ZIKA VIRUS (11): AMERICAS, RESEARCH, OBSERVATIONS

Posted on 05TH JUN 2017
tagged Zika Virus, Americas

A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Cases in various countries:
Americas
Americas cumulative case numbers

Caribbean
---
Cuba

South America
---
Peru (Lima)

Imported cases with no possibility of ongoing mosquito transmission
---
USA:
- Case numbers mainland
- Territories and Commonwealth

[2] IgM ELISA evaluation
[3] Mechanism for neurotropism
[4] CDC Guidance
[5] Inhibitory plant extract

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Cases in various countries
Americas
---
Americas cumulative case numbers
As of 25 May 2017
http://www.paho.org/hq/index.php?option=com_content&view=article&id=1239...
Country / Locally acquired: suspected / Confirmed / Imported / Deaths / Conf. Congenital Syndrome
North America:
Bermuda / 0 / 0 / 6 / 0 / 0
Canada / 0 / 0 / 499 / 0 / 1
USA / 0 / 225 / 5013 / 0 / 80

Latin America:
Mexico / 0 / 8772 / 15 / 0 / 5

Central American Isthmus:
Belize / 1294 / 206 / 0 / 0 / 0
Costa Rica / 6396 / 1810 / 32 / 0 / 5
El Salvador / 11 521 / 51 / 0 / 0 / 4
Guatemala / 3678 / 921 / 0 / 0 / 140
Honduras / 32 130 / 302 / 0 / 0 / 4
Nicaragua / 0 / 2060 / 3 / 0 / 2
Panama / 4178 / 969 / 42 / 0 / 8

Latin Caribbean:
Cuba / 0 / 187 / 58 / 0 / 0
Dominican Republic / 4906 / 345 / 0 / 0 / 93
French Guiana / 10 385 / 483 / 10 / 0 / 17
Guadeloupe / 30 845 / 382 / 0 / 0 / 18
Haiti / 2955 / 5 / 0 / 0 / 1
Martinique / 36 680 / 21 / 0 / 0 /23
Puerto Rico / 0 / 40 301 / 137 / 5 / 35
Saint Barthelemy / 990 / 61 / 0 / 0 / 0
Saint Martin / 3280 / 200 / 0 / 0 / 1

Non-Latin Caribbean:
Anguilla / 29 / 23 / 1 / 0 / 0
Antigua and Barbuda / 465 / 14 / 2 / 0 / 0
Aruba / 1208 / 468 / 7 / 0 / 0
Bahamas / 0 / 25 / 3/ 0 / 0
Barbados / 705 / 150 / 0 / 0 / 1
Bonaire, St Eustatius and Saba / 235 / 381 / 0 / 0 / 0
Caymans / 232 / 31 / 10 / 0 / 0
Curacao / 2589 / 1259 / 0 / 0 / 0
Dominica / 1154 / 79 / 0 / 0 / 0
Grenada / 335 / 118 / 0 / 0 / 2
Guyana / 0 / 37 / 0 / 0 / 0
Jamaica / 7650 / 203 / 0 / 0 / 0
Montserrat / 18 / 5 / 0 / 0 / 0
Saint Kits and Nevis / 554 / 33 / 0 / 0 / 0
Saint Lucia / 822 / 50 / 0 / 0 / 0
Saint Vincent and the Grenadines / 508 / 83 / 0 / 0 / 0
Sint Maarten / 247 / 147 / 0 / 0 / 0
Suriname / 2768 / 723 / 0 / 4 / 4
Trinidad and Tobago / 0 / 718 / 1 / 0 / 3
Turks and Caicos / 201 / 25 / 3 / 0 / 0
Virgin Islands (UK) / 74 / 53 / 0 / 0 / 0
Virgin Islands (USA) / 1093 / 1026 / 2 / 0 / 0

Andean Area:
Bolivia / 1767 / 585 / 4 / 0 / 14
Colombia / 98 068 / 9802 / 0 / 0 / 157
Ecuador / 3972 / 1330 / 15 / 0 / 3
Peru / 5582 / 1042 / 22 / 0 / 0
Venezuela / 59 965 / 2413 / 0 / 0 / 0

[Brazil and] Southern Cone:
Brazil / 224 670 / 134 057 / 0 / 11 / 2698
Argentina / 869 / 101 / 40 / 0 / 2
Chile / 0 / 0 / 34 / 0 / 0
Paraguay / 674 / 16 / 0 / 0 / 2
Uruguay / 0 / 0 / 1 / 0 / 0

Totals, Americas / 565 692 / 212 298 / 5960 / 20 / 3323

[Maps showing the location of the affected islands and countries in the Americas mentioned above and below can be accessed at
http://healthmap.org/promed/p/35574;
North America at http://healthmap.org/promed/p/106;
Central America http://healthmap.org/promed/p/39455;
Caribbean http://www.mapsofworld.com/caribbean-islands/ and
South America at http://healthmap.org/promed/p/6186. - Mod.TY]

Caribbean
---
Cuba. 3 Jun 2017. (reported) Zika virus infections spreading in 6 provinces; Holguin reports an epidemic [no current case numbers given].
http://www.telesurtv.net/english/news/Cuba-Fights-Rising-Dengue-Zika-Inf...

South America
---
Peru (Lima). 2 Jun 2017. (conf.) 23 cases since 16 Apr 2017.
https://www.terra.com.co/vidayestilo/salud/peru-detecta-un-brote-de-23-c... [in Spanish]

Imported cases with no possibility of ongoing mosquito transmission
---
USA:
- Case numbers mainland. Zika virus disease in the United States, 1 Jan 2017 - 31 May 2017
http://www.cdc.gov/zika/geo/united-states.html
State / Symptomatic cases / Viremic blood donors
Alabama 3 / 0
Arizona 1 / 0
Arkansas 0 / 0
California 13 / 1
Colorado 3 / 0
Connecticut 0 / 0
Delaware 0 / 0
District of Columbia 0 / 0
Florida 15 / 3
Georgia 1 / 0
Hawaii 0 / 0
Idaho 0 / 0
Illinois 4 / 0
Indiana 1 / 0
Iowa 1 / 0
Kansas 2 / 0
Kentucky 1 / 0
Louisiana 1 / 0
Maine 1 / 0
Maryland 3 / 0
Massachusetts 5 / 0
Michigan 6 / 0
Minnesota 0 / 0
Mississippi 2 / 0
Missouri 1 / 0
Montana 0 / 0
Nebraska 1 / 0
Nevada 0 / 0
New Hampshire 0 / 0
New Jersey 2 / 0
New Mexico 0 / 0
New York 24 / 1
North Carolina 3 / 0
North Dakota 0 / 0
Ohio 3 / 0
Oklahoma 0 / 0
Oregon 1 / 0
Pennsylvania 3 / 0
Rhode Island 2 / 0
South Carolina 0 / 0
South Dakota 0 / 0
Tennessee 0 / 0
Texas 10 / 1
Utah 0 / 0
Vermont 2 / 0
Virginia 3 / 0
Washington 2 / 0
West Virginia 0 / 2
Wisconsin 2 / 0
Wyoming 0 / 0
Total 123 / 8

- Territories and Commonwealth:
Symptomatic / Blood donors
American Samoa 3 / 0
Puerto Rico 460 / 3
US Virgin Islands 36 / 0
Total 499 / 3
[A map of the USA showing the states and territories mentioned above can be accessed at http://www.mapsofworld.com/usa/.]

--
Communicated by:
ProMED-mail

and
Roland Hübner
Superior Health Council
Brussels
Belgium

******
[2] IgM ELISA evaluation
Date: Fri 7 Apr 2017 On Line ahead of print.
Source: Diagnostic Microbiology & Infect. Dis. [edited]
http://dx.doi.org/10.1016/j.diagmicrobio.2017.04.002
http://www.dmidjournal.com/article/S0732-8893(17)30113-X/fulltext

Kamran Kadkhoda, Ainsley Gretchen, Adrianna Racano. Evaluation of a commercially available Zika virus IgM ELISA: specificity in focus.

Abstract
Zika virus (ZIKV), an emerging arbovirus, has become the center of attention since it was linked to congenital abnormalities. Given the overlapping clinical picture of ZIKV disease with other infectious diseases and as an exigent public health matter, timely and reliable diagnosis of ZIKV infection is crucial. We evaluated the performance of a commercially available NS1-based ZIKV IgM ELISA. Our results showed suboptimal sensitivity within the 1st 5 days after onset while specificity remained robust.

--
Communicated by:
Dr. Kamran Kadkhoda
Cadham Provincial Public Health Laboratory, Winnipeg, MB, Canada
Departments of Medical Microbiology & Infectious Diseases, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
Department of Immunology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada

[The need for development of sensitive and specific diagnostic tests to differentiate Zika, dengue and chikungunya virus infections is urgent, especially for pregnant women and infected men who could transmit Zika virus sexually. Several tests have been developed, and their performance in the field awaits evaluation. One of the main challenges is that the majority of Zika virus infected individuals develop few or no symptoms and are unlikely to seek medical attention and undergo diagnostic testing. - Mod.TY]

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[3] Mechanism for neurotropism
Date: Thu 1 Jun 2017
Source: Science eaam9243 DOI: 10.1126/science.aam9243 [edited]
http://science.sciencemag.org/content/early/2017/05/31/science.aam9243

Pavithra L. Chavali, Lovorka Stojic, Luke W. Meredith, Nimesh Joseph, et al. Neurodevelopmental protein Musashi 1 interacts with the Zika genome and promotes viral replication.

Abstract
A recent outbreak of Zika virus in Brazil has led to a simultaneous increase in reports of neonatal microcephaly. Zika targets cerebral neural precursors, a cell population essential for cortical development, but the cause of this neurotropism remains obscure. Here we report that the neural RNA-binding protein Musashi-1 (MSI1) interacts with the Zika genome and enables viral replication. Zika infection disrupts the binding of MSI1 to its endogenous targets, thereby deregulating expression of factors implicated in neural stem cell function. We further show that MSI1 is highly expressed in neural progenitors of the human embryonic brain, and is mutated in individuals with autosomal recessive primary microcephaly. Selective MSI1 expression in neural precursors could therefore explain the exceptional vulnerability of these cells to Zika infection.

--
Communicated by:
ProMED-mail

[This report makes a significant contribution to the understanding of the mechanism of Zika virus infection on fetal brain microcephaly development. - Mod.TY]

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[4] CDC Guidance
Date: Thu 1 Jun 2017
Source: CDC Guidance [edited]
https://www.cdc.gov/zika/geo/post-cautionary-guidance.html

Guidance for Areas with a Previous Zika Cautionary (Yellow) Designation in the Continental United States and Hawaii

These recommendations provide guidance for health departments and healthcare providers caring for people with exposure to areas where the Zika cautionary (yellow) designation has been lifted. Although the level of risk of Zika virus transmission after a yellow area designation is lifted is unknown, it is likely to be low; sporadic cases may still occur. Healthcare providers should continue to evaluate pregnant women for potential exposure to Zika virus and symptoms of Zika virus disease.

All women and men who live in or travel to an area that had a yellow area designation lifted should check the CDC website frequently for updates about Zika virus transmission.

Recommendations for areas where the Zika cautionary (yellow) designation has been lifted:

Travel
- Lifting of a yellow area designation means that there are no longer precautionary travel recommendations for the area.
- Healthcare providers should continue to discuss the risks of Zika for all pregnant woman with exposure to an area where the yellow designation has been lifted.

Prevention
Because we do not know the level of risk for local transmission in areas where a yellow designation has been lifted, CDC recommends
- Pregnant women and their partners who live in or travel to these areas and who wish to reduce their risk of Zika virus infection should be counseled to consistently and correctly use condoms every time they have sex (including vaginal, anal, and oral sex) or they should not have sex during the pregnancy. Because Zika virus can persist for months in semen, there may still be a continuing risk for sexual transmission, whether or not the partner had symptoms of Zika virus infection.
- Women who are not pregnant and men who travel to these areas who wish to reduce their risk of Zika virus infection should consider using condoms consistently and correctly during sex, or not having sex, to maximally reduce their risk for sexually transmitting Zika virus to the uninfected partner. Men should consider this for at least 6 months, and women should consider this for at least 8 weeks from the date the yellow designation was lifted. Please see Preconception Counseling below.

In addition, all women including pregnant women and men who live in or travel to these areas should be advised to remain aware of any new reports of Zika virus transmission and should consider following steps to prevent mosquito bites [see original report at above URL] to reduce their risk for mosquito-borne illnesses, including Zika virus.

Testing and Diagnosis
CDC recommends Zika virus laboratory testing for the following groups:
- Pregnant women, regardless of symptoms, who lived in or traveled to a previously designated yellow area between the earliest date that testing was recommended for the area and 8 weeks after the date the yellow designation was lifted and who conceived up to 8 weeks after the yellow designation was lifted.

- Pregnant women who have had sex without a condom:
a. With a partner who has been diagnosed with Zika virus disease.
b. With a partner who lived in or traveled to a previously designated yellow area between the earliest date that testing was recommended for the area and the date the designation was lifted. In addition, consider testing pregnant women who have had sex without a condom with a partner who lived in or traveled to one of these areas while it had a yellow designation up to 6 months after the date the designation was lifted.
c. With a partner who traveled to any area with risk of Zika and a CDC travel notice.

- Pregnant women who have an exposure to previously designated yellow areas and who have prenatal findings suggestive of congenital Zika syndrome.

- Neonates who have abnormalities consistent with congenital Zika syndrome and whose mothers have an exposure to areas with risk of Zika including previously designated yellow areas.

- Anyone with an exposure to areas with risk of Zika including previously designated yellow areas who have signs and symptoms consistent with Zika virus disease.

Preconception Counseling
If the person has Zika symptoms and/or diagnosis: Women and men who are planning to conceive in the near future should be advised to wait at least 8 weeks after symptom onset if a woman had Zika symptoms and/or diagnosis, and at least 6 months after symptom onset if a man had Zika symptoms and/or diagnosis, before attempting conception.

If the person has no Zika symptoms and does not have ongoing exposure: Women and men with an exposure to previously designated yellow areas between the earliest date that testing was recommended for the area and the date the yellow designation was lifted should consider waiting at least 8 weeks after last possible exposure if female, and at least 6 months if male, before attempting conception.

If the person has no Zika symptoms and has ongoing exposure: Healthcare providers should discuss reproductive life plans with women and men who are planning to become pregnant in the near future who live in or frequently travel to previously designated yellow areas. Although the level of Zika virus transmission is likely to be low, sporadic cases may still occur. In addition, couples should consider the possible resurgence of active transmission of Zika virus during the next mosquito season in their pregnancy planning. Couples may choose not to wait or may choose to delay attempting conception depending on individual circumstances (e.g., age, fertility) and risk tolerance.

Please refer to the information from the Food and Drug Administration for guidance on reducing the risk for Zika virus transmission by donated human cells, tissues, and cellular and tissue-based products, including reproductive tissues.

An exposure means that a person has lived in, traveled to, or had sex without a condom with someone who lived in or traveled to a designated red or yellow area.

People with ongoing exposure include those who live in or frequently travel (e.g., daily, weekly) to a red or yellow area.

--
Communicated by:
ProMED-mail

[Although these recommendations are intended for USA residents, those living in other countries may find them useful as well. Readers interested in the additional information linked in this report may wish to consult the original report at the above URL. - Mod.TY]

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[5] Inhibitory plant extract
Date: 2 Jun 2017
Source: News.com.au [edited]
http://www.news.com.au/national/breaking-news/native-aussie-plant-kills-...

Queensland researchers have found a way to kill the Zika virus using compounds found in an Australian native plant.

The compounds halt the virus, which causes birth defects, and stop it replicating without damage to host mammalian cells, QUT [Queensland University of Technology] scientists say.

"The research is in the early stages, but we are aiming to ultimately synthesise the compounds in question and turn our attention to preclinical testing," lead researcher Dr Trudi Collet said in a statement.

She didn't name the plant, presumably for commercial reasons, but said it was fairly common, and its compounds were found to kill 100 per cent of the Zika infection in cells.

"It's also exciting because of the implications of this work for other viruses. Zika, dengue, West Nile, Japanese encephalitis and yellow fever are all from the same family of viruses, flaviviridae."

Researchers will spend the next 3-5 months working to synthesise the compounds and will then to go on to test them on the other viruses.

QUT researchers have been working in collaboration with Australian-based biotech company Health Focus Products Australia.

HFPA chairman and founder Dr Mark Baldock says Zika is becoming more prevalent and has been shown to remain in human sperm for 6 months.

He says the breakthrough offers promise of one day being able to eliminate the virus from people who contract it in the very early stages, thereby reducing risks around conception.

[Byline: Tracey Ferrier]

--
Communicated by:
ProMED-mail

[As is pointed out in the interesting above report, this is early stages in the research. Efficacy and safety in animals will be necessary. Since 80 percent of Zika virus infections are mild or asymptomatic, affected individuals are unlikely to seek medical attention and be given the drug. However, perhaps the drug will be effective in clearing Zika virus persistence in infected men, where there is evidence of the virus genome being detectable up to 6 months in some individuals. - Mod.TY]

See Also

Zika virus (10): Americas, Asia, Middle East, research 20170529.5069572
Zika virus (09): Americas, Asia, Europe, research, observations 20170517.5043638
Zika virus (08): Americas, Asia, research, observations 20170501.5005629
Zika virus (07): Americas, PAHO/WHO 20170429.5003908
Zika virus (06): Americas, Pacific, Asia, Africa, research 20170416.4974439
Zika virus (05): Americas, Pacific, Asia, research, observations 20170326.4927523
Zika virus (04): Americas, Asia Europe, research, observations 20170320.4912123
Zika virus (03): Americas, research 20170309.4888510
Zika virus (02): Americas, Asia, Africa, Pacific, research, observations 20170217.4846633
Zika virus (01): Americas, Asia, Africa, research 20170117.4772206
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