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This weeks NY State mosquito report cites 22 Zika Pregnancy Cases, excluding those reported by New York City, https://www.health.ny.gov/diseases/west_nile_virus/docs/weekly_arboviral_surveillance_report.pdf

HEALTH ZIKA VIRUS OUTBREAK JUN 30 2016, 12:15 PM ETNew Zika Studies Reveal Invisible Damage to Babiesby MAGGIE FOX SHARE Zika virus causes different types of brain damage in babies, not just microcephaly, according to two new reports. Brazilian researchers found as many as one in five babies born with brain damage caused by Zika had normal-sized heads. That means babies who may seem normal may in fact suffer from serious conditions that parents and doctors may not notice until they get older. Pediatrician Alexia Harrist from the United States' Centers for Disease Control and Prevention (CDC) examines 3-month-old Shayde Henrique, who was born with microcephaly, in Joao Pessoa, Brazil, Tuesday, Feb. 23, 2016. Andre Penner / APThe findings show that if a pregnant woman is infected with Zika — even if a baby is born with a normal-sized head — the child could have severe brain damage. "ABOUT ONE IN FIVE DEFINITE OR PROBABLE CASES HAD HEAD CIRCUMFERENCES IN THE NORMAL RANGE."Worse, the study confirms that many of the pregnant women whose babies were affected didn't have the obvious symptoms of Zika, such as a rash. The virus is known to cause invisible infections in most people who catch it — usually good news, but that's bad news for pregnant women who may not know anything is amiss until their babies start showing symptoms as they grow. And the study also found that even late in pregnancy, babies can suffer brain damage caused by Zika. In other words, there's no stage of pregnancy that's safe. Dr. Cesar Victora of the Federal University of Pelotas in Rio Grande do Sul, Brazil, looked at 602 newborn babies suspected of having been affected by Zika. "About one in five definite or probable cases had head circumferences in the normal range," they wrote in their report, published in the Lancet medical journal. Related: Can I Ever Get Pregnant If I've Had Zika? That suggests that many babies may have been part of Brazil's Zika epidemic but their doctors and parents may not yet know. "The finding of several newborn babies with neuroimaging abnormalities despite normal sized heads suggests that the initial focus on microcephaly was too narrow," they wrote. Other studies have shown that Zika homes in on developing brain and nerve cells and doctors feared babies who seemed fine at first in fact would have brain damage caused by Zika. This study confirms it's true. Geovane Silva holds his son Gustavo Henrique, who has microcephaly, at the Oswaldo Cruz Hospital in Recife, Brazil, on Jan. 26. UESLEI MARCELINO / ReutersOther studies have also shown that Zika causes far more symptoms than microcephaly alone. Babies born to moms infected with Zika can have vision and hearing problems and other disorders that depend on just what part of the brain the virus has damaged. Zika targets brain and nerve cells. The Brazilian team's finding confirms this happens throughout pregnancy. "As expected, the earlier the rash occurred during pregnancy, the smaller was the mean head circumference at birth, suggesting a causal association," they wrote. "Rashes in the third trimester of pregnancy were associated with brain abnormalities despite normal-sized heads," they added. Related: Zika Study Will Track 10,000 Pregnant Women "Among Zika virus affected pregnancies, some fetuses will have brain abnormalities and microcephaly, others will have abnormalities with normal head sizes, and presumably others will not be affected." "RASHES IN THE THIRD TRIMESTER OF PREGNANCY WERE ASSOCIATED WITH BRAIN ABNORMALITIES DESPITE NORMAL-SIZED HEADS."Another recent study found that while Zika usually clears up within two weeks at the longest, pregnant female monkeys could be infected for as long as two months. Doctors suspect the same thing may happen in pregnant women and if that's the case, the virus could affect a developing baby all during the time, as well. And, Victora's team said, newborn babies may be at risk, also. In another report in Lancet, Dr. Sherif Zaki of the Centers for Disease Control and Prevention and colleagues examined three Zika-affected babies who died after they were born, and the placenta from two babies who miscarried. They found Zika caused many different types of brain damage as well as limb and genital malformations. The two women who miscarried were infected early in pregnancy, and lost the pregnancies soon after, they said http://www.nbcnews.com/storyline/zika-virus-outbreak/new-zika-studies-reveal-invisible-damage-babies-n601736

SummaryBackgroundIn November, 2015, an epidemic of microcephaly was reported in Brazil, which was later attributed to congenital Zika virus infection. 7830 suspected cases had been reported to the Brazilian Ministry of Health by June 4, 2016, but little is known about their characteristics. We aimed to describe these newborn babies in terms of clinical findings, anthropometry, and survival. MethodsWe reviewed all 1501 liveborn infants for whom investigation by medical teams at State level had been completed as of Feb 27, 2016, and classified suspected cases into five categories based on neuroimaging and laboratory results for Zika virus and other relevant infections. Definite cases had laboratory evidence of Zika virus infection; highly probable cases presented specific neuroimaging findings, and negative laboratory results for other congenital infections; moderately probable cases had specific imaging findings but other infections could not be ruled out; somewhat probable cases had imaging findings, but these were not reported in detail by the local teams; all other newborn babies were classified as discarded cases. Head circumference by gestational age was assessed with InterGrowth standards. First week mortality and history of rash were provided by the State medical teams. FindingsBetween Nov 19, 2015, and Feb 27, 2015, investigations were completed for 1501 suspected cases reported to the Brazilian Ministry of Health, of whom 899 were discarded. Of the remainder 602 cases, 76 were definite, 54 highly probable, 181 moderately probable, and 291 somewhat probable of congenital Zika virus syndrome. Clinical, anthropometric, and survival differences were small among the four groups. Compared with these four groups, the 899 discarded cases had larger head circumferences (mean Z scores −1·54 vs −3·13, difference 1·58 [95% CI 1·45–1·72]); lower first-week mortality (14 per 1000 vs 51 per 1000; rate ratio 0·28 [95% CI 0·14–0·56]); and were less likely to have a history of rash during pregnancy (20·7% vs 61·4%, ratio 0·34 [95% CI 0·27–0·42]). Rashes in the third trimester of pregnancy were associated with brain abnormalities despite normal sized heads. One in five definite or probable cases presented head circumferences in the normal range (above −2 SD below the median of the InterGrowth standard) and for one third of definite and probable cases there was no history of a rash during pregnancy. The peak of the epidemic occurred in late November, 2015. InterpretationZika virus congenital syndrome is a new teratogenic disease. Because many definite or probable cases present normal head circumference values and their mothers do not report having a rash, screening criteria must be revised in order to detect all affected newborn babies. FundingBrazilian Ministry of Health, Pan American Health Organization, and Wellcome Trust.

Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigationhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30902-3/fulltext

Outcomes of Pregnancies with Laboratory Evidence of Possible Zika Virus Infection in the United States, 2016Language:EnglishEspañolPortuguêsRecommend on FacebookTweet Pregnancy Outcomes in the United States and the District of ColumbiaLiveborn infants with birth defects*7Includes aggregated data reported to the US Zika Pregnancy Registry as of June 23, 2016 Pregnancy losses with birth defects**5Includes aggregated data reported to the US Zika Pregnancy Registry as of June 23, 2016 Pregnancy Outcomes in the United States TerritoriesLiveborn infants with birth defects*0Includes aggregated data from the US territories reported to the US Zika Pregnancy Registry and data from Puerto Rico reported to the Zika Active Pregnancy Surveillance System as of June 23, 2016 Pregnancy losses with birth defects**1Includes aggregated data from the US territories reported to the US Zika Pregnancy Registry and data from Puerto Rico reported to the Zika Active Pregnancy Surveillance System as of June 23, 2016 What these numbers show These numbers reflect poor outcomes among pregnancies with laboratory evidence of possible Zika virus infection reported to the US Zika Pregnancy Registry.The number of live-born infants and pregnancy losses with birth defects are combined for the 50 US states, the District of Columbia, and the US territories. To protect the privacy of the women and children affected by Zika, CDC is not reporting individual state, tribal, territorial or jurisdictional level data.The poor birth outcomes reported include those that have been detected in infants infected with Zika before or during birth, including microcephaly, calcium deposits in the brain indicating possible brain damage, excess fluid in the brain cavities and surrounding the brain, absent or poorly formed brain structures, abnormal eye development, or other problems resulting from damage to brain that affects nerves, muscles and bones, such as clubfoot or inflexible joints.What these new numbers do not show These numbers are not real time estimates. They will reflect the outcomes of pregnancies reported with any laboratory evidence of possible Zika virus infection as of 12 noon every Thursday the week prior; numbers will be delayed one week.These numbers do not reflect outcomes among ongoing pregnancies.Although these outcomes occurred in pregnancies with laboratory evidence of Zika virus infection, we do not know whether they were caused by Zika virus infection or other factors.Where do these numbers come from? These data reflect pregnancies reported to the US Zika Pregnancy Registry. CDC, in collaboration with state, local, tribal and territorial health departments, established this registry for comprehensive monitoring of pregnancy and infant outcomes following Zika virus infection. The data collected through this system will be used to update recommendations for clinical care, to plan for services and support for pregnant women and families affected by Zika virus, and to improve prevention of Zika virus infection during pregnancy.* Includes microcephaly, calcium deposits in the brain indicating possible brain damage, excess fluid in the brain cavities and surrounding the brain, absent or poorly formed brain structures, abnormal eye development, or other problems resulting from damage to the brain that affects nerves, muscles and bones, such as clubfoot or inflexible joints. **Includes miscarriage, stillbirths, and terminations with evidence of the birth defects mentioned above Page last reviewed: June 15, 2016Page last updated: June 30, 2016

Pregnancy Outcomes in the United States and the District of Columbiahttp://www.cdc.gov/zika/geo/pregnancy-outcomes.html Liveborn infants with birth defects*7Includes aggregated data reported to the US Zika Pregnancy Registry as of June 23, 2016 Pregnancy losses with birth defects**5Includes aggregated data reported to the US Zika Pregnancy Registry as of June 23, 2016

US States and the District of Columbia*287*Includes aggregated data reported to the US Zika Pregnancy Registry as of June 23, 2016 US Territories**250**Includes aggregated data from the US territories reported to the US Zika Pregnancy Registry and data from Puerto Rico reported to the Zika Active Pregnancy Surveillance System as of June 23, 2016

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of June 29, 2016) http://www.cdc.gov/zika/geo/united-states.html StatesTravel-associated cases* No. (% of cases in states) (N=935)Locally acquired cases† No. (% of cases in states) (N=0)Alabama2 (<1)0 (0)Arizona6 (1)0 (0)Arkansas5 (1)0 (0)California55 (6)0 (0)Colorado8 (1)0 (0)Connecticut1 (<1)0 (0)Delaware5 (1)0 (0)District of Columbia6 (1)0 (0)Florida182 (20)0 (0)Georgia26 (3)0 (0)Hawaii10 (1)0 (0)Illinois16 (2)0 (0)Indiana10 (1)0 (0)Iowa7 (1)0 (0)Kansas5 (<1)0 (0)Kentucky6 (1)0 (0)Louisiana6 (1)0 (0)Maine6 (1)0 (0)Maryland31 (3)0 (0)Massachusetts32 (3)0 (0)Michigan10 (1)0 (0)Minnesota19 (2)0 (0)Mississippi3 (<1)0 (0)Missouri5 (1)0 (0)Montana1 (<1)0 (0)Nebraska2 (<1)0 (0)Nevada7 (1)0 (0)New Hampshire4 (1)0 (0)New Jersey21 (2)0 (0)New Mexico3 (<1)0 (0)New York236 (25)0 (0)North Carolina16 (2)0 (0)Ohio16 (2)0 (0)Oklahoma6 (1)0 (0)Oregon7 (1)0 (0)Pennsylvania††31 (3)0 (0)Rhode Island15 (2)0 (0)South Carolina6 (<1)0 (0)Tennessee8 (1)0 (0)

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June 30, 2016 DEPARTMENT OF HEALTH DAILY ZIKA UPDATE: FOUR NEW TRAVEL-RELATED CASES http://www.floridahealth.gov/newsroom/2016/06/063016-zika-update.htmlContact:Communications [email protected](850) 245-4111 Tallahassee, Fla.—In an effort to keep Florida residents and visitors safe and aware about the status of the Zika virus, the 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 four new cases with one in Broward, one Duval, one Orange and one in Seminole counties. Of the cases confirmed in Florida, 18 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 41, 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 33 Citrus 1 Clay 2 Collier 3 Duval 3 Escambia 1 Highlands 1 Hillsborough 5 Lee 5 Martin 1 Miami-Dade 68 Okaloosa 1 Orange 17 Osceola 9 Palm Beach 12 Pasco 2 Pinellas 6 Polk 4 Santa Rosa 1 Seminole 8 St. Johns 2 Volusia 2 Total cases not involving pregnant women 195 Cases involving pregnant women regardless of symptoms* 41 *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 2,180 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 24 counties included in the declaration– Alachua, Brevard, Broward, Citrus, Clay, Collier, Duval, Escambia, Highlands, Hillsborough, 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 Centers for Diseases Control (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 the Centers for Disease Control and Prevention (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.Florida currently has the capacity to test 5,537 people for active Zika virus and 1,947 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 33 Citrus 1 Clay 2 Collier 3 Duval 3 Escambia 1 Highlands 1 Hillsborough 5 Lee 5 Martin 1 Miami-Dade 68 Okaloosa 1 Orange 17 Osceola 9 Palm Beach 12 Pasco 2 Pinellas 6 Polk 4 Santa Rosa 1 Seminole 8 St. Johns 2 Volusia 2 Total cases not involving pregnant women 195 Cases involving pregnant women regardless of symptoms* 41 *Counties of pregnant women will not be shared.

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

Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of June 29, 2016) http://www.cdc.gov/zika/geo/united-states.html StatesTravel-associated cases* No. (% of cases in states) (N=935)Locally acquired cases† No. (% of cases in states) (N=0)Alabama2 (<1)0 (0)Arizona6 (1)0 (0)Arkansas5 (1)0 (0)California55 (6)0 (0)Colorado8 (1)0 (0)Connecticut1 (<1)0 (0)Delaware5 (1)0 (0)District of Columbia6 (1)0 (0)Florida182 (20)0 (0)Georgia26 (3)0 (0)Hawaii10 (1)0 (0)Illinois16 (2)0 (0)Indiana10 (1)0 (0)Iowa7 (1)0 (0)Kansas5 (<1)0 (0)Kentucky6 (1)0 (0)Louisiana6 (1)0 (0)Maine6 (1)0 (0)Maryland31 (3)0 (0)Massachusetts32 (3)0 (0)Michigan10 (1)0 (0)Minnesota19 (2)0 (0)Mississippi3 (<1)0 (0)Missouri5 (1)0 (0)Montana1 (<1)0 (0)Nebraska2 (<1)0 (0)Nevada7 (1)0 (0)New Hampshire4 (1)0 (0)New Jersey21 (2)0 (0)New Mexico3 (<1)0 (0)New York236 (25)0 (0)North Carolina16 (2)0 (0)Ohio16 (2)0 (0)Oklahoma6 (1)0 (0)Oregon7 (1)0 (0)Pennsylvania††31 (3)0 (0)Rhode Island15 (2)0 (0)

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of June 29, 2016) http://www.cdc.gov/zika/geo/united-states.html StatesTravel-associated cases* No. (% of cases in states) (N=935)Locally acquired cases† No. (% of cases in states) (N=0)Alabama2 (<1)0 (0)Arizona6 (1)0 (0)Arkansas5 (1)0 (0)California55 (6)0 (0)Colorado8 (1)0 (0)Connecticut1 (<1)0 (0)Delaware5 (1)0 (0)District of Columbia6 (1)0 (0)Florida182 (20)0 (0)Georgia26 (3)0 (0)Hawaii10 (1)0 (0)Illinois16 (2)0 (0)Indiana10 (1)0 (0)Iowa7 (1)0 (0)Kansas5 (<1)0 (0)Kentucky6 (1)0 (0)Louisiana6 (1)0 (0)Maine6 (1)0 (0)Maryland31 (3)0 (0)Massachusetts32 (3)0 (0)Michigan10 (1)0 (0)Minnesota19 (2)0 (0)Mississippi3 (<1)0 (0)Missouri5 (1)0 (0)Montana1 (<1)0 (0)Nebraska2 (<1)0 (0)Nevada7 (1)0 (0)New Hampshire4 (1)0 (0)New Jersey21 (2)0 (0)New Mexico3 (<1)0 (0)New York236 (25)0 (0)North Carolina16 (2)0 (0)Ohio16 (2)0 (0)Oklahoma6 (1)0 (0)Oregon7 (1)0 (0)Pennsylvania††31 (3)0 (0)

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of June 29, 2016) http://www.cdc.gov/zika/geo/united-states.html StatesTravel-associated cases* No. (% of cases in states) (N=935)Locally acquired cases† No. (% of cases in states) (N=0)Alabama2 (<1)0 (0)Arizona6 (1)0 (0)Arkansas5 (1)0 (0)California55 (6)0 (0)Colorado8 (1)0 (0)Connecticut1 (<1)0 (0)Delaware5 (1)0 (0)District of Columbia6 (1)0 (0)Florida182 (20)0 (0)Georgia26 (3)0 (0)Hawaii10 (1)0 (0)Illinois16 (2)0 (0)Indiana10 (1)0 (0)Iowa7 (1)0 (0)Kansas5 (<1)0 (0)Kentucky6 (1)0 (0)Louisiana6 (1)0 (0)Maine6 (1)0 (0)Maryland31 (3)0 (0)Massachusetts32 (3)0 (0)Michigan10 (1)0 (0)

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of June 29, 2016) http://www.cdc.gov/zika/geo/united-states.html StatesTravel-associated cases* No. (% of cases in states) (N=935)Locally acquired cases† No. (% of cases in states) (N=0)Alabama2 (<1)0 (0)Arizona6 (1)0 (0)Arkansas5 (1)0 (0)California55 (6)0 (0)Colorado8 (1)0 (0)Connecticut1 (<1)0 (0)Delaware5 (1)0 (0)District of Columbia6 (1)0 (0)Florida182 (20)0 (0)Georgia26 (3)0 (0)Hawaii10 (1)0 (0)Illinois16 (2)0 (0)Indiana10 (1)0 (0)Iowa7 (1)0 (0)Kansas5 (<1)0 (0)Kentucky6 (1)0 (0)Louisiana6 (1)0 (0)Maine6 (1)0 (0)Maryland31 (3)0 (0)Massachusetts32 (3)0 (0)

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of June 29, 2016) http://www.cdc.gov/zika/geo/united-states.html StatesTravel-associated cases* No. (% of cases in states) (N=935)Locally acquired cases† No. (% of cases in states) (N=0)Alabama2 (<1)0 (0)Arizona6 (1)0 (0)Arkansas5 (1)0 (0)California55 (6)0 (0)Colorado8 (1)0 (0)Connecticut1 (<1)0 (0)Delaware5 (1)0 (0)District of Columbia6 (1)0 (0)Florida182 (20)0 (0)Georgia26 (3)0 (0)Hawaii10 (1)0 (0)Illinois16 (2)0 (0)Indiana10 (1)0 (0)Iowa7 (1)0 (0)Kansas5 (<1)0 (0)

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of June 29, 2016) http://www.cdc.gov/zika/geo/united-states.html StatesTravel-associated cases*No. (% of cases in states)(N=935)Locally acquired cases†No. (% of cases in states)(N=0)Alabama2 (<1)0 (0)Arizona6 (1)0 (0)Arkansas5 (1)0 (0)California55 (6)0 (0)Colorado8 (1)0 (0)

As of June 29, 2016 (5 am EST) Zika virus disease and Zika virus congenital infection are nationally notifiable conditions.This update from the CDC Arboviral Disease Branch includes provisional data reported to ArboNET for January 01, 2015 – June 29, 2016.US States Locally acquired mosquito-borne cases reported: 0Travel-associated cases reported: 934Laboratory acquired cases reported: 1Total: 935Sexually transmitted: 13Guillain-Barré syndrome: 4US Territories Locally acquired cases reported: 2,020Travel-associated cases reported: 6Total: 2,026*Guillain-Barré syndrome: 10*Sexually transmitted cases are not reported for areas with local mosquito-borne transmission of Zika virus because it is not possible to determine whether infection occurred due to mosquito-borne or sexual transmission. Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of June 29, 2016) StatesTravel-associated cases* No. (% of cases in states) (N=935)Locally acquired cases† No. (% of cases in states) (N=0)Alabama2 (<1)0 (0)Arizona6 (1)0 (0)Arkansas5 (1)0 (0)California55 (6)0 (0)Colorado8 (1)0 (0)Connecticut1 (<1)0 (0)Delaware5 (1)0 (0)District of Columbia6 (1)0 (0)Florida182 (20)0 (0)Georgia26 (3)0 (0)Hawaii10 (1)0 (0)Illinois16 (2)0 (0)Indiana10 (1)0 (0)Iowa7 (1)0 (0)Kansas5 (<1)0 (0)Kentucky6 (1)0 (0)Louisiana6 (1)0 (0)Maine6 (1)0 (0)Maryland31 (3)0 (0)Massachusetts32 (3)0 (0)Michigan10 (1)0 (0)Minnesota19 (2)0 (0)Mississippi3 (<1)0 (0)Missouri5 (1)0 (0)Montana1 (<1)0 (0)Nebraska2 (<1)0 (0)Nevada7 (1)0 (0)New Hampshire4 (1)0 (0)New Jersey21 (2)0 (0)New Mexico3 (<1)0 (0)New York236 (25)0 (0)North Carolina16 (2)0 (0)Ohio16 (2)0 (0)Oklahoma6 (1)0 (0)Oregon7 (1)0 (0)Pennsylvania††31 (3)0 (0)Rhode Island15 (2)0 (0)South Carolina6 (<1)0 (0)Tennessee8 (1)0 (0)Texas49 (5)0 (0)Utah2 (<1)0 (0)Vermont2 (<1)0 (0)Virginia27 (3)0 (0)Washington6 (1)0 (0)West Virginia6 (1)0 (0)Wisconsin2 (<1)0 (0) TerritoriesTravel-associated cases* No. (% of cases in territories) (N=6)Locally acquired cases† No. (% of cases in territories) (N=2,020)American Samoa0 (0)29 (1)Puerto Rico5 (83)1,970 (98)US Virgin Islands1 (17)21 (1)*Travelers returning from affected areas, their sexual contacts, or infants infected in utero †Presumed local mosquito-borne transmission †† One additional case acquired through laboratory transmission Page last reviewed: February 4, 2016Page last updated: June 30, 2016