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Embed HULL INSPECTION AND MAINTENANCE PROGRAM. Guide for Hull Inspection and Maintenance Program GUIDE FOR HULL INSPECTION AND MAINTENANCE PROGRAM SEPTEMBER 2012 American Bureau of Shipping Incorporated by Act of Legislature of the State of New York 1862 Copyright 2012 American Bureau of Shipping ABS Plaza Northchase Drive Houston, TX USA Foreword Foreword This is the third edition of the Guide for Hull Inspection and Maintenance Program. ABS supports the implementation by Owners of a proactive hull maintenance program complying with self-imposed standards and the requirements in this Guide.

In conjunction with the normal classification surveys, such an approach provides a means to regularly evaluate and maintain the vessel s hull structural condition. The edition adopts a more logical approach for applying requirements on Mobile Offshore Drilling Units (MODUs). Ships in service provide more opportunities to monitor the vessel s hull structure. Prema Kavali 2011 Songs Free Download South Mp3 there. MODU crew may have difficulties in safely accessing spaces as frequently as may be possible on a ship. This revision has taken this factor into account and clarifies requirements for Hull Inspection and Monitoring Program for MODUs so that these can be applied in a more efficient manner. This Guide becomes effective on the first day of the month of publication.

Users are advised to check periodically on the ABS website to verify that this version of this Guide is the most current. We welcome your feedback. Comments or suggestions can be sent electronically by to ii ABS GUIDE FOR HULL INSPECTION AND MAINTENANCE PROGRAM. 2012 Table of Contents GUIDE FOR HULL INSPECTION AND MAINTENANCE PROGRAM CONTENTS SECTION 1 Introduction General IACS PR 33 Owner s Hull Inspection and Maintenance Schemes Scope Statutory Requirements.

CMMS Product Consultant – ABS NS: Based in Dubai office of American Bureau of Shipping looking after the clients in middle-east using ABS NS5 PMS Software. • Strategically develop, implement, evaluate and maintain the activities, policies and procedures of ABS Nautical Systems (NS5) Fleet Management System.

1 SECTION 2 Program Requirements Age and Type of Vessel Surveys Damages and Failures Implementation Confirmation of Onboard Documents and Software Implementation Survey Periodic Surveys Cancellation of Program. 3 SECTION 3 HIMP Requirements Details of the Program HIMP Inspection Intervals and Requirements Inspection Intervals Inspection Requirements for Vessels other than Mobile Offshore Drilling Units Inspection Requirements for Mobile Offshore Drilling Units Qualified Inspector Training. 8 SECTION 4 Onboard Documentation General. 9 APPENDIX 1 References and Definitions References Definitions ABS GUIDE FOR HULL INSPECTION AND MAINTENANCE PROGRAM iii This Page Intentionally Left Blank Section 1: Introduction SECTION 1 Introduction 1 General The Hull Inspection and Maintenance Program (HIMP) is offered by ABS to assist Owners and Operators to more effectively inspect and maintain the hull structure on their vessels.

Note: The general term vessel used throughout this Guide is meant to be a ship, a barge, an offshore unit or facility, or any other floating or fixed structure where HIMP would be applicable. Vessels enrolled in this program may be eligible for the optional class notation HIMP. This Guide sets forth requirements for the HIMP intended to assist users in the development, improvement, and application of their hull maintenance management systems. This Guide details the procedures associated with the development and implementation of an approved Hull Inspection and Maintenance Program. When properly performed by Owner s qualified inspectors who are acceptable to ABS, such a program may be used as an aid to more effectively assess and document the condition of the hull structure. Hull structure inspection and maintenance on vessels using the HIMP with or without the associated notation, does not supersede the judgment of an ABS Surveyor, nor does it waive ABS Surveyor attendance for the periodic surveys necessary for maintenance of Class, including damage and repair, as required by the applicable ABS Rules or Guides used for classing the vessel s hull structure.

1.1 IACS PR 33 Owner s Hull Inspection and Maintenance Schemes Owner s hull inspection and maintenance schemes are to be encouraged as a means for maintaining compliance with classification and statutory requirements between surveys. However, these schemes are not to be accepted as an alternative to, or a substitute for, the performance of required classification and/or statutory surveys of the hull by the Surveyors of the Society, or of another duly authorized Society. The Surveyors may be assisted, where appropriate, by service suppliers as defined in UR Z17. 3 Scope This Guide is intended to address the requirements for the Hull Inspection and Maintenance Program in conjunction with the applicable requirements of the ABS Rules/Guides.

These requirements are applicable to those features that are permanent in nature and can be verified by plan review, calculation, physical survey or other approved means. 3.1 Statutory Requirements The application of this Guide does not cover any statutory survey requirements that may apply to the vessel being considered (e.g., Load Line, SOLAS, MARPOL, MODU Code). Although ABS is authorized to perform statutory surveys on behalf of many flag States, ABS is not in a position to alter or waive the statutory requirements. The administration or regulatory body is the final determining body for statutory or regulatory requirements under their jurisdiction. ABS GUIDE FOR HULL INSPECTION AND MAINTENANCE PROGRAM Section 2: Program Requirements SECTION 2 Program Requirements In order to enroll in the Hull Inspection and Maintenance Program (HIMP), vessels are to meet the following conditions: 1 Age and Type of Vessel There is no restriction on the age or type of a vessel when entered into the program. HIMP is offered to all ABS classed vessels. When an existing vessel applies to enter the program, ABS will conduct a review of the vessel s survey history to assess the details of the hull structure, previous hull damages, open recommendations and tank coating conditions.

Upon completion of this review, the Owner is to be notified of any issues, which do not comply with the HIMP requirements. Vessels found to be in satisfactory condition may be considered eligible for HIMP.

To assist in the ABS review, Owners may support the application with details of their in-place maintenance programs. 3 Surveys ABS periodic surveys required to maintain classification of the vessel are to be up-to-date and without any outstanding recommendations affecting the vessel s hull structure. 5 Damages and Failures Any class and/or statutory outstanding recommendations/deficiencies associated with the vessel s hull structure are to be satisfactorily rectified prior to participation in HIMP. Damage, failure, deterioration or repair to the hull, which affects or may affect classification, is to be submitted for examination by an ABS Surveyor at the first opportunity. All repairs found necessary are to be carried out to the Surveyor s satisfaction prior to participation in HIMP. 7 Implementation Implementation of HIMP requires an onboard attendance by ABS. The HIMP notation becomes fully effective upon verification survey and confirmation of the following by the ABS Surveyor.

7.1 Confirmation of Onboard Documents and Software The following documents are to be confirmed by the attending Surveyor: i) Approval by ABS for entry into HIMP. I ABS NS5 HIM software is installed and operational on the vessel s computer, or alternatively, an ABS approved HIMP manual is placed on board. Written confirmation from ABS that it has provided Owner s representatives with Qualified Inspector training, or alternatively, evidence of another ABS approved Qualified Inspector training program.

2 ABS GUIDE FOR HULL INSPECTION AND MAINTENANCE PROGRAM. 2012 Section 2 Program Requirements 7.3 Implementation Survey When ABS verification in accordance with 2/7.1 is completed, the following implementation survey is to be carried out: i) A minimum of two ballast tanks are to be examined by the classroom trained Inspector in the presence of the ABS Surveyor. I The Inspector s decisions, including grading of the zones within the space on each of the six criteria in accordance with the ABS Inspection Grading Criteria for the ABS Hull Inspection and Maintenance Program (HIMP) (see Resources Publications Marine), is to be assessed by the Surveyor. The Inspector s capability and proper entry of the findings into the ABS NS5 HIM software, as a result of the above examination, is to be assessed by the Surveyor. Upon satisfactory completion of the above, the attending Surveyor is to report back to ABS recommending the vessel s HIMP to be initiated in the ABS system. 9 Periodic Surveys HIMP is to be subject to annual confirmation surveys conducted in conjunction with each Annual Survey Hull, and the Surveyor is to review and verify the following information: i) Vessel s Status and History i ABS NS5 HIM software maintained with the minimum inspection criteria as outlined in Subsection 3/1 of this Guide, or alternatively, an ABS Approved HIMP manual reflecting compliance with the aforementioned minimum inspection criteria is onboard the vessel.

HIMP information is being updated on the NS5 HIM software, or alternatively, the ABS approved HIMP manual and the planned inspections are being carried out and reported upon by a qualified Inspector responsible for maintaining the details of the program as required. At the time of the survey, the Surveyor is also to conduct a general review of the HIMP inspections undertaken by the qualified Inspector(s) within the previous year.

Areas with damages or other defects indicated in the inspection report(s), that affect or may affect classification are to be examined by an ABS Surveyor. Note: During other classification surveys such as the Intermediate and Special Periodical or Continuous Survey Hull, the records of the Hull Inspection and Maintenance Program are to be made available for the attending Surveyor(s) to review prior to conducting the survey. 11 Cancellation of Program The class notation HIMP may be terminated by ABS if any of the following is found: i) The program is not being satisfactorily carried out i Maintenance records are found to be unacceptable General condition of the hull structure is determined to be unacceptable Under any of the following circumstances, the program, as well as the HIMP notation, is to be suspended at such time until an updated plan is resubmitted for approval: i) Change of ownership or management of the vessel Transfer of class The Owner may cancel the HIMP at any time by informing ABS in writing. ABS GUIDE FOR HULL INSPECTION AND MAINTENANCE PROGRAM Section 3: HIMP Requirements SECTION 3 HIMP Requirements 1 Details of the Program The Owner s HIMP program is to at least include the following: i) Confirmation that the Company has a safety policy and procedures in place for confined space entry. (For information only) i iv) The program is to at least report on structural condition/grading of all applicable items required to be inspected in accordance with 3/3.3 through 3/3.5 of this Guide.

Grading of the zones within the tanks/spaces inspected on each of the six criteria in accordance with the ABS Inspection Grading Criteria for the ABS Hull Inspection and Maintenance Program (HIMP) General Arrangement plans available onboard v) Mid-ship Section plan available onboard for ship-shaped vessels vi) v vi ix) Operations Manual for offshore units is to be available onboard. Maintenance descriptions for each item detailing the minimum work necessary to demonstrate that a satisfactory examination of the item will be made. Sample reporting and recording procedures to demonstrate that the HIMP is being properly adhered to onboard the vessel. This is to include a system for reporting the following information to the Owners/Management office as well as recording same onboard the vessel: Details of the inspections carried out (details are to include proper structure identification such as tank/hold information, frame number, deck, shell plating, stringers, bulkheads and longitudinals as identified on the vessel s drawings) The conditions as found including documentation by representative digital photographs. A minimum of six (6) photos per any zone examined. The photos are to be digitally date stamped.

Any findings, repairs or maintenance undertaken shall be reported upon by a Company-consistent scheme which is capable of denoting the severity of any finding. Training of qualified Inspectors is to be provided by ABS, or alternatively, another ABS-approved training program (see Subsection 3/5). When the training has been provided by a facility other than ABS, a record of the ABS approval of the training program shall be kept onboard the vessel for verification at annual surveys.

X) Records of qualified Inspectors are to be maintained onboard the vessel for Surveyor verification. As a minimum, this shall include the individual s name, title, unique qualification tracking number (e.g., License no., seaman card no., company employee no., qualification certificate no., etc.), the name of the facility which provided the training, and the date of the last related training or re-training. 3 HIMP Inspection Intervals and Requirements The inspections performed in accordance with the NS5 HIM software or the ABS-approved HIMP manual are not intended to preclude the Owner from carrying out occasional or additional inspections and maintenance as a result of an unexpected failure or event (such as damage resulting from heavy weather or cargo loading/unloading operations) which may affect the condition of the hull or equipment. When occasional inspections and maintenance are carried out, the details of such inspections including the conditions found, are to be recorded.

4 ABS GUIDE FOR HULL INSPECTION AND MAINTENANCE PROGRAM. 2012 Section 3 HIMP Requirements If any deficiency which affects or may affect classification is discovered during the HIMP inspection, it is to be submitted by the Owner or Operator for examination by a Surveyor at the first opportunity in accordance with 7-1-1/7 of the ABS Rules for Survey After Construction (Part 7), 7-2-1/7 of the ABS MODU Rules and Part 1 of the ABS Rules. 3.1 Inspection Intervals The following minimum intervals are to be maintained Annual Inspections Annual inspections are required to be completed prior to ABS attendance for the Annual Survey of Hull. Annual Survey of Hull cannot be credited by ABS until all due annual inspections are completed by the qualified Inspector and reported in ABS NS5 HIM software. In general, frequency of annual inspections is to be 12 months. In no case is this frequency to be extended beyond 18 months from the date the last such inspection was completed Intermediate Inspections Intermediate inspections are required to be completed prior to ABS attendance for the Drydocking Survey (or UWILD if agreed by ABS).

Drydocking Survey cannot be credited by ABS until all due intermediate inspections are completed by the qualified Inspector and reported in ABS NS5 HIM software. In general, frequency of intermediate inspections is to be between 24 to 36 months. In no case is this frequency to be extended beyond 36 months from the date the last such inspection was completed. Note: For mobile offshore drilling units, the requirements of an Intermediate Inspection are the same as a rulerequired Intermediate Drydocking/UWILD Year Inspections 5 year inspections are required to be completed prior to ABS attendance for the Special Survey of Hull.

Special Survey of Hull cannot be credited by ABS until all due 5 year inspections are completed by the qualified Inspector and reported in ABS NS5 HIM software. The frequency of the 5 year inspections is not to exceed 60 months from the anniversary date or completion of the last such inspection.

Adobe Flash Player is required to view this feature. If you are using an operating system that does not support Flash, we are working to bring you alternative formats. Original Article Zika Virus Outbreak on Yap Island, Federated States of Micronesia Mark R. Duffy, D.V.M., M.P.H., Tai-Ho Chen, M.D., W. Thane Hancock, M.D., M.P.H., Ann M. Powers, Ph.D., Jacob L.

Kool, M.D., Ph.D., Robert S. Lanciotti, Ph.D., Moses Pretrick, B.S., Maria Marfel, B.S., Stacey Holzbauer, D.V.M., M.P.H., Christine Dubray, M.D., M.P.H., Laurent Guillaumot, M.S., Anne Griggs, M.P.H., Martin Bel, M.D., Amy J. Lambert, M.S., Janeen Laven, B.S., Olga Kosoy, M.S., Amanda Panella, M.P.H., Brad J. Biggerstaff, Ph.D., Marc Fischer, M.D., M.P.H., and Edward B. N Engl J Med 2009; 360:2536-2543 DOI: 10.1056/NEJMoa0805715. Background In 2007, physicians on Yap Island reported an outbreak of illness characterized by rash, conjunctivitis, and arthralgia.

Although serum from some patients had IgM antibody against dengue virus, the illness seemed clinically distinct from previously detected dengue. Subsequent testing with the use of consensus primers detected Zika virus RNA in the serum of the patients but no dengue virus or other arboviral RNA.

No previous outbreaks and only 14 cases of Zika virus disease have been previously documented. Methods We obtained serum samples from patients and interviewed patients for information on clinical signs and symptoms. Zika virus disease was confirmed by a finding of Zika virus RNA or a specific neutralizing antibody response to Zika virus in the serum. Patients with IgM antibody against Zika virus who had a potentially cross-reactive neutralizing-antibody response were classified as having probable Zika virus disease. We conducted a household survey to estimate the proportion of Yap residents with IgM antibody against Zika virus and to identify possible mosquito vectors of Zika virus.

Results We identified 49 confirmed and 59 probable cases of Zika virus disease. The patients resided in 9 of the 10 municipalities on Yap. Rash, fever, arthralgia, and conjunctivitis were common symptoms. No hospitalizations, hemorrhagic manifestations, or deaths due to Zika virus were reported. We estimated that 73% (95% confidence interval, 68 to 77) of Yap residents 3 years of age or older had been recently infected with Zika virus. Aedes hensilli was the predominant mosquito species identified. Zika virus is a flavivirus (family Flaviviridae) related to West Nile, dengue, and yellow fever viruses.

Zika virus was isolated in 1947 from a rhesus monkey in the Zika forest near Entebbe, Uganda; its genome was sequenced in 2006. There is serologic evidence of human Zika virus infection in Africa and Asia, and the virus has been isolated from humans in Uganda, Nigeria, and Senegal. Zika virus is believed to be transmitted to humans by infected mosquitoes and has been isolated from Aedes africanus, Aedes luteocephalus, and Aedes aegypti. No outbreaks and only 14 cases of human Zika virus disease have been previously documented. Until this outbreak, no transmission of Zika virus had been reported outside of Africa and Asia. In April and May 2007, physicians on Yap Island, Federated States of Micronesia, noted an outbreak of illness characterized by rash, conjunctivitis, subjective fever, arthralgia, and arthritis. Although three patients tested positive with a commercially available dengue IgM kit, the physicians had the impression that this illness was clinically distinct from dengue, which had been detected on Yap in two previous outbreaks.

In June 2007, serum from acutely ill patients was sent to the Centers for Disease Control and Prevention (CDC) Arbovirus Diagnostic and Reference Laboratory in Fort Collins, Colorado. Ten of 71 samples (14%) were found to contain Zika virus RNA according to reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. RT-PCR assays with the use of consensus primers for nucleic acid of other arboviruses, including dengue, chikungunya, o'nyong-nyong, Ross River, Barmah Forest, and Sindbis viruses, were all negative. We conducted an investigation to define the epidemiologic features of the outbreak and to describe the clinical manifestations of Zika virus disease. Case Definition and Finding We reviewed medical records and conducted prospective surveillance at the hospital and all four health centers on Yap to identify patients with suspected Zika virus disease during the period from April 1 through July 31, 2007.

A patient with suspected disease had acute onset of generalized macular or papular rash, arthritis or arthralgia, or nonpurulent conjunctivitis. Patients with suspected disease were asked to provide blood specimens during the acute phase (i.e., within 10 days after the onset of symptoms) and during the convalescent phase (i.e., 14 days later).

We interviewed a convenience sample of these patients with the use of a standard questionnaire to collect information about demographic features, clinical signs and symptoms, and the duration and severity of the illness. Christopher Mcdougall Urodzeni Biegacze Pdf Converter there. Laboratory Analysis and Case Classification Serum samples were tested by enzyme-linked immunosorbent assay (ELISA) for IgM antibodies against Zika virus and dengue virus. Titers of neutralizing antibody to Zika virus and dengue virus were determined with the use of plaque-reduction neutralization tests with a cutoff value of 90% (PRNT 90).

Serum samples from patients in the acute phase were tested by RT-PCR for Zika virus and dengue virus RNA. We considered a patient to have confirmed Zika virus disease if Zika virus RNA was detected in the serum or if all the following findings were present: IgM antibody against Zika virus (detected by ELISA), Zika virus PRNT 90 titer of at least 20, and a ratio of Zika virus PRNT 90 titer to dengue virus PRNT 90 titer of at least 4.

A patient was classified as having probable Zika virus disease if IgM antibody against Zika virus was detected by ELISA, Zika virus PRNT 90 titer was at least 20, the ratio of Zika virus PRNT 90 titer to dengue virus PRNT 90 titer was less than 4, and either no Zika virus RNA was detected by RT-PCR or the serum sample was inadequate for the performance of RT-PCR ( Figure 1 Case Classification of 185 Patients Who Sought Health Care and Met the Case Definition for Suspected Zika Virus Disease on Yap during the Period from April through July 2007. The presence of Zika virus RNA was determined by reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. PRNT 90 denotes plaque-reduction neutralization test with a cutoff value of 90%. Household Survey We surveyed the community to define the extent of the outbreak and determine risk factors for infection. We used simple, random, one-stage cluster sampling to select 200 (16%) of the 1276 households on Yap, and we sought to enroll all household members 3 years of age or older.

We used a standard questionnaire to collect data from consenting household residents regarding age, sex, birthplace, potential risk factors for infection, and illness since April 1, 2007. We obtained blood samples from all eligible consenting household residents.

Participants in whom IgM antibody against Zika virus was detected by ELISA were considered to have evidence of recent Zika virus infection. Entomologic Investigation Water-holding containers and containers with mosquito larvae or pupae were counted at the surveyed households.

Larvae and pupae were collected and identified. Adult mosquitoes were collected by light traps, gravid traps, and aspiration at representative points on Yap and were then pooled according to species, trap location, and collection date. Pools of immature and mature mosquitoes were tested by viral culture and by RT-PCR for Zika virus RNA for evidence of infection. Statistical Analysis The attack rates of Zika virus infection were calculated with the use of 2000 census data for the Federated States of Micronesia. Survey and surveillance data were analyzed with the use of SPSS software, version 12.0, and S-Plus software, version 8.

For descriptive results, categorical variables were given as proportions and continuous variables were described by the mean or the median and range. For population inferences from the household survey, standard errors, confidence intervals, and P values were calculated with the sampling design taken into account and with the use of a finite population correction. Categorical variables from the household survey were compared with the use of the Rao and Scott correction to the chi-square test.

Standard calibration-weighted estimators were used to adjust for nonresponse to the household survey by calibration to the Yap 2000 census population according to 10-year age groups and sex for the eligible population. Inferences for the entomologic survey were based on a simple random sample of households, and the score confidence interval was used for population binomial proportions. Case Finding We identified 185 cases of suspected Zika virus disease. Of these, 49 (26%) were confirmed and 59 (32%) were probable cases ( ). Acute-phase serum samples were collected within 10 days after the onset of illness from 45 of the 49 patients with confirmed disease (92%), and Zika virus RNA was detected in 15 of these 45 patients (33%).

No dengue virus RNA was detected in any of the 137 acute-phase serum samples tested (45 of these 137 patients had confirmed Zika virus disease, 51 had probable disease, and 41 had suspected disease). The date of symptom onset among patients with confirmed or probable disease ranged from April 15 to July 14 ( Figure 2 Confirmed and Probable Cases of Zika Virus Disease on Yap among Persons Seeking Health Care, According to Week of Onset of Illness during the Period from April through July 2007. The number of cases peaked in late May and subsided in early July.

The median age of patients with confirmed or probable disease was 36 years (range, 1 to 76); 66 of these patients (61%) were female. The overall attack rate for confirmed and probable Zika virus disease detected among patients presenting to health care facilities was 14.6 per 1000 Yap residents. The attack rates ranged from 3.6 per 1000 population in both the Kanifay and the Gilman municipalities to 21.5 per 1000 population in Tomil municipality ( Figure 3 Attack Rates for Confirmed and Probable Zika Virus Disease per 1000 Population According to Municipality on Yap during the Period from April through July 2007. The sex-specific attack rates were 17.9 per 1000 females and 11.4 per 1000 males. Cases occurred among all age groups, but the incidence of confirmed and probable Zika virus disease detected by health care surveillance was highest among persons 55 to 59 years of age ( Figure 4 Attack Rates for Confirmed and Probable Zika Virus Disease on Yap According to Age Group during the Period from April through July 2007. Of 49 patients with confirmed Zika virus disease, 31 (63%) provided information regarding symptoms and exposures.

The age and sex distributions of these 31 patients were similar to those of the remaining 18 patients with confirmed disease. The most commonly reported symptoms were rash, fever (measured or reported), arthritis or arthralgia, and conjunctivitis ( Table 1 Clinical Characteristics of 31 Patients with Confirmed Zika Virus Disease on Yap Island during the Period from April through July 2007.

Other symptoms included myalgia, headache, retro-orbital pain, edema, and vomiting. Twenty patients (65%) reported a subjective fever; the body temperature of 12 of these patients was measured by a health care provider, and none of the recorded temperatures were above 37.9°C. The median duration of rash was 6 days (range, 2 to 14), and that of arthralgia was 3.5 days (range, 1 to 14). No deaths, hospitalizations, or hemorrhagic complications were associated with Zika virus illness during this outbreak. None of the 31 patients who reported symptoms had traveled outside of Yap within 2 weeks before the onset of symptoms.

Household Survey Surveys were completed in 173 of 200 randomly selected households (86%). The 173 enrolled households had 852 residents, and the median number of residents per household was 5 (range, 1 to 18). Forty-four residents were under 3 years of age and therefore were not eligible to participate in the survey. We obtained blood samples from 557 of the 808 eligible residents (69%). The age and sex distributions of the participants differed significantly from those of the eligible Yap population recorded in the 2000 census (P.

Entomologic Investigation Of the 1366 water-holding containers identified during the household survey, 587 (43% [95% CI, 40 to 46]) were infested with mosquito larvae or pupae; infested containers were found at 148 of the 170 households surveyed (87% [95% CI, 81 to 91]). A total of 12 mosquito species belonging to four genera were identified; 9 species were identified by examination of larvae, and an additional 3 species were collected as adults. Aedes hensilli was the predominant species identified and was present in 489 of the water-holding containers (36% [95% CI, 33 to 38]). No other species was present in more than 3% of the containers. No virus or viral nucleic acid could be detected in any mosquito pool. Discussion In this Zika virus outbreak, approximately three quarters of Yap residents were infected with Zika virus, and we estimated that more than 900 people had illness attributable to Zika virus infection. Zika virus infection was widespread across all geographic areas of Yap and caused relatively mild illness lasting several days.

There were no deaths or hospitalizations attributed to Zika virus. We were unable to detect Zika virus in any mosquito samples, and therefore we cannot determine with certainty the vector of transmission.

On the basis of the relative abundance of Aedes hensilli and previous evidence that this species was the most likely vector of dengue virus transmission on Yap, it is plausible that Aedes hensilli was a vector of Zika virus transmission in this outbreak. The clinical signs and symptoms of Zika virus infection were consistent with those described in a previous report of one male patient but different from those described in a previous case series. In that case series, rash or conjunctivitis was not reported and arthralgia was noted in only one of seven patients.

Fever was reported in all seven patients, but the study included only patients who were hospitalized with febrile illness. The detection of Zika virus RNA in the serum of acutely ill patients and the absence of nucleic acid of other arboviruses provide convincing evidence that the outbreak was caused by Zika virus.

Although the transmission of dengue virus is common in Micronesia, none of the 137 patients for whom acute-phase specimens were available had evidence of dengue virus RNA in their serum. All 108 patients with confirmed or probable Zika virus disease had IgM antibody against Zika virus and neutralizing antibodies. ELISA for IgM is a relatively sensitive and specific assay for detecting arboviral infections. Although the ELISA for IgM antibody against Zika virus may cross-react with IgM against other flaviviruses, such as dengue virus or yellow fever virus, it is not likely to cross-react with IgM against alphaviruses such as chikungunya or Ross River viruses.

PRNTs effectively discriminate among different primary flavivirus infections, but patients who have secondary infections (those who have been previously vaccinated against or exposed to another flavivirus) may have indeterminate PRNT results. The patients with confirmed Zika virus disease had titers of neutralizing antibodies against Zika virus that were at least four times as high as their titers of neutralizing antibodies against dengue virus, a finding that provides strong evidence of primary Zika virus infection. The patients with probable Zika virus disease also had neutralizing antibodies against Zika virus, but the titers were less than four times as high as the titers of neutralizing antibodies against dengue virus.

Although the results from these patients do not definitively confirm Zika virus infection, they are consistent with Zika virus infection after a previous dengue virus infection. The attack rates of Zika virus disease detected by surveillance were higher among females than males and among older persons than younger persons. In contrast, the prevalence of IgM antibody against Zika virus detected by the survey was higher in male participants (perhaps because of the possibility of their greater exposure to mosquitoes) and was relatively evenly distributed across age groups. These discrepancies may be because of differences in health care–seeking behavior for this relatively mild illness. The estimated ratio of symptomatic to asymptomatic patients with Zika virus infection in this outbreak is similar to that described for West Nile virus infection. We think it unlikely that Zika virus circulated unrecognized on Yap before this outbreak. The compact clustering of cases in May and June and the high seroprevalence of IgM antibody against Zika virus are consistent with an acute outbreak of Zika virus illness in a population without previous immunity to Zika virus.

Although precise estimates of the persistence of IgM antibody against Zika virus are not available, IgM antibodies to dengue virus generally do not persist longer than 90 days. IgM antibodies to West Nile virus typically persist for about 5 months. There were no reports of widespread disease outbreaks on Yap in the 2 years before this outbreak. These results support the conclusion that this outbreak resulted from a recent introduction of Zika virus. Zika virus might have been introduced to Yap by a viremic nonhuman primate (monkeys live on nearby Palau but not on Yap), but there were no reports of any importation or recent arrival of nonhuman primates.

No other nonprimate vertebrates or birds are known to be reservoirs of Zika virus; unless evidence of such a reservoir is discovered, introduction of Zika virus through an infected nonprimate vertebrate seems unlikely. It is more likely that Zika virus was introduced by an infected mosquito or a viremic human. We did not find any recently ill residents who had traveled outside of Yap, but the virus could have been imported by a person with undetected infection.

Serologic evidence of Zika virus infection in humans has been reported in the Philippines, and travel between Yap and the Philippines is common. The accessibility of air travel and the abundance of mosquito vectors of flavivirus in the Pacific region raise concern for the spread of Zika virus to other islands in Oceania and even to the Americas. The potential for such spread is illustrated by the following anecdote. A medical volunteer visited Yap from June 17 to June 29, 2007, and had onset of symptoms meeting the case definition of suspected Zika virus disease on July 7, 2007, after her return to the United States.

She had IgM antibody against Zika virus and neutralizing antibody in her serum on July 20, indicating she had been infected with Zika virus on Yap and was probably viremic after arrival in the United States. The emergence of Zika virus as an important human pathogen on Yap in 2007 underscores the ease with which exotic pathogens are transported between continents and the need for clinical vigilance and strong epidemiologic and laboratory surveillance systems to detect the spread of infectious diseases. The views expressed are those of the authors and do not necessarily represent the views of the Department of Health and Human Services. No potential conflict of interest relevant to this article was reported.

We thank the physicians and staff at the Wa'ab Community Health Centers, the Yap State Department of Health Service, the Federated States of Micronesia Department of Health, Education, and Social Affairs, the CDC Arboviral Diseases Branch Diagnostic and Reference Laboratory, and the CDC Global Disease Detection Program for their support and assistance with this investigation. References • 1 Kuno G, Chang GJ, Tsuchiya KR, Karabatsos N, Cropp CB. Phylogeny of the genus Flavivirus. J Virol 1998;72:73-83 • 2 Simpson DI. Zika virus infection in man.

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Arthropod-borne virus antibodies in sera of residents of Kainji Lake Basin, Nigeria 1980. Trans R Soc Trop Med Hyg 1983;77:149-151 • 8 Darwish MA, Hoogstraal H, Roberts TJ, Ahmed IP, Omar F. A sero-epidemiological survey for certain arboviruses (Togaviridae) in Pakistan. Trans R Soc Trop Med Hyg 1983;77:442-445 • 9 Olson JG, Ksiazek TG, Gubler DJ, et al.

A survey for arboviral antibodies in sera of humans and animals in Lombok, Republic of Indonesia. Ann Trop Med Parasitol 1983;77:131-137 • 10 Monlun E, Zeller H, Le Guenno B, et al. Surveillance of the circulation of arbovirus of medical interest in the region of eastern Senegal. Bull Soc Pathol Exot 1993;86:21-28 • 11 Fagbami A. Epidemiological investigations on arbovirus infections at Igbo-Ora, Nigeria. Trop Geogr Med 1977;29:187-191 • 12 Moore DL, Causey OR, Carey DE, et al.

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