niman

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8.26.16 1 x x x x 9.2.16 1 x x x x Totals 15 6 9 1 6 5 3 15 7 6 2 http://idph.iowa.gov/Portals/1/userfiles/7/Zika update 09022016.pdf

Sep 2 update

Aug 26 update

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of August 31, 2016)§ http://www.cdc.gov/zika/geo/united-states.html States Travel-associated cases* No. (% of cases in states) (N=2,687) Locally acquired cases† No. (% of cases in states) (N=35) Alabama 24 (1) 0 (0) Arizona 20 (1) 0 (0) Arkansas 9 (<1) 0 (0) California 152 (6) 0 (0) Colorado 27 (1) 0 (0) Connecticut 52 (2) 0 (0) Delaware 11 (<1) 0 (0) District of Columbia 11 (<1) 0 (0) Florida 507 (19) 35 (100) Georgia 69 (3) 0 (0) Hawaii 11 (<1) 0 (0) Idaho 2 (<1) 0 (0)

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of August 31, 2016)§ http://www.cdc.gov/zika/geo/united-states.html States Travel-associated cases* No. (% of cases in states) (N=2,687) Locally acquired cases† No. (% of cases in states) (N=35) Alabama 24 (1) 0 (0) Arizona 20 (1) 0 (0) Arkansas 9 (<1) 0 (0) California 152 (6) 0 (0) Colorado 27 (1) 0 (0)

Malaysia detects first locally-transmitted Zika case Source: Xinhua 2016-09-03 18:08:09 KUALA LUMPUR, Sept. 3 (Xinhua)-- Malaysia's Ministry of Health said on Saturday that they detected possibly the country's first locally-transmitted Zika case in a 61-year-old man in Sabah on the Kalimantan island. "The ministry is currently investigating the travel history of the patient in the recent period,"said the statement, noting that there is a high possibility that the infection was transmitted locally since the patient has not travelled abroad recently and it was likely he got bitten by an Aedes mosquito carrying Zika. According to the statement, the man first showed symptoms of a fever on Aug. 27 and sought treatment at local clinic. As his conditions worsened and began to have more symptoms such as muscle aches and diarrhea, he had further treatment at a hospital. As he was also suffering from other diseases such high blood pressure, cardiovascular problems and chronic kidney disease, his condition was very serious at the hospital, but not due to Zika infection, said the statement. It added vector control measures have been taken in the residential area and other places visited by the patient. Given that the virus has been detected in this country, more Zika cases are expected if no precaution measures are taken by the community and the people, said the ministry. Malaysia confirmed its first Zika case on Thursday in a 58-year-old woman who had visited her daughter in Singapore. http://news.xinhuanet.com/english/2016-09/03/c_135657623.htm

SEPTEMBER 2, 2016 7:30 PM Six more local Zika infections in Miami Beach, city officials say PATRICK FARRELL BY DANIEL CHANG AND JOEY FLECHAS [email protected] LINKEDIN GOOGLE+ PINTEREST REDDIT PRINT ORDER REPRINT OF THIS STORY Miami Beach officials on Friday reported six new local Zika infections linked to their city, announcing the news through social media. The Florida Department of Health typically announces new cases, but state offices in Tallahassee were closed due toHurricane Hermine. The department late Friday confirmed the cases. Interactive feature: Daily Florida Zika virus tracker Commissioner Michael Grieco firstannounced the news via FacebookFriday afternoon, posting a message along with a photo of a resolution he drafted opposing aerial spraying of pesticides in Miami Beach to control mosquitoes that spread Zika. Grieco said he posted the note to “get information out as quickly and clearly as possible so people are informed,” adding that he doesn’t post unless it’s important. “I don’t tell people about puppy dogs and ice cream,” he said. The state health department has previously reported at least six other cases linked to Miami Beach. Gov. Rick Scott declared a public health emergency for Zika in February for affected counties. On Thursday, the state’s Department of Agriculture and Consumer Services reported that mosquitoes trapped on South Beach had tested positive for Zika — the first conclusive proof that insects in the U.S. are carrying the virus. The finding verified what health officials have known since at least July 29, when they identified a one-square-mile section of Miami’s Wynwood neighborhood as the first in the nation where mosquitoes were spreading Zika. A second area with active spread of the disease was identified on Aug. 19, when health officials said mosquitoes were transmitting the virus in a 1.5-square-mile section of Miami Beach. The agriculture department said Zika-positive mosquitoes were found in three traps located in the area of Miami Beach where the virus is spreading, but they identified only one place: the Miami Beach Botanical Garden, which closed on Monday. State officials have refused to identify the other two locations in Miami Beach where mosquitoes tested positive for Zika, citing a statutory exemption for epidemiological investigations. In response to the finding of Zika-positive mosquitoes, the governor issued a press release stating that the Centers for Disease Control and Prevention had recommended aerial spraying on Miami Beach by helicopter — something Grieco said he and his constituents strongly oppose. “I would say for every person that had a concern about the virus, five to 10 people were exponentially more concerned about the potential of Naled aerial spraying in Miami Beach,” he said. Zika guide Questions about Zika? We’ve got you drained and covered From A to Zika: Answers to key questions How do you know if you have Zika and what happens if you aren’t pregnant? 15 ways to protect yourself against Zika Florida has reported a total of 49 local Zika infections, not including the cases identified by Miami Beach officials on Friday. An additional 656 Floridians, including 80 pregnant women, have acquired the disease this year after traveling outside the country to places where Zika is widespread. Miami Beach officials were first informed of the new cases at 3 p.m. in an email from City Manager Jimmy Morales’ office, which noted that, “We have been notified by the Department of Health that at 4 p.m. today they will be announcing the confirmation of six new Zika cases on Miami Beach.” Miami Beach Mayor Philip Levine said the health department held a conference call with city officials at 4 p.m. and also informed them of the new cases linked to the Beach. Miami Herald staff writer Alex Harris contributed to this report. Read more here: http://www.miamiherald.com/news/health-care/article99677017.html#storylink=cpy

Miami Beach officials on Friday reported six new local Zika infections linked to their city, announcing the news through social media. The Florida Department of Health typically announces new cases, but state offices in Tallahassee were closed due toHurricane Hermine. The department late Friday confirmed the cases. http://www.miamiherald.com/news/health-care/article99677017.html Read more here: http://www.miamiherald.com/news/health-care/article99677017.html#storylink=cpy

SEP 2 2016, 2:23 PM ET Zika Count Rises to 189 in Singapore by MAGGIE FOX SHARE Singapore reported another big batch of Zika virus cases Friday, bringing its total count in just a week to 189, and World Health Organization officials said the spread of the virus definitely still constitutes a global health emergency. Zika's apparent quick spread out of Latin America back to Asia and Africa has WHO officials worried. They have no idea if the virus will spread as explosively as it has in the Americas, and they cannot predict if it will cause a fresh wave of birth defects and side-effects such as the paralyzing Guillain-Barré syndrome. Miami-Dade mosquito control worker Carlos Vargas looks for the Aedes aegypti mosquito larvae at a home in Miami, Florida, on June 8. Of the 40 different types of mosquito found in Miami-Dade, the Aedes aegypti mosquito, or yellow fever mosquito, is responsible for transmitting diseases such as the Zika virus. Rhona Wise / AFP - Getty Images They don't even know if they can keep track of it if it spreads into countries with poor healthcare systems and little facility to test people for the virus. "There's still an urgent need to continue global research and this still does remain an emergency of international concern," said Dr. David Heymann, chairman of WHO's emergency committee. "ZIKA IS BEGINNING TO SPREAD, CONTINUING TO CAUSE OUTBREAKS IN MANY COUNTRIES AROUND THE WORLD." "This extraordinary event is rapidly becoming, unfortunately, an ordinary event. And Zika is beginning to spread, continuing to cause outbreaks in many countries around the world," Heymann told reporters. Related: Zika Took Her Baby Tiny Singapore — the city-state is only about two-thirds the size of Washington, D.C. — only first saw Zika a week ago. It's moved quickly to try to contain local spread of the virus, carried by the same mosquitoes that spread dengue virus. It has also quickly reported every case it finds to WHO. "The way the government of Singapore has handled the outbreak really represents a role model," said Dr. Peter Salama, executive director of WHO's Health Emergency Program. It's not entirely certain that the strain is the same one that swept across Latin America, causing at least two outbreaks in south Florida, Salam added. Genetic sequencing can determine that. Experts are worried because they cannot predict what Zika will do. The virus was first identified back in 1947 and seemed relatively innocuous. When it did infect people, which appeared to be rarely, it didn't even cause symptoms in most of them and appeared to cause, at worst, a rash, muscle aches and fever. But when it showed up in Brazil, authorities immediately noticed a giant increase in cases of microcephaly, a severe birth defect defined by a small head. It's caused when the virus attacks the brain cells in a developing fetus, killing them off and stunting the growth of the skull. Related: Expect More U.S. Zika Cases Now Zika has been shown to cause a range of other, sometimes less-visible birth defects. There's no doubt it's the virus causing them — it's been found in the damaged brain tissue of miscarried babies and lab experiments have shown that the virus zeros in on immature brain cells. It's also causing a rare paralyzing side effect seen with other infections calledGuillain-Barré syndrome. The question no one can answer is whether all this is new. "A year ago, there wasn't a test for Zika," says U.S. Centers for Disease Control and Prevention Director Dr. Tom Frieden. Zika is closely related to dengue and chikungunya and tests mix them up. There had not been a good test that could tell if someone was infected with Zika in the past, and no one can say how many people in Asia or Africa have been infected with Zika previously — or whether they will be immune if it comes around again. There are two known strains of Zika: One that originated in Africa, and the one that spread from Asia to Latin America. "This is a new manifestation of an old disease," Salama said. "THIS IS A NEW MANIFESTATION OF AN OLD DISEASE." Added to all that, Zika is difficult to prevent. Most people don't show obvious symptoms when they are infected, making it hard to track. They can unknowinglyspread it through sex, or infect mosquitoes that can then bite someone else. The Aedes mosquitoes that spread Zika are very hard to kill, and the steady march of the virus illustrates just how easily travelers can carry it from one country to another. "Even if they do not feel sick, travelers returning to the United States from Singapore should take steps to prevent mosquito bites for three weeks so that they do not spread Zika to uninfected mosquitoes," the CDC advises. Related: Hiding in the Bushes: Florida Blames Bromeliads for Zika The same advice goes for any country or territory with active Zika outbreaks — including parts of Miami. "Travelers returning from Singapore who have a pregnant partner should either use condoms or not have sex for the rest of the pregnancy," the CDC adds. "People who have traveled to Singapore should use condoms for at least eight weeks after travel to protect their sex partners. Men who have Zika symptoms or are diagnosed with Zika should use condoms for at least six months after symptoms start; women with symptoms should use condoms for at least eight weeks after symptoms start." People in Zika zones should use mosquito repellent, cover up and stay inside behind screens as possible, the CDC and WHO both advise. And women who might become pregnant need full access to birth control, they both added. http://www.nbcnews.com/storyline/zika-virus-outbreak/zika-count-rises-189-singapore-n642141

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CDPH Weekly Update on Number of Zika Virus Infections in California September 2, 2016 The following table provides the number of travel-associated infections with Zika virus in California residents in 2015 and 2016. CDPH is following CDC testing guidelines. This table is updated every Friday. As of September 2, 2016, there have been 241 travel-associated Zika virus infections in California. Please note that, with commercial laboratories now conducting Zika testing in CA, the number of cases reported this week increased substantially. This upward trend is likely to continue. • Total infections: 241 • New infections reported this week: 52 • Cumulative number of infections due to sexual transmission: 1 • Cumulative number of infections in pregnant women: 32a o Liveborn infants with birth defects: 2b o Pregnancy losses with birth defects: 0c Zika virus infections in California, 2015-2016d (as of September 2, 2016) County Travel-associated e Locally acquired f Alameda (City of Berkeley) 16g (1) 0 Contra Costa 11 0 Fresno 1 0 Kern 2 0 Lake 1 0 Los Angeles (City of Long Beach) 64h (1) 0 Marin 4 0 Merced 3 0 Monterey 2 0 Napa 2 0 Orange 16 0 Riverside 7 0 Sacramento 4 0 San Bernardino 8 0 San Diego 34i 0 San Francisco 20 0 San Joaquin 5 0 San Mateo 5 0 Santa Barbara 2 0 Santa Clara 15 0 Santa Cruz 1 0 Solano 1 0 Sonoma 5 0 Stanislaus 2 0 Tulare 3 0 Ventura 2 0 Yolo 4 0 Yuba 1 0 Total 241 0 a Local Health Departments and CDPH are monitoring all pregnant women and their infants b Includes microcephaly, calcium deposits in the brain indicating possible brain damage, excess fluid in the brain cavities and surrounding the brain, absent or poorly formed brain structures, abnormal eye development, or other problems resulting from damage to the brain that affects nerves, muscles and bones, such as clubfoot or inflexible joints. c Includes miscarriage, stillbirths, and terminations with evidence of the birth defects mentioned above d Total number includes laboratory-confirmed and probable infections as defined by the CSTE Position Statement e Persons exposed through travel to an affected area or contact with a traveler f Presumed local mosquito-borne transmission g Includes one resident of the City of Berkeley h Includes one resident of the City of Long Beach I Includes one non-resident https://www.cdph.ca.gov/HealthInfo/discond/Documents/TravelAssociatedCasesofZikaVirusinCA.pdf

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of August 31, 2016)§ http://www.cdc.gov/zika/geo/united-states.html States Travel-associated cases* No. (% of cases in states) (N=2,687) Locally acquired cases† No. (% of cases in states) (N=35) Alabama 24 (1) 0 (0) Arizona 20 (1) 0 (0) Arkansas 9 (<1) 0 (0) California 152 (6) 0 (0) Colorado 27 (1) 0 (0) Connecticut 52 (2) 0 (0) Delaware 11 (<1) 0 (0) District of Columbia 11 (<1) 0 (0) Florida 507 (19) 35 (100) Georgia 69 (3) 0 (0) Hawaii 11 (<1) 0 (0) Idaho 2 (<1) 0 (0) Illinois 51 (2) 0 (0) Indiana 31 (1) 0 (0) Iowa 14 (1) 0 (0) Kansas 13 (<1) 0 (0) Kentucky 20 (1) 0 (0) Louisiana 26 (1) 0 (0) Maine 11 (<1) 0 (0) Maryland 85 (3) 0 (0) Massachusetts 65 (2) 0 (0) Michigan 43 (2) 0 (0) Minnesota 40 (1) 0 (0)

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of August 31, 2016)§ http://www.cdc.gov/zika/geo/united-states.html States Travel-associated cases* No. (% of cases in states) (N=2,687) Locally acquired cases† No. (% of cases in states) (N=35) Alabama 24 (1) 0 (0) Arizona 20 (1) 0 (0) Arkansas 9 (<1) 0 (0) California 152 (6) 0 (0) Colorado 27 (1) 0 (0) Connecticut 52 (2) 0 (0) Delaware 11 (<1) 0 (0) District of Columbia 11 (<1) 0 (0) Florida 507 (19) 35 (100) Georgia 69 (3) 0 (0) Hawaii 11 (<1) 0 (0) Idaho 2 (<1) 0 (0) Illinois 51 (2) 0 (0) Indiana 31 (1) 0 (0) Iowa 14 (1) 0 (0) Kansas 13 (<1) 0 (0) Kentucky 20 (1) 0 (0) Louisiana 26 (1) 0 (0) Maine 11 (<1) 0 (0) Maryland 85 (3) 0 (0) Massachusetts 65 (2) 0 (0) Michigan 43 (2) 0 (0)

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of August 31, 2016)§ http://www.cdc.gov/zika/geo/united-states.html States Travel-associated cases* No. (% of cases in states) (N=2,687) Locally acquired cases† No. (% of cases in states) (N=35) Alabama 24 (1) 0 (0) Arizona 20 (1) 0 (0) Arkansas 9 (<1) 0 (0) California 152 (6) 0 (0) Colorado 27 (1) 0 (0) Connecticut 52 (2) 0 (0) Delaware 11 (<1) 0 (0) District of Columbia 11 (<1) 0 (0) Florida 507 (19) 35 (100) Georgia 69 (3) 0 (0) Hawaii 11 (<1) 0 (0) Idaho 2 (<1) 0 (0) Illinois 51 (2) 0 (0) Indiana 31 (1) 0 (0) Iowa 14 (1) 0 (0) Kansas 13 (<1) 0 (0) Kentucky 20 (1) 0 (0) Louisiana 26 (1) 0 (0) Maine 11 (<1) 0 (0) Maryland 85 (3) 0 (0) Massachusetts 65 (2) 0 (0)

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County Cases Bell 5 Bexar 9 Brazos 1 Collin 5 Dallas 33 Denton 4 El Paso 2 Ellis 1 Fort Bend 7 Frio 1 Galveston 3 Gray 1 Grayson 1 Gregg 1 Hamilton 1 Harris 45 Jefferson 2 Lubbock 1 Matagorda 1 Medina 1 Midland 1 Montgomery 1 Palo Pinto 1 Randall 1 Tarrant 18 Travis 3 Val Verde 1 Walker 1 Williamson 4 Wise 1 Total 157 Dallas Pregnant Registry 18 Texas Preg Reg excl Dallas 28 Total 203