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The StudyIn early December 2013, during the ZIKV outbreak, a 44-year-old man in Tahiti had symptoms of ZIKV infection: asthenia, low grade fever (temperature from 37.5°C to 38°C) and arthralgia. Symptoms lasted 3 days. Eight weeks later, he described a second episode of symptoms compatible with ZIKV infection: temperature from 37.5°C to 38°C, headache on days 1–3, and wrist arthralgia on days 5–7. The patient did not seek treatment, thus biological samples were not collected during the first 2 periods of illness. The patient fully recovered from the second episode, but 2 weeks later he noted signs of hematospermia and sought treatment. Because the patient had experienced symptoms of ZIKV infection some weeks before, he was referred to our laboratory in the Institut Louis Malardé, Papeete, Tahiti for ZIKV infection diagnostic testing. The medical questionnaire revealed no signs of urinary tract infection, prostatitis, urethritis, or cystitis, and the patient stated that he did not had any recent physical contact with persons who had acute ZIKV infection. We collected blood and semen samples. Direct and macroscopic examinations of the semen confirmed hematospermia. We extracted RNA using the NucliSENS easyMAG system (bioMérieux, Marcy l’Etoile, France) from 200 μL of blood and from 500 μL of semen and urine; both were eluted by 50 μL of elution buffer. We used 5 μL of RNA extracted for amplification. We tested blood and semen RNA extracts using real-time reverse transcription PCR (rRT-PCR) as described using 2 primers/probe amplification sets specific for ZIKV (3). The rRT-PCR results were positive for ZIKV in semen and negative in blood, and confirmed by sequencing of the genomic position 858–1138 encompassing the prM/E protein coding regions of ZIKV. The generated sequence (GenBank accession no. KM014700) was identical to those previously reported at the beginning of the ZIKV outbreak (3). Three days later, we collected a urine sample, then a second set of blood and semen samples. Semen and urine from this second collection were not found to contain traces of blood by both direct and macroscopic examinations. rRT-PCR detected ZIKV RNA in the semen and urine, but not in the blood sample. We quantified ZIKV RNA loads using an RNA synthetic transcript standard that covers the region targeted by the 2 primers/probe sets. RNA loads were: 2.9 × 107 copies/mL and 1.1 × 107 copies/mL in the first and second semen samples, respectively, and 3.8 × 103 copies/mL in the urine sample. We cultured semen and urine as described for dengue virus cultured from urine (6). Briefly, 200 μL of each sample diluted in 200 μL of 1% fetal calf serum (FCS) minimum essential medium (MEM) were inoculated onto Vero cells and incubated for 1 h at 37°C; inoculum was then removed and replaced by 1 mL of culture medium. We also inoculated a negative control (200 μL of 1% FCS-MEM) and a positive control (5 μL of a ZIKV-positive serum diluted in 200 μL of 1% FCS-MEM). The cells were then incubated at 37°C in 5% CO2 for 6 days. The presence of ZIKV in the culture fluids was detected by rRT-PCR as described. Replicative ZIKV particles were found in the 2 semen samples but none were detected in the urine sample. This finding does not exclude the possibility that ZIKV particles were present in urine. Positive samples were not titered.

Zika virus (ZIKV) is a mosquitoborne arbovirus in the family Flaviviridae, genus Flavivirus. It was first isolated in 1947 from a rhesus monkey in the Zika forest of Uganda (1). Sporadic human cases were reported from the 1960s in Asia and Africa. The first reported large outbreak occurred in 2007 on Yap Island, Federated States of Micronesia (2). The largest known ZIKV outbreak reported started in October 2013 in French Polynesia, South Pacific (3), a territory of France comprising 67 inhabited islands; an estimated 28,000 persons (11% of the population) sought medical care for the illness (4). The most common symptoms of Zika fever are rash, fever, arthralgia, and conjunctivitis. Most of the patients had mild disease, but severe neurologic complications have been described in other patients in French Polynesia (5).

AbstractIn December 2013, during a Zika virus (ZIKV) outbreak in French Polynesia, a patient in Tahiti sought treatment for hematospermia, and ZIKV was isolated from his semen. ZIKV transmission by sexual intercourse has been previously suspected. This observation supports the possibility that ZIKV could be transmitted sexually.

Volume 21, Number 2—February 2015DispatchPotential Sexual Transmission of Zika VirusOn This PageThe StudyConclusionsSuggested CitationDownloadsPDF[1.05 MB - 3 pgs]RIS[TXT - 2 KB]AltmetricDidier Musso , Claudine Roche, Emilie Robin, Tuxuan Nhan, Anita Teissier, and Van-Mai Cao-LormeauAuthor affiliations: Institut Louis Malardé, Papeete, Tahiti, French Polynesia http://wwwnc.cdc.gov/eid/article/21/2/14-1363_article

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|KU647676.1|Zika virus strain MRS_OPY_Martinique_PaRi_2015 polyprotein gene, complete cds508508100%3e-140100%KU647676.1Select seq gb|KU509998.1|Zika virus strain Haiti/1225/2014, complete genome508508100%3e-140100%KU509998.1Select seq gb|KU365778.1|Zika virus strain BeH819015 polyprotein gene, complete cds508508100%3e-140100%KU365778.1Select seq gb|KU312315.1|Zika virus isolate Z1106027 polyprotein gene, partial cds508508100%3e-140100%KU312315.1Select seq gb|KU312314.1|Zika virus isolate Z1106031 polyprotein gene, partial cds508508100%3e-140100%KU312314.1Select seq gb|KU312313.1|Zika virus isolate Z1106032 polyprotein gene, partial cds508508100%3e-140100%KU312313.1Select seq gb|KM212966.1|Zika virus isolate NC13(FP)-26112013-22072 glycoprotein gene, partial cds508508100%3e-140100%KM212966.1Select seq gb|KJ579441.1|Zika virus isolate PF13-CP221013c polyprotein gene, partial cds508508100%3e-140100%KJ579441.1Select seq dbj|AB908162.1|Zika virus gene for polyprotein, partial cds, strain: ZIKV Hu/Tahiti/01u/2014NIID508508100%3e-140100%AB908162.1Select seq gb|KU501217.1|Zika virus strain 8375 polyprotein gene, complete cds502502100%1e-13899%KU501217.1Select seq gb|KU501216.1|Zika virus strain 103344 polyprotein gene, complete cds502502100%1e-13899%KU501216.1Select seq gb|KU501215.1|Zika virus strain PRVABC59, complete genome502502100%1e-13899%KU501215.1Select seq gb|KU365780.1|Zika virus strain BeH815744 polyprotein gene, complete cds502502100%1e-13899%KU365780.1Select seq gb|KU365779.1|Zika virus strain BeH819966 polyprotein gene, complete cds502502100%1e-13899%KU365779.1Select seq gb|KU365777.1|Zika virus strain BeH818995 polyprotein gene, complete cds502502100%1e-13899%KU365777.1Select seq gb|KU312312.1|Zika virus isolate Z1106033 polyprotein gene, complete cds502502100%1e-13899%KU312312.1Select seq gb|KU321639.1|Zika virus strain ZikaSPH2015, complete genome502502100%1e-13899%KU321639.1Select seq gb|KM212965.1|Zika virus isolate NC13(FP)-20112013-22015 glycoprotein gene, partial cds502502100%1e-13899%KM212965.1Select seq gb|KM212964.1|Zika virus isolate NC14-17042014-4554 glycoprotein gene, partial cds502502100%1e-13899%KM212964.1Select seq gb|KM212963.1|Zika virus isolate NC14-23012014-250 glycoprotein gene, partial cds502502100%1e-13899%KM212963.1Select seq gb|KJ776791.1|Zika virus strain H/PF/2013 polyprotein gene, complete cds502502100%1e-13899%KJ776791.1Select seq gb|KJ680134.1|Zika virus strain PF13-091213-121 polyprotein gene, partial cds502502100%1e-13899%KJ680134.1Select seq gb|JN860885.1|Zika virus isolate FSS13025 polyprotein gene, partial cds499499100%2e-13799%JN860885.1Select seq gb|KF993678.1|Zika virus strain PLCal_ZV from Canada polyprotein gene, partial cds49149199%2e-13599%KF993678.1Select seq gb|KU646828.1|Zika virus isolate Si322 polyprotein gene, partial cds48448495%4e-133100%KU646828.1Select seq gb|EU545988.1|Zika virus polyprotein gene, complete cds484484100%4e-13398%EU545988.1Select seq gb|KU646827.1|Zika virus isolate Si323 polyprotein gene, partial cds47947995%2e-13199%KU646827.1Select seq gb|KJ634273.1|Zika virus strain CK-ISL 2014 E protein (E) gene, partial cds47947995%2e-13199%KJ634273.1Select seq gb|HQ234499.1|Zika virus isolate P6-740 polyprotein gene, partial cds439439100%1e-11995%HQ234499.1

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

LOCUS KM014700 281 bp RNA linear VRL 06-FEB-2015 DEFINITION Zika virus polyprotein gene, partial cds. ACCESSION KM014700 VERSION KM014700.1 GI:734568018 KEYWORDS . SOURCE Zika virus ORGANISM Zika virus Viruses; ssRNA viruses; ssRNA positive-strand viruses, no DNA stage; Flaviviridae; Flavivirus. REFERENCE 1 (bases 1 to 281) AUTHORS Musso,D., Roche,C., Robin,E., Nhan,T., Teissier,A. and Cao-Lormeau,V.M. TITLE Potential sexual transmission of zika virus JOURNAL Emerging Infect. Dis. 21 (2), 359-361 (2015) PUBMED 25625872 REFERENCE 2 (bases 1 to 281) AUTHORS Roche,C. TITLE Direct Submission JOURNAL Submitted (17-JUN-2014) PMIE, Institut Louis Malarde, BP 30, Papeete, Tahiti 98713, French Polynesia FEATURES Location/Qualifiers source 1..281 /organism="Zika virus" /mol_type="genomic RNA" /isolate="PF14-280114-118sp" /isolation_source="sperm" /host="Homo sapiens" /db_xref="taxon:64320" /country="French Polynesia" /collection_date="28-Jan-2014" CDS <1..>281 /codon_start=2 /product="polyprotein" /protein_id="AJA06126.1" /db_xref="GI:734568019" /translation="PAYSIRCIGVSNRDFVEGMSGGTWVDVVLEHGGCVTVMAQDKPT VDIELVTTTVSNMAEVRSYCYEASISDMASDSRCPTQGEAYLDKQSDTQ" ORIGIN 1 cccggcatac agcatcaggt gcataggagt cagcaatagg gactttgtgg aaggtatgtc 61 aggtgggact tgggttgatg ttgtcttgga acatggaggt tgtgtcaccg taatggcaca 121 ggacaaaccg actgtcgaca tagagctggt tacaacaaca gtcagcaaca tggcggaggt 181 aagatcctac tgctatgagg catcaatatc agacatggct tcggacagcc gctgcccaac 241 acaaggtgaa gcctaccttg acaagcaatc agacactcaa t

LOCUS KM014700 281 bp RNA linear VRL 06-FEB-2015 DEFINITION Zika virus polyprotein gene, partial cds. ACCESSION KM014700 VERSION KM014700.1 GI:734568018 KEYWORDS . SOURCE Zika virus ORGANISM Zika virus Viruses; ssRNA viruses; ssRNA positive-strand viruses, no DNA stage; Flaviviridae; Flavivirus. REFERENCE 1 (bases 1 to 281) AUTHORS Musso,D., Roche,C., Robin,E., Nhan,T., Teissier,A. and Cao-Lormeau,V.M. TITLE Potential sexual transmission of zika virus JOURNAL Emerging Infect. Dis. 21 (2), 359-361 (2015) PUBMED 25625872 REFERENCE 2 (bases 1 to 281) AUTHORS Roche,C. TITLE Direct Submission JOURNAL Submitted (17-JUN-2014) PMIE, Institut Louis Malarde, BP 30, Papeete, Tahiti 98713, French Polynesia FEATURES Location/Qualifiers source 1..281 /organism="Zika virus" /mol_type="genomic RNA" /isolate="PF14-280114-118sp" /isolation_source="sperm" /host="Homo sapiens" /db_xref="taxon:64320" /country="French Polynesia" /collection_date="28-Jan-2014"http://www.ncbi.nlm.nih.gov/nuccore/KM014700.1

Increase in congenital malformations On 27 January 2016, Brazil reported that of 4180 suspected cases of microcephaly, 270 were confirmed, 462 were discarded and 3448 are still under investigation. This compares to an average of 163 microcephaly cases recorded nationwide per year. Only six of the 270 confirmed cases of microcephaly had evidence of Zika infection. According to the US Centers for Disease Control and Prevention (US CDC) and Ministry of Health Brazil, the results of two specimens taken during autopsy from the brain tissues of microcephalic patients, indicated infection with Zika virus. A placenta was also evaluated and found to be PCR positive for Zika. Although the microcephaly cases in Brazil are spatiotemporally associated with the Zika virus outbreak, health authorities and agencies are investigating and conducting comprehensive research to confirm a causal link. Following the Zika outbreak in French Polynesian, health authorities reported an unusual increase in the number of congenital malformations in babies born between March 2014 and May 2015. Eighteen cases were reported, nine of which were diagnosed as microcephaly. Other countries with current outbreaks (Cape Verde, Colombia, El Salvador and Panama) have not reported an increase in microcephaly.

Increase in neurological syndromes National health authorities have reported an observed increase of Guillain-Barré syndrome (GBS)1 in Brazil and El Salvador which coincided with the Zika virus outbreaks. During the French Polynesia outbreak in 2013/2014, national authorities also reported an observed increase in neurological syndromes in the context of co-circulating dengue virus and Zika virus. Seventy-four patients presented with neurological or auto-immune syndromes after the manifestation of symptoms consistent with Zika virus infection. Of these, 42 were classified as GBS. On January 22 Brazil reported an increase of GBS at the national level. A total of 1708 GBS cases were registered between January and November 2015. Most of Brazil’s states have Zika, chikungunya and dengue virus circulation. 1 Guillain-Barré syndrome is a rare condition in which a person’s immune system attacks their peripheral nervous system. The syndrome can affect the nerves that control muscle movement as well as those that transmit feelings of pain, temperature and touch. This can result in muscle weakness and loss of sensation in the legs and/or arms. The cause of Guillain-Barré cannot always be determined, but it is often triggered by an infection (such as HIV, dengue, or influenza) and less commonly by immunization, surgery, or trauma.

Current Situation In February 2015, Brazil detected cases of fever and rash that were confirmed to be Zika virus in May 2015. The last official report received dated 1 December 2015, indicated 56,318 suspected cases of Zika virus disease in 29 States, with localized transmission occurring since April 2015. Due to the magnitude of the outbreak, Brazil has stopped counting cases of Zika virus. Today the Brazilian national authorities estimate 500,000 to 1,500,000 cases of Zika virus disease. In October 2015, both Colombia and Cape Verde, off the coast of Africa, reported their first outbreaks of the virus. As of 22 January 2016 Colombia had reported 16,419 cases, El Salvador 3,836 cases and Panama 99 cases of Zika virus disease. As of 12 February, a total of 39 countries in multiple regions have reported autochthonous (local) circulation of Zika virus, and there is evidence of local transmission in six additional countries (Figure 1). Imported cases have been reported in the United States of America, Europe and non-endemic countries of Asia and the Pacific.

Background Zika virus is an emerging viral disease that is transmitted through the bite of an infected mosquito, primarily Aedes aegypti, the same vector that transmits chikungunya, dengue and yellow fever. Zika has a similar epidemiology, clinical presentation and transmission cycle in urban environments as chikungunya and dengue, although it generally causes milder illness. Symptoms of Zika virus disease include fever, skin rash, conjunctivitis, muscle and joint pain, malaise and headache, which normally last for 2 to 7 days. There is no specific treatment but symptoms are normally mild and can be treated with common pain and fever medicines, rest and drinking plenty of fluids. Zika virus was first identified in 1947 in a monkey in the Zika forest of Uganda, and was first isolated in humans in 1952 in Uganda and the United Republic of Tanzania. Zika virus has been causing sporadic disease in Africa and Asia. Outbreaks were reported for the first time from the Pacific in 2007 and 2013 in Yap Island (Federated States of Micronesia) and French Polynesia, respectively. There was subsequent spread of the virus to other Pacific islands, including New Caledonia, Cook Islands, Easter Island (Chile), Fiji, Samoa, Solomon Islands and Vanuatu. The geographical range of Zika virus has been steadily increasing ever since (Figure 1).

OVERVIEW OF THE SITUATION This strategy has been developed to guide the international response to the current cluster of congenital malformations (microcephaly) and other neurological complications (Guillain-Barré Syndrome) that could be linked to Zika virus infection.

PART I: FOREWORD BY THE DIRECTOR-GENERAL Since the Zika virus was first identified in a monkey in Uganda in 1947, it has rarely caused illness in humans. When people have become infected with the virus, the disease it causes has generally been mild, with small outbreaks occurring in a relatively narrow geographical band around the equator. The situation today is dramatically different. Last year the virus was detected in the Americas, where it is now spreading explosively. Possible links with neurological complications and birth malformations have rapidly changed the risk profile of Zika from a mild threat to one of very serious proportions. The Zika situation is particularly serious because of the potential for further international spread, given the wide geographical distribution of the mosquito vector, the lack of population immunity in newly affected areas, and the absence of vaccines, specific treatments and rapid diagnostic tests. WHO has activated its Emergency Operations incident management system to coordinate the international response to this outbreak. This Strategic Response and Joint Operations Plan aims to provide support to affected countries, build capacity to prevent further outbreaks and control them when they do occur, and to facilitate research that will help us better understand this virus and its effects. Margaret Chan Director-General

ZIKA STRATEGIC RESPONSE FRAMEWORK & JOINT OPERATIONS PLAN JANUARY-JUNE 2016 http://who.int/emergencies/zika-virus/strategic-response-framework.pdf?ua=1

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

A fourth case of the Zika virus has been reported in Illinois, the Illinois Department of Public Health said in a statement on its website. IDPH told NBC Chicago a woman who is not pregnant has the virus. Further details about her age or her travel history were not disclosed. Source: http://www.nbcchicago.com/news/health/Woman-Becomes-3rd-Case-of-Zika-Virus-in-Illinois-369031181.html#ixzz40NwCpeRN Follow us: @nbcchicago on Twitter | nbcchicago on Facebook

Zika Virus As of February 16, 2016, the Illinois Department of Public Health is reporting four cases of Zika virus disease statewide.http://www.dph.illinois.gov/topics-services/diseases-and-conditions/zika

16 Being Tested In Allegheny Co. For Zika VirusFebruary 16, 2016 4:39 PMFiled Under: Allegheny County Health Department, Pennsylvania, Pennsylvania Department of Health, Zika Virus 8PITTSBURGH (KDKA/AP) — State health officials have released the latest numbers on the Zika virus as concerns continue to grow globally. The Pennsylvania Department of Health says they are awaiting the results of more than 53 blood tests. At least 16 of those tests are from Allegheny County, says the Allegheny County Health Department. Last week, health officials confirmed that two women tested positive for the virus. At least one of those cases was near Philadelphia. Join The Conversation On The KDKA Facebook Page Stay Up To Date, Follow KDKA On Twitter Symptoms of the Zika virus include fever, a rash and achy joints. Most people recover in about a week, but doctors believe the virus puts pregnant women at serious risks for birth defects. For the latest on the Zika virus in Pennsylvania, visit the state Health Department’s website here. http://pittsburgh.cbslocal.com/2016/02/16/16-being-tested-in-allegheny-co-for-zika-virus/

53 people in Pennsylvania await Zika test results BY BEN SCHMITT | Tuesday, Feb. 16, 2016, 1:54 p.m. Email NewslettersSign up for one of our email newsletters. Updated 3 minutes ago Fifty-three Pennsylvanians now have pending tests for the mosquito-borne Zika virus with federal officials, a steep climb from last week. The state Department of Health on Tuesday released new figures indicating eight residents have tested negative for the virus while two unidentified women have tested positive and recovered. The Centers for Disease Control and Prevention in Atlanta is performing the blood tests. A week ago, the state health department said 12 tests were pending with the CDC. Officials did not immediately respond to request for comment to explain the increase. Worldwide, health authorities suspect the virus led to an increase in Brazil of microcephaly, in which children are born with abnormally small heads. As a result, the World Health Organization recently declared an international health emergency. The CDC advised pregnant women or those considering becoming pregnant to avoid travel to places with Zika outbreaks. There's no vaccine for the virus, which spreads primarily through bites from a mosquito not typically found in Pennsylvania or Ohio. In Allegheny County, results are pending for 16 people, according to the county health department. The CDC said sexual transmission of the virus is possible, but mosquito bites remain the primary way Zika is transmitted. Ben Schmitt is a Tribune-Review staff writer. Reach him at (412) 320-7991 [email protected] http://triblive.com/news/adminpage/9984729-74/health-virus-zika

ZIKA VIRUSUpdated 2/16/16 Zika virus is a generally mild illness that is spread primarily through the bite of an infected mosquito. Common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes), lasting from several days to one week. Rarely, the virus is spread from mother to child. Spread of the virus through blood transfusion and sexual contact has also been reported. The current Zika virus outbreak began in May 2015 in Brazil, leading to reports of Guillain-Barré syndrome and pregnant women giving birth to babies with birth defects and poor pregnancy outcomes. The outbreak has spread to numerous countries and areas, prompting the Centers for Disease Control and Prevention (CDC) to issue travel notices to regions where the Zika virus transmission is ongoing. The first case of Zika virus disease contracted in the U.S. occurred recently in Texas and involved an individual who had sexual contact with someone who acquired the Zika infection while traveling abroad. Other confirmed cases of the illness in the U.S. have occured in individuals who had traveled to areas affected by the Zika outbreak. TRAVEL ALERTThe CDC has issued a travel alert for people traveling to regions and certain countries where Zika virus transmission is ongoing. The list of affected areas may change frequently, so please check www.cdc.gov/zika for the most up-to-date information. POTENTIAL RISK TO PREGNANT WOMENHealth authorities are currently investigating a potential link between Zika virus in pregnant women and microcephaly (an abnormally small head) in their babies. Until more is known, the CDC recommends that all pregnant women consider postponing travel to areas where Zika virus transmission is ongoing. Women who are pregnant or planning to become pregnant and must travel to these areas should consult with their health care provider and take extra care to protect themselves from mosquito bites when traveling to an area known to have Zika. Update: Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure (Feb 5, 2016) CDC's Interim Guidelines for Pregnant Women during a Zika Virus Outbreak (Jan. 19, 2016) Men who have recently traveled to a Zika-affected area and have a pregnant partner should take steps to prevent sexual transmission of Zika virus. Interim Guidelines for Prevention of Sexual Transmission of Zika Virus (Feb 5, 2016) ABOUT ZIKA VIRUSZika virus occurs in tropical areas with large mosquito populations, and is known to circulate in Africa, the Americas, Asia, and the Pacific. The virus was first discovered in 1947, but the first outbreak of the disease wasn't documented until 2007. SYMPTOMS, DIAGNOSIS AND TREATMENTZika virus is spread primarily to people through the bite of an infected Aedes species of mosquito. The primary mosquito that carries the disease is not found in Pennsylvania. A secondary mosquito, known commonly as the Asian Tiger mosquito, may potentially carry the Zika virus. The Asian Tiger mosquito has been reported in southern and southeastern Pennsylvania but is not active in winter months. Zika virus cannot be transmitted through casual contact. The incubation period (time from being bitten by the infected mosquito to symptoms) is not clear, but is likely between a few days to one week. Symptoms:The symptoms, which are usually mild and last for 2-7 days, include:Fever;Rash;Muscle and/or joint pain;Conjunctivitis (red eyes); andHeadache.Severe illness requiring hospitalization is uncommon. Deaths from Zika virus are rare. Diagnosis: See your health care provider if you develop the symptoms described above and have visited an area where Zika is found.If you have recently traveled to Zika-affected areas, tell your health care provider when and where you traveled. If you are pregnant and traveled to a Zika-affected area during your pregnancy, contact your health care provider.All Zika virus testing should be coordinated with the Pennsylvania Department of Health at 1-877-PA-HEALTH. Specimens will be routed to the CDC for testing as appropriate.Testing might also be done to rule out other viruses that have similar symptoms. Treatment: No vaccine or medications are available to prevent or treat Zika virus.Treat the symptoms:Get plenty of rest;Drink fluids to prevent dehydration; andTake medicine, such as acetaminophen, to reliever fever and pain. Do not take aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen.PREVENTION The best way to prevent Zika is to protect against mosquito bites when traveling to an affected area. This can be done by: Using an insect repellent containing DEET;Wearing light-colored clothes that cover as much of the body as possible;Using physical barriers such as screens, closed doors and windows, and;Sleeping under mosquito nets.Sexual transmission of Zika virus is possible. Men who have traveled to Zika-affected areas should take steps to prevent the spread of Zika virus through sexual contact. Interim Guidelines for Prevention of SexualTransmission of Zika Virus (Feb 5, 2016) If you develop symptoms within two weeks of visiting a Zika-affected country, contact your health care provider.

http://www.health.pa.gov/My Health/Diseases and Conditions/U-Z/Pages/Zika.aspx#.VsOU6vkrLZa

A leading pediatric neurologist who has studied the brains of babies stricken with the Zika virus says the damage is far more severe than global health officials are telling the public. Dr. William Dobyns was emailed the images by a specialist in Brazil and told The Daily Beast the cases are some of the worst he’s seen in more than 30 years of study. Dobyns says images also share telltale signs of viral infection, though a definitive link from the birth defects to the Zika virus has not yet been established. The iconic image of the Zika outbreak are babies born with abnormally small heads, a condition called microcephaly. The microcephaly diagnosis is made when a baby’s head is at least two standard deviations below the mean for age and sex. These heads are six deviations below the mean, Dobyns estimates.“In these kids with Zika you see really severe microcephaly,” he said. “The heads are probably minus five to six standard deviations below the norm, and that’s really small. If the appearance of the head seems problematic, the brain is worse.” Dobyns said, based on the pictures, that some of the infants may have brains that are 10 standard deviations below the mean for age and sex. An estimated 15 percent of children born with microcephaly have normal intelligence, but in Brazil, that percentage may be zero. “The idea that these children are mildly handicapped is a fantasy,” Dobyns said. “OK, so they’re awake and feeding, but how much does it take to be awake and be feeding?” Microcephaly afflicts 25,000 children in the United States annually and has been linked to a number of factors like chromosomal abnormalities, malnutrition, and exposure to drugs or other toxins. It is only infections that cause cases of microcephaly like this though. “When a baby’s brain is growing and a severe viral infection happens, it shrinks,” Dobyns said. Brain scans show an abundance of damaged white matter, Dobyns said, indicating that trauma was incurred during development, not prescribed genetically. Not only was development interrupted, the Zika babies’ brains look like those of children whose mothers were infected with the Cytomegalovirus. Like Zika, CMV leaves people with a mild cold but can cause severe cases of microcephaly. Not only are CMV-ravaged brains shrunken, they don’t have ridges and wrinkles like normal brains. The condition is known as polymicrogyria and was also seen in the Zika brains. (Polymicrogyria, can produce stroke-like symptoms, seizures, and extreme muscle impairment.) The final sign that a virus caused microcephaly in the Zika babies are calcium salts found in a critical part of the brain, Dobyns said. The vast majority of calcium in the body goes to bones, but in this case it is deposited where it does not belong: the brain’s cerebral cortex. Once there, the deposits harden and interfere with functions ranging from memory to motor control.

LISTEN UP02.16.16 12:01 AM ETDoctor: Zika Virus Likely Causing Brain Damage Worse Than What You’re ToldWilliam Dobyns studied five children stricken with the virus and found the most severe cases of birth defects he’s seen in 30 years—defects he has seen from another virus before.http://www.thedailybeast.com/articles/2016/02/16/doctor-zika-virus-likely-causing-brain-damage-worse-than-what-you-re-told.html