Date: Tue, 24 May 2016 19:44:40 +0200

Praia, Cape Verde, May 24, 2016 (AFP) - The only African cases of the Zika virus strain linked to surging cases of neurological disorders and birth defects are under control on Cape Verde, the Atlantic island's health chief has said.   The World Health Organization on Friday announced that the Zika virus strain circulating in Cape Verde had been shown to be the same as the one behind an explosion of cases in the Americas.

Tiny Cape Verde is the only African nation affected by the so-called "Asian strain", detected through the sequencing of the 7,500 Zika cases confirmed there.   National director for health Tomas Valdez told AFP on Monday night there had been an abrupt drop in the number of cases since the first recorded in October 2015 thanks to a series of successful public health campaigns.   "The epidemic has been progressively curbed," Valdez said.   "In January suspected cases went down, in February and March even more, and in the last week we have counted just four cases, with zero cases some days," he added.

The internationally renowned Institut Pasteur in Dakar, Senegal had helped set up a laboratory in Cape Verde's capital, Praia, to track all the pregnant women on the archipelago infected with the virus, he said, while extra travel precautions were in place.    "We are doing everything according to international health regulations to guard against the spread of the virus to neighbouring countries and beyond," he said.

Three cases of microcephaly have been recorded on Cape Verde but none of the rare but serious neurological disorder Guillain-Barre Syndrome, also caused by the Zika strain.   In Brazil, the hardest-hit country, more than 1.5 million people have been infected with Zika, and nearly 1,400 cases of microcephaly have been registered since the outbreak began last year.   Researchers estimate that a woman infected with Zika during pregnancy has a one-percent chance of giving birth to a baby with the birth defect.
Friday 20th May 2016
WorldHealthOrganizationNews@who.int

BRAZZAVILLE / 20 May 2016 - Sequencing of the virus in Cabo Verde by Institut Pasteur, Dakar confirms that the Zika virus currently circulating in Cabo Verde is the same as the one circulating in the Americas - the Asian type- and was most likely imported from Brazil. This is the first time that the Zika strain responsible for the outbreaks linked to neurological disorders and microcephaly has been detected in Africa.

“The findings are of concern because it is further proof that the outbreak is spreading beyond South America and is on the doorstep of Africa.  This information will help African countries to re-evaluate their level of risk and adapt and increase their levels of preparedness,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

As a first step, these countries should heighten risk communication to pregnant women to raise awareness of complications associated with the Asian type of Zika virus and promote protection steps to avoid mosquito bites as well as sexual transmission. In addition, countries should increase their surveillance for Zika transmission and congenital malformations, such as microcephaly, as well as Guillain-Barré syndrome.

Activated since February 2016, WHO Zika Virus Disease Incident Management System in Brazzaville and at Headquarters will continue to review existing risk assessments, increase surveillance, and assess laboratory testing capacity and support community engagement and risk communications in priority countries.  In addition, WHO and its partners will support the countries in the African region to step up preparedness efforts for early detection, confirmation and management of potential complications related to Zika infection. The response will build on investments in strengthened systems made in West Africa during the Ebola emergency.  

Zika in Cabo Verde

As of 8 May 2016, there have been 7557 suspected cases of Zika in Cabo Verde. At least 3 cases of microcephaly have been reported from Cabo Verde with one case reported by the U.S. Centers for Disease Control and Prevention (CDC) after being delivered in Boston Hospital in the USA. So far, no case of Guillain-Barre Syndrome (GBS) has been reported from Cabo Verde.

Media inquiries:

Ms Ebba Kalondo
Emergencies Communications Officer, WHO AFRO
Phone: +232 7653 3284
Email: kalondoe@who.int
 
Mr Collins Boakye-Agyemang
Regional Communications Advisor, WHO AFRO
Mobile: +242 06520 6565
Email: boakyeagyemangc@who.int
 
Ms Nyka Alexander
Media Officer, WHO 
Phone: +41 79 634 02 95
Email: alexandern@who.int
Date: Sat, 19 Mar 2016 17:42:03 +0100

Dakar, March 19, 2016 (AFP) - The World Health Organization (WHO) has dispatched a team to Cape Verde to monitor a Zika virus outbreak following the west African archipelago's first recorded microcephaly case.   The WHO said in a statement released Friday it was sending a team of epidemiologists, maternal health specialists and communication staff at the request of the government.   "WHO is sending a team to Cabo Verde (Cape Verde), with joint participation of experts from WHO AFRO and the Institut Pasteur, Dakar," it said, referring to a Senegal-based infectious disease centre.

It follows Cape Verde's announcement on Tuesday of the first appearance of microcephaly on the islands, a severe deformation of the brains of infants whose link with the mosquito-borne Zika virus is under close study.   Cape Verde recorded 33 suspected cases of Zika in the first week of March alone, and has registered almost 7,500 cases since October 21 last year, according to WHO figures.

Zika usually causes mild symptoms in adults, with a low fever, headaches and joint pain.   But its quick spread has caused alarm due to an observed association with microcephaly and Guillain-Barre, a rare condition in which the body's immune system attacks a part of the nervous system that controls muscle strength.   "Investigations are underway to determine if this case of microcephaly is linked to Cabo Verde's outbreak of Zika virus," the WHO statement said.   There is currently no vaccine for the virus.

Brazil has been hardest hit by Zika, with some 1.5 million people infected and 745 confirmed cases of microcephaly in children born to women infected with the virus while pregnant.   Affected countries are focusing on wiping out mosquito populations in an effort to curb its spread.   The number of babies with the condition has surged since a Zika outbreak sweeping Latin America was detected last year.   All told, some 40 countries have reported transmission within their borders since then.
Fri 18/03/2016 15:42WHO SUPPORTS CABO VERDE IN MANAGING ZIKA VIRUS
 
Geneva 18 March 2016: Responding to a request from the Ministry of Health in Cabo Verde, the World Health Organization (WHO) is sending a team to Cabo Verde, with joint participation of experts from WHO AFRO and the Institut Pasteur, Dakar.

Although the number of cases of Zika in Cabo Verde is declining, the Minister of Health announced on 15 March the first case of microcephaly. Investigations are underway to determine if this case of microcephaly is linked to Cabo Verde’s outbreak of Zika virus. Among the 7490 suspected cases of Zika virus reported between 21 October 2015 and 6 March 2016, 165 involve pregnant women, from which 44 women have already delivered without any complications or abnormalities. Between 29 February and 6 March 2016, 33 suspected cases of Zika were registered on 2 of 9 islands in Cabo Verde, in Santiago island and São Filipe municipality (Fogo island).

There has been no circulation of the Zika virus on the islands of Sal, São Vicente, Santo Antão, São Nicolau and Brava. Furthermore there have been no cases reported on the islands of Boa Vista and Maio since mid-February.

The team includes epidemiologists, laboratory experts, maternal health specialists and communication staff who will collaborate with the Ministry of Health to evaluate the reported case of microcephaly and to gain a better understanding of the dynamics of the outbreak and its impact. It will also identify potential remaining gaps and to support the country’s response and investigations.

The team will be building on the work already underway by the health authorities in the country. The first group departed for Cabo Verde on 17 March to provide laboratory technical support, including further laboratory investigation and enhancing laboratory diagnostics capacity. Other team members will review surveillance data and systems tracking Zika virus and its complications, assess and document vector control processes, review interventions for managing pregnancy in the context of Zika virus, and support outreach to communities and the public to raise awareness .
 
WHO is also assisting the Ministry of Health to implement WHO guidelines for managing pregnancies of women infected with Zika to ensure women’s decisions about their pregnancies are based on the best possible information about risks to the fetus.

Included in WHO guidance for pregnant women in the context of Zika are the following recommendations:
  • Pregnant women living in areas of Zika virus transmission should follow the same prevention guidelines as the general population.
  • Pregnant women living in areas with ongoing Zika virus transmission should a) attend their regular antenatal care visits in accordance with national standards and comply with the recommendations of their health-care providers and b) start antenatal care visits early for diagnosis and appropriate care and follow-up if they develop any Zika virus symptoms or signs.
  • Accurate and evidence-based information on the prognosis of the identified abnormalities should be provided to the affected pregnant woman, and her partner if she wishes.
  • Based on the prognosis of associated fetal brain abnormalities, the woman – and her partner if she wishes – should be offered non-directive counselling so that she, in consultation with her health-care provider, can make a fully informed choice about the next steps in the management of her pregnancy.
  • Women who carry their pregnancy to term (until the birth of the baby) must receive appropriate care and support to manage anxiety, stress and the birth environment.
  • Plans for care and management of the baby soon after birth should be discussed with the parents in consultation with a paediatrician or paediatric neurologist where available.
  • Women who wish to discontinue their pregnancy should receive accurate information about their options to the full extent of the law, including harm reduction where the care desired is not readily available.
  • Women, whatever their individual choices with respect to their pregnancies, must be treated with respect and dignity.
Additional links

http://who.int/csr/resources/publications/zika/pregnancy-management/en/

http://who.int/csr/resources/publications/zika/psychosocial-support/en/
Date: Mon 2 Nov 2015
Source: Voice of America [in Portuguese, trans. Mod.TY, edited]
<http://www.voaportugues.com/content/virus-de-zika-confirmado-em-cabo-verde/3033052.html>

The Cape Verde minister of health today [2 Nov 2015] confirmed the occurrence of a Zika virus outbreak, adding that since September [2015] there were nearly 1000 patients with this disease, which is transmitted the same way that dengue [viruses] are. The minister of health, Cristina Fontes Lima, and the director general of health, Tomas Valdez, confirmed the disease after tests of blood samples sent in October [2015] to the Institut Pasteur in Dakar were positive. Of the 64 samples, 17 were positive, according to Cristina Fontes Lima, who stated also that the tests ruled out dengue, chikungunya, yellow fever, measles, and rubella, among other diseases.

Tomas Valdez stated that "up until yesterday [1 Nov 2015], since September [2015] approximately 1000 cases with symptoms compatible with Zika virus infection were attended in the Agostinho Neto Hospital and the Praia Health Centers [Praia county]. Among the symptoms were red spots on the face, trunk and arms with strong itching, headache and low-grade fever."

On average, the health services have attended 50-60 cases per day from this infection, having created a line for attention at the urgent care unit in the Agostinho Neto Hospital.

Tomas Valdez explained that the infection has a benign course of around 7 days and does not present with complications that require hospitalization. He added that there is no vaccine, so treatment is symptomatic with paracetamol, and said that up to now the cases have been registered "essentially in Praia city".

Zika virus is [relatively] new and the 1st transmission between humans was [reported] in the 1950s in Nigeria. In order to avoid infection, the authorities recommend elimination of catchments of stagnant water [in which the vector mosquitoes breed] and use of protection against mosquito bites.

The director general of health added, however, that it is still not possible to relate this outbreak to the epidemic of the same virus currently going on in Brazil.
===================
[This is a substantial outbreak of Zika virus. Although the reference laboratory confirmed several of the infections as due to Zika virus (17 of 64 samples tested), one wonders if the 47 negative samples were not taken at the point in time that would permit diagnosis or if the febrile patients were infected with a different pathogen. One hopes that the Cape Verde Zika virus has been (or will be) isolated for genetic comparison with sequences from the outbreak in Brazil and the recent outbreaks in some of the Pacific Islands.

A HealthMap/ProMED-mail map showing the location of Cape Verde can be accessed at
<http://healthmap.org/promed/p/15>. - ProMED Mod.TY]
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