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Maryland Confirmed Zika Virus Infections (As of June 22, 2016) Travel-AssociatedLocally Acquired Vector-BorneTotal26026 http://phpa.dhmh.maryland.gov/Pages/Zika.aspx

Maryland Confirmed Zika Virus Infections (As of June 22, 2016) Travel-AssociatedLocally Acquired Vector-BorneTotal26026

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of June 22, 2016) http://www.cdc.gov/zika/geo/united-states.html StatesTravel-associated cases* No. (%) (N=820)Locally acquired cases† No. (%) (N=0)Alabama2 (<1)0 (0)Arizona3 (<1)0 (0)Arkansas5 (1)0 (0)California52 (6)0 (0)Colorado5 (1)0 (0)Connecticut1 (<1)0 (0)Delaware5 (1)0 (0)District of Columbia6 (1)0 (0)Florida162 (20)0 (0)Georgia25 (3)0 (0)Hawaii10 (1)0 (0)Illinois16 (2)0 (0)Indiana10 (1)0 (0)Iowa7 (1)0 (0)Kansas2 (<1)0 (0)Kentucky6 (1)0 (0)Louisiana7 (1)0 (0)

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*4Includes aggregated data reported to the US Zika Pregnancy Registry as of June 16, 2016 Pregnancy losses with birth defects**4Includes aggregated data reported to the US Zika Pregnancy Registry as of June 16, 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 16, 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 16, 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 22, 2016

Pregnancy Outcomes in the United States and the District of ColumbiaLiveborn infants with birth defects*4Includes aggregated data reported to the US Zika Pregnancy Registry as of June 16, 2016 Pregnancy losses with birth defects**4Includes aggregated data reported to the US Zika Pregnancy Registry as of June 16, 2016 http://www.cdc.gov/zika/geo/pregnancy-outcomes.html

Pregnant Women with Any Laboratory Evidence of Possible Zika Virus Infection in the United States and Territories, 2016Language:EnglishEspañolPortuguêsRecommend on FacebookTweet Pregnant Women with Any Laboratory Evidence of Possible Zika Virus InfectionUS States and the District of Columbia*265*Includes aggregated data reported to the US Zika Pregnancy Registry as of June 16, 2016 US Territories**216**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 16, 2016

As of June 22, 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 22, 2016.US States Locally acquired mosquito-borne cases reported: 0Travel-associated cases reported: 819Laboratory acquired cases reported: 1Total: 820Sexually transmitted: 11Guillain-Barré syndrome: 4US Territories Locally acquired cases reported: 1,854Travel-associated cases reported: 6Total: 1,860Guillain-Barré syndrome: 7 Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of June 22, 2016) StatesTravel-associated cases* No. (%) (N=820)Locally acquired cases† No. (%) (N=0)Alabama2 (<1)0 (0)Arizona3 (<1)0 (0)Arkansas5 (1)0 (0)California52 (6)0 (0)Colorado5 (1)0 (0)Connecticut1 (<1)0 (0)Delaware5 (1)0 (0)District of Columbia6 (1)0 (0)Florida162 (20)0 (0)Georgia25 (3)0 (0)Hawaii10 (1)0 (0)Illinois16 (2)0 (0)Indiana10 (1)0 (0)Iowa7 (1)0 (0)Kansas2 (<1)0 (0)Kentucky6 (1)0 (0)Louisiana7 (1)0 (0)Maine6 (1)0 (0)Maryland26 (3)0 (0)Massachusetts28 (3)0 (0)Michigan9 (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 Jersey17 (2)0 (0)New Mexico3 (<1)0 (0)New York198 (24)0 (0)North Carolina15 (2)0 (0)Ohio14 (2)0 (0)Oklahoma6 (1)0 (0)Oregon7 (1)0 (0)Pennsylvania††24 (3)0 (0)Rhode Island11 (1)0 (0)South Carolina1 (<1)0 (0)Tennessee5 (1)0 (0)Texas42 (5)0 (0)Utah2 (<1)0 (0)Vermont1 (<1)0 (0)Virginia27 (3)0 (0)Washington5 (1)0 (0)West Virginia6 (1)0 (0)Wisconsin2 (<1)0 (0) Territories(N=6)(N=1,854)American Samoa0 (0)29 (2)Puerto Rico5 (83)1,804 (97)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 22, 2016

SummaryAs of 22 June 2016, 61 countries and territories report continuing mosquito-borne transmission (Fig. 1) of which:47 countries are experiencing a first outbreak of Zika virus since 2015, with no previous evidence of circulation, and with ongoing transmission by mosquitoes.14 countries reported evidence of Zika virus transmission between 2007 and 2014, with ongoing transmission.In addition, four countries or territories have reported evidence of Zika virus transmission between 2007 and 2014, without ongoing transmission: Cook Islands, French Polynesia, ISLA DE PASCUA – Chile and YAP (Federated States of Micronesia)Ten countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual route.The United States Center for Disease Control and Prevention (US-CDC) reported one, laboratory-acquired case of Zika virus infection.In the week to 22 June 2016, Anguilla is the latest territory to report mosquito-borne Zika virus transmission.As of 22 June 2016, microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection or suggestive of congenital infection have been reported by twelve countries or territories. Three of those reported microcephaly cases borne from mothers with a recent travel history to Brazil (Slovenia, United States of America), the Bolivarian Republic of Venezuela and Colombia (Spain), for one additional case the precise country of infection is not determined (as the case travelled to three known affected countries in Latin America).As of 9 June, the US-CDC reported three live born infants with birth defects and thre pregnancy losses with birth defects with laboratory evidence of possible Zika virus infection.In the context of Zika virus circulation, 13 countries and territories worldwide have reported an increased incidence of Guillain-Barré syndrome (GBS) and/or laboratory confirmation of a Zika virus infection among GBS cases.In the context of Zika virus circulation, 13 countries and territories worldwide have reported an increased incidence of Guillain-Barré syndrome (GBS) and/or laboratory confirmation of a Zika virus infection among GBS cases.Zika infection was diagnosed in four patients with a severe neurological condition in Guadeloupe.Based on research to date, there is scientific consensus that Zika virus is a cause of microcephaly and GBS.Sequencing of the virus that causes the Zika outbreak in Cabo Verde showed that the virus is of the Asian lineage and the same as the one that circulates in Brazil.The third meeting of the Emergency Committee (EC) convened by the Director-General under the International Health Regulations (2005) regarding microcephaly, other neurological disorders and Zika virus was held by on 14 June 2016.The global Strategic Response Framework launched by the World Health Organization (WHO) in February 2016 encompasses surveillance, response activities and research. An interim report6 has been published on some of the key activities being undertaken jointly by WHO and international, regional and national partners in response to this public health emergency. A revised strategy for the period of July 2016 to December 2017 was published on 17 June.WHO has developed new advice and information on diverse topics in the context of Zika virus. WHO’s latest information materials, news and resources to support corporate and programmatic risk communication, and community engagement are available online. Download the image jpg, 384kb

Zika situation report23 June 2016Zika virus, Microcephaly and Guillain-Barré syndromeRead the full situation reporthttp://www.who.int/emergencies/zika-virus/situation-report/23-june-2016/en/

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PRESS RELEASE ---For Immediate Release DCHHS Reports 10th Zika Virus Case in Dallas County DALLAS (June 23, 2016) – Dallas County Health and Human Services (DCHHS) is reporting the tenth case of Zika virus in Dallas County in 2016. The case was confirmed through testing in the DCHHS lab. DCHHS has submitted the case for review to the Texas Department of State Health Services. The 55-year-old patient is a resident of Irving who was infected with the virus during recent travel to Guatemala. For medical confidentiality and personal privacy reasons, DCHHS does not provide additional identifying information. While sexual transmission of Zika virus is possible, it is primarily transmitted to people by Aedes species mosquitoes. The most common symptoms of Zika virus are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting several days to a week. DCHHS advises individuals with symptoms to see a healthcare provider if they visited an area where Zika virus is present or had sexual contact with a person who traveled to an area where Zika virus is present. There is no specific medication available to treat Zika virus and there is not a vaccine. The best ways to avoid Zika virus are to avoid mosquito bites and sexual contact with a person who has Zika virus. There are currently no reports of Zika virus being locally-transmitted by mosquitoes in Dallas County. However, imported cases make local spread by mosquitoes possible because the mosquitoes that can transmit the virus are found locally. DCHHS advises recent travelers with Zika virus symptoms as well as individuals diagnosed with the virus to protect themselves from further mosquito bites. For more information on Zika virus, including prevention, go to the DCHHS website. # For additional information, contact: Erikka D. Neroes, Public Information [email protected] 214.819.6329 (office) 214.394.8109 (cell) Zachary Thompson, Director 214.755.9299 (cell)

The 55-year-old patient is a resident of Irving who was infected with the virus during recent travel to Guatemala.

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Cape Verde registers 11 cases of microcephaly associated with Zika virus URL: Print06/23/2016 10h58Praia (Cape Verde)Agency LusaCape Verde has recorded 11 cases of microcephaly associated with Zika virus, and one of the babies diagnosed with the disease was stillborn, according to the country's Ministry of Health, released today (23). The figures were disclosed by the medical epidemiologist Maria de Lurdes Monteiro, the Integrated Surveillance Service and Responses to Epidemics for reflection and dialogue on the impact of Zika in women, sponsored by UN Women in Cape Verde. According to the doctor, until the 14th of this month were born 10 babies with microcephaly associated with zika virus. Another was born dead with multiple malformations. Maria de Lurdes said nine of the cases occurred in the city of Praia and two on the island of Maio, where the death was registered. The doctor reported that the authorities accompany about 240 pregnant women and 170 in Praia, 44 in São Filipe, on Fogo Island, 22 May and four in Boavista. The first case of microcephaly associated with the Zika virus in Cape Verde was detected in March this year, six months after the disease has been declared epidemic. So far, there have been more than 7,500 suspected cases. Of the total cases, which fell from January, Maria de Lurdes said that 65% were reported in women and the rest in men. Recalling that the mosquito that transmits the disease is the "main enemy of public health in Cape Verde" at this time, the doctor added that the goal should be to vector control, to eliminate all mosquito outbreaks. She stressed the need to involve all civil society in combating the disease, women's empowerment, in carrying out cleaning campaigns before, during and after the rainy season, use of repellents and clothing to protect the body, among other measures. Earlier this month, Minister of Cape Verde Health, Arlindo Rosario, said that since April 25 the circulation of the virus is not detected in the country and analyzed mosquitoes are not infected. In an interview, vanilloid Furtado, UN Women program coordinator in Cape Verde, said the biggest concern is with pregnant women, the consequences and risks, and babies born with microcephaly. Because the majority of cases (65%) have been diagnosed in women, the coordinator said it plans to draw up a plan to control and have multi-sectoral and comprehensive responses to the impacts of the disease in women. Edition: Grace Adjuto

Cape Verde has recorded 11 cases of microcephaly associated with Zika virus, and one of the babies diagnosed with the disease was stillborn, according to the country's Ministry of Health, released today (23). The figures were disclosed by the medical epidemiologist Maria de Lurdes Monteiro, the Integrated Surveillance Service and Responses to Epidemics for reflection and dialogue on the impact of Zika in women, sponsored by UN Women in Cape Verde. According to the doctor, until the 14th of this month were born 10 babies with microcephaly associated with zika virus. Another was born dead with multiple malformations. Maria de Lurdes said nine of the cases occurred in the city of Praia and two on the island of Maio, where the death was registered. http://agenciabrasil.ebc.com.br/internacional/noticia/2016-06/cabo-verde-registra-11-casos-de-microcefalia-associados-ao-virus-zika?utm_source=dlvr.it&utm_medium=twitter

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Cape Verde has recorded 11 cases of microcephaly associated with Zika virus, and one of the babies diagnosed with the disease was stillborn, according to the country's Ministry of Health, released today (23). The figures were disclosed by the medical epidemiologist Maria de Lurdes Monteiro, the Integrated Surveillance Service and Responses to Epidemics for reflection and dialogue on the impact of Zika in women, sponsored by UN Women in Cape Verde. According to the doctor, until the 14th of this month were born 10 babies with microcephaly associated with zika virus. Another was born dead with multiple malformations. Maria de Lurdes said nine of the cases occurred in the city of Praia and two on the island of Maio, where the death was registered. http://agenciabrasil.ebc.com.br/internacional/noticia/2016-06/cabo-verde-registra-11-casos-de-microcefalia-associados-ao-virus-zika?utm_source=dlvr.it&utm_medium=twitter

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Laboratory-confirmed travel-related cases of Zika virus in Ontario^ as of June 21, 2016Number of laboratory-confirmed*casesCountries of Travel§78*Aruba, Barbados, Brazil, Columbia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, French West Indies, Mexico, Nicaragua, Panama, South Caribbean, Venezuela*Note: One of the 78 laboratory-confirmed cases of Zika virus in Ontario is non-travel related. http://health.gov.on.ca/en/public/publications/disease/zika.aspx

Laboratory-confirmed travel-related cases of Zika virus in Ontario^ as of June 21, 2016Number of laboratory-confirmed*casesCountries of Travel§78*Aruba, Barbados, Brazil, Columbia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, French West Indies, Mexico, Nicaragua, Panama, South Caribbean, Venezuela*Note: One of the 78 laboratory-confirmed cases of Zika virus in Ontario is non-travel related.

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Number of cases reportedCounty/Area TodayYear to Date (6/22/16) Albany12Dutchess04Erie01Lewis01Monroe02Nassau017Niagara01Oneida02Onondaga14Ontario01Orange01Putnam01Rockland03St Lawrence11Schenectady01Suffolk019Tompkins01Westchester05NYS (ex NYC)367NYC9214NYS Total12281

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