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Latest Facts and Advisories as of 6/8/2016 [Español (PDF)]Reported cases of Zika in New York City: 13318 of the 133 cases were pregnant at the time of diagnosis;All cases contracted Zika while visiting other countries; andAll patients have recovered.

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Texas has had 41 reported cases of Zika virus disease. Of those, 40 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: http://www.texaszika.org/ CountyCasesBexar6Collin1Dallas6Denton2Ellis1Fort Bend2Grayson1Harris13Tarrant4Travis2Val Verde1Williamson1Wise1Total41

Zika Virus – June 8, 2016. Texas has had 41 reported cases of Zika virus disease. Of those, 40 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: CountyCasesBexar6Collin1Dallas6Denton2Ellis1Fort Bend2Grayson1Harris13Tarrant4Travis2Val Verde1Williamson1Wise1Total41

ReferencesWHO. Epidemiological alert: neurological syndrome, congenital malformations, and Zika virus infection. Implications for public health in the Americas. http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=32405&lang=en; Dec 1, 2015. ((accessed May 12, 2016).)View in Article WHO. WHO director-general summarizes the outcome of the emergency committee regarding clusters of microcephaly and Guillain-Barré syndrome.http://www.who.int/mediacentre/news/statements/2016/emergency-committee-zika-microcephaly/en/; Feb 1, 2016. ((accessed May 2, 2016).)View in Article Ventura, CV, Maia, M, Bravo-Filho, V, Gois, AL, and Belfort, R Jr. Zika virus in Brazil and macular atrophy in a child with microcephaly. Lancet. 2016; 387: 228View in Article | Summary | Full Text | Full Text PDF | PubMed | Scopus (31)Ventura, CV, Maia, M, Ventura, BV et al. Ophthalmologic findings in infants with microcephaly and presumable intra-uterus zika virus infection. Arq Bras Oftalmol. 2016; 79: 1–3View in Article | CrossRef | PubMed | Scopus (12)de Paula Freitas, B, de Oliveira Dias, JR, Prazeres, J et al. Ocular findings in infants with microcephaly associated with presumed zika virus congenital infection in Salvador, Brazil. JAMA Ophthalmol. 2016; 134: 529–535View in Article | CrossRef | Scopus (3)

The emergence of Zika virus (ZIKV) in Brazil coincided with increased reports of newborn babies with microcephaly, congenital malformations, and neurological syndromes.1 In February, 2016, WHO declared ZIKV and microcephaly a Public Health Emergency of International Concern because of the rapid spread of ZIKV infection.2 In January, 2016, we reported ocular findings in infants with microcephaly and presumed congenital Zika virus infection in Pernambuco, Brazil.3, 4 Similar ocular findings have been reported in infants assessed in Bahia, Brazil.5 These reports followed establishment of microcephaly (head circumference two SDs below the mean for age and sex) as an inclusion criterion for the screening of babies for congenital Zika virus infection.3, 4, 5 Therefore, the presence or absence of microcephaly was used as a cutoff for screening, and only cases that fulfilled this criterion were classified as presumed cases of congenital Zika virus infection and further investigated. To the best of our knowledge, no reports exist on infants with diagnosis of congenital Zika virus infection, who did not have microcephaly, but did have ocular findings. Here we report the ophthalmic findings of an infant (age at exam: 57 days; head circumference: 33 cm; weight at birth: 3500 g; gestational age at birth: 38 weeks) who was referred for ophthalmic examination by a neurologist for suspected congenital Zika virus infection. The mother reported that she did not have ZIKV-related symptoms, use illicit drugs, drink alcohol, or smoke during pregnancy. The infant presented lower limb and upper limb spasms at birth. CT scans detected cerebral calcifications in the basal ganglia, ventriculomegaly, and lissencephaly. Ocular examination included anterior segment biomicroscopy and fundus evaluation. A chorioretinal scar was detected on the macular region of the left eye (figure), similar to scars previously reported in congenital Zika virus infection.3, 4, 5 FigureChorioretinal scar on the macular region of the left eye with no associated optic disc findings in an infant without microcephaly View Large Image | View Hi-Res Image | Download PowerPoint SlideToxoplasmosis, rubella, cytomegalovirus, herpes simplex, HIV, and dengue fever virus were ruled out in both mother and infant. IgM antibody capture (MAC)-ELISA for ZIKV was done in the cerebral spinal fluid of the infant, which was positive, confirming our hypothesis of congenital Zika virus infection. This case highlights that microcephaly should not be a required criterion for congenital Zika virus infection diagnosis, since infants without microcephaly could still have been infected by ZIKV during gestation. We emphasise the need for public health authorities to provide fundus screening to infants with suspected congenital Zika virus infection, because ocular findings might be underdiagnosed if microcephaly continues to be an inclusion criterion in the screening of this group of infants. We declare no competing interests.

The emergence of Zika virus (ZIKV) in Brazil coincided with increased reports of newborn babies with microcephaly, congenital malformations, and neurological syndromes.1 In February, 2016, WHO declared ZIKV and microcephaly a Public Health Emergency of International Concern because of the rapid spread of ZIKV infection.2

Camila V Ventura, Mauricio Maia, Natalia Dias, Liana O Ventura, Rubens Belfort JrPublished Online: 07 June 2016DOI: http://dx.doi.org/10.1016/S0140-6736(16)30776-0

Zika: neurological and ocular findings in infant without microcephalyhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30776-0/fulltext

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List of weekly reports http://portalsaude.saude.gov.br/index.php/o-ministerio/principal/leia-mais-o-ministerio/197-secretaria-svs/20799-microcefalia

06.07.2016 at 18h04 Ministry of Health confirmed 1,551 cases of microcephaly in BrazilFolder considers that most cases were due to virus infection zika R7 Home Get News On Your MobileText: -A + AFrom R7 Microcephaly cases reach 1,551 in BrazilAEThe Ministry of Health announced on Tuesday (7), new numbers of cases of microcephaly in Brazil. They are confirmed 1,551 cases of the disease and other nervous system disorders, suggestive of congenital infection throughout the country. The report gathers information sent weekly by state health departments related to week 22 of this year, which runs through June 4. A total of 7,830 suspected cases reported since October 2015 - of which 3,017 remain under investigation. Other 3,262 were discarded because of normal tests, or because they have microcephaly and or malformations confirmed because no infectious or do not meet the case definition. Infants with microcephaly are suffering with uncontrollable crying, convulsions and irritation Of the total confirmed cases, 224 were confirmed by specific laboratory criteria for zika virus. The Ministry of Health, however, points out that this figure does not represent adequately the total number of cases related to the virus. The folder considers that there was infection zika most of the mothers who had babies with a final diagnosis of microcephaly. The 1,551 confirmed cases in Brazil occurred in 556 municipalities located in 25 Brazilian states and the Federal District.There is no confirmation register only in the state of Acre. In relation to deaths in the same period, there were 310 suspected deaths of microcephaly and / or alteration of the central nervous system after birth or during pregnancy (miscarriage or stillbirth) in the country. Of these, 69 were confirmed to microcephaly and / or alteration of the central nervous system. Other 197 remain under investigation and 44 were discarded. Pregnant women who get diagnosed earlier deal better with microcephaly of children The Ministry of Health says it is investigating all cases of microcephaly and other disorders of the central nervous system, informed by the states, and the possible relationship with the Zika virus and other congenital infections.Microcephaly may be caused by , various infectious agents beyond zika such as syphilis, toxoplasmosis, other infectious agents, rubella, cytomegalovirus and herpes viral. The folder guides pregnant women adopt measures to reduce the presence of Aedes aegypti, the elimination of breeding, and protect themselves from mosquito exposure, keeping doors and windows closed or screened, wear pants and long sleeved shirts and use repellents allowed to pregnant women. http://noticias.r7.com/saude/ministerio-da-saude-confirma-1551-casos-de-microcefalia-em-todo-o-brasil-07062016?utm_source=twitterfeed&utm_medium=twitter

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June 7, 2016 DEPARTMENT OF HEALTH DAILY ZIKA UPDATE: FIVE NEW TRAVEL-RELATED CASES TODAY Contact: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 five new travel related cases today including one in Escambia, one in Hillsborough, one in Osceola, one in Palm Beach and one in Seminole counties. The Declaration of Public Health Emergency has been updated to include Escambia County. Of the cases confirmed in Florida, seven cases 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 38, with 9 having met the previous CDC case definition. County Number of Cases (all travel related) Alachua 4 Brevard 3 Broward 19 Clay 2 Collier 2 Escambia 1 Hillsborough 4 Lee 5 Martin 1 Miami-Dade 51 Orange 10 Osceola 6 Palm Beach 8 Pasco 1 Pinellas 4 Polk 3 Santa Rosa 1 Seminole 4 St. Johns 2 Volusia 2 Total cases not involving pregnant women 133 Cases involving pregnant women regardless of symptoms* 38 *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 1,978 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 19 counties included in the declaration– Alachua, Brevard, Broward, Clay, Collier, Hillsborough, Lee, Martin, Miami-Dade, 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.Florida currently has the capacity to test 6,085 people for active Zika virus and 1,775 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.Based on CDC guidance released, DOH will now report pregnant women with evidence of Zika virus regardless of symptoms. Prior to new guidance, CDC guidance was only to report cases of Zika if the pregnant women was symptomatic.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. http://www.floridahealth.gov/newsroom/2016/06/060716-zika-update.html

County Number of Cases (all travel related) Alachua 4 Brevard 3 Broward 19 Clay 2 Collier 2 Escambia 1 Hillsborough 4 Lee 5 Martin 1 Miami-Dade 51 Orange 10 Osceola 6 Palm Beach 8 Pasco 1 Pinellas 4 Polk 3 Santa Rosa 1 Seminole 4 St. Johns 2 Volusia 2 Total cases not involving pregnant women 133 Cases involving pregnant women regardless of symptoms* 38 *Counties of pregnant women will not be shared.

Zika Virus – June 7, 2016. Texas has had 40 reported cases of Zika virus disease. Of those, 39 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. Case counts by county: Bexar – 6 Collin – 1 Dallas – 6 Denton – 2 Fort Bend – 2 Grayson – 1Harris – 13 Tarrant – 4 Travis – 2 Val Verde – 1 Williamson – 1 Wise – 1

Alabama Residents Tested for Zika Virus as of June 07, 2016 Number Tested PositiveNumber of SubmissionsNumber with Results Pending5 77 4

First case of Zika confirmed in Franklin County By GARY SEMAN JR.Monday June 6, 2016 7:05 PM 36 6 0 42 View Larger Local health officials have confirmed the first case of Zika infection in Franklin County. A 38-year-old Columbus woman is believed to have contracted the virus while vacationing in the Dominican Republic. The woman, whose name was not released, is recovering, said Jose Rodriguez, spokesman for Columbus Public Health. She presented symptoms of Zika infection shortly after returning from vacation and submitted a blood sample. The Ohio Department of Health made the diagnosis at its Reynoldsburg lab, Rodriguez said. Those symptoms include fever, rash and joint pain. Most people who contract the virus exhibit no symptoms. Zika has been linked to birth defects in children, according to the Centers for Disease Control and Prevention. The Columbus woman was not pregnant, Rodriguez said. The Franklin County case is the 14th confirmed in Ohio. Rodriguez said 63 people have been tested, including 24 in Franklin County. One was positive, 10 were negative and thirteen are pending, he said. He said local health officials would survey the local woman’s neighborhood for daytime mosquitoes. If they’re found, the city will spray the area with insecticides, he said. http://www.thisweeknews.com/content/stories/2016/06/09/franklin-countys-first-zika-case-confirmed-WB-GS.html

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First Zika Virus Case Reported In Washtenaw CountyBy JORGE AVELLAN • 1 HOUR AGOSHARETwitter Facebook Google+ Email CREDIT NPR.ORGThe Zika virus has reached Washtenaw County. ListenListening... 0:4189.1 WEMUs Jorge Avellan reveals the first positive test for Zika virus in Washtenaw County The Washtenaw County Health Department confirmed that one person in our area has tested positive for the Zika virus. It's been categorized as a travel associated case. Health department spokesperson Susan Cerniglia says most people get infected with the virus through mosquito bites, but there is evidence that it's also sexually transmitted. She did not want to go into details about the person infected but said the local resident is not pregnant and recovering. More than 48 people in Washtenaw County have requested a Zika virus test after they or a family member traveled to tropical regions of the world. If you plan to travel to such areas, it's recommended to use long sleeve shirts, pants, repellent and a mosquito net. The infected mosquitoes are currently not found in Michigan. Cerniglia added that the Centers for Disease Control and Prevention is no longer in charge of local Zika virus tests. They are now being processed by the state laboratory after being conducted by local doctors. The CDC has reported over 600 Zika virus cases across the United States. http://wemu.org/post/first-zika-virus-case-reported-washtenaw-county#stream/0

Zika Testing in Washtenaw County as of June 2, 2016Tests CompletedTravel-Associated CasesLocally-Acquired Cases* 4810*Zika is spread to people primarily through the bite of an infected Aedes aegypti mosquito. These mosquitoes are not currently found in Michigan, but are common in more tropical areas.

http://www.ewashtenaw.org/government/departments/public_health/news/2016-news-items/zika

CHP notified of additional imported case of Zika Virus Infection in Guangdong ******************************************************* The Centre for Health Protection (CHP) of the Department of Health (DH) today (June 6) received notification of an additional imported case of Zika Virus Infection from the Health and Family Planning Commission of Guangdong Province, and again urged the public to adopt strict anti-mosquito measures and safe sex during travel. Pregnant women and those planning pregnancy should not travel to affected areas. A 32-year-old female patient who lives in Venezuela arrived in Guangdong on May 30. She subsequently developed fever and skin rash and was then hospitalised for isolation and management. To date, 21 imported cases of Zika Virus Infection have been notified in the Mainland. The DH's Port Health Office has stepped up inspection at boundary control points (BCPs) to maintain strict environmental hygiene with effective mosquito control. Port Health Inspectors have reinforced training for contractors of BCPs, including at the airport, harbour ports and ground crossings, on port hygiene and pest control for effective vector prevention. Health promotion at BCPs has been enhanced through pamphlets and posters to alert travellers to necessary measures against Zika. "Routine health surveillance on the body temperature of inbound travellers at all boundary control points is ongoing. Suspected cases will be referred to healthcare facilities for follow-up. However, at present, around 70 to 80 per cent of infected people are asymptomatic and most can recover fully. Therefore, we again urge those arriving from Zika-affected areas to apply insect repellent for 14 days upon arrival to reduce the risk of transmission," a spokesman for the DH said. The DH has been working closely with the travel industry and stakeholders, especially agents operating tours in Zika-affected areas and personnel receiving travellers in those areas (particularly pregnant women), to regularly update them on the latest disease information and health advice. As long as there is international travel, there is always a risk of the introduction of the Zika virus to Hong Kong. As asymptomatic infection is very common and the potential vector, Aedes albopictus, is present locally, there is also the risk of local spread if Zika is introduced to Hong Kong. The public should pay special attention to areas with ongoing Zika virus transmission (affected areas) and observe the ongoing health advice and special notes during travel. The DH has been maintaining close liaison with the World Health Organization (WHO) as well as overseas, neighbouring and Mainland health authorities to closely monitor the latest developments of Zika. Locally, no human Zika cases have been reported to the CHP to date. To prevent Zika Virus Infection, in addition to general anti-mosquito measures, the DH draws the public's attention to the special notes below: A. Travelling abroad * If going to areas with ongoing Zika virus transmission (affected areas), travellers, especially those with immune disorders or severe chronic illnesses, should arrange a consultation with a doctor at least six weeks before the trip, and take extra preventive measures to avoid mosquito bites; * Those arriving from affected areas should apply insect repellent for 14 days upon arrival. If feeling unwell, e.g. having fever, they should seek medical advice as soon as possible, and provide travel details to a doctor; * Travellers should consider not having sex during travel to affected areas, or else condoms should be used; * Travellers returning from affected areas should consider abstinence for at least 2 months upon return, or else condoms should be used. If male travellers returning from affected areas were diagnosed with Zika virus infection or have compatible symptoms, they should consider abstinence for at least 6 months upon onset, or else condoms should be used; B. Pregnant women and those preparing for pregnancy * Pregnant women and those preparing for pregnancy should not travel to affected areas. Those who must travel should seek medical advice from their doctor before the trip, adopt contraception if appropriate, strictly follow steps to avoid mosquito bites during the trip, and consult and reveal their travel history to their doctor if symptoms develop after the trip. Women preparing for pregnancy are advised to continue to adopt contraception for at least two months after returning from affected areas if they have no symptoms of Zika virus infection, or 6 months if one or both members of the couple are symptomatic; C. Special notes for prevention of sexual transmission regarding adverse pregnancy outcomes * Pregnant women should not have sex with male partners who have travelled to affected areas, or else condoms should be used throughout the pregnancy; * Any male traveller returning from affected areas should: (i) Abstain from sex with his pregnant partner, or else use condoms throughout the pregnancy; and (ii) Use a condom for at least six months if his female partner may get pregnant. The public may visit the pages below for more disease information and health advice: * The CHP's Zika page (www.chp.gov.hk/en/view_content/43086.html); * The Zika page of the DH's Travel Health Service (www.travelhealth.gov.hk/english/popup/popup_zika.html); * The Outbound Travel Alert page of the Security Bureau (www.sb.gov.hk/eng/ota); * Anti-mosquito precautions for women (www.fhs.gov.hk/english/health_info/woman/30014.html); and * The WHO Zika virus situation reports (www.who.int/emergencies/zika-virus/en). Ends/Monday, June 6, 2016 Issued at HKT 19:54 NNNN http://www.info.gov.hk/gia/general/201606/06/P201606060895.htm