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World: Situation Report - Zika virus Microcephaly Guillain-Barré Syndrome - 18 August 2016

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Source: World Health Organization
Country: Anguilla, Antigua and Barbuda, Argentina, Aruba (The Netherlands), Bahamas, Barbados, Belize, Bolivia (Plurinational State of), Bonaire, Saint Eustatius and Saba (The Netherlands), Brazil, Canada, Cayman Islands, Chile, Colombia, Costa Rica, Cuba, Curaçao (The Netherlands), Dominica, Dominican Republic, Ecuador, El Salvador, French Guiana (France), Grenada, Guadeloupe (France), Guatemala, Guinea-Bissau, Guyana, Haiti, Honduras, Jamaica, Martinique (France), Mexico, Nicaragua, Panama, Paraguay, Peru, Puerto Rico (The United States of America), Saint Barthélemy (France), Saint Lucia, Saint Martin (France), Saint Vincent and the Grenadines, Sint Maarten (The Netherlands), Suriname, Trinidad and Tobago, Turks and Caicos Islands, United States of America, United States Virgin Islands, Venezuela (Bolivarian Republic of), World

KEY UPDATES

Countries and territories reporting mosquito-borne Zika virus infections for the first time:
 Bahamas

Countries and territories reporting microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection for the first time:
 Honduras and Suriname

Countries and territories reporting Guillain-Barré syndrome (GBS) cases associated with Zika virus infection for the first time:
 Costa Rica and Guatemala

Operational measures from the WHO Eastern Mediterranean Region:
 WHO will conduct Zika risk assessment missions including to Somalia
 WHO is planning a training workshop on Incident Command System with partners in addition to a workshop to develop surveillance strategy and guidance for detection of Zika and other arboviral diseases, both for November 2016.
 WHO is rolling out three training workshops on prevention and control of Aedes mosquitos for national entomologists from August to October

ANALYSIS
 Overall, the global risk assessment has not changed.
 Zika virus continues to spread geographically to areas where competent vectors are present.
 Recent cases of Zika virus in Africa highlight the need to better understand the virology of the global outbreak.
 Thus far, outbreaks of the Asian lineage of the Zika virus appear to be more associated with neurologic and congenital complications than historic cases of the African lineage; however, with few known cases of the African lineage, it is possible that such complications were simply never identified. Thus it remains crucial to sequence Zika isolates, particularly from cases in Africa, to understand whether there has indeed been a real shift in the clinical manifestations of Zika infection since the first identified outbreak in 2007.
 Further entomologic (mosquito) studies should be prioritized in newly affected areas to understand transmission dynamics, inform localized risk assessments, and focus vector control interventions including providing appropriate health promotion messages.


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