ZIKA VIRUS (12): AMERICAS, ASIA, RESEARCH, OBSERVATIONS

Posted on 12TH JUN 2017
tagged Zika Virus, Americas; Asia

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

Cases in various countries not mentioned above or more recent case numbers.
Caribbean
---
Puerto Rico

South America
---
Peru
- National
- Piura region

Asia
---
Singapore

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

[2] USA: Pregnancy outcomes
[3] Zika detection in semen
[4] Vaccine protects testes
[5] Dual Zika and chikungunya virus transmission
[6] NS1 vaccine

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[1] Cases in various countries
Americas
---
Americas cumulative case numbers
As of 8 Jun 2017
http://www.paho.org/hq/index.php?option=com_content&view=article&id=1239...
Country / Locally acquired: suspected / Confirmed [conf] / Imported / Deaths / Conf Congenital Syndrome
North America:
Bermuda / 0 / 0 / 6 / 0 / 0
Canada / 0 / 0 / 507 / 0 / 1
USA / 0 / 225 / 5015 / 0 / 80

Latin America:
Mexico / 0 / 8785 / 15 / 0 / 5

Central American Isthmus:
Belize / 1294 / 206 / 0 / 0 / 0
Costa Rica / 6415 / 1818 / 32 / 0 / 5
El Salvador / 11 531 / 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 / 40 330 / 137 / 5 / 38
Saint Barthelemy / 990 / 61 / 0 / 0 / 0
Saint Martin / 3280 / 200 / 0 / 0 / 1

Non-Latin Caribbean:
Anguilla / 30 / 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 / 200 / 25 / 3 / 0 / 0
Virgin Islands (UK) / 74 / 53 / 0 / 0 / 0
Virgin Islands (USA) / 1115 / 1017 / 2 / 0 / 0

Andean Area:
Bolivia / 1767 / 585 / 4 / 0 / 14
Colombia / 98 135 / 9802 / 0 / 0 / 159
Ecuador / 3842 / 1694 / 15 / 0 / 3
Peru / 5653 / 1109 / 22 / 0 / 0
Venezuela / 59 965 / 2413 / 0 / 0 / 0

[Brazil and] Southern Cone:
Brazil / 224 670 / 134 057 / 0 / 11 / 2722
Argentina / 869 / 101 / 40 / 0 / 2
Chile / 0 / 0 / 34 / 0 / 0
Paraguay / 672 / 16 / 0 / 0 / 2
Uruguay / 0 / 0 / 1 / 0 / 0

Totals, Americas / 565 749 / 212 770 / 5970 / 20 / 3352

[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]

Cases in various countries not mentioned above or more recent case numbers.
Caribbean
---
Puerto Rico. 5 Jun 2017. (conf) since the beginning of the outbreak as of 20 May 2017, 40 000 cases with 38 related birth defects. Outbreak declared over with about 10 cases reported in every 4-week period since mid-April [2017], down from more than 8000 cases in 4-week periods at the same time last year [2016].
https://www.statnews.com/2017/06/05/puerto-rico-zika-outbreak/

South America
---
Peru
- National. 6 Jun 2017. (reported) 391 cases). District and region most affected: Comas, Lima (conf) 26 cases.
http://ojo.pe/ciudad/zika-sancudo-amenaza-a-lima-y-ya-esta-en-36-distrit... [in Spanish]

[This report was posted on ProMED-ESP () and sent in by Kathryn Soderholm (). - Mod.TY]

- Piura region. 3 Jun 2017. (conf) 1st locally acquired case.
http://ojo.pe/ciudad/piura-confirman-primera-caso-autoctono-en-piura-242... [in Spanish]

Asia
---
Singapore. 11 Jun 2017. (conf) 2 new cases [total case numbers for 2017 not given].
http://english.astroawani.com/malaysia-news/johor-monitors-zika-situatio...

[Maps of Singapore can be accessed at http://www.lib.utexas.edu/maps/middle_east_and_asia/singapore_pol_05.jpg and http://healthmap.org/promed/p/150. - Mod.TY]

Imported cases with little or no possibility of ongoing mosquito transmission
---
USA
- case numbers mainland. Zika virus disease in the United States, 1 Jan 2017-7 Jun 2017
http://www.cdc.gov/zika/geo/united-states.html
State / Symptomatic cases / Viremic blood donors
Alabama / 3 / 0
Alaska / 1 / 0
Arizona / 1 / 0
Arkansas / 0 / 0
California / 14 / 1
Colorado / 3 / 0
Connecticut / 0 / 0
Delaware / 0 / 0
District of Columbia / 0 / 0
Florida / 15 / 3
Georgia / 1 / 0
Hawaii / 1 / 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 / 1
Wisconsin / 2 / 0
Wyoming / 0 / 0
Totals / 125 / 7

- Territories and Commonwealth with the possibility of ongoing transmission:
Symptomatic / Blood donors
American Samoa / 3 / 0
Puerto Rico / 462 / 3
US Virgin Islands / 37 / 0
Total / 502 / 3

[A map of the USA showing the states and territories mentioned above can be accessed at http://www.mapsofworld.com/usaMod.TY - ]

--
Communicated by:
ProMED-mail

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[2] USA: Pregnancy outcomes
Date: Thu 8 Jun 2017
Source: CDC. MMWR Morb Mortal Wkly Rep 2017; 66 [edited]
https://www.cdc.gov/mmwr/volumes/66/wr/mm6623e1.htm

ref: Shapiro-Mendoza CK, Rice ME, Galang RR, et al: Pregnancy outcomes after maternal Zika virus infection during pregnancy -- US Territories, 1 Jan 2016- 25 Apr 2017. MMWR Morb Mortal Wkly Rep 2017; doi: http://dx.doi.org/10.15585/mmwr.mm6623e1
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Summary
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What is already known about this topic?
Zika virus infection during pregnancy causes serious brain abnormalities and/or microcephaly and has been associated with other severe birth defects. Local transmission of Zika virus was reported in U.S. territories in 2016.

What is added by this report?
Overall, about 5 percent of fetuses and infants born to women with laboratory evidence of recent possible Zika virus infection in the U.S. territories had possible Zika-associated birth defects, the same as the percentage reported in the 50 U.S. states during 2016. Possible Zika-associated birth defects including brain abnormalities and/or microcephaly were reported following Zika virus infection during every trimester of pregnancy. Among completed pregnancies with positive nucleic acid tests confirming Zika virus infection identified in the 1st, 2nd, and 3rd trimesters, the percentages of fetuses or infants with possible Zika-associated birth defects was 8, 5, and 4 percent, respectively.

What are the implications for public health practice?
Current data suggest that Zika virus infection during any trimester of pregnancy might result in Zika-associated birth defects. Identification and follow-up of infants born to women with laboratory evidence of recent possible Zika virus infection during pregnancy can facilitate timely and appropriate clinical intervention services and assessment of future needs. Information about adherence to the recommended newborn testing and screening can improve monitoring and care of infants affected by Zika.

--
Communicated by:
ProMED-mail

[The risks of teratogenic effects when Zika virus infection occurs during any phase of pregnancy are real. Pregnant women should avoid exposure whether by mosquito bite in areas of active virus transmission or from unprotected sexual contact with men who have been in those localities. - Mod.TY]

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[3] Zika detection in semen
Date: Sun 4 Jun 2017 12:12 CDT
Source: American Society for Microbiology [edited]
https://www.asm.org/index.php/newsroom/item/6506-zika-virus-successfully...

Research presented at ASM Microbe 2017 by experts at the Fertility and Cryogenics Lab shows a reliable clinical assay that can detect the Zika virus from semen samples.

"This assay can help reduce Zika infection rates and allow couples who are identified at risk due to travel or geographic location plan their pregnancy," said lead author Hisham Greiss MD, PhD, HCLD [High-complexity Clinical Laboratory Director] at the Fertility and Cryogenics Lab.

A total of 100 semen samples were spiked with a recombinant Accuplex ZIKV (SeraCare Life Sciences) at 5 viral copies per ml and processed in Aptima Urine Transport medium (Hologic Inc.) and tested using Aptima® ZIKV assay released under the FDA's emergency use authorization on the fully automated Panther system from Hologic, Inc. The samples were also tested for West Nile virus, Chagas and dengue, recombinant dengue virus, recombinant chikungunya virus, human papilloma virus, herpes simplex virus 1, herpes simplex virus 2, _Chlamydia_, and gonorrhea. The experiment was repeated 3 times and in triplicates each time.

The assay was found to be 100 percent sensitive and 100 percent specific to ZIKV RNA from semen samples with a limit of detection of 5 viral copies per mL of semen.

Zika fever symptoms are often misdiagnosed due to its nonspecific clinical symptoms, so an accurate diagnosis is of paramount importance for management of the disease and to prevent neonatal infections. Zika infection during pregnancy can also cause serious birth defects and is associated with other pregnancy problems.

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Communicated by:
ProMED-mail Rapporteur Mary Marshall

[A fast, sensitive and specific test for the presence of Zika virus in semen will be useful for testing semen of men who have been in areas of Zika virus transmission and for sperm banks.

The abstract for this 4 Jun 2017 presentation at the ASM meeting is available at http://www.abstractsonline.com/pp8/#!/4358/presentation/2808. This citation was provided by Roland Hübner. - Mod.TY]

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[4] Vaccine protects testes
Date: Wed 7 Jun 2017
Source: Nature Communications [edited]
https://www.nature.com/articles/ncomms15743

ref: Griffin BD, Muthumani K, Warner BM, et al: DNA vaccination protects mice against Zika virus-induced damage to the testes. Nat Commun. 2017 Jun 7;8:15743. doi: 10.1038/ncomms15743
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Abstract
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Zika virus (ZIKV) is an emerging pathogen causally associated with serious sequelae in fetuses, inducing fetal microcephaly and other neurodevelopment defects. ZIKV is primarily transmitted by mosquitoes, but can persist in human semen and sperm, and sexual transmission has been documented. Moreover, exposure of type-I interferon knockout mice to ZIKV results in severe damage to the testes, epididymis, and sperm. Candidate ZIKV vaccines have shown protective efficacy in preclinical studies carried out in animal models, and several vaccines have entered clinical trials. Here, we report that administration of a synthetic DNA vaccine encoding ZIKV pre-membrane and envelope (prME) completely protects mice against ZIKV-associated damage to the testes and sperm and prevents viral persistence in the testes following challenge with a contemporary strain of ZIKV. These data suggest that DNA vaccination merits further investigation as a potential means to reduce ZIKV persistence in the male reproductive tract.

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Communicated by:
ProMED-mail Rapporteur Mary Marshall

[It will be interesting to see the results when the vaccine has completed tests in non-human primates. - Mod.TY]

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[5] Dual Zika and chikungunya virus transmission
Date: Thu 1 Jun 2017
Source: PLoS Neglected Tropical Diseases [edited]
https://doi.org/10.1371/journal.pntd.0005654 [edited]
) also sent in this report, and is thanked. - Mod.TY]

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[6] NS1 vaccine
Date: Sun 4 Jun 2017
Source: American Society for Microbiology [edited]
https://www.asm.org/index.php/newsroom/item/6507-development-of-a-novel-...

Research presented by Farshad Guirakhoo, PhD, Chief Scientific Officer, GeoVax, Inc, at the ASM Microbe 2017 meeting showed a new Zika virus vaccine that gives 100 percent protection in mice. The vaccine is the 1st to be based on the Zika virus NS1 protein, and the 1st to show single-dose protection against Zika in an immunocompetent lethal mouse challenge model. Results of the study were presented on [4 Jun 2017] at the American Society for Microbiology (ASM) Microbe conference in New Orleans [1-5 Jun 2017].

In the presented study, outbred immunocompetent mice were exposed to a lethal challenge dose of Zika virus delivered directly into the brain. "A single dose of GeoVax's NS1 vaccine candidate protected 100 percent of vaccinated animals," said Guirakhoo. In contrast, 80-90 percent of sham-immunized control animals died within 7-10 days.

Because the NS1 antigen is not presented on the surface of the virus, it was chosen as the target immunogen for the vaccine to avoid a potential risk of disease enhancement when vaccines are developed based on Zika virus envelope proteins. This antibody dependent enhancement (ADE) of infection phenomena has been shown between Zika virus and a related flavivirus, dengue, in both in vitro and in vivo studies.

An NS1-based vaccine could also limit or block transmission of Zika virus in its mosquito vector. The NS1 protein is abundantly produced by flaviviruses in infected hosts and is picked up together with the virus after the mosquito takes a blood meal from humans. The NS1 proteins interfere with the innate immune system of the mosquito, evolved to fight foreign pathogens, allowing the flavivirus to replicate and disseminate in mosquitoes. Therefore, said Guirakhoo, "a vaccine that can induce effective antibodies to NS1 and disable its function has the potential to reduce growth and transmission of Zika virus in its mosquito vector. This could enhance vaccine effectiveness in endemic areas by blocking the virus transmission from infected individuals to other members of the community."

--
Communicated by:
ProMED-mail

[This approach to NS-1 antigen selection for a vaccine, to avoid the risk of ADE, is interesting. Presumably, the next steps will be to test the vaccine in non-human primates and in vector mosquitoes. - Mod.TY]

See Also

Zika virus (11): Americas, research, observations 20170604.5083731
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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