niman

CDPH Weekly Update on Number of Zika Virus Infections in California August 5, 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 August 5, 2016, there have been 134 travel-associated Zika virus infections in California. • Total infections: 134 (includes 14 new infections confirmed this past week and 6 infections reclassified due to national reporting changes) • Cumulative number of infections due to sexual transmission: 1 • Cumulative number of infections in pregnant women: 23a o Liveborn infants with birth defects: 2b o Pregnancy losses with birth defects: 0c Zika virus infections in California, 2015-2016d (as of August 5, 2016) County Travel-associated e Locally acquired f Alameda 10 0 Contra Costa 7 0 Fresno 1 0 Los Angeles 29 0 Marin 1 0 Merced 3 0 Monterey 1 0 Napa 2 0 Orange 10 0 Riverside 3 0 San Bernardino 7 0 San Diego 23g 0 San Francisco 10 0 San Joaquin 3 0 San Mateo 3 0 Santa Clara 10 0 Santa Cruz 1 0 Solano 1 0 Sonoma 2 0 Stanislaus 2 0 Tulare 2 0 Yolo 2 0 Yuba 1 0 Total 134 0 https://www.cdph.ca.gov/HealthInfo/discond/Documents/TravelAssociatedCasesofZikaVirusinCA.pdf

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

This week, the Louisiana Department of Health has confirmed four additional cases of Zika virus. As in all of the other cases in Louisiana, the patients travelled to regions in the Americas with ongoing Zika transmission and sought medical care in Louisiana after returning, where tests confirmed the viral infection. This brings the total to 19 cases of travel-associated Zika confirmed in Louisiana. http://www.dhh.louisiana.gov/index.cfm/newsroom/detail/3924

Department Reports Four Additional Travel-Related Zika Cases in Louisiana August 05, 2016 Total of 19 state residents have had the infection, all are travel-related cases Baton Rouge, La. – This week, the Louisiana Department of Health has confirmed four additional cases of Zika virus. As in all of the other cases in Louisiana, the patients travelled to regions in the Americas with ongoing Zika transmission and sought medical care in Louisiana after returning, where tests confirmed the viral infection. This brings the total to 19 cases of travel-associated Zika confirmed in Louisiana. Although the state of Florida has reported several locally transmitted cases in that state, this is not the situation in Louisiana. Local transmission occurs when an infected mosquito in the area bites another person in the area and transmits the virus. This local transmission is much more likely in the parishes around Lake Pontchartrain than other areas of the state. National and state case counts compiled by the CDC can be found here. Once a travel-related case is identified, public health officials and local mosquito control agencies are notified to take action to minimize the potential for local spread. Early Detection Efforts in Louisiana Public health officials in Louisiana are on high alert to detect and report Zika virus cases as early as possible. According to Dr. Frank Welch, Medical Director for the department’s Bureau of Community Preparedness, the early detection of Zika virus is a key strategy to prevent its spread. “Our surveillance activities include working with hospitals and other health care providers who notify us if and when a possible Zika case is diagnosed, “Welch said. “We also work with mosquito control agencies throughout the state who conduct mosquito testing in areas of known human cases to determine if mosquitos in those areas are carrying the virus." Avoiding Infection by Zika Virus State health officials work with local officials and the healthcare community throughout Louisiana to educate and develop prevention strategies against the local spread of the Zika virus. Working with parishes where we have both returning travelers from Zika affected areas and the mosquito that spreads Zika is doubly important. Zika virus is of greatest threat to pregnant women, as their child may be at risk for certain severe birth defects as a result of infection. Pregnant women and women trying to get pregnant should avoid travel to areas with Zika transmission. The CDC has a list of travel notices for these areas here. Because Zika can spread through sexual activity, pregnant women should have their partners use a condom correctly every time or abstain from sex. All travelers to areas where Zika virus is active should be aware and take the following steps to protect themselves from mosquito bites: Use an EPA-approved insect repellent. Wear light-colored, long sleeves and pants. Sleep under a mosquito net if you are outdoors or in an area without door and window screens. The same precautions apply at home, and people should also make sure their house is mosquito-proof by ensuring their windows and doors have intact screens. Once a week or after every rainfall, empty standing water from any containers around your home, especially in small containers. For more information about preventing Zika virus, visit ldh.la.gov/zika. The Louisiana Department of Health strives to protect and promote health statewide and to ensure access to medical, preventive and rehabilitative services for all state residents. To learn more about LDH, visit www.ldh.la.gov. For up-to-date health information, news and emergency updates, follow LDH's Twitter account and Facebook. http://www.dhh.louisiana.gov/index.cfm/newsroom/detail/3924

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

August 5, 2016 DEPARTMENT OF HEALTH DAILY ZIKA UPDATE Contact: Communications [email protected] (850) 245-4111 Tallahassee, Fla.—In an effort to keep Florida residents and visitors safe and aware about the status of the Zika virus, the department will continue to issue a Zika virus update each week day at 2 p.m. Updates will include a CDC-confirmed Zika case count by county and information to better keep Floridians prepared. There are 13 new travel-related cases today with five in Orange County, three in Seminole County, two in Brevard County, two in Palm Beach County and one in St. Lucie County. Please visit our website to see the full list of travel-related cases. There is one new non-travel related case today inside the identified one-square mile in Miami-Dade County. This individual was tested as one of the 26 close contacts around the two original cases. This case is considered probable and has been sent to CDC for confirmatory testing, along with the three other probable cases. For a complete breakdown of non-travel and travel-related Zika infections to-date, please see below. Infection Type Infection Count Travel-Related Infections of Zika 351 Non-Travel Related Infections of Zika 16 Infections Involving Pregnant Women 55 ACTIVE INVESTIGATIONS 1) Identified one-square mile in Miami-Dade: Original two cases in the area of interest in Miami-Dade: tested 26 close contacts, one confirmed and four probable; 52 individuals from the community have been tested, six were positive but asymptomatic 142 individuals in the northwest quadrant of the identified area have been tested; only one travel-related infection was identified. After this very intensive active case finding, the department did not identify any additional cases of local transmission. No additional active surveillance is planned in the northwest section of the identified square mile area. Yesterday, 42 samples were collected for testing. Mosquito abatement and reduction activities are on-going. 2) Miami-Dade investigation outside the one-square mile: Testing has been completed for 11 individuals with no additional positives. Sample collection and door-to-door outreach continues. Mosquito abatement and reduction activities are on-going. CLOSED INVESTIGATIONS The department has closed out the investigations into the first cases in Miami-Dade and Broward County. The department tested 124 close contacts and individuals from the community and found no additional positives. On August 4, the department announced we have completed testing in a 10 block area of the northwest quadrant of the one-square mile area and no people within the 10 block radius tested positive. The department has cleared that area and is continuing to test people within the one-square mile radius. A map detailing the area is below. The department still believes active transmission is only taking place within the identified one-square mile area in Miami-Dade County. There are no active investigations in Broward County and no areas of active transmission in Broward County. One case does mean active transmission is taking place and that’s why the department conducts a thorough investigation by sampling close contacts and community members around each case to determine if additional people are infected. The department has not yet determined where the individual likely contracted Zika and will share more details as the investigation progresses. If the department finds evidence that active transmission is occurring in an area, we will notify the media and the public. The department has conducted testing for the Zika virus for more than 2,460 people statewide. Florida currently has the capacity to test 6,239 people for active Zika virus and 1,840 for Zika antibodies. The department still believes active transmissions of the Zika virus are occurring in one small area in Miami-Dade County, just north of downtown. The exact location is within the boundaries of the following area: NW 5th Avenue to the west, US 1 to the east, NW/NE 38th Street to the north and NW/NE 20thStreet to the south. This area is about one square mile and a map is below to detail the area. This remains the only area of the state where the department has confirmed there are local transmissions of Zika. If investigations reveal additional areas of likely active transmission, the department will announce a defined area of concern. CDC recommends that women who are pregnant or thinking of becoming pregnant postpone travel to areas with widespread Zika infection. Florida’s small case cluster is not considered widespread transmission, however, pregnant women are advised to avoid non-essential travel to the impacted area in Miami-Dade County (see map below). If you are pregnant and must travel or if you live or work in the impacted area, protect yourself from mosquito bites by wearing insect repellent, long clothing and limiting your time outdoors. According to CDC guidance, providers should consider testing all pregnant women with a history of travel to a Zika affected area for the virus. It is also recommended that all pregnant women who reside in or travel frequently to the area where active transmission is likely occurring be tested for Zika in the first and second trimester. Pregnant women in the identified area can contact their medical provider or their local county health department to be tested and receive a Zika prevention kit. CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. Additionally, the department is working closely with the Healthy Start Coalition of Miami-Dade County to identify pregnant women in the one square mile area to ensure they have access to resources and information to protect themselves. CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. Florida has been monitoring pregnant women with evidence of Zika regardless of symptoms since January. The total number of pregnant women who have been or are being monitored is 55. On Feb. 12, Governor Scott directed the State Surgeon General to activate a Zika Virus Information Hotline for current Florida residents and visitors, as well as anyone planning on traveling to Florida in the near future. The hotline, managed by the Department of Health, has assisted 3,079 callers since it launched. The number for the Zika Virus Information Hotline is 1-855-622-6735. The department urges Floridians to drain standing water weekly, no matter how seemingly small. A couple drops of water in a bottle cap can be a breeding location for mosquitoes. Residents and visitors also need to use repellents when enjoying the Florida outdoors. For more information on DOH action and federal guidance, please click here. For resources and information on Zika virus, click here. About the Florida Department of Health The department, nationally accredited by the Public Health Accreditation Board, works to protect, promote and improve the health of all people in Florida through integrated state, county and community efforts. Follow us on Twitter at @HealthyFla and on Facebook. For more information about the Florida Department of Health, please visit www.FloridaHealth.gov.

There is one new non-travel related case today inside the identified one-square mile in Miami-Dade County. This individual was tested as one of the 26 close contacts around the two original cases. This case is considered probable and has been sent to CDC for confirmatory testing, along with the three other probable cases. http://www.floridahealth.gov/newsroom/2016/08/080516-zika-update.html

Louisiana tally page (Newsroom) http://www.dhh.louisiana.gov/index.cfm/page/2478

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

July 29, 2016 Today, the Louisiana Department of Health has confirmed one additional case of Zika virus. As in all of the other cases in Louisiana, this patient travelled to a region with ongoing Zika transmission and sought medical care in Louisiana after returning, where tests confirmed the viral infection. This brings the total to 15 cases of travel-associated Zika confirmed in Louisiana. http://www.dhh.louisiana.gov/index.cfm/newsroom/detail/3914

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

The first case of Zika in Idaho was discovered in Rathdrum, Idaho health officials said. The 60-year-old woman had recently traveled to Mexico where she got the virus. It is the first reported case in the state and Idaho is now the 47th state to report a travel-related Zika this year. She did show classic symptoms of Zika, including fever, rash, achy joints, and pinkeye. The symptoms did not require hospitalization, health officials said. http://www.krem.com/news/local/kootenai-county/rathdrum-woman-tests-positive-for-zika/286757870

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

RiverStone Health and the Montana Department of Public Health and Human Services confirmed Wednesday the first Zika virus case has been reported in Yellowstone County. This marks the fourth reported case in Montana and was discovered in an adult male who traveled to an affected area. A press release by RiverStone Health did not clarify exactly where the man traveled to or the severity of his symptoms. http://www.kxlf.com/story/32680589/first-case-of-zika-reported-in-yellowstone-county

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

Current Indiana Zika Count There are 27 confirmed cases of Zika in Indiana as of August 5, 2016. Note: These numbers are updated each week on Friday. http://in.gov/isdh/26910.htm

Current Indiana Zika Count There are 27 confirmed cases of Zika in Indiana as of August 5, 2016. Note: These numbers are updated each week on Friday.

Indiana has started a Zika tally page http://in.gov/isdh/26910.htm

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

Wisconsin Annual Summary Data - 2016 Updated August 3, 2016 Confirmed Zika virus cases 18 Probable* Zika virus cases 0 Completed testing - Total 573 * 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 August 3, 2016 Confirmed Zika virus cases 18 Probable* Zika virus cases 0 Completed testing - Total 573 * Probable cases have presumptive positive laboratory results without confirmatory CDC testing.

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

Current as of August 3, 2016 Table: Travel History of Patients with Positive Test Results by Zika Affected Country or Territory Visited - Connecticut, February 15 - August 3, 2016 Countries/Territories Visited Zika Positive Flavivirus Positive* Total Aruba 1 1 Belize 1 1 Brazil 1 1 Colombia 2 1 3 Dominican Republic 23 1 24 El Salvador 1 1 Guatemala 1 1 2 Haiti 1 3 4 Honduras 2 1 3 Jamaica 4 4 Mexico 1 1 Nicaragua 1 1 Puerto Rico 11 1 12 St. Lucia 2 2 U.S. Virgin Islands 1 1 Venezuela 2 2 Total 49 14 63

Zika Virus Testing, Cumulative Results Current as of August 3, 2016 Table: Travel History of Patients with Positive Test Results by Zika Affected Country or Territory Visited - Connecticut, February 15 - August 3, 2016 Countries/Territories Visited Zika Positive Flavivirus Positive* Total Aruba 1 1 Belize 1 1 Brazil 1 1 Colombia 2 1 3 Dominican Republic 23 1 24 El Salvador 1 1 Guatemala 1 1 2 Haiti 1 3 4 Honduras 2 1 3 Jamaica 4 4 Mexico 1 1 Nicaragua 1 1 Puerto Rico 11 1 12 St. Lucia 2 2 U.S. Virgin Islands 1 1 Venezuela 2 2 Total 49 14 63 *Test results unable to distinguish between Zika virus, a single-stranded RNA virus in the genusFlavivirus, and others that are closely related including dengue, West Nile, Japanese encephalitis, and yellow fever viruses1. A positive test may mean infection with any of these viruses. Figure: Number of Patients with Positive Zika Virus Test Result by Test Type and Month of Specimen Collection - Connecticut, February 15 - August 3, 2016 Tests Performed for Diagnosis of Zika Virus Infection