Zika Virus Update May 2016
As of April 20, 2016, 57countries and territories have reported cases of Zika virus infection. Puerto Rico and the US territories have reported 503 cases, with almost all (500) contracting the disease locally. Only three cases were travel related. More than 380 cases of Zika virus have been reported in all but seven states in the continental United States. Florida has reported more than 90 cases, with most occurring in the southern-most counties. Although most US infections were acquired while travelling in other countries, eight people have been infected by sexual transmission. Canada has reported 67 travel-related cases and 1 locally sexually transmitted case.
Almost 1300 cases of microcephaly or birth defects have been reported, with the vast majority occurring in Brazil. According to Anthony Fauci at the NIH, the evidence is now unequivocal that the direct cause of microcephaly and other congenital abnormalities in fetuses of Zika-infected mothers is the virulent neurotropism of the virus. Pregnant women can remain viremic for as long as 10 weks, which puts the fetus at risk for a prolonged period of time.
Many people do not develop symptoms after infection with Zika virus. Those who do, exhibit symptoms similar to other arbovirus infections such as fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days. Rarely, some individuals develop Guillain-Barré syndrome, which can cause temporary paralysis.
Most infections are spread by mosquitoes although the virus can also be transmitted sexually and through the blood. CDC is battling Aedes aegypti mosquito on several fronts including the use of larvicides in its many breeding grounds and attacking adult mosquitoes in Puerto Rico with outdoor insecticide spraying near the homes of pregnant women. Unfortunately, Aedes aeqypti mosquito is very difficult to totally eliminate because is lives in houses.
FDA has issued an Emergency Use Authorization (EUA) to authorize the use of the Centers for Disease Control and Prevention’s (CDC) Zika IgM antibody capture ELISA (Zika MAC-ELISA) for the in vitro qualitative detection of human IgM antibodies to Zika virus in serum or cerebrospinal fluid. FDA has also authorized use of CDC’s Trioplex Real-time RT-PCR Assay (Trioplex rRT-PCR) for the in vitro qualitative detection of Zika virus in serum, cerebrospinal fluid amniotic fluid and urine. This assay detects Zika virus, dengue virus and chikungunya virus.
On April 28, 2016, Quest Diagnostics announced that it had received FDA EUA for a Zika Virus RNA Qualitative Real-Time RT-PCR test developed by its subsidiary, Focus Diagnostics. This is the first test from a commercial clinical laboratory to receive EUA. This test can be performed at any CLIA high-complexity laboratory in the Quest Diagnostics network, which includes several dozen labs in the United States, including in Toa Baja and Puerto Rico Quest Diagnostics plans to make the new test broadly available to physicians for patient testing.
http://www.paho.org/hq/index.php?option=com_content&view=article&id=11989&Itemid=135&lang=en
http://www.cdc.gov/zika/state-labs/index.html
