas where the Zika virus is circulating in the Americas. The ministry will continue to update Ontarians and health care providers on the status of Zika virus as updates are received from the Public Health Agency of Canada, World Health Organization, Pan American Health Organization and U.S. Centres for Disease Control and Prevention." Additional background on the Zika virus: On January 15, 2016, the Public Health Agency of Canada issued a Public Health Notice and aTravel Health Notice concerning Zika virus following confirmed travel-related cases of Zika virus infection in Canada originating from Central and South America. Advice to Ontarians Ontarians visiting affected areas should protect themselves against Zika virus by taking individual protective measures to prevent mosquito bites, including using insect repellent, protective clothing, mosquito nets, screened doors and windows. There is no vaccine or medication that protects against Zika virus infection. Additional ResourcesMinistry of Health and Long-Term Care: Zika VirusPublic Health Ontario: Zika virus factsheetWorld Health Organization: Zika virus factsheetCentres for Disease Control and Prevention: Zika virus informationMedia ContactsJoanne Woodward FraserMinistry of Health and Long-Term Care ontario.ca/health-news 416-314-6197

Statement from Chief Medical Officer of Health on Zika Virus February 19, 2016 4:30 P.M.Ministry of Health and Long-Term Care Today, Dr. David Williams, Chief Medical Officer of Health, issued the following statement: "Ensuring that Ontarians are fully informed about emerging and infectious diseases such as Zika virus is a priority. Together with the Public Health Agency of Canada, Public Health Ontario, the U.S. Centers for Disease Control and Prevention, the World Health Organization and other national and international partners, our ministry has been monitoring and assessing Zika virus. On Tuesday, Public Health Ontario received positive test results for Zika virus for an individual who had travelled to South America. This is the first confirmed case of Zika virus infection in Ontario.. https://news.ontario.ca/mohltc/en/2016/02/joint-statement-from-minister-of-health-and-acting-chief-medical-officer-of-health-on-zika-virus-1.html

Health confirmed 90 cases of zikaA total of 90 cases of zika have been confirmed so far this year, also reported 276 suspects, according to the Ministry of Health. Filed in:Ministry of Health,Zika virus,mosquitoBy Geldi Muñoz Palala February 19, 2016 at 12: 54hThe department reports the highest number of cases is 24 Suchitepequez, Zacapa followed with 13, last year they recorded 5 and 32 respectively. Health confirmed an increase in cases of Zika in the country, compared to 2015. (Photo Prensa Libre: Newspaper PL) Edgar Arana Ministry spokesman, said 14 confirmed cases among pregnant women are. National Laboratory to confirm a case it takes a week because they must pass several tests such as dengue, chikungunya and measles. Arana said that performs preventive actions, which have been mainly in the whole area of the south coast. Each health area made their actions. Of the 200 suspected cases reported in 2015 only 68 were confirmed. One in four infected develop symptoms, so Health keeps monitoring pregnant women. The reportThe Health Ministry Suchitepequez highlighted in the highest number of confirmed cases of Zika, also highlights the increase in cases compared to 2015. 2016 2015 Suchitepequez245Zacapa1332Guatemala93Chiquimula81Saint Rose70Escuintla6elevenQuetzaltenango43Retalhuleu43Quiche51Sacatepequez20Alta Verapaz20Izabal10Jutiapa03Petén East10San Marcos11Northern Guatemala02Progress11Southern Guatemala10Guatemala northwest10

Health confirmed 90 cases of zikaA total of 90 cases of zika have been confirmed so far this year, also reported 276 suspects, according to the Ministry of Health. http://www.prensalibre.com/guatemala/comunitario/salud-confirma-90-casos-de-zika

Iowa Resident Tests Positive for Zika Virus Author: Polly Carver-Kimm/Friday, February 19, 2016/Categories: IDPH News, Infectious Disease Prevention, General Health Rate this article: 5.0 The Iowa Department of Public Health (IDPH) today announced an Iowa resident, who recently traveled to countries where Zika virus transmission is ongoing, has tested positive for the virus. Following approval of Zika testing by IDPH, health care providers send specimens to the State Hygienic Laboratory, which then routes them to the CDC for analysis. The older adult (61 to 80 years of age) female has a travel history to Central America. “The general public is not at risk of contracting this virus, because the mosquitoes that transmit Zika are not established in Iowa,” said IDPH Medical Director, Dr. Patricia Quinlisk. “However, Iowans traveling to areas where there is ongoing Zika virus transmission should take care to protect themselves from mosquito bites.” The CDC is currently advising pregnant women to delay travel to foreign countries where Zika is being transmitted. There have been reports of a serious birth defect of the brain called microcephaly (meaning small head) and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant. Women who are trying to become pregnant should talk to their doctor about their plans to become pregnant and the risk of Zika virus infection. The CDC is currently recommending that if your male sexual partner has traveled to or lives in an area with active Zika virus transmission you should abstain from sex or use condoms the right way every time you have vaginal, anal, and oral sex for the duration of the pregnancy. The CDC is investigating a possible link between Zika virus infection and Guillain-Barre Syndrome, a rare neurological condition which causes varying degrees of paralysis; in addition, mosquitoes in areas where Zika transmission is ongoing may also carry diseases like dengue or chikungunya. Therefore, any traveler (males, females and children) visiting areas with ongoing Zika transmission should carefully follow steps to avoid mosquito bites: Wearing long-sleeved shirts and long pantsUsing EPA-registered insect repellentsUsing permethrin-treated clothingStaying and sleeping in screened-in or air-conditioned roomsAvoid or limit outdoor activities during peak mosquito times.The Zika virus illness is usually mild with symptoms lasting for several days to a week and hospitalizations are rare. Most people exposed to Zika virus won’t develop any symptoms at all. There is currently no vaccine or treatment for the virus. To learn more about Zika virus, including a link to a Zika-affected travel map, visit https://idph.iowa.gov/ehi/zika.

The Iowa Department of Public Health (IDPH) today announced an Iowa resident, who recently traveled to countries where Zika virus transmission is ongoing, has tested positive for the virus. Following approval of Zika testing by IDPH, health care providers send specimens to the State Hygienic Laboratory, which then routes them to the CDC for analysis. The older adult (61 to 80 years of age) female has a travel history to Central America. http://idph.iowa.gov/News/ArtMID/646/ArticleID/158107/Iowa-Resident-Tests-Positive-for-Zika-Virus

ZIKA VIRUSColombian Clinic Probes A Mystery: Is Zika Triggering A Rare Disorder?Updated February 19, 20163:56 PM ETPublished February 19, 20165:16 AM ETNURITH AIZENMANBECKY SULLIVANTwitter Instagram Listen to the StoryMorning Edition 5:45PlaylistDownloadEmbedTranscriptJohann Castro Hernandez, 18, is recovering from Guillain-Barre Syndrome. He appeared to have fallen sick with Zika virus around New Year's. About two weeks later, he began developing symptoms: His tongue went numb, his arms and legs felt as if they'd fallen asleep, then he began to have trouble breathing. His mom, Janina Hernandez, is at right. Becky Sullivan/NPRJohann Castro Hernandez is an 18-year-old college kid who loves playing soccer. Only these days, he can barely lift his legs, let alone kick a ball. His body looks weirdly thin, with no muscle tone. His movements are slow and tentative. This story is part of NPR's ongoing coverageof Zika virus. For the last month, he's been in the intensive care unit of a health facility called Clinica Norte in Cucuta, a city in northeast Colombia where doctors have diagnosed him with Guillain-Barre syndrome, a rare neurological condition that can leave people temporarily paralyzed for weeks. Castro sits at a table looking into a hand mirror as his mother pushes down on his forehead. It's a physical therapy exercise to help him regain use of his facial muscles. He's supposed to furrow his brow — then release. "Down, down and release," His mother instructs. Castro focuses hard on his image in the mirror. But his face stays put. "It's like my brain sends the order but the muscles don't follow it," he says. In the room next door, another Guillain-Barre patient is in even worse shape. He's a 58-year-old day laborer named Jose Cordero. He lies in his hospital bed, breathing tubes leading into his mouth. His sister, Ana Tilcia Cordero, stands by his side, staring down at him sadly. She touches his leg gently. "Can you feel it?" she asks. "No?" Cordero, fixes his eyes on her and strains to shake his head. That's all he can manage. The head of the ICU, Dr. Arturo Arias, pokes his head into the room. "Hi Jose," he says. "Look over here — at me!" He smiles — encouraging. "Don't worry," he tells Cordero. "You'll get better soon." But as the doctor leaves the room, his expression is dark. Cordero's situation is serious, he says. "So far he hasn't been responding to treatment." When you have Guillian-Barre your immune system basically starts attacking your nerve cells. For most people it starts with a tingling or numbness in the arms and legs, like when limbs fall asleep. There's weakness and pain. For some that's where it ends. But many other patients quickly deteriorate further. "It gets harder and harder to move," says Arias. Eventually a patient is paralyzed and can't even get out of bed. In the worst cases the paralysis is so severe that a machine is needed to breathe. There's a risk of death from complications like pneumonia or heart attacks. Treatments like plasmapheresis — a procedure that removes antibodies from your blood — can help. Ultimately patients do recover the ability to breathe. But it can take months to walk again. Some people never do. Guillain-Barre is a rare disorder. The U.S., for example, records 3,000 to 6,000 cases a year. At his ICU Arias sees about a case a year. So when a patient came in with the syndrome the first week of January, he wasn't too concerned. The following week, two more patients arrived. "Two more patients in the same month," Arias thought. "That's strange." When the fourth case showed up, he decided to call his friends at other ICUs around town. "Hi, how many Guillain-Barre cases have you had lately?" he asked them. The answers stunned him. Four, said one colleague. Another had five. Another eight. And there was something else. Practically every one of these patients — including both Castro the college student and Jose Cordero — said that shortly before they developed Guillain-Barre they had come down with the telltale signs of a Zika infection: rashes, pink eye, fever. Arias brightens at the sight of a visitor to the clinic. Dr. Juan Manuel Anaya has just arrived to help Arias launch a study to puzzle out the Zika connection. He's here from Colombia's capital, Bogota, where he directs a center for autoimmune disease research at the Universidad del Rosario. "We think that Zika is involved in almost all the [surge of] cases [of Guillain-Barre] physicians in Cucuta have seen," Arias explains. GOATS AND SODAZika In French Polynesia: It Struck Hard In 2013, Then DisappearedAnd it's not just here. Across Colombia there have been almost 100 Guillain-Barre cases linked to Zika since the outbreak began last fall — about twice the usual number. Other countries where Zika is spreading — Brazil, El Salvador, Venezuela — have seen similar spikes. And it turns out the same thing happened a few years ago during a Zika outbreak in French Polynesia. We ask Anaya if he thinks Zika is linked to Guillain-Barre. "Mostly, it's an open question," he says. Still, he adds, viral infections are often a trigger for Guillain-Barre. To prove a specific link with Zika, researchers like Anaya — and there are now quite a number doing similar work in South America — will also have to explain why only a small share of people who get Zika then come down with Guillain-Barre. "So we're looking for previous exposures to toxins, for instance. Or previous exposure to another virus." They'll also be running genetic tests. Meanwhile, the patients are struggling to overcome the syndrome. Castro finishes up his last physical therapy exercise. He's supposed to pucker his lips, then release them in a kiss. His mother, Janina Hernandez, has to push his lips into position. Still, he is at least able to hold them there, then make a kissing sound. Hernandez looks at her son proudly. Tomorrow he's set to go home. But it's been such a rough road, she says. "When we first got here he was so worried," she recalls. "I would say to him, 'Get some rest so you can get better.' And he would say, 'No. I'm afraid if I go to sleep I'll stop breathing.'" Then one morning, that's exactly what happened. "I started to shake and shake and shake," Castro remembers. "And the doctor said we have to intubate him" — to insert a breathing tube into his trachea. By day, Castro tried to keep up a brave face for his mother. Alone, at night, "I'm not gonna lie," he says, "there was more than one night that I cried. I got to a point where I thought, 'Am I going to be stuck like this?'" Now, he's optimistic. "I'm going to do these exercises every day," he says, "until I can play [soccer] again." http://www.npr.org/sections/goatsandsoda/2016/02/19/467318839/colombian-clinic-probes-a-mystery-is-zika-triggering-a-rare-disorder?utm_source=dlvr.it&utm_medium=twitter

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|KF993678.1|Zika virus strain PLCal_ZV from Canada polyprotein gene, partial cds20352035100%0.099%KF993678.1Select seq gb|KU509998.1|Zika virus strain Haiti/1225/2014, complete genome20302030100%0.099%KU509998.1Select seq gb|KJ776791.1|Zika virus strain H/PF/2013 polyprotein gene, complete cds20302030100%0.099%KJ776791.1Select seq gb|KU647676.1|Zika virus strain MRS_OPY_Martinique_PaRi_2015 polyprotein gene, complete cds20262026100%0.099%KU647676.1Select seq gb|KU501217.1|Zika virus strain 8375 polyprotein gene, complete cds20262026100%0.099%KU501217.1Select seq gb|KU501216.1|Zika virus strain 103344 polyprotein gene, complete cds20262026100%0.099%KU501216.1Select seq gb|KU501215.1|Zika virus strain PRVABC59, complete genome20212021100%0.099%KU501215.1Select seq gb|KU321639.1|Zika virus strain ZikaSPH2015, complete genome20212021100%0.099%KU321639.1Select seq gb|KU365780.1|Zika virus strain BeH815744 polyprotein gene, complete cds20122012100%0.099%KU365780.1Select seq gb|KU365779.1|Zika virus strain BeH819966 polyprotein gene, complete cds20122012100%0.099%KU365779.1Select seq gb|KU365777.1|Zika virus strain BeH818995 polyprotein gene, complete cds20122012100%0.099%KU365777.1Select seq gb|KU312312.1|Zika virus isolate Z1106033 polyprotein gene, complete cds20122012100%0.099%KU312312.1Select seq gb|KU365778.1|Zika virus strain BeH819015 polyprotein gene, complete cds20032003100%0.099%KU365778.1Select seq gb|JN860885.1|Zika virus isolate FSS13025 polyprotein gene, partial cds19991999100%0.099%JN860885.1Select seq gb|EU545988.1|Zika virus polyprotein gene, complete cds19841984100%0.098%EU545988.1Select seq gb|HQ234499.1|Zika virus isolate P6-740 polyprotein gene, partial cds18191819100%0.095%HQ234499.1Select seq gb|KM078936.1|Zika virus strain CHI1410214 NS5 protein gene, partial cds1710171084%0.099%KM078936.1Select seq gb|KM078961.1|Zika virus strain CHI2612114 NS5 protein gene, partial cds1709170984%0.099%KM078961.1Select seq gb|KM078930.1|Zika virus strain CHI2283714 NS5 protein gene, partial cds1707170784%0.099%KM078930.1Select seq gb|KM078971.1|Zika virus strain CHI2613014 NS5 protein gene, partial cds1703170384%0.099%KM078971.1Select seq gb|KM078970.1|Zika virus strain CHI2490414 NS5 protein gene, partial cds1703170384%0.099%KM078970.1Select seq gb|KM078933.1|Zika virus strain CHI1058514 NS5 protein gene, partial cds1703170384%0.099%KM078933.1Select seq gb|KM078929.1|Zika virus strain CHI1805214 NS5 protein gene, partial cds1701170184%0.099%KM078929.1Select seq gb|KJ873160.1|Zika virus isolate NC14-03042014-3481 nonstructural protein 5 gene, partial cds1579157977%0.099%KJ873160.1

LOCUS KU179098 1148 bp RNA linear VRL 19-FEB-2016 DEFINITION Zika virus isolate JMB-185 nonstructural protein 5 gene, partial cds. ACCESSION KU179098 VERSION KU179098.1 GI:998491569 KEYWORDS . SOURCE Zika virus ORGANISM Zika virus Viruses; ssRNA viruses; ssRNA positive-strand viruses, no DNA stage; Flaviviridae; Flavivirus. REFERENCE 1 (bases 1 to 1148) AUTHORS Perkasa,A., Yudaputri,F., Haryanto,S., Hayati,R.F., Ma'roef,C.N., Antonjaya,U., Yohan,B., Myint,K.S.A., Ledderman,J.P., Rosenberg,R., Powers,A.M. and Sasmono,R.T. TITLE Isolation of Zika virus from febrile patient, Indonesia JOURNAL Emerging Infect. Dis. 22 (5) (2016) In press REMARK Publication Status: Available-Online prior to print REFERENCE 2 (bases 1 to 1148) AUTHORS Perkasa,A., Yudaputri,F., Haryanto,S., Hayati,R.F., Ma'roef,C.N., Antonjaya,U., Yohan,B., Myint,K.S.A., Ledderman,J.P., Rosenberg,R., Powers,A.M. and Sasmono,R.T. TITLE Direct Submission JOURNAL Submitted (20-NOV-2015) Dengue Unit, Eijkman Institute for Molecular Biology, Jl. Diponegoro 69, Jakarta 10430, Indonesia COMMENT ##Assembly-Data-START## Sequencing Technology :: Sanger dideoxy sequencing ##Assembly-Data-END## FEATURES Location/Qualifiers source 1..1148 /organism="Zika virus" /mol_type="genomic RNA" /isolate="JMB-185" /isolation_source="serum" /host="Homo sapiens" /db_xref="taxon:64320" /country="Indonesia: Jambi" /collection_date="30-Dec-2014" CDS <1..>1148 /note="NS5" /codon_start=1 /product="nonstructural protein 5" /protein_id="AMK49492.1" /db_xref="GI:998491570" /translation="GAIFEEEKEWKTAVEAVNDPRFWALVDKEREHHLRGECQSCVYN MMGKREKKQGEFGKAKGSRAIWYMWLGARFLEFEALGFLNEDHWMGRENSGGGVEGLG LQRLGYVLEEMSRIPGGRMYADDTAGWDTRISRFDLENEALITNQMEKGHRALALAII KYTYQNKVVKVLRPAEKGKTVMDIISRQDQRGSGQVVTYALNTFTNLVVQLIRNMEAE EVLEMQDLWLLRRSEKVTNWLQSNGWDRLKRMAVSGDDCVVKPIDDRFAHALRFLNDM GKVRKDTQEWKPSTGWDNWEEVPFCSHHFNKLHLKDGRSIVVPCRHQDELIGRARVSP GAGWSIRETACLAKSYAQMWQLLYFHRRDLRLMANAICSSVPVDWVPTG" ORIGIN 1 ggagcaatat ttgaagagga aaaagagtgg aagactgcag tggaagctgt gaacgatcca 61 aggttctggg ctctagtgga caaggaaaga gagcaccacc tgagaggaga gtgccagagc 121 tgtgtgtaca acatgatggg aaaaagagaa aagaaacaag gggaatttgg aaaggccaag 181 ggcagccgcg ccatctggta tatgtggcta ggggctagat ttctagagtt cgaagccctt 241 ggattcttga acgaggatca ctggatgggg agagagaact caggaggtgg tgttgaaggg 301 ctgggattac aaagactcgg atatgtccta gaagagatga gtcgcatacc aggaggaagg 361 atgtatgcag atgatactgc tggctgggac acccgcatca gcaggtttga tctggagaat 421 gaagctctaa tcaccaacca aatggagaaa gggcacaggg ccttggcatt ggccataatc 481 aagtatacat accaaaacaa agtggtaaag gtccttagac cagctgaaaa agggaagaca 541 gttatggaca ttatttcaag acaagaccaa agggggagcg gacaagttgt cacttacgct 601 cttaatacat ttaccaacct agtggtgcag ctcattcgga atatggaggc tgaggaagtt 661 ctagagatgc aagacttgtg gctgctgcgg aggtcagaga aagtgaccaa ctggttgcag 721 agcaacggat gggataggct caaacgaatg gcagtcagtg gagatgattg cgttgtgaag 781 ccaattgatg ataggtttgc acatgccctc aggttcttga atgatatggg aaaagttagg 841 aaggacacac aagagtggaa accctcgact ggatgggaca actgggaaga agttccgttt 901 tgctcccacc acttcaacaa gctccatctc aaggacggga ggtccattgt ggttccctgc 961 cgccaccaag atgaactgat tggccgggcc cgcgtctctc caggggcggg atggagcatc 1021 cgggagactg cttgcctagc aaaatcgtat gcgcaaatgt ggcagctcct ttatttccac 1081 agaagggacc tccgactgat ggccaatgcc atttgttcat ctgtgccagt tgactgggtt 1141 ccaactgg

LOCUS KU179098 1148 bp RNA linear VRL 19-FEB-2016 DEFINITION Zika virus isolate JMB-185 nonstructural protein 5 gene, partial cds. ACCESSION KU179098 VERSION KU179098.1 GI:998491569 KEYWORDS . SOURCE Zika virus ORGANISM Zika virus Viruses; ssRNA viruses; ssRNA positive-strand viruses, no DNA stage; Flaviviridae; Flavivirus. REFERENCE 1 (bases 1 to 1148) AUTHORS Perkasa,A., Yudaputri,F., Haryanto,S., Hayati,R.F., Ma'roef,C.N., Antonjaya,U., Yohan,B., Myint,K.S.A., Ledderman,J.P., Rosenberg,R., Powers,A.M. and Sasmono,R.T. TITLE Isolation of Zika virus from febrile patient, Indonesia JOURNAL Emerging Infect. Dis. 22 (5) (2016) In press REMARK Publication Status: Available-Online prior to print REFERENCE 2 (bases 1 to 1148) AUTHORS Perkasa,A., Yudaputri,F., Haryanto,S., Hayati,R.F., Ma'roef,C.N., Antonjaya,U., Yohan,B., Myint,K.S.A., Ledderman,J.P., Rosenberg,R., Powers,A.M. and Sasmono,R.T. TITLE Direct Submission JOURNAL Submitted (20-NOV-2015) Dengue Unit, Eijkman Institute for Molecular Biology, Jl. Diponegoro 69, Jakarta 10430, Indonesia COMMENT ##Assembly-Data-START## Sequencing Technology :: Sanger dideoxy sequencing ##Assembly-Data-END## FEATURES Location/Qualifiers source 1..1148 /organism="Zika virus" /mol_type="genomic RNA" /isolate="JMB-185" /isolation_source="serum" /host="Homo sapiens" /db_xref="taxon:64320" /country="Indonesia: Jambi" /collection_date="30-Dec-2014"

Weekly tallies http://portalsaude.saude.gov.br/index.php/o-ministerio/principal/leia-mais-o-ministerio/197-secretaria-svs/20799-microcefalia

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

Travel-Associated Cases of Zika Virus in California (as of February 19, 2016) Year CDC final confirmed cases* CDC preliminary positive cases** 2013 1 NA 2014 3 NA 2015 3 1 2016 3 0 https://www.cdph.ca.gov/HealthInfo/discond/Documents/TravelAssociatedCasesofZikaVirusinCA.pdf