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At A Glance - Zika in the U.S.(as of July 20, 2016) North CarolinaTravel-associated Zika virus disease cases reported: 21Locally acquired vectorborne cases reported: 0 http://epi.publichealth.nc.gov/zika/

At A Glance - Zika in the U.S.(as of July 20, 2016) North CarolinaTravel-associated Zika virus disease cases reported: 21Locally acquired vectorborne cases reported: 0

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

As of July 22, 201644 confirmed travel-related Zika cases in Georgiahttp://dph.georgia.gov/

As of July 22, 201644 confirmed travel-related Zika cases in Georgia

Alabama Residents Tested for Zika Virus as of July 22, 2016 Number of SubmissionsPositive Test Results for Zika or Flavivirus, unspecified (likely Zika)141 14

NYC reports microcephaly; Florida probes possible 2nd local Zika caseFiled Under: ZikaLisa Schnirring | News Editor | CIDRAP News | Jul 22, 2016Share Tweet LinkedIn Email Print & PDFnyc_sign_post.jpgjoanne1234 / iStockNew York City health officials today reported the first baby born with Zika-related microcephaly in a local hospital, a day after Florida said it was investigating a second suspected local Zika case, this one in Broward County. Elsewhere, Puerto Rico's governor today turned down a Centers for Disease Control and Prevention (CDC) proposal for aerial spraying for mosquitoes. The rapidly evolving developments come a day after federal officials announced $60 million more to help states battle Zika virus and as the nation and its territories are well into their summer mosquito seasons. Baby's mother got sick in an affected areaIn a statement, New York City's health department (NYC Health) said the baby's mother was infected while in an area of ongoing Zika transmission. The baby has been diagnosed as having microcephaly and other brain problems, and tests were positive for Zika virus infection, NYC Health said in a press release. NYC Health Commissioner Mary Bassett, MD, MPH, said in the statement, While not surprising, given the travel trends of our global city, this case is a strong reminder of the tragic consequences of the Zika virus. We are monitoring the baby's health closely and connecting the family with the necessary services to take care of their child." At a media briefing streamed live online today, Bassett said she learned of the case yesterday and that the baby was born this month. To protect the family's privacy health officials offered no other details, but said they were working with the CDC on the case. Jay Varma, MD, the health department's deputy commissioner for disease control, said 41 pregnant women who were infected with Zika virus have been reported in the city, the number is growing, and the cases are being evaluated on a regular basis. NYC Health said the mayor had invested $21 million in Zika preparedness, which included expanding testing capacity and dedicating a call center for health providers to process lab results. As of Jul 15 NYC Health has tested about 2,000 pregnant women. Because of travel patterns and large populations of immigrants from areas where the virus is circulating, and according to the CDC's latest totals, New York leads the nation in travel-related Zika cases. So far the city has reported 346 cases, including 4 sexually transmitted infections. More than half of infected people reported travel to the Dominican Republic. Yesterday in an update the CDC said 18 poor birth outcomes have been reported in pregnant women infected with Zika virus, including 12 live births and 6 pregnancy losses. Florida probes second caseIn other Zika developments, the Florida Department of Health yesterday said it was investigating another suspected case involving local transmission, its second such announcement this week. In a statement, it said the possible nontravel-related case is in Broward County, which neighbors Miami-Dade County, the location of the first suspected local case. In a news release yesterday, Florida Health said Gov Rick Scott asked the state's surgeon general to request help from a CDC medical epidemiologist with investigations into both cases. That help arrived today in the form of Marc Fischer, MD, MPH, a CDC medical epidemiologist, Florida Health said in its daily Zika update. In the press release, Florida Health said Zika kits and repellent are being distributed to pregnant women in the affected area of Broward County, including through doctors' offices. Health officials are asking residents and visitors to cooperate with requests for blood and urine for testing in the investigation areas. In its update today, Florida Health said so far about 200 people have been interviewed and tested as part of the two investigations, that it is waiting for more lab results, and that it would share more details when available. It noted that door-to-door outreach with mosquito control is under way in the homes, workplaces, and other locations the two suspected case-patients frequented. Since yesterday, the state has received reports of 19 more travel-related Zika cases, 1 involving a pregnant woman. It now has 353 such illnesses, 47 of them in pregnant women. News of the first suspected local case prompted OneBlood, which provides blood services throughout Florida and to parts of Georgia and South Carolina, to announce yesterday that it will start testing donated blood for Zika virus on Aug 1 using a new test that was granted emergency use authorization. The first step is to screen a portion of collections in unaffected areas, making those blood products available to hospitals with high-risk patients, such as pregnant women, the company said in a statement. If the case is confirmed as local, OneBlood would stop collections in the affected zip code and supply that area with blood from an unaffected area. Spraying nixed; other developmentsPuerto Rico's governor today rejected a CDC suggestion to begin aerial spraying for mosquitoes with naled, and said he will support spraying with Bti, (Bacillus thuringiensis israelensis) an organic larvicide, the Associated Press (AP) reported today. The CDC has suggested aerial spraying as part of an integrated mosquito control program for the territory, which has been experiencing a surge of Zika activity. According to the AP, Puerto Ricans have organized protests about naled's possible impact on humans and wildlife. Puerto Rico's government was angered when the CDC sent the territory an unannounced shipment of naled, for which the CDC apologized today, saying it moved too quickly in the event that Puerto Rican officials would want to use the pesticide. A multidisciplinary mission will visit Guinea-Bissau next week to help investigate its recent local Zika cases, the World Health Organization (WHO) said in its weekly update yesterday. Four positive samples were sent to the Pasteur Institute in Dakar on July 1 for gene sequencing to determine if the outbreak strain is the one fueling the outbreak in the Americas or the one that has circulated for many decades in Africa. Results are still pending, the WHO said. Colombia's number of Zika-related microcephaly cases and related birth defects continues to grow, with 21 now reported, the WHO also noted in its weekly update. The number increased by 3 from last week. Brazil also reported 22 more confirmed cases, boosting its total to 1,709. The Caribbean island of Saba, a territory of the Netherlands, reported its first local Zika virus transmission, the European Centre for Disease Prevention and Control said today in its latestweekly communicable disease threats report. St Eustatius, Saba's neighbor to the southeast, also recently reported its first local case.See also: Jul 22 NYC Health press release NYC Health Zika background and totals Jul 21 Florida Health press release Jul 22 Florida Health Zika update Jul 21 OneBlood press release Jul 12 CIDRAP News story "Experts warn spraying may not be very effective against Aedes" http://www.cidrap.umn.edu/news-perspective/2016/07/nyc-reports-microcephaly-florida-probes-possible-2nd-local-zika-case

NYC reports microcephaly; Florida probes possible 2nd local Zika caseFiled Under: ZikaLisa Schnirring | News Editor | CIDRAP News | Jul 22, 2016Share Tweet LinkedIn Email Print & PDFnyc_sign_post.jpgjoanne1234 / iStockNew York City health officials today reported the first baby born with Zika-related microcephaly in a local hospital, a day after Florida said it was investigating a second suspected local Zika case, this one in Broward County. Elsewhere, Puerto Rico's governor today turned down a Centers for Disease Control and Prevention (CDC) proposal for aerial spraying for mosquitoes. The rapidly evolving developments come a day after federal officials announced $60 million more to help states battle Zika virus and as the nation and its territories are well into their summer mosquito seasons. Baby's mother got sick in an affected areaIn a statement, New York City's health department (NYC Health) said the baby's mother was infected while in an area of ongoing Zika transmission. The baby has been diagnosed as having microcephaly and other brain problems, and tests were positive for Zika virus infection, NYC Health said in a press release. NYC Health Commissioner Mary Bassett, MD, MPH, said in the statement, While not surprising, given the travel trends of our global city, this case is a strong reminder of the tragic consequences of the Zika virus. We are monitoring the baby's health closely and connecting the family with the necessary services to take care of their child." At a media briefing streamed live online today, Bassett said she learned of the case yesterday and that the baby was born this month. To protect the family's privacy health officials offered no other details, but said they were working with the CDC on the case. Jay Varma, MD, the health department's deputy commissioner for disease control, said 41 pregnant women who were infected with Zika virus have been reported in the city, the number is growing, and the cases are being evaluated on a regular basis. NYC Health said the mayor had invested $21 million in Zika preparedness, which included expanding testing capacity and dedicating a call center for health providers to process lab results. As of Jul 15 NYC Health has tested about 2,000 pregnant women. Because of travel patterns and large populations of immigrants from areas where the virus is circulating, and according to the CDC's latest totals, New York leads the nation in travel-related Zika cases. So far the city has reported 346 cases, including 4 sexually transmitted infections. More than half of infected people reported travel to the Dominican Republic. Yesterday in an update the CDC said 18 poor birth outcomes have been reported in pregnant women infected with Zika virus, including 12 live births and 6 pregnancy losses. Florida probes second caseIn other Zika developments, the Florida Department of Health yesterday said it was investigating another suspected case involving local transmission, its second such announcement this week. In a statement, it said the possible nontravel-related case is in Broward County, which neighbors Miami-Dade County, the location of the first suspected local case. In a news release yesterday, Florida Health said Gov Rick Scott asked the state's surgeon general to request help from a CDC medical epidemiologist with investigations into both cases. That help arrived today in the form of Marc Fischer, MD, MPH, a CDC medical epidemiologist, Florida Health said in its daily Zika update. In the press release, Florida Health said Zika kits and repellent are being distributed to pregnant women in the affected area of Broward County, including through doctors' offices. Health officials are asking residents and visitors to cooperate with requests for blood and urine for testing in the investigation areas. In its update today, Florida Health said so far about 200 people have been interviewed and tested as part of the two investigations, that it is waiting for more lab results, and that it would share more details when available. It noted that door-to-door outreach with mosquito control is under way in the homes, workplaces, and other locations the two suspected case-patients frequented. Since yesterday, the state has received reports of 19 more travel-related Zika cases, 1 involving a pregnant woman. It now has 353 such illnesses, 47 of them in pregnant women. News of the first suspected local case prompted OneBlood, which provides blood services throughout Florida and to parts of Georgia and South Carolina, to announce yesterday that it will start testing donated blood for Zika virus on Aug 1 using a new test that was granted emergency use authorization. The first step is to screen a portion of collections in unaffected areas, making those blood products available to hospitals with high-risk patients, such as pregnant women, the company said in a statement. If the case is confirmed as local, OneBlood would stop collections in the affected zip code and supply that area with blood from an unaffected area. Spraying nixed; other developmentsPuerto Rico's governor today rejected a CDC suggestion to begin aerial spraying for mosquitoes with naled, and said he will support spraying with Bti, (Bacillus thuringiensis israelensis) an organic larvicide, the Associated Press (AP) reported today. The CDC has suggested aerial spraying as part of an integrated mosquito control program for the territory, which has been experiencing a surge of Zika activity. According to the AP, Puerto Ricans have organized protests about naled's possible impact on humans and wildlife. Puerto Rico's government was angered when the CDC sent the territory an unannounced shipment of naled, for which the CDC apologized today, saying it moved too quickly in the event that Puerto Rican officials would want to use the pesticide. A multidisciplinary mission will visit Guinea-Bissau next week to help investigate its recent local Zika cases, the World Health Organization (WHO) said in its weekly update yesterday. Four positive samples were sent to the Pasteur Institute in Dakar on July 1 for gene sequencing to determine if the outbreak strain is the one fueling the outbreak in the Americas or the one that has circulated for many decades in Africa. Results are still pending, the WHO said. Colombia's number of Zika-related microcephaly cases and related birth defects continues to grow, with 21 now reported, the WHO also noted in its weekly update. The number increased by 3 from last week. Brazil also reported 22 more confirmed cases, boosting its total to 1,709. The Caribbean island of Saba, a territory of the Netherlands, reported its first local Zika virus transmission, the European Centre for Disease Prevention and Control said today in its latestweekly communicable disease threats report. St Eustatius, Saba's neighbor to the southeast, also recently reported its first local case.See also: Jul 22 NYC Health press release NYC Health Zika background and totals Jul 21 Florida Health press release Jul 22 Florida Health Zika update Jul 21 OneBlood press release Jul 12 CIDRAP News story "Experts warn spraying may not be very effective against Aedes" http://www.cidrap.umn.edu/news-perspective/2016/07/nyc-reports-microcephaly-florida-probes-possible-2nd-local-zika-case

NYC reports microcephaly; Florida probes possible 2nd local Zika caseFiled Under: ZikaLisa Schnirring | News Editor | CIDRAP News | Jul 22, 2016Share Tweet LinkedIn Email Print & PDFnyc_sign_post.jpgjoanne1234 / iStockNew York City health officials today reported the first baby born with Zika-related microcephaly in a local hospital, a day after Florida said it was investigating a second suspected local Zika case, this one in Broward County. Elsewhere, Puerto Rico's governor today turned down a Centers for Disease Control and Prevention (CDC) proposal for aerial spraying for mosquitoes. The rapidly evolving developments come a day after federal officials announced $60 million more to help states battle Zika virus and as the nation and its territories are well into their summer mosquito seasons. Baby's mother got sick in an affected areaIn a statement, New York City's health department (NYC Health) said the baby's mother was infected while in an area of ongoing Zika transmission. The baby has been diagnosed as having microcephaly and other brain problems, and tests were positive for Zika virus infection, NYC Health said in a press release. NYC Health Commissioner Mary Bassett, MD, MPH, said in the statement, While not surprising, given the travel trends of our global city, this case is a strong reminder of the tragic consequences of the Zika virus. We are monitoring the baby's health closely and connecting the family with the necessary services to take care of their child." At a media briefing streamed live online today, Bassett said she learned of the case yesterday and that the baby was born this month. To protect the family's privacy health officials offered no other details, but said they were working with the CDC on the case. Jay Varma, MD, the health department's deputy commissioner for disease control, said 41 pregnant women who were infected with Zika virus have been reported in the city, the number is growing, and the cases are being evaluated on a regular basis. NYC Health said the mayor had invested $21 million in Zika preparedness, which included expanding testing capacity and dedicating a call center for health providers to process lab results. As of Jul 15 NYC Health has tested about 2,000 pregnant women. Because of travel patterns and large populations of immigrants from areas where the virus is circulating, and according to the CDC's latest totals, New York leads the nation in travel-related Zika cases. So far the city has reported 346 cases, including 4 sexually transmitted infections. More than half of infected people reported travel to the Dominican Republic. Yesterday in an update the CDC said 18 poor birth outcomes have been reported in pregnant women infected with Zika virus, including 12 live births and 6 pregnancy losses. Florida probes second caseIn other Zika developments, the Florida Department of Health yesterday said it was investigating another suspected case involving local transmission, its second such announcement this week. In a statement, it said the possible nontravel-related case is in Broward County, which neighbors Miami-Dade County, the location of the first suspected local case. In a news release yesterday, Florida Health said Gov Rick Scott asked the state's surgeon general to request help from a CDC medical epidemiologist with investigations into both cases. That help arrived today in the form of Marc Fischer, MD, MPH, a CDC medical epidemiologist, Florida Health said in its daily Zika update. In the press release, Florida Health said Zika kits and repellent are being distributed to pregnant women in the affected area of Broward County, including through doctors' offices. Health officials are asking residents and visitors to cooperate with requests for blood and urine for testing in the investigation areas. In its update today, Florida Health said so far about 200 people have been interviewed and tested as part of the two investigations, that it is waiting for more lab results, and that it would share more details when available. It noted that door-to-door outreach with mosquito control is under way in the homes, workplaces, and other locations the two suspected case-patients frequented. Since yesterday, the state has received reports of 19 more travel-related Zika cases, 1 involving a pregnant woman. It now has 353 such illnesses, 47 of them in pregnant women. News of the first suspected local case prompted OneBlood, which provides blood services throughout Florida and to parts of Georgia and South Carolina, to announce yesterday that it will start testing donated blood for Zika virus on Aug 1 using a new test that was granted emergency use authorization. The first step is to screen a portion of collections in unaffected areas, making those blood products available to hospitals with high-risk patients, such as pregnant women, the company said in a statement. If the case is confirmed as local, OneBlood would stop collections in the affected zip code and supply that area with blood from an unaffected area. Spraying nixed; other developmentsPuerto Rico's governor today rejected a CDC suggestion to begin aerial spraying for mosquitoes with naled, and said he will support spraying with Bti, (Bacillus thuringiensis israelensis) an organic larvicide, the Associated Press (AP) reported today. The CDC has suggested aerial spraying as part of an integrated mosquito control program for the territory, which has been experiencing a surge of Zika activity. According to the AP, Puerto Ricans have organized protests about naled's possible impact on humans and wildlife. Puerto Rico's government was angered when the CDC sent the territory an unannounced shipment of naled, for which the CDC apologized today, saying it moved too quickly in the event that Puerto Rican officials would want to use the pesticide. A multidisciplinary mission will visit Guinea-Bissau next week to help investigate its recent local Zika cases, the World Health Organization (WHO) said in its weekly update yesterday. Four positive samples were sent to the Pasteur Institute in Dakar on July 1 for gene sequencing to determine if the outbreak strain is the one fueling the outbreak in the Americas or the one that has circulated for many decades in Africa. Results are still pending, the WHO said. Colombia's number of Zika-related microcephaly cases and related birth defects continues to grow, with 21 now reported, the WHO also noted in its weekly update. The number increased by 3 from last week. Brazil also reported 22 more confirmed cases, boosting its total to 1,709. The Caribbean island of Saba, a territory of the Netherlands, reported its first local Zika virus transmission, the European Centre for Disease Prevention and Control said today in its latestweekly communicable disease threats report. St Eustatius, Saba's neighbor to the southeast, also recently reported its first local case.See also: Jul 22 NYC Health press release NYC Health Zika background and totals Jul 21 Florida Health press release Jul 22 Florida Health Zika update Jul 21 OneBlood press release Jul 12 CIDRAP News story "Experts warn spraying may not be very effective against Aedes" http://www.cidrap.umn.edu/news-perspective/2016/07/nyc-reports-microcephaly-florida-probes-possible-2nd-local-zika-case

UTMB researchers find first direct evidence that A. aegypti mosquito transmits Zika virusBy admin -July 21, 2016130 0Share on Facebook Tweet on Twitter GALVESTON, Texas – In collaboration with colleagues from Mexico, University of Texas Medical Branch at Galveston researchers were the first to directly connect the Aedes aegypti mosquito with Zika transmission in the Americas, during an outbreak in southern Mexico. The findings are available in the Journal of Infectious Diseases. The findings will help scientists to better target efforts for controlling the population of mosquitoes carrying the Zika virus. In early 2015 the first Zika infections were described in Brazil, harbingers of an explosive hemispheric epidemic. As of July 2016, local Zika infections have been reported in 39 countries and territories in the Americas, with the epidemic spreading throughout most of northern South America and nearly all of Central America and the Caribbean. Many countries in North America and Europe have also reported hundreds of imported cases. "Because several experimental studies have suggested that A. aegypti is not highly susceptible to Zika virus infection and there has been a lack of direct evidence of A. aegypti infection during outbreaks, some scientists have speculated that other common tropical urban mosquitoes such as Culex quinquefasciatus could be involved," said UTMB professor Scott Weaver, senior author of this paper. "We sought to more directly investigate which mosquito is responsible for spreading Zika virus so that we can selectively tailor our mosquito control efforts to a specific mosquito species' habits." The signs and symptoms of Zika infection are similar to the mosquito-borne diseases chikungunya and dengue. However, near the beginning of the outbreak in November of 2015 physicians in communities on the Mexico-Guatemala border reported to the Centro Regional de Investigacion Salud Publica an increase in the number of patents showing signs and symptoms thought to be different from those of chikungunya or dengue. To investigate this outbreak further, during November and December last year, researchers from the Mexican National Institute of Public Health completed a house-to-house survey to identify patients who met the World Health Organization case definition of Zika virus infection in several locations in the state of Chiapas. The researchers collected 119 blood samples with permission from people suspected of Zika virus infection. Zika virus was confirmed in 21 percent of the blood samples using a PCR-based test. No pregnant females were studied. The researchers also gathered adult mosquitoes in and around 69 homes of suspected Zika patients using backpack aspirators, and identified Zika virus in several samples of A. aegypti but not in other mosquito species. "Our study indicates that A. aegypti was the principal carrier of Zika virus in the Tapachula area of Chiapas State, based on the detection of virus in several mosquito pools and the prior demonstrated transmission competence of this species of mosquito," said Weaver. "It's important to note that Zika was not found in C. quinquefasciatus, another common urban tropical mosquito discussed as a potential Zika vector." ### Other authors of this paper include UTMB's Mathilde Guerbois, Sasha Azar, Grace Leal, Shannan Rossi, Christopher Roundy, Thomas Wood, Steven Widenn and Nikos Vasilakis; Ildefonso Fernandez-Salas, Rogelio Danis-Lozano, Iliana Garcia-Malo and Mauricio Casas-Martinez from Instituto Nacional de Salud Pública, Centro Regional de Salud Pública, Tapachula, Chiapas, México; Celia Alpuche-Aranda from the Instituto Nacional de Salud Pública, Centro de Investigación sobre Enfermedades Infecciosas, Cuernavaca, Morelos, México; Esteban Diaz-Gonzalez from the Universidad Autónoma de Nuevo León, Centro de Investigación y Desarrollo en Ciencias de la Salud, Monterrey, Nuevo León; Samanta Del Río-Galván from the Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, San Nicolás de los Garza, Nuevo León and Rosa Sanchez-Casas from the Universidad Autónoma de Nuevo León, Facultad de Medicina Veterinaria y Zootecnia, Escobedo, Nuevo León. This research was supported by the National Institutes of Health. Media Contact Donna [email protected]@utmb_news http://www.utmb.edu http://scienmag.com/utmb-researchers-find-first-direct-evidence-that-a-aegypti-mosquito-transmits-zika-virus/

Outbreak of Zika virus infection, Chiapas State, Mexico, 2015, and first confirmed transmission by Aedes aegypti mosquitoes in the AmericasMathilde Guerbois1,*, Ildefonso Fernandez-Salas2,*, Sasha R. Azar1,Rogelio Danis-Lozano2, Celia M. Alpuche-Aranda3, Grace Leal1, Iliana R. Garcia-Malo2,Esteban E. Diaz-Gonzalez4,5, Mauricio Casas-Martinez2, Shannan L. Rossi1,Samanta L. Del Río-Galván5, Rosa M. Sanchez-Casas4,6, Christopher M. Roundy1,Thomas G. Wood7, Steven G. Widen7, Nikos Vasilakis1 and Scott C. Weaver1,#+Author Affiliations 1Institute for Human Infections and Immunity and Departments of Microbiology & Immunology and Pathology, University of Texas Medical Branch, Galveston, Texas2Instituto Nacional de Salud Pública, Centro Regional de Salud Pública, Tapachula, Chiapas, México3Instituto Nacional de Salud Pública, Centro de Investigación sobre Enfermedades Infecciosas, Cuernavaca, Morelos, México4Universidad Autónoma de Nuevo León, Centro de Investigación y Desarrollo en Ciencias de la Salud, Monterrey, Nuevo León5Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, San Nicolás de los Garza, Nuevo León6Universidad Autónoma de Nuevo León, Facultad de Medicina Veterinaria y Zootecnia, Escobedo, Nuevo León7Department of Biochemistry and Molecular Biology, University of Texas Medical, Branch, Galveston, Texas↵#Corresponding author: Dr. Scott Weaver, Dept. of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0610 ([email protected]).↵* These authors contributed equally AbstractBackground. After decades of obscurity, Zika virus (ZIKV) has spread through the Americas since 2015 accompanied by congenital microcephaly and Guillain Barré syndrome. Although these epidemics presumably involve transmission by Aedes aegypti, no direct evidence of vector involvement has been reported, prompting speculation that other mosquitoes such as Culex quinquefasciatus could be involved. Methods. We detected an outbreak of ZIKV infection in southern Mexico in late 2015. Sera from suspected ZIKV-infected patients were analyzed for viral RNA and antibodies. Mosquitoes were collected in and around patient homes and tested for ZIKV. Results. Of 119 suspected ZIKV-infected patients, 25 (21%) were confirmed by RT-PCR of serum collected 1-8 days after the onset of signs and symptoms including rash, arthralgia, headache, pruritus, myalgia, and fever. Of 796 mosquitoes collected, A. aegypti yielded ZIKV detection by RT-PCR in 15 of 55 pools (27.3%). No ZIKV was detected in C. quinquefasciatus. ZIKV sequences derived from sera and mosquitoes showed a monophyletic relationship suggestive of a point source introduction from Guatemala. Conclusions. These results demonstrate the continued, rapid northward progression of ZIKV into North America with typically mild disease manifestations, and implicate A. aegypti for the first time as a principal vector in North America. http://jid.oxfordjournals.org/content/early/2016/07/18/infdis.jiw302.full.pdf+html?sid=20edfafe-b0cc-4352-b63e-55692d73138f

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July 22, 2016 – The Health Department today reported the first baby delivered with Zika-related microcephaly at a hospital in New York City. The baby and mother are currently in care and being monitored by physicians. The baby’s mother was infected while in an area with ongoing Zika transmission. The baby has been diagnosed with microcephaly – or a smaller than normal head – and other brain problems. Tests have determined that the baby is positive for Zika. The Health Department is working closely with the Centers for Disease Control and Prevention on this case. http://www1.nyc.gov/site/doh/about/press/pr2016/pr058-16.page

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Pregnancy Outcomes in the United States and the District of ColumbiaLiveborn infants with birth defects*12Includes aggregated data reported to the US Zika Pregnancy Registry as of July 14, 2016 Pregnancy losses with birth defects**6Includes aggregated data reported to the US Zika Pregnancy Registry as of July 14, 2016 http://www.cdc.gov/zika/geo/pregnancy-outcomes.html

Pregnancy Outcomes in the United States and the District of ColumbiaLiveborn infants with birth defects*12Includes aggregated data reported to the US Zika Pregnancy Registry as of July 14, 2016 Pregnancy losses with birth defects**6Includes aggregated data reported to the US Zika Pregnancy Registry as of July 14, 2016

Second Case of Zika in Florida May Have Come from Local MosquitoesBoth investigations are underway with no official time line for answers By Helen Branswell, STAT on July 22, 2016 Credit: William Volcov/Brazil Photo Press/LatinContent/Getty ImagesHealth officials in Florida announced Thursday that they’re investigating a second case of Zika infection that may have been locally acquired. The patient is in Broward County, which is adjacent to Miami-Dade County. The first patient, whose case was announced Tuesday and is still under investigation, is a woman living in Miami-Dade. The Florida Department of Health called the new case “a possible non-travel related case.” The statement did not indicate whether the department believes the two cases may be linked, nor did it give any indication about how far away the two people live from one another. Florida has asked for help from the Centers for Disease Control and Prevention, which is sending a medical epidemiologist to assist with the investigation. “CDC has been working with state, local, and territorial health officials to prepare for the possibility of locally acquired Zika infection in the United States,” the CDC said Thursday in a statement. “Officials from Florida participated in all these activities, and their experience in responding to mosquito-borne diseases similar to Zika, including dengue and chikungunya, has been an important source of knowledge in this effort.” When public health officials have warned about potential transmission of Zika in the US, Florida has been at the top of the at-risk list. The state has Aedes aegypti mosquitoes, a species known to transmit Zika. And, as the CDC noted, Florida has experience with other viral diseases spread by these mosquitoes. In 2014, the state had the first US outbreak of chikungunya, which took place in the same part of the state — southeastern Florida. There were about a dozen cases in that outbreak recorded in Miami-Dade, Broward, Palm Beach, and Saint Lucie counties. Infectious diseases expert Michael Osterholm said given the nature of Aedes aegypti, he suspects these two Zika cases, if locally acquired, may not be linked. Aedes aegypti bite near where they breed, traveling very short distances over their lifetimes. “From where it’s hatched to where it lives is often just hundreds of yards,” said Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy. “So unless these two people lived in the exact same neighborhood … it really just is an issue of the beginning of the Zika mosquito season in Florida,” Osterholm said. He suggested people could do a lot to reduce their risk of infection by cleaning up their properties and neighborhoods, ensuring there are no places for the mosquitoes to breed. “I think these early cases don’t give us a clue yet to the total number of cases that might be found,” he said. “But we shouldn’t be surprised if we have a number of cases. Clearly not hundreds, but we could have 20, 30, 40 cases” between now and September. Experience with the other diseases spread by Aedes mosquitoes suggests aspects of the American lifestyle — air-conditioning in many homes and cars, the use of screens to cover doors and windows — could protect against the really large Zika outbreaks being seen in many parts of Latin America. If confirmed, the Florida cases will be the first known instances where Zika infection was acquired in the US from mosquitoes. There have been 15 recorded cases of sexual transmission of the virus in the US and one laboratory worker was infected in a lab accident. New figures posted by the CDC on Thursday show that as of July 20, 1,403 travel-related cases of Zika infection have been detected in the US. Of those, 400 have been pregnant women. Twelve infants with Zika-related birth defects have been born in the US so far, the agency reported. Another six affected pregnancies were lost, either to stillbirth, miscarriage, or termination. Florida has reported 334 travel-related Zika cases, 46 of them pregnant women. So far, there is no confirmed case of local mosquito transmission of the virus; the Florida patients would be the first. Republished with permission from STAT. This article originally appeared on July 21, 2016. http://www.scientificamerican.com/article/second-case-of-zika-in-florida-may-have-come-from-local-mosquitoes/?WT.mc_id=SA_TW_HLTH_NEWS

Second Case of Zika in Florida May Have Come from Local MosquitoesBoth investigations are underway with no official time line for answers By Helen Branswell, STAT on July 22, 2016 Credit: William Volcov/Brazil Photo Press/LatinContent/Getty ImagesHealth officials in Florida announced Thursday that they’re investigating a second case of Zika infection that may have been locally acquired. The patient is in Broward County, which is adjacent to Miami-Dade County. The first patient, whose case was announced Tuesday and is still under investigation, is a woman living in Miami-Dade. The Florida Department of Health called the new case “a possible non-travel related case.” The statement did not indicate whether the department believes the two cases may be linked, nor did it give any indication about how far away the two people live from one another. Florida has asked for help from the Centers for Disease Control and Prevention, which is sending a medical epidemiologist to assist with the investigation. “CDC has been working with state, local, and territorial health officials to prepare for the possibility of locally acquired Zika infection in the United States,” the CDC said Thursday in a statement. “Officials from Florida participated in all these activities, and their experience in responding to mosquito-borne diseases similar to Zika, including dengue and chikungunya, has been an important source of knowledge in this effort.” When public health officials have warned about potential transmission of Zika in the US, Florida has been at the top of the at-risk list. The state has Aedes aegypti mosquitoes, a species known to transmit Zika. And, as the CDC noted, Florida has experience with other viral diseases spread by these mosquitoes. In 2014, the state had the first US outbreak of chikungunya, which took place in the same part of the state — southeastern Florida. There were about a dozen cases in that outbreak recorded in Miami-Dade, Broward, Palm Beach, and Saint Lucie counties. Infectious diseases expert Michael Osterholm said given the nature of Aedes aegypti, he suspects these two Zika cases, if locally acquired, may not be linked. Aedes aegypti bite near where they breed, traveling very short distances over their lifetimes. “From where it’s hatched to where it lives is often just hundreds of yards,” said Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy. “So unless these two people lived in the exact same neighborhood … it really just is an issue of the beginning of the Zika mosquito season in Florida,” Osterholm said. He suggested people could do a lot to reduce their risk of infection by cleaning up their properties and neighborhoods, ensuring there are no places for the mosquitoes to breed. “I think these early cases don’t give us a clue yet to the total number of cases that might be found,” he said. “But we shouldn’t be surprised if we have a number of cases. Clearly not hundreds, but we could have 20, 30, 40 cases” between now and September. Experience with the other diseases spread by Aedes mosquitoes suggests aspects of the American lifestyle — air-conditioning in many homes and cars, the use of screens to cover doors and windows — could protect against the really large Zika outbreaks being seen in many parts of Latin America. If confirmed, the Florida cases will be the first known instances where Zika infection was acquired in the US from mosquitoes. There have been 15 recorded cases of sexual transmission of the virus in the US and one laboratory worker was infected in a lab accident. New figures posted by the CDC on Thursday show that as of July 20, 1,403 travel-related cases of Zika infection have been detected in the US. Of those, 400 have been pregnant women. Twelve infants with Zika-related birth defects have been born in the US so far, the agency reported. Another six affected pregnancies were lost, either to stillbirth, miscarriage, or termination. Florida has reported 334 travel-related Zika cases, 46 of them pregnant women. So far, there is no confirmed case of local mosquito transmission of the virus; the Florida patients would be the first. Republished with permission from STAT. This article originally appeared on July 21, 2016. http://www.scientificamerican.com/article/second-case-of-zika-in-florida-may-have-come-from-local-mosquitoes/?WT.mc_id=SA_TW_HLTH_NEWS

MC Map Update https://www.google.com/maps/d/u/0/edit?mid=1RcVTrkYW6hax_iITjKUkEcBCVeI

Review 15 July 2016Among the epidemiological weeks 01 to 27, 2016 have been21 confirmed cases of microcephaly associated virusZika, 75 cases were dismissed, and 160 cases are under consideration. http://www.ins.gov.co/boletin-epidemiologico/Boletn Epidemiolgico/2016 Boletín epidemiológico semana 27.pdf

SummaryWHO and partners established a definition of what constitutes an outbreak, endemic transmission, and the interruption of mosquito-borne transmission in order to better characterize the level of transmission of Zika virus infection (Table 1, Fig. 2). This classification system was put into use as of the situation report of 7 July 2016.As of 20 July 2016, 65 countries and territories (Fig. 1, Table 1) have reported evidence of mosquito-borne Zika virus transmission since 2007 (62 of these countries and territories have reported evidence of mosquito-borne Zika virus transmission since 2015):48 countries and territories with a first reported outbreak from 2015 onwards (Table 1).Four countries are classified as having possible endemic transmission or have reported evidence of local mosquito-borne Zika infections in 2016.13 countries and territories have reported evidence of local mosquito-borne Zika infections in or before 2015, but without documentation of cases in 2016, or with the outbreak terminated.No new country or territory has reported mosquito-borne Zika virus transmission in the week to 20 July 2016.Eleven countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual route (Table 2).One case of Zika virus infection, whose mode of transmission is currently being investigated, was recently reported in the United States of America. The case is a family contact of an individual who died in June. The blood samples of the deceased case were found to have high amounts of Zika virus, more than 100 000 times higher than what has been found in other samples of infected people.The first documented case of female-to-male sexual transmission of Zika virus infection was reported in the United States of America on 15 July 2016.As of 20 July 2016, 13 countries or territories have reported microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection or suggestive of congenital infection. Three of those countries reported microcephaly cases born from mothers with a recent travel history to Zika-affected countries in the WHO Region of the Americas (Table 3).As of 20 July 2016, the United States Centers for Disease Control and Prevention (US-CDC) reported nine live-born infants with birth defects and six pregnancy losses with birth defects with laboratory evidence of Zika virus infection.As of 20 July 2016, 15 countries and territories worldwide have reported an increased incidence of Guillain-Barré syndrome (GBS) and/or laboratory confirmation of a Zika virus infection among GBS cases (Table 4).Based on research to date, there is scientific consensus that Zika virus is a cause of microcephaly and GBS.In Guinea-Bissau, on 29 June 2016, Institute Pasteur Dakar (IPD) confirmed that four of 12 samples tested positive for Zika by PCR. All 12 samples tested negative against IgM Zika. Four additional samples were sent to IPD on 1 July for gene sequencing and the results are still pending.The government of Guinea-Bissau with support from the WHO Country Office (WCO) is demonstrating strong leadership in response to these findings. The WCO has availed funds to support the logistical needs of the response activities. A multidisciplinary assessment mission to Guinea-Bissau is planned for the last week of July and will support the investigation of the outbreak and assess the level of preparedness in Guinea-Bissau.The global Strategic Response Framework launched by WHO in February 2016 encompasses surveillance, response activities and research. An interim report describing some of the key activities being undertaken jointly by WHO and international, regional and national partners in response to this public health emergency was published on 27 May 2016. A revised strategy for the period of July 2016 to December 2017 was published on 17 June.WHO has developed advice and information on diverse topics in the context of Zika virus. WHO’s latest information materials, news and resources to support corporate and programmatic risk communication and community engagement are available online. Download the image jpg, 384kb

Zika situation report21 July 2016Zika virus, Microcephaly and Guillain-Barré syndromeRead the full situation reporthttp://who.int/emergencies/zika-virus/situation-report/21-july-2016/en/

Baby born with Zika-related microcephaly in New York CityEighth baby born with Zika infection in the United States, officials saidThe child has brain damage and a smaller than normal head Tests confirmed the baby and mother both have the Zika virusIt comes as Florida officials scramble to test local mosquitoes for the virus Miami reported non-travel-related case this week, fears Zika is in the US By MIA DE GRAAF FOR DAILYMAIL.COM PUBLISHED: 11:24 EST, 22 July 2016 | UPDATED: 14:52 EST, 22 July 2016 http://www.dailymail.co.uk/health/article-3703673/Baby-born-Zika-related-microcephaly-New-York-City.html 702shares51 View comments A baby has been born with Zika-related microcephaly in New York City, officials revealed on Friday. The child and mother are being monitored by doctors at a public hospital. Officials confirmed the baby was born with a smaller than normal head and other neurological issues. Tests confirmed the baby has the Zika virus. SCROLL DOWN FOR VIDEO +2Birth defects: Zika, primarily spread by mosquitos, can lead to a condition in babies called microcephaly. It stunts the growth of a fetus, potentially leaving a baby with brain damage and a shrunken skull (file image) HOW DOES ZIKA INFECT A BABY AND WHAT IS MICROCEPHALY?INFECTION A mother can pass the virus to her unborn baby during pregnancy or during childbirth. There are three ways this can happen, according to a recent study. 1. Through the placenta During the first trimester, it can travel through the placenta by infecting numerous placental cells - something very few viruses can do. This route is the most damaging to the fetus, and is most likely to leave the child with birth defects, including microcephaly. 2. Through the amniotic sac In the second and third trimester, the virus can make its way through the amniotic sac. This route is less likely. The baby would have a much smaller risk of birth defects at this stage than if it were infected in the first trimester. 3. During childbirth Since the virus can live in the woman's womb lining, there is a chance the baby can become infected when it is born. BIRTH DEFECTS There is a range of Zika-related birth defects. The most common, and most obvious, is microcephaly, which stunts the development of the baby's brain, leaving the skull abnormally small. Babies with microcephaly will have slow growth, and will likely be smaller than their peers. Behaviourally, they are hyperactive, impulsive and often irritable. There is no cure. Treatment involves supportive care and close monitoring. Infected babies may also have excess fluid in and around the brain, abnormal eye development, clubfoot, inflexible joints, and calcium deposits in the brain. It is not known how the mother was infected. This is the eighth case of a child being treated for Zika in the United States. Health officials did not immediately respond to questions about how the mother became infected. 'Today, I am the bearer of sad news: we have confirmed New York City's first baby born with microcephaly associated with the Zika virus,' Dr Herminia Palacio, Deputy Mayor for Health and Human Services, said on Friday. 'The City has been preparing for this scenario for many months now, and we stand ready to help families caring for an infant with microcephaly. 'This case is a sad reminder that Zika can have tragic consequences for pregnant women.' As of this week, at least 400 pregnant women have been diagnosed with Zika in the United States - all from mosquito bites abroad or sex with a Zika-infected person. More than 2,000 pregnant women are being tested for the virus in New York City after traveling to regions which already have Zika. As of July 15, 41 of those women had been confirmed to have the Zika virus. Hundreds more are being examined for possible exposure through sex. New York was the first city to report a case of a woman infecting a man through sex. The news, which was released on July 15, forced the CDC to rewrite the official guidelines on anti-Zika protection. Previously, studies had only shown that men could pass on the virus through sex, since Zika was seen to survive for weeks in semen. However, the New York case showed the virus can also thrive in female sexual organs. Addressing the news on Friday, New York City Health Commissioner Dr Mary Bassett urged all pregnant women to postpone any plans to travel to a Zika-infected region. 'While not surprising, given the travel trends of our global city, this case is a strong reminder of the tragic consequences of the Zika virus,' she said. 'We are monitoring the baby's health closely and connecting the family with the necessary services to take care of their child. 'I remind all pregnant women in New York City, and those trying to get pregnant, that they should delay travel to places where there is active Zika transmission. 'As we see today, the consequences for the child can be devastating.' New York City has the highest number of Zika-infected patients, according to the latest CDC figures - closely followed by Florida. The majority of cases are travel-related, mostly to the Dominican Republic. RELATED ARTICLESPrevious1NextWhere is Zika and will it reach YOU? New interactive maps...Florida mosquitoes being tested for Zika after woman...Seven babies and 400 pregnant women infected with Zika in...Revealed: How Zika passes from mother to baby in the womb -...SHARE THIS ARTICLEShare702 sharesMillions of women have been warned to avoid pregnancy or take intense precautions to avoid the Zika virus. The infection, primarily spread by Aedes aegypti mosquitos, stunts the growth of a fetus, potentially leaving babies with brain damage and shrunken skulls. But as the epidemic has spread, scientists have been grappling to understand the exact routes Zika takes from mosquito, to mother, to unborn baby. +2Officials fear the Miami case could be the first to come directly from a mosquito bite in the United States. They are now testing US mosquitoes for the virus, which is most commonly carried by the Aedes aegypti (pictured) World Health Organization comments on Zika and microcephaly Loaded: 0%Progress: 0%0:00PlayMute Current Time0:00/Duration Time0:41FullscreenNeed Text On Monday, experts at the University of California released the first comprehensive map showing the two routes the infection can take. Unlike most viruses - which cannot cross the protective placenta - their research seems to suggest that Zika can. However, the team said they have evidence to show an older generation antibiotic could block this process. ZIKA UPDATES: LATEST NEWS ON THE INFECTION IN THE USFLORIDA FEARS US MOSQUITOES HAVE ZIKA AFTER NON-TRAVEL INFECTION Miami health officials started trapped mosquitoes this week to test them for Zika. On Wednesday, a Miami woman was diagnosed with the virus despite not traveling abroad. Officials fear this case could be the first to come directly from a mosquito bite in the continental United States. Control teams are now shipping batches of locally-caught mosquitoes to confirm whether the infection has reached the state - while spraying the patient's neighborhood to prevent an outbreak. UTAH ALSO PROBING NON-TRAVEL INFECTION Mosquitoes in Utah may also have contracted Zika, officials warned this week. Crews in Salt Lake City are setting traps in old tires and junkyards and dumping mosquito-eating fish into ponds and abandoned pools. It is an attempt to get hold of Zika-infected mosquitoes to test them. Earlier this week, Utah officials revealed a man who cared for his dying father was infected with Zika. The elderly man had traveled abroad. He also had other health problems. Since the son's infection doesn't involve travel or sex, it has raised more questions about how the virus might spread. NEW YORK CITY CONFIRMED WOMEN CAN INFECT MEN THROUGH SEX A New York City woman in her twenties infected her male partner with the Zika virus through sex, officials revealed on July 15. It is the first time female-to-male transmission of the germ has been documented. Zika is usually spread by mosquitoes, and multiple studies have found the virus can survive two months or more in semen - even after symptoms fade. There is little research on Zika's presence in women, and how they pass it on. However, the CDC confirmed that a female patient passed on the virus to a man after having sex just once. NEW TESTS SHOW VIRUS COULD LIVE 3 MONTHS IN SEMEN - RATHER THAN 2 Zika virus has been detected in a man's semen more than three months after he reported symptoms, scientists discovered this week. Previously, Zika had been found to lurk in semen for up to 62 days - so the new finding of 93 days has caused alarm in the scientific community. In this newly reported case, the 27-year-old man from France came down with mild symptoms of the virus only days after returning home from Thailand last year. Doctors described his case in the Lancet Infectious Diseases journal. The man had decided to freeze his sperm before chemotherapy, which led to French scientists deciding to to test his sample for Zika. While the virus was found in his semen, it was not found in his blood or urine. ZIKA FOUND IN ANOTHER MOSQUITO - WHICH IS 20 TIMES MORE COMMON Another much more common species of mosquito is able to transmit the Zika virus to humans, scientists have discovered. The alarming finding could make it difficult to limit the spread of the virus, which has been linked to thousands of birth defects as it sweeps rapidly through the Americas. Until now, the mosquito species Aedes aegypti had been identified as the main transmitter of Zika infections. But Brazilian scientists have discovered the Culex quinquefasciatus mosquito can carry the virus. The Culex is 20 times more common than the Aedes aegypti – the bug which also transmits dengue fever and Chikungunya. It is particularly common in Los Angeles.