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ACTIVE INVESTIGATIONS Information on Active Investigations When a local case of Zika virus is confirmed through laboratory testing, the department conducts a thorough investigation around the case to determine if additional people are infected. The department interviews and tests close contacts and community members around the case. Knowing if additional people are infected helps the department determine if there is a zone where mosquitoes are transmitting the virus. Not every case results in a designation of active transmission in an area. In some instances, a case of Zika is an isolated incident with no additional people infected. For more information on the department’s testing and investigation process, click here. paragraph break Current Number of Active Investigations: 12 Miami-Dade County: 8 open investigations Palm Beach: 1 open investigations Unknown: 3 open investigations *Note: Exposure occurred in Miami Beach and overseas in an area with widespread transmission of Zika. paragraph break Current Number of Closed Investigations: 33 Miami-Dade County: 26 closed investigations Palm Beach County: 5 closed investigation Broward County: 1 closed investigation Pinellas: 1 closed investigation paragraph break Sampling Activities For Active Investigations Miami Beach in Miami-Dade County (Area of Active Transmission) Total # of Samples Collected Positive Negative Pending Results 1,064 72 992 0 paragraph break One-square mile area within NW 79th St. to the North, NW 63rd St. to the South, NW 10th Ave. to the West and N. Miami Ave. to the East in Miami-Dade County (Area of Active Transmission) Total # of Samples Collected Positive Negative Pending Results 117 8 103 6 paragraph break Palm Beach County – 1 Investigation Total # of Samples Collected Positive Negative Pending Results 0 0 0 0 paragraph break Miami-Dade Investigations Outside of Areas of Active Transmission– 6 Investigations Total # of Samples Collected Positive Negative Pending Results 30 0 30 0 paragraph break Wynwood Area in Miami-Dade County – Note: This investigation is closed, but the department is providing the sampling results below for reference. Total # of Samples Collected Positive Negative Pending Results 525 33 491 0 Data as of Oct. 27, 2016 - 3:20 PM ET

Puerto Rico: 1st baby born with microcephaly due to Zika By DANICA COTO 47 minutes ago SAN JUAN, Puerto Rico (AP) — Puerto Rico on Friday reported its first case of a baby born with microcephaly as a result of a Zika infection, raising concerns because officials said the medical condition wasn't identified until the mother was nearly eight months pregnant. The baby was born in the past two weeks with severe brain defects as well as hearing and vision problems and remains hospitalized, according to Health Secretary Ana Rius. She said authorities are investigating why the microcephaly case was identified so late although the mother presented Zika symptoms between her second and third month of pregnancy. She added that the mother did not receive continuous prenatal care until late in her second trimester. Rius declined to provide any other details, except to say that the case occurred in the capital of San Juan. She also stressed that all pregnant women should demand to be tested for Zika in their first, second and third trimester. Puerto Rico is facing a Zika epidemic with nearly 31,500 cases reported, including more than 2,400 pregnant women. A total of 233 people have been hospitalized and six deaths have been reported, four of them linked to Zika and other medical conditions and the remaining two to a paralysis condition called Guillain-Barre that has been tied to the virus. The U.S. Centers for Disease Control and Prevention has warned it expects a surge of babies being born with severe deformities in Puerto Rico in upcoming months. A recent study estimates that up to 10,300 pregnant women on the island could be infected with Zika and that between 100 to 270 babies could be born with microcephaly. Rius said at least five other pregnant women in Puerto Rico whose fetuses have microcephaly will give birth between November and January. The epidemic hits at a time when Puerto Rico is mired in amid a deep economic crisis that officials say has depleted government funds. The island has been seeking more federal funds to help fight the weekly increase in cases that has hit the tourism industry hard. The baby born with microcephaly will be referred to public health clinics, where it will receive medical care up to age 3, Rius said. "If it survives, it will be referred to other childhood programs," she said.

Puerto Rico on Friday reported its first case of a baby born with microcephaly as a result of a Zika infection, raising concerns because officials said the medical condition wasn't identified until the mother was nearly eight months pregnant. The baby was born in the past two weeks with severe brain defects as well as hearing and vision problems and remains hospitalized, according to Health Secretary Ana Rius. https://apnews.com/2909c1f1a62949cab685b2fde51ed4f1

As of Thursday, *October 27, 2016, VDH has reported 87 cases of Zika virus disease in Virginia residents to the CDC ( 10 in Northwest Region, 43 in Northern Region, 10 in Eastern Region, 15 in Central Region and 9 in Southwest Region). All Virginia cases are associated with travel to a Zika-affected area. CDC has issued a travel alert (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing. *Updated weekly. Week runs Thursday – Wednesday.

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Wisconsin Annual Summary Data - 2016 Updated October 26, 2016 Confirmed Zika virus cases 49 Probable* Zika virus cases 2 Completed testing - Total 822 * Probable cases have presumptive positive laboratory results without confirmatory CDC testing. https://www.dhs.wisconsin.gov/arboviral/zika.htm

Wisconsin Annual Summary Data - 2016 Updated October 26, 2016 Confirmed Zika virus cases 49 Probable* Zika virus cases 2 Completed testing - Total 822 * Probable cases have presumptive positive laboratory results without confirmatory CDC testing.

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of October 26, 2016)§ States Travel-associated cases* No. (% of cases in states) (N=3,952) Locally acquired cases† No. (% of cases in states) (N=139) Alabama 28 (1) 0 (0) Arizona 40 (1) 0 (0) Arkansas 13 (<1) 0 (0) California 309 (8) 0 (0) Colorado 46 (1) 0 (0) Connecticut 58 (1) 0 (0) Delaware 16 (<1) 0 (0) District of Columbia 25 (1) 0 (0) Florida 708 (18) 139 (100) Georgia 93 (2) 0 (0) Hawaii 14 (<1) 0 (0) Idaho 4 (<1) 0 (0) Illinois 76 (2) 0 (0) Indiana 40 (1) 0 (0) Iowa 17 (<1) 0 (0) Kansas 16 (<1) 0 (0) Kentucky 24 (1) 0 (0) Louisiana 34 (1) 0 (0) Maine 12 (<1) 0 (0) Maryland 105 (3) 0 (0) Massachusetts 101 (3) 0 (0) Michigan 62 (2) 0 (0) Minnesota 47 (1) 0 (0) Mississippi 23 (1) 0 (0) Missouri 32 (1) 0 (0) Montana 7 (<1) 0 (0) Nebraska 12 (<1) 0 (0) Nevada 15 (<1) 0 (0) http://www.cdc.gov/zika/geo/united-states.html

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of October 26, 2016)§ States Travel-associated cases* No. (% of cases in states) (N=3,952) Locally acquired cases† No. (% of cases in states) (N=139) Alabama 28 (1) 0 (0) Arizona 40 (1) 0 (0) Arkansas 13 (<1) 0 (0) California 309 (8) 0 (0) Colorado 46 (1) 0 (0) Connecticut 58 (1) 0 (0) Delaware 16 (<1) 0 (0) District of Columbia 25 (1) 0 (0) Florida 708 (18) 139 (100) Georgia 93 (2) 0 (0) Hawaii 14 (<1) 0 (0) Idaho 4 (<1) 0 (0) Illinois 76 (2) 0 (0) Indiana 40 (1) 0 (0) Iowa 17 (<1) 0 (0) Kansas 16 (<1) 0 (0) Kentucky 24 (1) 0 (0) Louisiana 34 (1) 0 (0) Maine 12 (<1) 0 (0) Maryland 105 (3) 0 (0) Massachusetts 101 (3) 0 (0) Michigan 62 (2) 0 (0) Minnesota 47 (1) 0 (0) Mississippi 23 (1) 0 (0) Missouri 32 (1) 0 (0) Montana 7 (<1) 0 (0) Nebraska 12 (<1) 0 (0) http://www.cdc.gov/zika/geo/united-states.html

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of October 26, 2016)§ States Travel-associated cases* No. (% of cases in states) (N=3,952) Locally acquired cases† No. (% of cases in states) (N=139) Alabama 28 (1) 0 (0) Arizona 40 (1) 0 (0) Arkansas 13 (<1) 0 (0) California 309 (8) 0 (0) Colorado 46 (1) 0 (0) Connecticut 58 (1) 0 (0) Delaware 16 (<1) 0 (0) District of Columbia 25 (1) 0 (0) Florida 708 (18) 139 (100) Georgia 93 (2) 0 (0) Hawaii 14 (<1) 0 (0) Idaho 4 (<1) 0 (0) Illinois 76 (2) 0 (0) Indiana 40 (1) 0 (0) Iowa 17 (<1) 0 (0) Kansas 16 (<1) 0 (0) Kentucky 24 (1) 0 (0) Louisiana 34 (1) 0 (0) Maine 12 (<1) 0 (0) Maryland 105 (3) 0 (0) Massachusetts 101 (3) 0 (0) Michigan 62 (2) 0 (0) Minnesota 47 (1) 0 (0) Mississippi 23 (1) 0 (0) Missouri 32 (1) 0 (0) http://www.cdc.gov/zika/geo/united-states.html

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of October 26, 2016)§ States Travel-associated cases* No. (% of cases in states) (N=3,952) Locally acquired cases† No. (% of cases in states) (N=139) Alabama 28 (1) 0 (0) Arizona 40 (1) 0 (0) Arkansas 13 (<1) 0 (0) California 309 (8) 0 (0) Colorado 46 (1) 0 (0) Connecticut 58 (1) 0 (0) Delaware 16 (<1) 0 (0) District of Columbia 25 (1) 0 (0) Florida 708 (18) 139 (100) Georgia 93 (2) 0 (0) Hawaii 14 (<1) 0 (0) Idaho 4 (<1) 0 (0) Illinois 76 (2) 0 (0) Indiana 40 (1) 0 (0) Iowa 17 (<1) 0 (0) Kansas 16 (<1) 0 (0) Kentucky 24 (1) 0 (0) Louisiana 34 (1) 0 (0) Maine 12 (<1) 0 (0) Maryland 105 (3) 0 (0) Massachusetts 101 (3) 0 (0) http://www.cdc.gov/zika/geo/united-states.html

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of October 26, 2016)§ States Travel-associated cases* No. (% of cases in states) (N=3,952) Locally acquired cases† No. (% of cases in states) (N=139) Alabama 28 (1) 0 (0) Arizona 40 (1) 0 (0) Arkansas 13 (<1) 0 (0) California 309 (8) 0 (0) Colorado 46 (1) 0 (0) Connecticut 58 (1) 0 (0) Delaware 16 (<1) 0 (0) District of Columbia 25 (1) 0 (0) Florida 708 (18) 139 (100) Georgia 93 (2) 0 (0) Hawaii 14 (<1) 0 (0) Idaho 4 (<1) 0 (0) Illinois 76 (2) 0 (0) Indiana 40 (1) 0 (0) Iowa 17 (<1) 0 (0) Kansas 16 (<1) 0 (0) http://www.cdc.gov/zika/geo/united-states.html

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of October 26, 2016)§ States Travel-associated cases* No. (% of cases in states) (N=3,952) Locally acquired cases† No. (% of cases in states) (N=139) Alabama 28 (1) 0 (0) Arizona 40 (1) 0 (0) Arkansas 13 (<1) 0 (0) California 309 (8) 0 (0) Colorado 46 (1) 0 (0) Connecticut 58 (1) 0 (0) Delaware 16 (<1) 0 (0) http://www.cdc.gov/zika/geo/united-states.html

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of October 26, 2016)§ States Travel-associated cases* No. (% of cases in states) (N=3,952) Locally acquired cases† No. (% of cases in states) (N=139) Alabama 28 (1) 0 (0) Arizona 40 (1) 0 (0) Arkansas 13 (<1) 0 (0) California 309 (8) 0 (0) Colorado 46 (1) 0 (0) http://www.cdc.gov/zika/geo/united-states.html

Pregnant Women with Any Laboratory Evidence of Possible Zika Virus Infection US States and the District of Columbia* 953 *Includes aggregated data reported to the US Zika Pregnancy Registry as of October 20, 2016 US Territories** 2,027 **Includes aggregated data from the US territories reported to the US Zika Pregnancy Registry and data from Puerto Rico reported to the Zika Active Pregnancy Surveillance System as of October 20, 2016

As of October 26, 2016 (5 am EST) Zika virus disease and Zika virus congenital infection are nationally notifiable conditions. This update from the CDC Arboviral Disease Branch includes provisional data reported to ArboNET for January 01, 2015 – October 26, 2016. US States Locally acquired mosquito-borne cases reported: 139 Travel-associated cases reported: 3,951 Laboratory acquired cases reported: 1 Total: 4,091 Sexually transmitted: 33 Guillain-Barré syndrome: 13 MAPS OF ZIKA IN THE US More US Territories Locally acquired cases reported: 28,627 Travel-associated cases reported: 96 Total: 28,723* Guillain-Barré syndrome: 43 *Sexually transmitted cases are not reported for US territories because with local transmission of Zika virus it is not possible to determine whether infection occurred due to mosquito-borne or sexual transmission. Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of October 26, 2016)§ States Travel-associated cases* No. (% of cases in states) (N=3,952) Locally acquired cases† No. (% of cases in states) (N=139) Alabama 28 (1) 0 (0) Arizona 40 (1) 0 (0) Arkansas 13 (<1) 0 (0) California 309 (8) 0 (0) Colorado 46 (1) 0 (0) Connecticut 58 (1) 0 (0) Delaware 16 (<1) 0 (0) District of Columbia 25 (1) 0 (0) Florida 708 (18) 139 (100) Georgia 93 (2) 0 (0) Hawaii 14 (<1) 0 (0) Idaho 4 (<1) 0 (0) Illinois 76 (2) 0 (0) Indiana 40 (1) 0 (0) Iowa 17 (<1) 0 (0) Kansas 16 (<1) 0 (0) Kentucky 24 (1) 0 (0) Louisiana 34 (1) 0 (0) Maine 12 (<1) 0 (0) Maryland 105 (3) 0 (0) Massachusetts 101 (3) 0 (0) Michigan 62 (2) 0 (0) Minnesota 47 (1) 0 (0) Mississippi 23 (1) 0 (0) Missouri 32 (1) 0 (0) Montana 7 (<1) 0 (0) Nebraska 12 (<1) 0 (0) Nevada 15 (<1) 0 (0) New Hampshire 10 (<1) 0 (0) New Jersey 134 (3) 0 (0) New Mexico 9 (<1) 0 (0) New York 886 (22) 0 (0) North Carolina 72 (2) 0 (0) North Dakota 2 (<1) 0 (0) Ohio 67 (2) 0 (0) Oklahoma 27 (1) 0 (0) Oregon 31 (1) 0 (0) Pennsylvania†† 147 (4) 0 (0) Rhode Island 32 (1) 0 (0) South Carolina 53 (1) 0 (0) South Dakota 2 (<1) 0 (0) Tennessee 53 (1) 0 (0) Texas 232 (6) 0 (0) Utah 14** (<1) 0 (0) Vermont 9 (<1) 0 (0) Virginia 88 (2) 0 (0) Washington 51 (1) 0 (0) West Virginia 11 (<1) 0 (0) Wisconsin 43 (1) 0 (0) Wyoming 2 (<1) 0 (0) Territories Travel-associated cases* No. (% of cases in territories) (N=96) Locally acquired cases† No. (% of cases in territories) (N=28,627) American Samoa 7 (7) 47 (<1) Puerto Rico 87 (91) 28,111*** (98) US Virgin Islands 2 (2) 469 (2) §Only includes cases meeting the probable or confirmed CSTE case definition and does not include asymptomatic infections unless the case is a pregnant woman with a complication of pregnancy *Travelers returning from affected areas, their sexual contacts, or infants infected in utero †Presumed local mosquito-borne transmission ††One additional case acquired through laboratory transmission **Includes one case with unknown route of person-to-person transmission. ***The Puerto Rico Department of Health is retroactively reporting cases, resulting in larger than normal increases in cases in recent weeks. Page last reviewed: October 26, 2016 Page last updated: October 26, 2016 Content source: Centers for Disease Control and Prevention National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Division of Vector-Borne Diseases (DVBD)