H5N1

Zika virus teams up with other viruses to sicken people

Via NBC News, a report by Maggie Fox: Zika Virus Teams Up With Other Viruses to Sicken People. Excerpt (but you'd better read the whole thing):

Two studies out Monday show that the Zika virus may not be working alone in causing strange infections in South America. It may be getting help from dengue and chikungunya, too. 

One team found that mosquitoes can be infected with Zika and chikungunya at the same time and could, in theory, infect people with both viruses in a single bite.

And a second team found a range of unusual symptoms in people in Brazil last year as Zika, chikungunya and dengue all swept through populations, often infecting people at the same time. One of the oddest is known as "dancing eyes-dancing feet syndrome." 

The findings, presented at a meeting of the American Society of Tropical Medicine and Hygiene, add to the growing list of mysterious and previously unsuspected damage that Zika virus causes.

"Our analysis shows that each of these viruses may have the potential to cause a range of neurological complications, some very severe, and patients should be monitored for symptoms," said Dr. Isadora Siqueira of Brazil's Oswaldo Cruz Foundation, who worked on one study.  

"What's very difficult to determine is whether having a co-infection with two of these viruses increases the risk of neurological problems. We are still looking closely at the case of the patient who was infected with both chikungunya and dengue." 

Dengue and Zika are closely related viruses called flaviviruses. Chikungunya is in a different family, called alphaviruses, but all three are spread by Aedes aegypti mosquitoes and they can cause similar symptoms: fever, headache and body aches. Zika causes severe birth defects; dengue can cause a deadly hemorrhagic fever and chikungunya causes racking pain. 

They are not easy to tell apart and only with tests made available in recent months can doctors tell for sure which virus a patient has had.

Dominican Republic: Ten Zika-related microcephaly cases confirmed

Via Dominican Today: Confirmed: 10 babies with microcephaly linked to zika virus. Excerpt:

Santo Domingo.- The birth of babies with microcephaly (Guillain-Barre Syndrome) suspected of being linked to the zika virus reached 28, of which 10 are confirmed, while 18 additional cases currently await results from the US Centers for Disease Control and Prevention (CDC). 

Thus far in 2016, suspected zika cases total 5, 216, of which 948 are women in the first six months into pregnancy.  

Moreover, 274 cases of Guillain-Barre Syndrome were reported in people with a previous history of symptoms compatible with the virus. 

The data are contained in a Public Health Ministry bulletin covering the week from October 16 to 22, when five suspected cases of zika were reported in residents of Santiago, Puerto Plata and Greater Santo Domingo.  

The report says Greater Santo Domingo, Azua (south) and Bonao (central) are the municipalities with the highest number of suspected cases in the last four weeks.

Colombia: Zika update, week 44

The National Institute of Health has published its Boletín Epidemiológico for week 44. Here is my translation/summary of the Zika section, which begins on page 105:

Since the start of the endemic phase in week 29, through week 44, 4,078 Zika cases have been reported. Combined with those of the epidemic phase, the totals are 8,826 confirmed cases and 96,421 clinically suspected cases. In week 44, 162 cases were reported, 51 new this week and 111 delayed from earlier weeks.

The curve of reports has diminished since week 6 of 2016, with a slight increase in week 13. The average number of reports in the past five weeks is 112 cases per week. The national rate of incidence during the epidemic phase was 376.6 cases per 100,000 urban residents. The rate during the post-epidemic phase is 15.4 cases per 100,000 urban residents.

Women make up 63.7% of confirmed and suspected cases. Persons aged 30 to 64 make up 63.7% of cases; 14.2% are aged 25 to 29; babies under one year are 2.9% of cases and 3.2% are 3.2%.

Pregnant women diagnosed with Zika virus disease

From the start of the epidemic through week 44 of 2016, 5,884 cases have been diagnosed in pregnant women, as well as 13,535 cases in pregnant women who report having had symptoms compatible with Zika virus disease. 

Intensified surveillance for microcephaly and other congenital CNS defects

Between weeks 1 and 44 of 2016, 58 cases of microcephaly associated with Zika virus were confirmed, an increase of one since week 43; 225 cases were discarded and 389 cases are under study.

Special surveillance for neurological syndromes with preceding illness compatible with Zika virus disease

Since December 15,2015, through week 44, 655 cases of neurological syndromes have been reported. Men make up 55.6% (364 cases); persons over age 65 make up 12.5%. Guillain-Barré syndrome makes up 65.3% (428 cases) of reported syndromes. The curve of reports closely follows that of confirmed and suspected Zika cases.

WHO Zika situation report, November 10

WHO has published its Zika situation report for November 10. Click or tap through to download the full report. The summary:

Key updates 

• Countries and territories reporting mosquito-borne Zika virus infections for the first time in the past week: Montserrat, Palau 

• Countries and territories reporting microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection for the first time in the past week: None 

• Countries and territories reporting Guillain-Barré syndrome (GBS) cases associated with Zika virus infection for the first time in the past week: None 

• The fifth meeting of the Emergency Committee on Zika virus, microcephaly other neurological disorders will be convened on 18 November 2016. 

Analysis 

Overall, the global risk assessment has not changed. Zika virus continues to spread geographically to areas where competent vectors are present. Although a decline in cases of Zika infection has been reported in some countries, or in some parts of countries, vigilance needs to remain high.

Colombia: Zika update, week 43

The National Institute of Health has published its Boletín Epidemiológico for week 43. Here's my summary/translation of the Zika section, which begins on page 106.

From the start of the endemic phase in week 29, through week 43, 3,793 cases of Zika virus disease have been reported. Added to those in the epidemic phase, the total is 8,826 confirmed cases and 96,259 clinically suspected cases.

In week 43 330 cases were reported, 61 new this week and 269 reported late from earlier weeks. All cases were suspected, not confirmed.

The curve of reports has diminished steadily since week 6 of 2016, apart from a small increase in week 13. The average number of cases reported in the past five weeks is now 123 per week. The national incidence of Zika during the epidemic phase was 376.4 cases per 100,000 urban residents. In the endemic phase the incidence is 14.9 cases per 100,000 urban residents.

Women make up 66.3% of confirmed and suspected cases. Persons aged 30 to 64 make up 63.7%, and 14.2% are aged 25 to 29. Babies under one year make up 2.9% and adults 65 and older make up 3.2%.

Pregnant women diagnosed with Zika virus

From the start of the epidemic through week 43 of 2016, 5,884 pregnant women have been confirmed with Zika; 13,489 cases are suspected in women who reported having had symptoms compatible with Zika at some point in their pregnancy.

Intensified surveillance for microcephaly and other congenital CNS defects

Between weeks 1 and 43 of 2016, 57 Zika-associated microcephaly cases have been confirmed (the total in week 42 was 54); 223 cases were discarded, and 373 cases are under study.

Special surveillance for neurological syndromes with Zika-compatible previous infection

From December 15 2015 through week 43 of 2016, 651 neurological syndromes have been reported with previous illness compatible with Zika virus infection. Men make up 55.5% (361) of cases; persons aged 65 or older make up 12.4%. Cases of Guillain-Barré syndrome make up 65.6% of cases reported through the special surveillance. The curve of reports follows that of confirmed and suspected Zika cases in Colombia.

WHO Zika situation report, November 4

WHO has published its weekly Zika situation report for November 4. Click or tap through to download the full report. The summary:

Key updates 

• Countries and territories reporting mosquito-borne Zika virus infections for the first time in the past week: None 

• Countries and territories reporting microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection for the first time in the past week: Bolivia, Trinidad and Tobago, and Viet Nam 

• Countries and territories reporting Guillain-Barré syndrome (GBS) cases associated with Zika virus infection for the first time in the past week: None 

• The Ministry of Health and Sport of Myanmar reported a confirmed case of Zika virus. The case is under investigation as to determine if this is an autochthonous (locally-acquired) or imported case. 

Analysis 

• Overall, the global risk assessment has not changed since last week. 

• Viet Nam is the second county in South-East Asia to report microcephaly cases potentially linked with Zika virus. This follows the 2 microcephaly cases reported in Thailand in the 6 October Zika situation report. Similar to the cases reported in Thailand, genetic sequencing of the virus was not possible therefore it is not known whether the mother was infected with a virus related to the same lineage as previously isolated in South-East Asia, or if there has instead been transmission of a virus imported from another location. The mother of the baby with microcephaly reported in Viet Nam had no history of travel outside of the country. To date, there have been no imported Zika virus cases reported in Viet Nam.

Colombia: Zika update, week 42

That National Institute of Health has published its Boletín Epidemiológico for week 42. Here's my translation/summary of the Zika section, which begins on page 103:

From the start of the endemic phase in week 29, through week 42, 3,645 Zika cases have been reported; when added to those in the epidemic phase, the total is 8,826 confirmed cases and 95,929 clinically suspected. In week 42, 176 cases were reported, 82 in this week and 94 reported late from earlier weeks. All cases are suspected, not confirmed.

The curve of reports shows steady diminution since week 6, apart from a brief rise in week 13. The incidence of Zika during the epidemic phase was 375.6 per 100,000 urban residents. In the post-epidemic phase, the incidence is 14.4 per 100,000 urban residents.

Women make up 66.2% of all cases; 63.7% are in persons aged 30 to 64; 14.1% are persons aged 25-29; babies under one year old make up 2.9%, and persons aged 65 and older make up 3.2%.

Pregnant women diagnosed with Zika virus

From the start of the epidemic through week 42 of 2016, 5,82 Zika cases have been confirmed in pregnant women, and 13,214 are suspected in women reporting Zika-compatible symptoms at some point in their pregnancy.

Intensified surveillance for microcephaly and other CNS defects

Between weeks 1 and 42 of 2016, 54 cases of Zika-associated microcephaly have been confirmed; 216 were discarded, and 354 cases are under study. This is an increase of seven over week 41.

Special surveillance for neurological syndromes with Zika-compatible antecedent symptoms

From December 15, 2015 through week 42 of 2016, 646 cases of neurological syndromes have been reported with antecedent Zika-compatible symptoms. Men make up 55.4% (358 cases) of neurological syndromes; 12.4% (80 cases) are in persons aged 65 and older. Guillain-Barré syndrome makes up 65.6% (424 cases) of these cases.

WHO: Zika situation report, October 27

WHO has published its Zika situation report for October 27. The summary:

Key updates 

• Countries and territories reporting mosquito-borne Zika virus infections for the first time in the past week: None 

• Countries and territories reporting microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection for the first time in the past week: None 

Countries and territories reporting Guillain-Barré syndrome (GBS) cases associated with Zika virus infection for the first time in the past week: None 

• The Ministry of Health of Viet Nam reported a case of microcephaly, for which testing is underway to determine the cause. 

• The WHO Zika Virus Research Agenda has been published. The goal of the Agenda is to support the gathering of evidence to strengthen essential public health guidance to prevent and limit the impact of Zika virus and its complications. The Research Agenda identifies critical areas of research for which WHO is uniquely placed to implement and coordinate global action. 

• The quarterly update of the Zika Strategic Response Plan has been published. This update provides key information on the epidemiological situation, response, and updated funding information for WHO and partners.

Guillain-Barré syndrome and healthcare needs during Zika virus transmission, Puerto Rico, 2016

Via Emerging Infectious Diseases: Ahead of Print -Guillain-Barré Syndrome and Healthcare Needs during Zika Virus Transmission, Puerto Rico, 2016. The abstract:

To assist with public health preparedness activities, we estimated the number of expected cases of Zika virus in Puerto Rico and associated healthcare needs. Estimated annual incidence is 3.2–5.1 times the baseline, and long-term care needs are predicted to be 3–5 times greater than in years with no Zika virus.

Colombia: Zika update, week 41

The National Institute of Health has published its Boletín Epidemiológico for week 41. Here's my summary/translation of its Zika section:

From the start of the endemic phase in week 29 up through week 41, 3,645 Zika cases have been reported. This makes a total, since the start of the epidemic, of 8,826 confirmed cases and 95,898 suspected cases. The curve of report shows steady diminution since week 6 of 2016, apart from a brief increase in week 13. The average number of reports in the past five weeks was 133 cases/week.

Incidence of Zika during the epidemic phase was 376.2 cases per 100,000 urban resident. Post-epidemic, incidence is 13.7 per 100,000 urban residents. Women make up 66.3% of confirmed and suspected cases; 63.6% of cases were in persons aged 30-64; 2.8% were in babies under one year; 3.2% were in persons 65 and older.

Pregnant women diagnosed with Zika virus

From the start of the epidemic phase through week 41 of 2016, 5,881 cases have been confirmed in pregnant women; Zika is suspected in 13.223 women who reported symptoms compatible with Zika at some point in their pregnancy.

Intensified surveillance for microcephaly and other CNS congenital defects

Between weeks 1 and 41, 47 cases of Zika-associated microcephaly have been confirmed; 213 cases were discarded and 342 cases are under study.

Special surveillance for neurological syndromes with previous illness compatible with Zika virus infection

Since December 15, 2015, through week 41 of 2016, 642 cases of neurological syndromes have been reported after previous illness compatible with Zika virus. Men make up 55.6% (357) of these cases; 12.3% (79) are in persons 65 and older. Guillain-Barré syndrome made up 65.7%. The curve of such cases closely follows that of confirmed and suspected Zika cases.