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NEWS JUL 7 2016, 9:18 AM ETU.S. Urges Puerto Rico to Spray for Zika as More Pregnant Women Get Infectedby ASSOCIATED PRESS SHARE A flyer that reads, "Questions and answers: Zica virus infection during pregnancy" is seen posted outside a doctor's office, at a public hospital in San Juan, Puerto Rico, February 3, 2016. ?(C) Alvin Baez / Reuters / Reuters fileAs many as 50 pregnant women a day are becoming infected with Zika in Puerto Rico. The best defense is aerial spraying, said Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, (CDC) to The Associated Press. Zika is a virus spread by mosquitos that can cause microcephaly, which results in babies being born with brain damage and abnormally small heads. Frieden said Puerto Rico, which is a U.S. territory, lacks an integrated mosquito control program. "If any part of the continental U.S. had the kind of spread of Zika that Puerto Rico has now, they would have sprayed months ago," said Frieden. "This is more a question of neglect than anything else. ... If we wait until children with microcephaly are born, it will be too late. That's the problem." PlayFacebookTwitterGoogle PlusEmbed Puerto Rico Braces for Zika Outbreak 2:01The island is debating whether to spray with the insecticide Naled, which has sparked protests over concerns about the impact on human health and wildlife. Puerto Rico has one of the highest asthma rates in the world. Frieden said less than two tablespoons of Naled would be used per acre. He said the product was used last year on 6 million acres in Florida, including Miami. He also said it was used in New York and there was no increase in the number of asthma cases there. Gina McCarthy, administrator for the U.S. Environmental Protection Agency, told the AP that the spraying "can be done safely and effectively and is perhaps the most important tool we can use right now to change the trajectory." RELATED: In Puerto Rico, Health Workers Describe Battle Against Zika Legislators are holding public hearings over the fumigation proposal, though it will be up to Gov. Alejandro García Padilla to implement the spraying, which would be paid for by the U.S. federal government. A total of 339 pregnant women in Puerto Rico have been diagnosed with Zika. Puerto Rico reported its first microcephaly case in May; it involved a fetus who tested positive for Zika. PlayFacebookTwitterGoogle PlusEmbed CDC: Puerto Rico Will Be Ground Zero for Zika Outbreak in U.S. 2:07Overall, Puerto Rico has reported nearly 2,400 Zika cases, 44 hospitalizations and one death. In addition, 16 people have been diagnosed with a temporary paralysis condition known as Guillain-Barre that has been linked to Zika infections. More than 20 percent of Puerto Rico's 3.5 million people could be infected with Zika in an outbreak expected to peak by this summer, according to the CDC, though local health officials have said that number is too high. But Frieden said part of the issue is that 8 in 10 people show no symptoms or have mild symptoms. http://www.nbcnews.com/news/latino/u-s-urges-puerto-rico-spray-zika-more-pregnant-women-n605186

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CDCStatesStatesStatesStates 30-Jun30-Jun1-Jul5-Jul6-JulAL26699AR55555AZ67779CA5562687070CO88888CT130303030DE59999DC66666FL182236246252263GA2626262931HI1010101010IL1623232323IN1010101010IA79999KS55555KY66666LA67777MD3131313131MA3232323232ME66666MI1010101010MN1919191919MO56666MS33333MT11111NC1618181818ND01111NE22222NH44444NJ2139474747NM33333NV77777NY236367374386395OH1621212121OK66666OR715151515PA3131313636RI1515151515SC66666TN88888TX4972747474UT22222VA2727272727VT23333WA613131313WI28888WV66666 9351247128013111335

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Number of cases reportedCounty/Area TodayYear to Date (7/6/16) Albany03Clinton11Dutchess05Erie02Lewis01Monroe03Nassau120Niagara01Oneida02Onondaga04Ontario02Orange01Putnam01Rockland04St Lawrence01Schenectady01Suffolk125Tompkins01Westchester17NYS (ex NYC)485NYC5289NYS Total Confirmed9374NYS Pregnant Registry021NYS Total9395

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JULY 5, 2016 4:42 PM Woman has Fresno County’s first travel-associated case of Zika virusFresno County Department of Public Health says woman bitten by mosquito about three weeks ago Woman had rash, fever, muscle aches – three symptoms of Zika virus Blood bank says donate before travel to Zika active countries Woman brings Zika virus back to Fresno County from another nation. What's next? 0:55 FACEBOOK TWITTER EMAIL SHARE FACEBOOK TWITTER EMAIL SHARE 1 of 7Dr. Ken Bird, Fresno County health officer, holds a news conference Tuesday, July 5, 2016 to announce the first case of travel-associated Zika virus in Fresno County. The woman was infected in another country by a mosquito carrying the virus. John Walker jwalker@fresnobee.comBY BARBARA ANDERSON banderson@fresnobee.com A Fresno County woman is the first person to be infected by the Zika virus from a mosquito bite during travel to another country, health officials said Tuesday. The woman became infected within the past three weeks, said Dr. Kenneth Bird, the county’s health officer. She was not identified, and Bird said she has asked health officials not to disclose the country she visited to protect her identity. The Aedes aegypti mosquito, female at bottom, can carry the Zika virus, shown during a news conference to announce the first case of travel-associated Zika virus disease in Fresno County at the Fresno County Department of Health, Tuesday morning, July 5, 2016. JOHN WALKER jwalker@fresnobee.comZika is widespread in portions of southern Mexico, and in Central and South American countries and the Caribbean As of July 1, 68 people in California have had confirmed travel-associated Zika infections. Of those, three cases have been confirmed in San Joaquin County and one in Stanislaus County. Nationwide, there have 934 infections traced to infection during travel. “Everyone here needs to be sure they’re protecting themselves from mosquito bites,” Bird said. Health officials are concerned about the potential for spread of the virus from people who are infected during travel, return home and are bitten by mosquitoes here that can spread the virus. The Aedes aegypti mosquito, which can carry Zika, has been found in areas of Clovis and Fresno since 2013. In Fresno, the mosquito has been particularly active in the areas of Herndon and Polk avenues and in Old Fig Garden, said Tim Phillips, manager of the Fresno Mosquito and Vector Control District. In Clovis, the mosquito has been concentrated in southeast Clovis. ADVERTISINGThe infected Fresno County woman lives in an area that is not home to mosquitoes that carry Zika, Bird said. Mosquitoes trapped around her home are not those that can transmit the virus. 68 Number of travel-associated Zika cases in California But since her return to Fresno County from her travels, she has been bitten by mosquitoes that can carry West Nile virus, said Steve Mulligan, manager of the Consolidated Mosquito Abatement District. People who return from Zika-active countries should use insect repellent for three weeks to prevent its spread, according to federal health guidelines. Bird said the woman is not under quarantine. Health workers have given her information about protecting against mosquito bites and about safe sexual practices. Zika also can be spread through sexual contact. The health department is “taking it on faith” that she is abiding by the health instructions and is protecting herself from further mosquito bites, he said. The county may have dodged a local transmission, this time, but Mulligan remains concerned: “It’s important we don’t have a person who is infected meet up with a mosquito that can transmit it.” Phillips said the Aedes aegypti mosquito is not going to go away: “Everyone needs to get used to using repellents every day.” Mulligan said the mosquito can breed in small amounts of water, including in back yard drains, which he said should be screened to keep mosquitoes out. “These mosquitoes will find water,” he said. The Central California Blood Center is closely following reports of travel-associated Zika cases, said Leslie Botos, director of community relations and development, who on Tuesday spoke at a health department news conference called about the county’s first travel-associated Zika case. IT’S IMPORTANT WE DON’T HAVE A PERSON WHO IS INFECTED MEET UP WITH A MOSQUITO THAT CAN TRANSMIT IT. Steve Mulligan, mosquito abatement manager There is no federally-approved test to detect Zika in blood that is universally being used by blood banks. A test has been developed that is in use in Puerto Rico, where Zika is active and blood donations for a time had been suspended, Bird said. But in the continental United States, people are asked to delay donation for at least one month following return from a Zika-active country, Botos said. Someone who has sexual contact with a partner who in the three months before sexual contact was diagnosed with Zika virus infection or had traveled to an area with Zika transmission must wait a month to donate blood. “We ask that you give blood before you travel,” Botos said. However, travelers should not think they no longer can be donors, she said. Deferral does not have to be permanent. Call the blood bank to find out your eligibility to donate, she said. “Every day, we need 250 to 300 donors,” Botos said. “Every time a story about Zika is presented, we see a decline in donations to the point where it takes our blood supply to a very vulnerable position for patients who depend on blood every single day.” Barbara Anderson: 559-441-6310, @beehealthwriter Read more here: http://www.sacbee.com/news/local/health-and-medicine/article87854462.html#storylink=cpy

A Fresno County woman is the first person to be infected by the Zika virus from a mosquito bite during travel to another country, health officials said Tuesday. The woman became infected within the past three weeks, said Dr. Kenneth Bird, the county’s health officer. http://www.sacbee.com/news/local/health-and-medicine/article87854462.html Read more here: http://www.sacbee.com/news/local/health-and-medicine/article87854462.html#storylink=cpy

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ZIKA: First case confirmed in southwest Riverside CountyCounty public health officials believe a southwest Riverside County man got the virus while visiting the Caribbean. By SUZANNE HURT / STAFF WRITER Published: July 5, 2016 Updated: July 6, 2016 7:34 a.m. , JAMES GATHANY/CENTERS FOR DISEASE CONTROL AND PREVENTIONRiverside County public health officials on Tuesday, July 5, reported a local resident is sick with the Zika virus after returning from the Caribbean – becoming the county’s first known case of the disease as the number of cases in the U.S. and U.S. territories, including in pregnant women, continues to grow. The 50-year-old man tested positive for the primarily mosquito-borne virus after returning in mid-June from visiting the Dominican Republic, where the insects are known to carry Zika, according to Riverside County Department of Public Health spokesman Jose Arballo Jr. Health officials believe the man, who lives in southwest Riverside County, became infected during his travel outside the United States. The state public health department confirmed the infection last week. The man was not hospitalized and is expected to make a full recovery. “How long it takes you to recover can vary quite a bit from person to person,” Arballo said. Zika infection in pregnant women can cause severe fetal brain defects including microcephaly, and is believed to sometimes trigger Guillain-Barré syndrome, according to the Centers for Disease Control and Prevention. The city the Riverside County man lives in is not being disclosed to protect the man’s confidentiality. Health officials don’t know of any of his family members being sick, Arballo said. Riverside County joins four other Southern California counties with confirmed Zika cases. As of July 1, Los Angeles County reported 19 cases, San Diego County had 16, Orange County had 6 and San Bernardino County had 3, according to the California Department of Public Health’s website. Imperial and Ventura counties remain Southern California’s only counties without confirmed Zika cases. Imperial County had no cases as of Tuesday, July 5, said health department spokeswoman Maria Peinado. On March 25, California public health director Dr. Karen Smith announced the first confirmed case of Zika virus acquired in California after a woman got sick following sex with an infected man who had traveled. However, the state has revised its report, in line with the CDC, to say the confirmed cases all involve people exposed to Zika through travel to an affected area or contact with a traveler. The number of Zika cases reported to the CDC’s arboNETcq in the U.S. and Washington, D.C., grew from 820 as of June 22 to 935 by June 29, and in U.S. territories from 1,860 June 22 to 2,026 by June 29. In the U.S., one case was acquired in a lab and the rest were travel-related, with 13 spread through sex. In U.S. territories, all but six cases were locally acquired, according to the CDC. The number of pregnant women who have tested positive for Zika in the U.S. and Washington, D.C., grew from 265 as of June 16 to 287 by June 23, and from 216 in U.S. territories to 250. Contact the writer: 951-368-9444 or shurt@pe.com

The 50-year-old man tested positive for the primarily mosquito-borne virus after returning in mid-June from visiting the Dominican Republic, where the insects are known to carry Zika, according to Riverside County Department of Public Health spokesman Jose Arballo Jr. http://www.pe.com/articles/county-807479-riverside-zika.html

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July 6, 2016 FLORIDA DEPARTMENT OF HEALTH DAILY ZIKA UPDATE: 11 NEW TRAVEL-RELATED CASES http://www.floridahealth.gov/newsroom/2016/07/070616-zika-update.htmlContact:Communications OfficeNewsMedia@flhealth.gov(850) 245-4111 Tallahassee, Fla.—In an effort to keep Florida residents and visitors safe and aware about the status of the Zika virus, the Florida Department of Health will issue a Zika virus update each week day at 2 p.m. Updates will include a CDC-confirmed Zika case count by county and information to better keep Floridians prepared. There are 11 new travel-related cases today with three in Broward, three in Orange, two in Miami-Dade, one in Hillsborough, one in Lake and one in Osceola counties. The Declaration of Public Health Emergency has been amended to include Lake County. Of the cases confirmed in Florida, 28 are still exhibiting symptoms. According to CDC, symptoms associated with the Zika virus last between seven to 10 days. CDC recommends that women who are pregnant or thinking of becoming pregnant postpone travel to Zika affected areas. According to CDC guidance, providers should consider testing all pregnant women with a history of travel to a Zika affected area for the virus. CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. Florida has been monitoring pregnant women with evidence of Zika regardless of symptoms since January. The total number of pregnant women who have been monitored is 43, with 12 having met the previous CDC case definition. The Council of State and Territorial Epidemiologists and CDC released a new case definition for Zika that now includes reporting both asymptomatic and symptomatic cases of Zika. Prior to this change, states reported only symptomatic non-pregnant cases and pregnant cases regardless of symptoms. This change comes as a result of increased availability for testing in commercial laboratories. County Number of Cases (all travel related) Alachua 4 Brevard 4 Broward 37 Charlotte 1 Citrus 2 Clay 2 Collier 3 Duval 5 Escambia 1 Highlands 1 Hillsborough 6 Lake 1 Lee 6 Martin 1 Miami-Dade 72 Okaloosa 1 Orange 21 Osceola 10 Palm Beach 12 Pasco 4 Pinellas 6 Polk 6 Santa Rosa 1 Seminole 9 St. Johns 2 Volusia 2 Total cases not involving pregnant women 220 Cases involving pregnant women regardless of symptoms* 43 *Counties of pregnant women will not be shared. On Feb. 12, Governor Scott directed the State Surgeon General to activate a Zika Virus Information Hotline for current Florida residents and visitors, as well as anyone planning on traveling to Florida in the near future. The hotline, managed by the Department of Health, has assisted 2,223 callers since it launched. The number for the Zika Virus Information Hotline is 1-855-622-6735. All cases are travel-associated. There have been no locally-acquired cases of Zika in Florida. For more information on the Zika virus, click here. The department urges Floridians to drain standing water weekly, no matter how seemingly small. A couple drops of water in a bottle cap can be a breeding location for mosquitoes. Residents and visitors also need to use repellents when enjoying the Florida outdoors. More Information on DOH action on Zika: On Feb. 3, Governor Scott directed the State Surgeon General to issue a Declaration of Public Health Emergency for the counties of residents with travel-associated cases of Zika.There have been 26 counties included in the declaration– Alachua, Brevard, Broward, Charlotte, Citrus, Clay, Collier, Duval, Escambia, Highlands, Hillsborough, Lake, Lee, Martin, Miami-Dade, Okaloosa, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Santa Rosa, Seminole, St. Johns and Volusia – and will be updated as needed. DOH encourages Florida residents and visitors to protect themselves from all mosquito-borne illnesses by draining standing water; covering their skin with repellent and clothing; and covering windows with screens.DOH has a robust mosquito-borne illness surveillance system and is working with CDC, the Florida Department of Agriculture and Consumer Services and local county mosquito control boards to ensure that the proper precautions are being taken to protect Florida residents and visitors.On April 6, Governor Rick Scott and Interim State Surgeon General Dr. Celeste Philip hosted a conference call with Florida Mosquito Control Districts to discuss ongoing preparations to fight the possible spread of the Zika virus in Florida. There were 74 attendees on the call.On May 11, Governor Scott met with federal leaders on the importance of preparing for Zika as we would a hurricane. Governor Scott requested 5,000 Zika preparedness kits from HHS Secretary Sylvia Burwell as well as a plan from FEMA on how resources will be allocated to states in the event an emergency is declared.On June 1, Governor Scott requested for President Obama to provide preparedness items needed in order to increase Florida’s capacity to be ready when Zika becomes mosquito-borne in our state.On June 9, Governor Scott spoke with Health and Human Services Secretary Sylvia Burwell and CDC Director Dr. Tom Frieden on Zika preparedness and reiterated the requests that he has continued to make to the federal government to prepare for the Zika virus once it becomes mosquito-borne in Florida. Governor Scott also requested that the CDC provide an additional 1,300 Zika antibody tests to Florida to allow individuals, especially pregnant women and new mothers, to see if they ever had the Zika virus.On June 23, Governor Rick Scott announced that he will use his emergency executive authority to allocate $26.2 million in state funds for Zika preparedness, prevention and response in Florida.On June 28, the department announced the first confirmed case of microcephaly in an infant born in Florida whose mother had a travel-related case of Zika. The mother of the infant contracted Zika while in Haiti. Following the confirmation of this case, Governor Rick Scott called on CDC to host a call with Florida medical professionals, including OBGYNs and physicians specializing in family medicine, to discuss the neurological impacts of Zika and what precautions new and expecting mothers should take.On July 1, CDC hosted a call with Florida medical professionals, including OBGYNs and physicians specializing in family medicine, to discuss the neurological impacts of Zika and what precautions new and expecting mothers should take. More than 120 clinicians participated.Florida currently has the capacity to test 5,435 people for active Zika virus and 1,904 for Zika antibodies.Federal Guidance on Zika: According to CDC, Zika illness is generally mild with a rash, fever and joint pain. CDC researchers have concluded that Zika virus is a cause of microcephaly and other birth defects.The FDA released guidance regarding donor screening, deferral and product management to reduce the risk of transfusion-transmission of Zika virus. Additional information is available on the FDA website here.CDC has put out guidance related to the sexual transmission of the Zika virus. This includes CDC recommendation that if you have traveled to a country with local transmission of Zika you should abstain from unprotected sex.For more information on Zika virus, click here. About the Florida Department of Health The department, nationally accredited by the Public Health Accreditation Board, works to protect, promote and improve the health of all people in Florida through integrated state, county and community efforts. Follow us on Twitter at @HealthyFla and on Facebook. For more information about the Florida Department of Health, please visit www.FloridaHealth.gov.

County Number of Cases (all travel related) Alachua 4 Brevard 4 Broward 37 Charlotte 1 Citrus 2 Clay 2 Collier 3 Duval 5 Escambia 1 Highlands 1 Hillsborough 6 Lake 1 Lee 6 Martin 1 Miami-Dade 72 Okaloosa 1 Orange 21 Osceola 10 Palm Beach 12 Pasco 4 Pinellas 6 Polk 6 Santa Rosa 1 Seminole 9 St. Johns 2 Volusia 2 Total cases not involving pregnant women 220 Cases involving pregnant women regardless of symptoms* 43 *Counties of pregnant women will not be shared.

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https://public.health.oregon.gov/newsadvisories/Pages/zika.aspx Confirmed Zika Cases in Oregon, 2016As of 7/5/2016 Travel-associated cases: 12 Oregon mosquito-acquired cases: 0 Total: 12

Confirmed Zika Cases in Oregon, 2016As of 7/5/2016 Travel-associated cases: 12 Oregon mosquito-acquired cases: 0 Total: 12

Zika Virus – July 6, 2016. Texas has had 53 reported cases of Zika virus disease. Of those, 52 were in travelers who were infected abroad and diagnosed after they returned home; one of those travelers was a pregnant woman. One case involved a Dallas County resident who had sexual contact with someone who acquired the Zika infection while traveling abroad. Texas Zika Cases by County: CountyCasesBexar6Collin2Dallas10Denton2Ellis1Fort Bend2Grayson1Hamilton1Harris16Lubbock1Medina1Tarrant5Travis2Val Verde1Williamson1Wise1Total53

In stable condition the baby was born with microcephalyPOSTED BY: JESSICA SORIANOON:JULY 6, 2016IN: REP. DOMINICANNO COMMENTS PRINT EMAILSANTO DOMINGO, Dominican Republic.- At steady state the child born in the province of Barahona, with microcephaly and who is admitted at Children 's Hospital Robert Reid Cabral, if the authorities are waiting for the results remains to determine if it would be the first associated with the Zika virus. The health center director, José Miguel Ferreras, said she hoped the baby is within 15 percent of infants who survive with this disease. He reported that genetics and neurology specialists will determine when he will be discharged.http://www.noticiassin.com/2016/07/en-condicion-estable-el-bebe-nacio-con-microcefalia/

TABLE I. Provisional cases of selected* infrequently reported notifiable diseases (<1,000 cases reported during the preceding year), United States, week ending July 2, 2016 (WEEK 26)†http://wonder.cdc.gov/mmwr/mmwr_2016.asp?mmwr_year=2016&mmwr_week=26&mmwr_table=1&request=Submit&mmwr_location= Disease Total cases reported for previous years Current weekCum 20165-year weekly average§20152014201320122011States reporting cases during current week (No.26) Anthrax-------1 Arboviral diseases ¶,**: Chikungunya virus ††-506896NNNNNNNN Eastern equine encephalitis virus--0688154 Jamestown Canyon virus §§--011112223 La Crosse virus §§-1155808578130 Powassan virus-117812716 St. Louis encephalitis virus--02310136 Western equine encephalitis virus-------- Botulism, total-854195161152168153 foodborne-220371542724 infant-56313812713612397 other(wound & unspecified)-702019121832 Brucellosis1492126929911479TN (1 ) Chancroid-7011--158 Cholera--025141740 Cyclosporiasis **54429645388784123151ME (1 ), NYC (1 ), FL (1 ), TX (2 ) Diphtheria----1-1- Haemophilus influenzae, invasive disease (age <5 yrs) ¶¶: serotype b1902940313014WA (1 ) nontypeable serotype-84317412814111593 other serotype1611135266233263230AK (1 ) unknown serotype1108416739343748FL (1 ) Hansen's disease **-2228988818282 Hantavirus Infections **: Hantavirus infection (non-HPS) ††-3-1NNNNNNNN Hantavirus pulmonary syndrome (HPS)-911732213023 Hemolytic uremic syndrome, post-diarrheal **2828275250329274290FL (1 ), ID (1 ) Hepatitis B, virus infection perinatal-14137474840NP Influenza-associated pediatric mortality **, ***374113014116052118NY (1 ), UT (1 ), CA (1 ) Leptospirosis **-1704038NNNNNN Listeriosis522916766769735727870NY (2 ), OH (1 ), FL (2 ) Measles †††246918866718755220AZ (2 ) Meningococcal disease, invasive §§§: serogroup ACWY1533120123142161257OK (1 ) serogroup B13911118999110159WA (1 ) other serogroup-702125172020 unknown serogroup3954120196298260323FL (1 ), TN (1 ), CO (1 ) Novel influenza A virus infections ¶¶¶231632131314MN (1 ), WI (1 ) Plague--01310443 Poliomyelitis, paralytic--0--1-- Polio virus infection, nonparalytic **-------- Psittacosis **-3-48622 Q fever total **:2473158168170135134 acute1393123132137113110OH (1 ) chronic1803536332224NYC (1 ) Rabies, human--011216 SARS CoV-------- Smallpox-------- Streptococcal toxic shock syndrome **-1394335259224194168 Syphilis, congenital ****-1567490458348322360 Toxic shock syndrome (staphylococcal) **11516659716578OH (1 ) Trichinellosis **-401114221815 Tularemia1469314180203149166PA (1 ) Typhoid fever21307367349338354390NYC (1 ), KY (1 ) Vancomycin-intermediate Staphylococcus aureus **-51318321224813482 Vancomycin-resistant Staphylococcus aureus **--01--2- Viral hemorrhagic Fevers ††††: Crimean-Congo hemorrhagic fever----NPNPNPNP Ebola hemorrhagic fever----4NPNPNP Guanarito hemorrhagic fever----NPNPNPNP Junin hemorrhagic fever----NPNPNPNP Lassa fever----1NPNPNP Lujo virus----NPNPNPNP Machupo hemorrhagic fever----NPNPNPNP Marburg fever----NPNPNPNP Sabia-associated hemorrhagic fever----NPNPNPNP Yellow fever-------- Zika ††,§§§§ Zika virus congenital infectionNANANANNNNNNNNNN Zika virus disease, non-congenital infection51,0740NNNNNNNNNNPA (1 ), GA (1 ), FL (1 ), MS (1 ), CA (1 )[ Export This Table ] [ Next Part ] [ NNDSS Interactive Tables ] [ Mortality Interactive Tables ] -: No reported cases N: Not reportable. NA: Not Available NN: Not Nationally Notifiable. NP: Nationally notifiable but not published. Cum: Cumulative year-to-date counts. * Case counts for reporting years 2015 and 2016 are provisional and subject to change. Data for years 2011 through 2014 are finalized. For further information on interpretation of these data, seehttp://wwwn.cdc.gov/nndss/document/ProvisionalNationaNotifiableDiseasesSurveillanceData20100927.pdf. † This table does not include cases from the U.S. territories. Three low incidence conditions, rubella, rubella congenital, and tetanus, are in Table II to facilitate case count verification with reporting jurisdictions. § Calculated by summing the incidence counts for the current week, the 2 weeks preceding the current week, and the 2 weeks following the current week, for a total of 5 preceding years. Additional information is available athttp://wwwn.cdc.gov/nndss/document/5yearweeklyaverage.pdf. ¶ Includes both neuroinvasive and nonneuroinvasive. Updated weekly reports from the Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases (ArboNET Surveillance). Data for West Nile virus are available in Table II. ** Not reportable in all reporting jurisdictions. Data from states where the condition is not reportable are excluded from this table, except for the arboviral diseases and influenza-associated pediatric mortality. Reporting exceptions are available athttp://wwwn.cdc.gov/nndss/downloads.html. †† Office of Management and Budget approval of the NNDSS Revision #0920-0728 on January 21, 2016, authorized CDC to receive data for these conditions. CDC is in the process of soliciting data for these conditions (except Zika virus, congenital infection). CDC and the U.S. states are still modifying the technical infrastructure needed to collect and transmit data for Zika virus congenital infections. §§ Jamestown Canyon virus and Lacrosse virus have replaced California serogroup diseases. ¶¶ Data for Haemophilus influenzae (all ages, all serotypes) are available in Table II. *** Please refer to the MMWR publication for weekly updates to the footnote for this condition. ††† Please refer to the MMWR publication for weekly updates to the footnote for this condition. §§§ Data for meningococcal disease (all serogroups) are available in Table II. ¶¶¶ Please refer to the MMWR publication for weekly updates to the footnote for this condition. **** Updated weekly from reports to the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. †††† Please refer to the MMWR publication for weekly updates to the footnote for this condition. §§§§ All cases reported have occurred in travelers returning from affected areas, with their sexual contacts, or infants infected in utero.National Notifiable Diseases Surveillance System (NNDSS) MMWR web application provided by CDC WONDER, http://wonder.cdc.gov

2015 Zika cases were 59 in week 25 MMWR Zika ††,§§§§ Zika virus congenital infectionNANANANNNNNNNNNN Zika virus disease, non-congenital infection51,0740NNNNNNNNNNPA (1 ), GA (1 ), FL (1 ), MS (1 ), CA (1 )

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