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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of July 20, 2016) http://www.cdc.gov/zika/geo/united-states.html StatesTravel-associated cases* No. (% of cases in states) (N=1,404)Locally acquired cases† No. (% of cases in states) (N=0)Alabama8 (1)0 (0)Arizona7 (<1)0 (0)Arkansas5 (<1)0 (0)California69 (5)0 (0)Colorado17 (1)0 (0)

Zika found in common house mosquitoes in BrazilBy Debra Goldschmidt and Vasco Cotovio, CNN Updated 1:19 AM ET, Fri July 22, 2016 Everything you need to know about Zika 01:42Story highlightsMore research is needed to see how this will impact the spread of ZikaThere are many different types of Culex mosquitoes, not all can transmit the disease (CNN)Researchers in Brazil announced Thursday the "presence of the Zika virus" in Culex mosquitoes (the common house mosquito) in the eastern city of Recife. These findings were released with a word of caution, saying "the obtained data will require additional studies in order to assess the potential participation of Culex in the spread of Zika and its role in the epidemic." Zika in Florida: 2nd possible non-travel case investigatedResearchers collected 500 mosquitoes and found the virus in three pools of mosquitoes. Each pool contains between one and ten mosquitoes. The presence of the virus in these mosquitoes does not mean they can transmit the virus.Before this study was completed by the Oswaldo Cruz Foundation (Fiocruz), Zika was thought to solely by carried by the Aedes aegypti mosquito. Culex mosquitoes are "twenty times greater than the population of Aedes Aegypti" in the Recife metropolitan area, according to the study.CNN Map Recife Rio de Janeiro Fiocruz is a public institution attached to the Brazilian Ministry of Health. It is one of Brazil's oldest and most respected health care institutions that has been at the forefront of the fight against Zika. Zika Virus Infection Fast Facts Tom Skinner, U. S. Centers for Disease Control and Prevention's Senior Press Officer told CNN Thursday in response to the study's findings, "the study would need to be replicated to have a better understanding of possible implications. Body of scientific evidence to date clearly points to Aedes being the primary vector implicated in Zika outbreaks."Map: Tracking the Zika virus First case of female-to-male Zika transmissionThere are many different types of Culex mosquitoes. This study found the virus in Culex quinquefasciatus mosquitoes. A U.S. study published earlier this week in the journal Emerging Infectious Diseases, found a different type of Culex mosquito was not capable to transmitting the Zika virus in a lab setting. The mosquitoes that changed historyThey concluded that this type of mosquito is unlikely to transmit the virus in the U.S. New knowledge about the Zika virus is being discovered on a daily basis but this research seems in line with what's known, which is that the main vector is the Aedes mosquito.The virus has been spreading across the Americas since last year. The World Health Organization declared a public health emergency of international concern in February. Since then, researchers have found the virus can cause a devastating birth defect, calledmicrocephaly, in babies born to mother's who were infected with the virus during pregnancy.http://www.cnn.com/2016/07/22/health/zika-culex-mosquito-brazil/

JULY 22, 2016 7:00 AM How a Caribbean island became prime source of U.S. Zika casesMore than 1,300 Americans have contracted Zika while traveling outside the U.S. this year Visitors to the Dominican Republic account for more than a fifth of the cases New York, Florida and California tally 304 cases linked to the Caribbean island In this Jan. 18, 2016, photo, a female Aedes aegypti mosquito acquires a blood meal on the arm of a researcher at the Biomedical Sciences Institute in the Sao Paulo's University in Sao Paulo, Brazil. The CDC is working with Florida health officials to investigate what could be the first Zika infection from a mosquito bite in the continental United States.Andre Penner APBY PHIL GALEWITZ Kaiser Health News LINKEDINGOOGLE+PINTERESTREDDITPRINTORDER REPRINT OF THIS STORY More than 1,400 Americans contracted Zika while traveling outside the U.S. this year and a Caribbean-island nation is one of the top destinations where they caught the virus. Visitors to the Dominican Republic account for more than a fifth of the confirmed Zika cases in the U.S. through mid-July, according to data from state health departments. New York, Florida and California alone tally 304 cases linked to the country, the data show. As Florida officials investigate what may be the first non-travel-associated cases of Zika infection in the U.S., Kaiser Health News looked more deeply into the origins of the 1,404 travel-related cases reported by all states to the Centers for Disease Control and Prevention. For most people, Zika causes flu-like symptoms. Pregnant women are considered especially at risk of the threat, because Zika can cause severe birth defects, such as microcephaly. Interactive feature: Daily Florida Zikavirus trackerThe CDC does not break out the cases it tracks by country of origin — only by the infected person’s state of residency. It said in June that 48 percent of the travel-associated cases for all of 2015 and the first five months of 2016 originated in the Caribbean, 26 percent in Central America and 23 percent in South America. The cases numbered 591 at that time. Data from the four health departments that have reported more than half of the national case total — New York state, New York City, Florida and California — provide additional detail. More people who visited the Dominican Republic in 2016 returned with Zika than did U.S. residents who traveled to Puerto Rico, Colombia, Jamaica, El Salvador, Haiti, Guyana and Venezuela combined, the four departments’ figures show. What’s the explanation? In part, it reflects travel patterns between people living in the U.S. with family members in the Caribbean nation, public health officials say. “It’s not really tourists going back and forth,” said Chris Barker, a researcher who studies the epidemiology of mosquito-transmitted diseases at the veterinary medicine school at the University of California-Davis. The Florida Department of Health said the data “speaks to travel patterns, for one, and potentially the level of local transmission in these countries.” Travel also increases in the summer, the department noted, and testing has also increased. Dominican Republic immigrants are the fifth largest Hispanic group in the United States, numbering 960,000 in 2012, according to the Migration Policy Institute. Their highest population concentrations are in New York, New Jersey and Florida. Dominicans comprise New York City’s largest Hispanic group and “have a significant travel exchange with the Dominican Republic,” according to the city’s health department. It counts 207 travel-associated cases linked to the country, followed by 27 to Puerto Rico and 20 to Jamaica. “Dominicans, Puerto Ricans and Guyanese do not have a higher risk of transmission for Zika infection,” the department said in a statement. “The data we have released simply reflects New York City’s demographics and travel patterns.” People who travel outside the U.S. to visit family tend to make longer visits and often stay in residential locations, instead of “more sanitized areas made for tourists,” and that may increase their chances of getting bitten by a Zika-infected mosquito, Barker said. Travel-related Zika cases are a function of both travel volume and how active the virus is in countries being visited, according to Barker. “When there is a high level of both, that is where you have the most cases,” he said. Knowing which countries account for the most Zika travel cases helps drive public education efforts, said Vicki Kramer, chief of the vector-borne disease section at the California Department of Public Health. As in New York City and Florida, California’s Zika statistics are also linked to immigrant populations there. Of California’s 77 cases, the greatest numbers resulted from travel to El Salvador, Honduras and Guatemala, all countries where state residents go to see family and often make extended visits, Kramer said. New York City’s Health Department said it has done “extensive outreach” to local communities with strong ties to countries where Zika is active. “These data could mean that Dominican New Yorkers are paying attention and testing more than other groups, which, in a way, is encouraging for us,” the department said. With a population of about 10 million, the Dominican Republicshares the island of Hispaniola with Haiti. Comparing U.S. data with a dataset from an international public health group indicates many more American visitors to the Dominican Republic have contracted Zika than residents of the island. The Pan American Health Organization reports 101 locally-acquired cases there. Brazil’s cases — 64,311 in total — account for almost 80 percent of the Zika infections in the Western Hemisphere through July 14, according to the organization. The country is so vast that infections are more spread out than in other areas in Central and Latin America, Barker said. Public health sources for Zika statistics for the same country can vary. Puerto Rico’s tally is 2,162 on the Pan American Health Organization’s site. The CDC reports 2,843 locally-acquired cases. But among American travelers to both Brazil and Puerto Rico, the numbers appear to be far smaller, according to KHN’s analysis. Those figures show 80 travel-related cases linked to Puerto Rico and six to Brazil. Colombia was at 46 and El Salvador at 31. Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. http://www.miamiherald.com/news/health-care/article91119792.html Read more here: http://www.miamiherald.com/news/health-care/article91119792.html#storylink=cpy

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As of Thursday, July 21, 2016, VDH has reported 43 cases of Zika virus disease in Virginia residents to the CDC ( 6 in Northwest Region, 24 in Northern Region, 2 in Eastern Region, 7 in Central Region and 4 in Southwest Region). 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. http://www.vdh.virginia.gov/zika/zika-virus-update/

As of Thursday, July 21, 2016, VDH has reported 43 cases of Zika virus disease in Virginia residents to the CDC ( 6 in Northwest Region, 24 in Northern Region, 2 in Eastern Region, 7 in Central Region and 4 in Southwest Region). 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.

Florida DOH Tests Locals, Mosquitoes For Non-Travel Zika VirusJuly 20, 2016 6:44 PM By Donna RapadoFiled Under: Florida, Health, Miami-Dade County, Zika 8Follow CBSMIAMI.COM: Facebook | Twitter MIAMI (CBSMiami) – Tests are being conducted and we will soon know whether someone in Miami-Dade has acquired the Zika virus locally. It would be the first such case in the U.S. According to the head of Mosquito Control Chalmers Vasquez, he was notified last Friday that there was a possibility someone in an unidentified part of the county was suspected of being the first non-travel case of Zika. Chalmers says since then his team has been in the neighborhood gathering mosquito specimens for analysis and checking properties for standing water. Related: Zika Case Raising New Questions About How Virus Spreads “We have been knocking on doors and treating storm drains,” he says. “In Florida the numbers are alarming,” says Nova Southeastern University professor Dr. Marie Florent Carre, who has been involved in prevention and education efforts regarding the Zika virus. “We ask the public to use repellant.” Related: CDC Says Zika Definitely Causes Severe Birth Defects Symptoms of the Zika virus include fever, rash, joint pain, pinkeye, muscle pain, and headaches. In pregnant women, the Zika virus can cause serious birth defects. Dozens of pregnant women in south Florida have tested positive and are being monitored. The mosquito that can carry the Zika virus is common in South Florida and can be found in your backyard. “The mosquito likes to breed in small deposits of water,” says Vasquez. That is why everyone is urged to check for standing water on their property. Northwest Miami-Dade resident Angela Torres says she is concerned about the spread of Zika in South Florida. She says she visited the Caribbean recently and didn’t take chances. “I took mosquito repellant so when I came back there were no problems,” said Torres. As of Wednesday, there were 327 cases of the Zika virus in Florida with 89 cases reported in Miami-Dade County and 50 in Broward County. Health experts say we can all do our part in preventing the spread starting in our own homes. Click here for tips on how to prevent the spread of Zika or click here for more information on the Zika virus. http://miami.cbslocal.com/2016/07/20/florida-health-officials-test-people-mosquitoes-for-locally-spread-zika-virus/

HEALTH ZIKA VIRUS OUTBREAK JUL 21 2016, 7:38 PM ETFlorida May Have a Second Non-Travel-Related Case of Zikaby MAGGIE FOX SHARE Florida health officials said Thursday they were investigating a second possible case of Zika spread locally, and Brazilian scientists said they feared they may have found a second species of mosquito can transmit the virus. The two Florida cases — one in Miami-Dade county and another in Broward county — both appear to have no connections to travel to Zika-affected areas, and neither appears to have had sexual contact with a Zika-infected patient, but Florida officials are still checking both possibilities. In this photo, Christy Roberts, with the Harris County Public Health &amp; Environmental Services, examines mosquitos collected in a trap in Houston at the Harris County Mosquito Control lab, June 2. Zika has been sweeping through Latin America and the Caribbean in recent months, and the fear is that it will get worse there and arrive in the U.S. with the onset of mosquito season this summer. John Mone / APThey're also looking for mosquitoes infected with Zika near both homes, and testing people in both areas to see if anyone else may have been infected with Zika and not known it. Related: How Worried Should You be About Zika? "Residents and visitors are urged to participate in requests for blood and urine samples by the department in the areas of investigation. These results will help the department determine the number of people affected," the Florida Department of Health said in a statement. "IT'S A NEEDLE IN A HAYSTACK."The Centers for Disease Control and Prevention says it has official reports of 1,404 cases of Zika in the continental United States — all travel related. But the CDC says it's very likely that some travelers will be bitten by mosquitoes while still actively infected and that this could cause local Zika outbreaks. That's what Florida officials are checking for now. But it takes two factors for a local outbreak: An infected patient, and an Aedes mosquito that bites the person and then lives long enough for the virus to build up in its body before it bites someone else. Related: Zika Could Infect Thousands of Pregnant Women in Puerto Rico Finding infected mosquitoes isn't necessarily easy, said Dr. Peter Hotez, dean of tropical medicine at the Baylor College of Medicine in Houston. "It's a needle in a haystack," Hotez said. Mosquitoes don't transmit the virus to one another, so to find Zika-affected mosquitoes, workers must catch a mosquito that actually bit someone who was infected. "Just because they don't find Zike in an Aedes mosquito doesn't mean there is no transmission," he said. Florida is one of 26 U.S. states where Aedes aegypti mosquitoes have been found. "Now if they get lucky and find it, that's entirely confirmatory," Hotez added. At the same time, officials are making sure that there's no other possible way the two Florida patients could have been infected. "WE CONTINUE TO INVESTIGATE AND HAVE NOT RULED OUT TRAVEL OR SEXUAL TRANSMISSION AT THIS TIME.""We continue to investigate and have not ruled out travel or sexual transmission at this time," a department spokesperson told NBC News. Separately, Brazilian researchers said they'd found that a much more common mosquito, a species called Culex quinquefasciatus, has been infected with Zika. The same team of researchers, at Brazil's Oswaldo Cruz Foundation, reported in March that they had infected Culex mosquitoes with Zika in the lab. Related: Here's How You Find Zika Now they say they found the virus in live mosquitoes. If Culex can spread Zika, that would be more troubling. Culex mosquitoes are far more common in temperate zones, such as in the United States. But just this week another team, led by Scott Weaver at the University of Texas Medical Branch, said they had tried and been unable to infect Culex mosquitoes with Zika. "Without access to the methods and data (it is not published in a peer-reviewed journal yet) there is not much that I can say about this Brazilian study," Weaver told NBC News by email. "An effective vector requires not only susceptibility to infection and ability to transmit (virus replication in salivary glands) but a high rate of biting humans in the case of Zika virus." "IF THEY FOUND ZIKA IN THE CULEX MOSQUITOES, IT COULD BE THEY HAD TAKEN A BLOOD MEAL FROM SOMEONE WITH ZIKA AND THEN YOU WOULD FIND THE VIRUS."Hotez also says he doubts Culex mosquitoes play a big role in spreading Zika. "If they found Zika in the Culex mosquitoes, it could be they had taken a blood meal from someone with Zika and then you would find the virus. It doesn't mean they transmit the virus," Hotez said. And everywhere so far that Zika has spread have been areas where Aedes aegypti mosquitoes abound. Different mosquito species spread different diseases. Culex mosquitoes can spread West Nile virus, but so far are not known to spread Zika. Aedes aegypti mosquitoes spread yellow fever, dengue, chikungunya and Zika viruses, which are all closely related and biologically adapted to these mosquitoes. And malaria, caused by a parasite called Plasmodium, is spread by entirely different species of mosquito, mostly Anopheles. The big danger from Zika is to pregnant women. It causes severe birth defects in babies if the mother is infected while pregnant. The CDC says it knows of 400 pregnancies affected by Zika in the continental U.S. and another 378 in territories such as Puerto Rico. Of these, 12 babies have been born with birth defects caused by Zika and another six have died, miscarried or been aborted because of severe defects. http://www.nbcnews.com/storyline/zika-virus-outbreak/florida-may-have-second-non-travel-related-case-zika-n614481

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Miami-Dade, Broward Prep For Possible Local Zika CasesJuly 21, 2016 5:55 PMFiled Under: Babies, Florida, Health, Miami-Dade, Zika 5Follow CBSMIAMI.COM: Facebook | Twitter MIAMI (CBSMiami/AP) — Florida’s Department of Health has not ruled out sexual transmission or travel as the source of a Miami-area woman’s Zika infection. Meantime, they are waiting on results to find out whether mosquitoes collected in South Florida test positive for the Zika virus. That could help determine whether a local woman is the first person infected directly by a mosquito bite on the U.S. mainland. Related: Florida DOH Tests Locals, Mosquitoes For Non-Travel Zika Virus Fogging trucks drove through the patient’s neighborhood Thursday morning. Miami-Dade County Mosquito Control Operations Manager Chalmers Vasquez said inspectors are trying to get into every backyard to spray and eliminate breeding sites. Health officials said lab tests confirmed the patient’s infection earlier this week. Related: CDC Says Zika Definitely Causes Severe Birth Defects Miami-Dade County has the most confirmed Zika infections in Florida, but all have involved international travel. Vasquez says no mosquitoes collected in the county so far have tested positive for Zika. A team from Broward Mosquito Control was spraying to stop the spread of mosquitoes that could possibly be carrying the virus. With marching orders from the Florida Health Department, they were going door-to-door a Fort Lauderdale neighborhood just off downtown warning residents about the risk and checking for standing water. There may be one locally-acquired case in Miami-Dade County, meaning Broward County would be second in line to possibly get a locally acquired case. “It’s not a matter of if. It’s a matter of when we’re going to get a local case. What we’re really preparing for is how we’re going to handle when we have one of these non-travel related case,” said Anh ton with Broward Mosquito Control. But there’s a lot of confusion. The state health department went public with the Miami-Dade information Tuesday – four days after it surfaced and told everyone the Zika prevention kits and repellant would be available for pickup at the Miami-Dade Department of Health. No such kits are available. This means checking everything from your rain gutter to potted plants is important. Health experts say we can all do our part in preventing the spread starting in our own homes. Click here for tips on how to prevent the spread of Zika or click here for more information on the Zika virus. http://miami.cbslocal.com/2016/07/21/officials-await-miami-area-mosquito-test-results/?utm_source=rss&utm_medium=headoflettucemedia&utm_campaign=RSS

Investigate possible second indigenous case of zika in South Florida by TF / MiamiDiario Today at 08:44 pmThe Department of Health of Florida is investigating a possible case of zika unrelated to travel in Broward County .GalleryInvestigate possible second indigenous case of zika in South FloridaAuthor: File You may want to ... Florida: Key West celebrates 117 years of Hemingway US .: The number of babies with malformations zika Miami Trail Theatre hosted presentation of "Colombia, Wild Magic" Coast Guard intercepted a boat with immigrants in Key Biscayne They evacuated passengers flying American Airlines Palm Beach Airport leakage The department is working with the CDC in this case. The other possible indigenous case of zika reported in Miami-Dade . If confirmed, they will become the first cases of local transmission of the virus in the United States, reported Sun Sentinel . Among the more than 1,400 infections reported across the country so far, almost all have turned out to be people who became infected when traveling to areas where there zika. Fifteen cases were sexually transmitted. The Department of Health of Florida said they are still investigating both cases with the help of theCenters for Disease Control and Disease Prevention . In the case of Miami-Dade, it is known that it is a woman, according Local10 . according to the Miami Herald , in response to the second case, the Department of Health urged residents of the affected neighborhoods in Miami-Dade and Broward counties to cooperate with requests for samples of blood and urine to help determine the number of people infected . the authorities have not revealed the places in Miami-Dade and Broward under investigation. you may also be interested in :- Increase the number of babies with malformations zika - A common mosquito is a transmitter potential zika - Investigated possible first indigenous case zika in Florida in Miami-Dade Countyhttp://www.miamidiario.com/salud/miami-dade/florida/broward/zika-en-florida/zika-en-miami-dade/virus-zika-en-florida/virus-zika-en-miami-dade/362457

Zika in Florida: 2nd possible non-travel case investigatedBy Debra Goldschmidt, CNN Updated 8:22 PM ET, Thu July 21, 2016 Everything you need to know about Zika 01:42Story highlightsSexual transmission has not yet been ruled outA CDC epidemiologist is traveling to Florida to assist with the investigation (CNN)Health officials are investigating a possible non-travel related case of Zika virus in Broward County, Florida, the Florida Department of Health said Thursday. This individual has not traveled to an area where the virus is circulating. However, sexual transmission of the virus from a person who has traveled has not been ruled out, Florida Department of Health Communications Director Mara Gambineri said. Zika: Florida investigating non-travel related case"Residents and visitors are urged to participate in requests for blood and urine samples by the department in the areas of investigation. These results will help the department determine the number of people affected," the department of health said.The U.S. Centers for Disease Control and Prevention is assisting state and local health officials with the investigation. A senior epidemiologist from the CDC will arrive in Florida on Friday.The investigation announced Thursday is in addition to the ongoing investigation announced earlier this week of a suspected non-travel related case of Zika in Miami-Dade County. "We continue to investigate and have not ruled out travel or sexual transmission at this time." Gamnineri said Thursday, adding that more specifics on that investigation are expected on Friday. Zika virus: The latest you need to knowTo date, there are 334 cases of Zika virus in the state of Florida, including 46 pregnant women. Seven of those cases were newly reported Thursday in the state's daily Zika update.As of July 20, the CDC reported 1,404 cases of the virus in the continental United States and Hawaii. None of those cases is a result of local mosquito transmission. Fifteen of those individuals were infected by sexual transmission and there is one case of a laboratory-acquired infection. (The CDC updates its numbers weekly on Thursday, so those numbers do not count Thursday's newly reported cases in Florida or other states).Federal, state and local health officials nationwide have been preparing for locally acquired cases of the virus for months. "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," the CDC said.Join the conversationSee the latest news and share your comments with CNN Health on Facebook andTwitter. U.S. health officials have warned to expect local transmission of the virus from mosquitoes but don't expect widespread transmission, as has been seen in Puerto Rico and throughout the Americas.http://www.cnn.com/2016/07/21/health/broward-county-zika-investigation/index.html?utm_source=feedburner&utm_medium=twitter&utm_campaign=Feed%3A+rss%2Fcnn_latest+(RSS%3A+CNN+-+Most+Recent)

The Latest: Florida probing 2nd possibly local Zika caseStoryCommentsPrintCreate a hardcopy of this pageFont Size:Default font sizeLarger font size Posted: Thursday, July 21, 2016 5:13 pm | Updated: 5:32 pm, Thu Jul 21, 2016. Associated Press | MIAMI (AP) — The Latest on the Zika virus in Florida (all times local): 6:10 p.m. The Florida Health Department says it's now investigating a second possible non-travel related case of Zika infection in South Florida. The case is in Broward County, which neighbors Miami-Dade, where the first such investigation continues. The department says in a news release that it is working with Centers for Disease Control and Prevention, and that the state government has asked that the CDC to send an epidemiologist to Florida to help with the investigation. Health authorities are testing mosquitoes and have not yet confirmed that anyone has been infected by a bite in the mainland United States. ___ 5:15 p.m. A Florida Health department spokeswoman now says it's premature to conclude whether or not the Zika infection of a Miami-area woman is related to sex or travel. Spokewoman Mara Gambineri says her emailed statement earlier Thursday was incorrect. She says she was wrong and that she should have written that "''sexual transmission related to travel has not been ruled out." She says not all the blood and urine tests from the people around the infected patient have come back yet, and they can't definitively say that nobody involved traveled outside the United States recently. Mosquitoes tested as part of this investigation have so far tested negative for Zika, as of results that came back Thursday. ___ This item has been corrected; The health spokeswoman now says her earlier statement was incorrect, and that she should have written that "sexual transmission related to travel has not been ruled out." ___ 4:20 p.m. The largest blood bank in central Florida is going to start screening for the Zika virus. OneBlood said Thursday that it will start screening for the mosquito-borne virus Aug. 1. Dr. Rita Reik, OneBlood's chief medical officer, says in a statement that only a portion of collections will be screened. Hospitals and other facilities that want Zika-screened blood will have to make a request. Reik says that will allow them to have screened-blood for high-risk patients such as pregnant women. OneBlood's announcement comes as health officials are trying to determine whether a Miami-area woman is the first person directly infected by a mosquito on the U.S. mainland. ___ 3:50 p.m. U.S. health officials say the number of babies born in the U.S. with Zika-related defects has risen to 12, up from nine the week before. A report from the U.S. Centers for Disease Control and Prevention says the overall number of infected people in the U.S. also is rising, to more than 1,400 cases reported in the 50 states and the District of Columbia, including 400 pregnant women. None of the cases in this latest report are attributed to mosquito bites inside the continental United States. Fifteen people became infected through sex with people who contracted Zika while traveling abroad. The rest traveled themselves and were likely bitten in countries with Zika outbreaks. The numbers rose dramatically in Puerto Rico, where roughly 3,800 cases have been reported. The CDC says almost all of those cases are attributed to mosquito bites on the island. ___ 1 p.m. Health officials waited Thursday to see if mosquitoes collected near Miami test positive for the Zika virus. That could help determine whether a local woman is the first person infected directly by a mosquito bite on the U.S. mainland. Fogging trucks drove through the patient's neighborhood Thursday morning. Miami-Dade County Mosquito Control Operations Manager Chalmers Vasquez said inspectors are trying to get into every backyard to spray and eliminate breeding sites. Health officials said lab tests confirmed the patient's infection, and there's no apparent connection to travel outside the country. Miami-Dade County has the most confirmed Zika infections in Florida, but all have involved international travel. Vasquez says no mosquitoes collected in the county so far have tested positive for Zika. ___ 3:15 a.m. Florida health officials have trapped mosquitoes in an area of Miami-Dade County and are testing them for Zika to confirm whether a woman with the virus could be the first person infected directly by a mosquito bite in the continental United States. Florida's Department of Health and the U.S. Centers for Disease Control and Prevention did not immediately respond to questions about their investigation, but health officials said the case had no apparent connection to travel outside the country. The patient is a woman who lives in Miami-Dade County. That's according to a health official familiar with the case who wasn't authorized to reveal details beyond the statements of the agencies involved, and thus spoke on condition of anonymity. http://www.wacotrib.com/news/ap_nation/the-latest-florida-probing-nd-possibly-local-zika-case/article_d7445ffa-f21c-5fde-bae1-599df9cb1df4.html

Florida Investigating Second Possible Case of Locally Acquired ZikaState health officials reported first possible nontravel-related case this week ENLARGEThe Florida Department of Health said that mosquito control workers, like this one in Miami-Dade County, are working to reduce mosquito populations in the areas under investigation. PHOTO: AGENCE FRANCE-PRESSE/GETTY IMAGESBy BETSY MCKAYUpdated July 21, 2016 7:45 p.m. ET0 COMMENTSFlorida health officials said late Thursday that they are investigating a second case of Zika in a person whose source of infection is unknown. The second person resides in Broward County, whose county seat is Fort Lauderdale. The Florida Department of Health said that it is conducting an epidemiological investigation into a “possible nontravel related case of Zika virus” in that county, and added that its investigation into a similar case in neighboring Miami-Dade County, which it disclosed late Tuesday, is “ongoing.” It isn’t known if or how the two cases are connected. The case in Miami-Dade County is an adult woman, according to people familiar with the matter. The Florida Department of Health didn’t provide further details on either case beyond its short statements and didn’t respond immediately late Thursday to emailed questions. Florida officials didn’t indicate whether they have ruled out sexual transmission as a source of infection in the Broward County case. But if they have, they would be concerned, as with the case in Miami-Dade County, that the person acquired the virus locally from mosquitoes. Mosquitoes are the main mode of transmission of Zika generally, but mosquito-borne transmission has yet to be reported in the continental U.S. The Florida Department of Health said that at the direction of Gov.Rick Scott, the state surgeon general had asked the CDC to send a medical epidemiologist to assist with the investigations and response. The CDC confirmed that it has sent the requested scientist. The agency also said it has provided Florida “more than $8 million in Zika-specific funding and about $27 million in emergency preparedness funding that can be used toward Zika response efforts.” U.S. health officials have said they expect some transmission of Zika by mosquitoes this summer, particularly in Southern states such as Florida and parts of the Gulf Coast, where the species of mosquito that can carry Zika is most commonly found. But the CDC has said that it expects outbreaks would be limited, because most Americans live in air-conditioned residences that are spaced further apart than the homes in densely packed, poor neighborhoods where mosquitoes that are able to spread Zika thrive in the tropics. The range of the Aedes aegypti mosquito that is the main carrier of Zika is 150 meters or so. The Florida Department of Health said that mosquito control workers are working to reduce mosquito populations in the areas under investigation and that it is working to distribute Zika prevention kits to pregnant women through local obstetrician-gynecologists. The Broward County case is the third unexplained incidence of Zika to be reported this week. Utah health officials are trying to determine how the son of a man who had been infected with Zika got the disease himself. The son didn’t travel to an area where Zika was circulating, nor have sexual contact with an infected person. He did care for his acutely ill father, however. The CDC said that 1,404 cases of Zika had been reported in the continental U.S. and Hawaii as of July 20. None of the infections were due to local mosquito-borne transmission, the agency said. The cases include 15 from sexual transmission and one from a laboratory exposure. Write to Betsy McKay at [email protected] http://www.wsj.com/articles/florida-investigating-second-possible-case-of-locally-acquired-zika-1469143945

StatesStatesStatesStatesCDCStatesStatesStatesStatesCDCStates 11-Jul12-Jul13-Jul14-Jul14-Jul15-Jul18-Jul19-Jul20-Jul21-Jul21-JulAL11111111211111111811AR55555566656AZ999979999710CA7777777769868686866986CO1010101212121212121717CT3436363630363636363041DE91010108101010101010DC12121212912121212914FL276282293293229311319326327270334GA3131383833383838423942HI1010101010101010101010IL2626262623262626262330IN1010101212121212121313IA99999999999KS55555555555KY77777777799LA77777777788MD3131313535353535423642MA3939394949494949494949ME67777777777MI1010101313131313131313MN2121212121212121212121MO66688888888MS58888888899MT11111111111NC1818181818181919191819ND11110111111NE23333333333NH44444444455NJ4950545950595959595059NM33333333333NV77799999999NY411419432441339454466466466345494OH2124252525252525252626OK1212121212121212121212OR1616161616161616161216PA4040404039404444444244RI1616161616161616161717SC66171713171818181318TN1010101414141414141414TX74747495579510510510569109UT44455588868VA3333333838383838384043VT33333333333WA1314141511151717171317WI8899999991111WV67777888878 14241452150015711310161216541661167314041744

Number of cases reportedCounty/Area TodayYear to Date (7/19-21/16)Albany03Broome01Clinton01Dutchess05Erie03Lewis01Monroe03Nassau426Niagara01Oneida02Onondaga15Ontario03Orange12Otsego01Putnam01Rockland05St Lawrence01Schenectady01Suffolk129Tompkins01Westchester212NYS (ex NYC)9107NYC16362NYS Total Confirmed25469NYS Pregnant Registry025NYS Total25494

JULY 21, 2016 2:31 PM Second possible local Zika infection reported in South FloridaFlorida announced a second suspected case of local transmission, this one in Broward Mosquitoes tested in Miami-Dade area where first local transmission suspected Surveillance should include testing of area residents, epidemiologist says FACEBOOK TWITTER EMAIL SHARE Miami-Dade mosquito-control workers scour county in fight against Zika 2:04 FACEBOOK TWITTER EMAIL SHARE 1 of 2Florida officials are investigating the nation’s first possible case of mosquito-borne Zika virus transmission, identified this week in Miami-Dade County, where at least 89 people have contracted the disease this year. No mosquitoes in Miami-Dade have tested positive for the virus. Handout TNSBY DANIEL CHANG [email protected] LINKEDINGOOGLE+PINTERESTREDDITPRINTORDER REPRINT OF THIS STORY A second suspected case of mosquito-borne Zika infection was reported in Broward County on Thursday, two days after the Florida Department of Health announced a similar case in Miami-Dade — making South Florida the potential epicenter for the nation’s first local outbreak of the infectious disease. In response to the second case, Florida Surgeon General Celeste Philip requested that the federal Centers for Disease Control and Prevention send a medical epidemiologist to help with the investigation. The health department also urged residents in the affected Miami-Dade and Broward neighborhoods to cooperate with requests for blood and urine samples to help determine the number of people infected. FACEBOOK TWITTER EMAIL SHARE How Zika spreads (and who’s to blame)The mosquito kills nearly 750,000 people each year. Malaria is the cause for the majority of these deaths, but a Zika outbreak has the Americas scared of this insect. This is how the insect spreads disease to its victims. Sohail Al-Jamea and Meta Viers McClatchyThe health department has not disclosed the locations in Miami-Dade and Broward under investigation. If confirmed, the cases would be the first documented Zika infections caused by mosquitoes in the continental United States. To date, no mosquitoes captured in Miami-Dade have tested positive for the Zika virus, according to an official familiar with the health department’s investigation. Miami-Dade officials set up mosquito traps this week in the neighborhood where the infected person lives. The state health department reported a suspected local transmission of Zika virus in the area on Tuesday — four days after the case surfaced. The trapped mosquitoes were sent to a lab at Florida Gulf Coast University in Fort Myers to be tested for Zika virus and results came back negative, according to the official, who spoke on condition of anonymity. Florida’s Department of Health declined to verify the test results for mosquitoes trapped in the Miami-Dade area under investigation. Mara Gambineri, a spokesperson for the Florida health department, said the agency is still investigating and had no new information to report. But the Associated Press later reported that Gambineri had sent an emailed statement that “sexual transmission related to travel has not been ruled out” in the Miami-Dade case, and that not all the blood and urine tests from the people around the infected patient have come back yet. The department reported seven new Zika infections Thursday, including three pregnant women in undisclosed counties, three residents in Miami-Dade and one in Palm Beach — raising the statewide total to 334 people who have contracted the infectious disease this year. None of Florida’s confirmed Zika infections, including 92 people in Miami-Dade, have involved bites from local mosquitoes, according to the health department. The state’s official count does not yet include the suspected mosquito-borne transmission in Miami-Dade. State and local officials have been looking for Zika virus in local mosquitoes for months, placing traps near homes of people with infections confirmed by the health department. Those areas are targeted for inspection, surveillance and spraying. But a local epidemiologist said more can be done to prevent an outbreak following a local transmission. Aileen Marty, a physician and professor of infectious diseases with Florida International University’s Herbert Wertheim College of Medicine, said containment efforts may be more effective if a health agency also were to test for the virus among residents of the Miami-Dade neighborhood under investigation. “You have to test people,” Marty said. “Testing the mosquitoes is one thing. Think about how many mosquitoes there are and what percentage gets tested.” Zika can be difficult to diagnose in part because only one in five infected people show symptoms, which include fever, joint pain, rash and red eyes lasting seven to 10 days. Marty said the Centers for Disease Control and Prevention could help lead testing of people who have contracted Zika but are asymptomatic. It is unclear, however, whether any health agency is testing area residents for the virus. The Department of Health did not respond to questions about whether the agency is testing people who live in the Miami-Dade neighborhood under investigation but said that “it is standard” to conduct blood testing in an area of epidemiological investigation. The CDC has published a 58-page plan that outlines how the agency will respond to local transmissions of Zika, including the deployment of a CDC Emergency Response Team (CERT) capable of providing a wide range of help, from epidemiological investigation to public outreach. CDC officials did not immediately respond to questions about whether a CERT team has been deployed to Miami-Dade. The agency said this week that Florida and local officials are leading the investigation, and that the CDC has provided funding, including $2 million for Zika preparedness and another $5.6 million awarded this week. President Obama and Florida Gov. Rick Scott spoke by phone Wednesday about Zika. The CDC updated its weekly count of Zika cases nationwide on Thursday, reporting that 1,404 people in 46 states have contracted the disease. Only Alaska, Idaho, South Dakota and Wyoming have yet to report a Zika infection. Nearly all the cases were acquired by people traveling outside the country to areas where Zika is spread by mosquitoes, according to the CDC, which said 15 cases were sexually transmitted and one was acquired through laboratory exposure. Marty said that in order to prevent a larger outbreak in South Florida, health officials need to also test people who are at greatest risk of local transmission. “It's exactly what they should be doing,” Marty said. “They’ve got the mosquito trapping end of it very well done. Plus, they’re spraying for mosquitoes. But as far as I know, they haven’t started this whole surveillance of people.” ZIKA CASES REPORTED IN FLORIDA AS OF JULY 21 County Number of Cases Alachua 5 Brevard 6 Broward 50 Charlotte 1 Citrus 2 Clay 3 Collier 4 Duval 6 Escambia 1 Highlands 1 Hillsborough 7 Lake 1 Lee 6 Manatee 1 Martin 1 Miami-Dade 92** Okaloosa 1 Orange 33 Osceola 15 Palm Beach 14 Pasco 5 Pinellas 7 Polk 10 Santa Rosa 1 Seminole 9 St. Johns 2 St. Lucie 1 Volusia 3 Total cases not involving pregnant women 288 Cases involving pregnant women regardless of symptoms* 46 * Counties of pregnant women are not disclosed. ** Does not include suspected case of mosquito-borne transmission Source: Florida Department of Health Read more here: http://www.miamiherald.com/news/health-care/article91047207.html#storylink=cpyhttp://www.miamiherald.com/news/health-care/article91047207.html

Second case of Zika in Florida may have come from local mosquitoesFELIPE DANA/AP By HELEN BRANSWELL @HelenBranswell JULY 21, 2016 TwitterFacebookLinkedInEmailRepublishPrint Health 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 county. 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. Florida has asked for help from the Centers for Disease Control and Prevention, which is sending a medical epidemiologist to help with the investigation. 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 many of its citizens appear to travel to places where Zika outbreaks are occurring. Florida has reported 334 cases of travel related Zika to date, giving it one of the highest tallies in the country. Of those people, 46 are pregnant women. There have been more than 1,300 Zika cases in the United States. Almost all of the patients were infected while traveling in a Zika-infected area; a few others acquired the virus through sexual transmission. So far, there is no confirmed case of local mosquito transmission of the virus; the Florida patients would be the first. Helen Branswell can be reached at [email protected] Follow Helen on Twitter @HelenBranswell https://www.statnews.com/2016/07/21/florida-zika-local-transmission/

Zika is found in common Culex mosquitos, signaling a potentially larger risk “Culex is a much more abundant species,” Ayres told a news conference in Rio de Janeiro on Thursday, where she presented theresults. The researchers analyzed 456 female Culex mosquitoes, which they divided into 80 “pools” or sample groups of between one and 10 mosquitoes each. They found Zika-infected insects in three of these pools. Ayres said the research proved that Culex can transmit Zika and that it could have played a role in the rapid spread of the disease in Brazil. “It can transmit Zika. What we need to know now is which species is the most important — if Culex is the primary vector or the secondary vector. We need to do more research,” she said. Paulo Gadelha, president of the Oswaldo Cruz Foundation, expressed some caution during Thursday’s news conference. He said that a study at the institution in Rio by researcher Ricardo Lourenço-de-Oliveira had so far failed to find Zika in around 750 Culex mosquitoes. “It could be that mosquitoes circulating in the Northeast [of Brazil] have more interaction,” he said, stressing that more research was needed. Gadilha said the discovery did not change the low risk of Zika during Brazil’s Olympics, which open in Rio on Aug. 5 during the country’s cooler winter season. “The risk you have of Zika during this period is very, very remote,” he said. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Texas said that if researchers have found Zika in Culex mosquitoes only a handful of times, “it’s hard to know what that means; it may not be a finding of great biological significance.” But if they are detecting the virus in Culex mosquitoes in large numbers and on a consistent basis, “That would be a game changer.” Hotez was skeptical that Culex mosquitoes are going to start spreading Zika in a significant way. “So far, every place we’ve seen Zika has been a place where you have Aedes aegypti mosquitoes,” he said. “There no reason why one would have to speculate that another mosquito vector is involved.” https://www.washingtonpost.com/world/the_americas/zika-is-found-in-common-culex-mosquitos-signaling-a-potentially-larger-risk/2016/07/21/e1b37e0e-4f6f-11e6-bf27-405106836f96_story.html

07/21/2016 Fiocruz identifies Culex mosquito with potential transmission of Zika virus By: Solange Argenta (Fiocruz Pernambuco) Unpublished research conducted by the Oswaldo Cruz Foundation (Fiocruz) detected the presence of Zika virus in mosquito Culex quinquefasciatus (the popular muriçoca or house mosquito) collected in the city of Recife.This finding confirms the species as a potential vector of the virus that zika, a situation which, according to scientific literature, had not been proven to date. The survey was conducted by Fiocruz Pernambuco in the metropolitan area of Recife, where the population of Culex quinquefasciatus is about twenty times greater than the population of Aedes aegypti . Preliminary results of field research identified the presence of Culex quinquefasciatus naturally infected zika virus in three of the 80 pools * (groups) of mosquitoes analyzed to date. In two of these samples they were not fed mosquitoes, indicating that the virus was widespread in the insect body and not in a recent power in an infected host. The technique used in the experiment was quantitative RT-PCR based detection of RNA (genetic material) virus. The material of these positive pools was used to isolate the circulating virus strains in Reef, in cell culture, where it was observed cytopathic effect induced in the cells - i.e., destruction or damage of vero cells was observed, which proves the presence viral activity. The collection of mosquitoes was made based on the addresses of the reported cases of zika in the cities of Recife and Arcoverde, obtained from the Health Department of Pernambuco State (SES-PE). The total number of mosquitoes examined in the study was approximately 500. The aim of the project is to compare the role of some species of mosquitoes in Brazil of arbovirus transmission. Priority was given to Zika virus because the epidemic of the disease in Brazil and its connection with microcephaly. In the laboratory stage, in order to investigate the vector competence of the species Culex quinquefasciatus and Aedes aegypti , mosquitoes were fed a mixture of blood and viruses, allowing the monitoring of pathogen replication process within the insect. There were two mosquito infections each infection with two different virus concentrations (104 and 106) of Ziku BRPE243 / 2015 lineage. "The smallest simulates viremia condition of a real patient. Then the mosquitoes were collected at different times: at time zero (after infection), three days, seven days, 11 and 15 days after virus infection, "says Constance Ayres, coordinator of the study. A control group with mosquitoes fed on blood without the virus, was also maintained. Each mosquitoes was dissected to extract the intestine, and salivary gland tissues that present barriers to the development of the virus. The procedure takes place so that, if species vector is not at a given moment the development of the virus is blocked by the mosquito.However, if it is vector, virus replication occurs, spreads in the insect body and just infecting the salivary gland, from which can be transmitted to other hosts during the blood meal, the release of saliva containing virus.According Constancia, from the third day after artificial feeding has been possible to detect the presence of the virus in the salivary glands of both species of mosquito investigated. After seven days, it was observed the peak of infection in the salivary glands which was confirmed by electron microscopy. Besides the detection of virus in these tissues (intestine , and salivary gland), saliva samples were investigated expelled by mosquitoes infected by quantitative RT-PCR. The viral load found in two species ( Aedes aegypti and Culex quinquefasciatus ) was similar. From the data obtained will require additional studies to assess the potential participation of Culex in the spread of Zika virus and its role in the epidemic. The current study is very important, since the vector control measures are different. Until the results of new evidence, the control policy Zika epidemic still guided by the same guidelines, with its central focus on the control of Aedes aegypti .

07/21/2016 Fiocruz identifies Culex mosquito with potential transmission of Zika virus By: Solange Argenta (Fiocruz Pernambuco) Unpublished research conducted by the Oswaldo Cruz Foundation (Fiocruz) detected the presence of Zika virus in mosquito Culex quinquefasciatus (the popular muriçoca or house mosquito) collected in the city of Recife.This finding confirms the species as a potential vector of the virus that zika, a situation which, according to scientific literature, had not been proven to date. http://portal.fiocruz.br/pt-br/content/fiocruz-identifica-mosquito-culex-com-potencial-de-transmissao-do-virus-zika-no-recife

Jul 21, 5:12 PM EDT CORRECTS: FLORIDA HEALTH OFFICIALS HAVE NOT RULED OUT SEXUAL TRANSMISSION IN MIAMI-AREA WOMAN'S ZIKA INFECTION. 01:31 /01:31 Raw: Plane Crashes in Ill. Residential Area AP Cruz Dominates RNC Twitter as Trump To Hit Stage AP State Investigating Fla. Therapist Shooting AP Raw: Plane Crashes in Ill. Residential Area AP Cruz Dominates RNC Twitter as Trump To Hit Stage AP MIAMI (AP) -- CORRECTS: Florida health officials have not ruled out sexual transmission in Miami-area woman's Zika infection. (Corrects APNewsAlert to reflect that a health department spokeswoman says her earlier statement was incorrect. She says she should have written that "sexual transmission related to travel has not been ruled out.") http://hosted.ap.org/dynamic/stories/U/US_APNEWSALERT?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT

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