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Map Update https://www.google.com/maps/d/u/0/edit?hl=en&hl=en&authuser=0&authuser=0&mid=zv94AJqgUct4.kT4qLMXp3SLU

January 11, 2016 – April 22, 2016 Number of people tested 149 Total # of pending results 5 Total # of negative results 141 Total # of positive results 3 ZIKA VIRUS CASE SUMMARY Female Number of Zika Virus Cases in NH 1 1 1 3 Note: Number of positive results and number of cases may not match because some people may have submitted more than one sample or may not be a NH resident and therefore not counted as a NH case. Pregnant Female Not pregnant Male TOTAL

http://www.dhhs.nh.gov/dphs/cdcs/zika/documents/zikasummary.pdf

January 11, 2016 – April 22, 2016 Number of people tested 149 Total # of pending results 5 Total # of negative results 141 Total # of positive results 3 ZIKA VIRUS CASE SUMMARY Female Number of Zika Virus Cases in NH 1 1 1 3 Note: Number of positive results and number of cases may not match because some people may have submitted more than one sample or may not be a NH resident and therefore not counted as a NH case. Pregnant Female Not pregnant Male TOTAL

HEALTH ZIKA VIRUS OUTBREAK APR 27 2016, 5:59 PM ETZika Virus Was In Haiti Before It Was in Brazil. Study Findsby MAGGIE FOX SHARE The Zika virus was circulating in Haiti in 2014, long before it became obvious that it was spreading fast in Brazil, a new study finds. A team that went back and checked out three mysterious infections in Haiti found they were caused by the Zika virus. Their study raises questions about when and how Zika actually arrived in the Americas. A military truck carries out fumigation in a neighborhood to stop the breeding of the dengue mosquito in Havana March 1, 2016. ENRIQUE DE LA OSA / Reuters"We know that the virus was present in Haiti in December of 2014," said Dr. Glenn Morris, a professor of medicine and the director of the University of Florida's Emerging Pathogens Institute. "And, based on molecular studies, it may have been present in Haiti even before that date." Zika's sweeping across the Americas and the Caribbean, as well as parts of the South Pacific. Once virtually ignored as a harmless and unremarkable virus, it is now alarming doctors and health officials because it's causing devastating birth defects and paralyzing neurological conditions. Brazil sounded the alert last year and at first scientists thought it had arrived there in 2014. Related: Zika Mysteries Stump Even the Experts But earlier this year, a large international team of experts used a "genetic clock" to show Zika virus has changed about as much as would be expected if it had been carried into the country in 2013. And it very closely matches a strain that circulated in French Polynesia in 2013. What's not clear is why it's now being seen to cause disease. Tests show it has mutated a bit, as all viruses do, but it's not yet clear if the mutations somehow make it more virulent. It's possible that because it's hit a very large population with no previous immunity to Zika, what would have been events so rare as to go unnoticed are now getting attention. "WE KNOW THAT THE VIRUS WAS PRESENT IN HAITI IN DECEMBER OF 2014."Zika is a close relative of dengue and chikungunya viruses, which have been spreading for longer. And it is spread by the same Aedes aegypti mosquito. But Zika is usually milder than dengue and even than chikungunya, not even causing noticeable symptoms in most people and usually causing little more than a rash, fever and body aches. Blood tests often confuse the three viruses. Writing in the Public Library of Sciences journal PLOS Neglected Tropical Diseases, the team said they went back and tested blood samples taken when chikungunya was sweeping across Haiti. "Zika virus was identified in plasma from three students seen in the Christianville Foundation Schools clinic," the team wrote. They included a 15-year old boy, a 7-year-old girl and a 4-year-old boy. None was very sick at all. None had the rash that so clearly characterizes Zika. "In none of the cases would it have been possible to have identified the illness as a Zika virus infection based on clinical presentation, rather than dengue virus or chikungunya virus," they wrote. So at least some of the cases diagnosed as chikungunya may have been Zika instead. "THERE IS A POSSIBILITY THAT THIS VIRUS HAD BEEN MOVING AROUND THE CARIBBEAN BEFORE IT HIT THE RIGHT COMBINATION OF CONDITIONS IN BRAZIL AND TOOK OFF."Because the children came from different schools and different towns, this suggests Zika was already fairly widespread in the area. "Officially, no cases of Zika virus infection were reported by the Haitian Ministry of Public Health and Population until January 6, 2016, when five cases were confirmed in patients in the metropolitan Port-au-Prince area," the researchers wrote. Related: New Map Finds 2 Billion at Risk of Zika But no one was really looking for Zika in the Caribbean until after the U.S. Centers for Disease Control and Prevention issued a travel alert in January of this year. "There is a possibility that this virus had been moving around the Caribbean before it hit the right combination of conditions in Brazil and took off," Morris said. The Aedes aegypti and Aedes albopictus mosquitoes that spread zika and chikungunya are found across the southern United States and as far north as New York. The Pan American Health Organization says Mexican researchers have found Zika in A. albopictus. If this becomes common, it suggests even wider spread of Zika than predicted, because these cousins of Aedes aegypti live farther north and circulate for longer. Haiti has almost the perfect conditions for the spread of mosquito-borne illnesses such as Zika. It's got a warm climate, people are poor and live in homes without screens or air conditioning, and there are plenty of places for mosquitoes to breed. Experts expect much less spread in the U.S., where most people live behind closed doors, with screens and air conditioning http://www.nbcnews.com/storyline/zika-virus-outbreak/zika-virus-was-haiti-it-was-brazil-study-finds-n563706

Latest Facts and Advisories as of 4/27/2016 [ Español (PDF)]Reported cases of Zika in New York City: 59 Eight of the fifty-nine cases were pregnant at the time of diagnosis;All cases contracted Zika while visiting other countries; andAll patients have recovered.Latest Facts and Advisories as of 4/18/2016 [ Español (PDF)]Reported cases of Zika in New York City: 40 Six of the forty cases were pregnant at the time of diagnosis;All cases contracted Zika while visiting other countries; andAll patients have recovered.Latest Facts and Advisories as of 4/13/2016 [ Español (PDF)]Reported cases of Zika in New York City: 33 Six of the thirty-three cases were pregnant at the time of diagnosis;All cases contracted Zika while visiting other countries; andAll patients have recovered.Latest Facts and Advisories as of 4/6/2016 [ Español (PDF)]Reported cases of Zika in New York City: 30 Five of the thirty cases were pregnant at the time of diagnosis;All cases contracted Zika while visiting other countries; andAll patients have recovered.Latest Facts and Advisories as of 3/30/2016 [ Español (PDF)]Reported cases of Zika in New York City: 25 Three of the twenty-five cases were pregnant at the time of diagnosis;All cases contracted Zika while visiting other countries; andAll patients have recovered.Latest Facts and Advisories as of 3/23/2016 [ Español (PDF)]Reported cases of Zika in New York City: 20 Two of the twenty cases were pregnant women;All cases contracted Zika while visiting other countries; andAll patients have recovered.

April 27 update April 13 update

The New York City Zika page updated today to 59, from the 40 reported last Monday. The New York State Wednesday update jumped from 36 to 61. These jumps in New York City were in marked contrast to the New York State numbers for locales outside of New York City, which rose from 37 to 38. The cause of the spike in New York City is unclear. They recently began doing their own testing (which had been done previously by the state lab, Wadsworth Center, in Albany). The numbers may have been impacted by test results from students returning from Spring break,or additional imports from Caribbean Islands,including Puerto Rico.

Zika presence in Americas older than previously thought Indo Asian News ServiceIANS India Private LimitedApril 27, 2016New York, April 27 (IANS) The Zika virus was present in Haiti several months before the first Zika cases were identified in Brazil in March last year, new research has found. "We know that the virus was present in Haiti in December of 2014," said one of the researchers Glenn Morris, professor of medicine at the University of Florida in the US. "And, based on molecular studies, it may have been present in Haiti even before that date," Morris said. Although the findings suggest that the Zika virus was circulating in the Americas prior to 2015, what remains unclear is exactly what confluence of factors caused the virus to take off in Brazil that has confirmed 91,387 cases of Zika so far this year, including 7,584 pregnant women at risk of having babies with birth defects. The findings were published in the journal PLOS Neglected Tropical Diseases. The Zika virus was virtually unknown outside of public health circles prior to the 2007 outbreak in the Yap Islands, a small group of islands in Micronesia where an estimated 73 percent of residents three years of age and older were infected with the virus. Researchers hope further inquiry would shed light on the factors that led to the proliferation of Zika virus in Brazil as well as the sharp rise in the number of birth defects in that nation in cases where pregnant women were infected with the then-uncommon flavivirus, the genus of viruses that include Zika. Scientists from University of Florida isolated the Zika virus from three patients while studying the transmission of dengue and chikungunya in Haiti in 2014. School children exhibiting febrile illness within the Gressier/Leogane region of Haiti were taken to a free outpatient clinic, where blood samples were drawn and screened for dengue, chikungunya and malaria. Upon isolation, the viruses were first considered "mystery" viruses, as tests indicated they were neither dengue nor chikungunya viruses, and little attention had been paid to the possibility that Zika virus might be present in the Caribbean. Using a sophisticated method, the researchers subsequently sequenced and identified them as Zika virus sequences. The plasma samples that yielded Zika virus were taken three months before March 2015, when Brazilian scientists first confirmed via genetic analysis that Zika virus was present in Brazil and causing a significant disease burden in the South American nation. --IANS https://in.news.yahoo.com/zika-presence-americas-older-previously-thought-110005149.html?utm_source=dlvr.it&utm_medium=twitter gb/dg

Map Update https://www.google.com/maps/d/u/1/edit?hl=en&hl=en&mid=zv94AJqgUct4.kT4qLMXp3SLU&authuser=1

Latest Facts and Advisories as of 4/27/2016 [ Español (PDF)]Reported cases of Zika in New York City: 59 Eight of the fifty-nine cases were pregnant at the time of diagnosis;All cases contracted Zika while visiting other countries; andAll patients have recovered.

TABLE I. Provisional cases of selected* infrequently reported notifiable diseases (<1,000 cases reported during the preceding year), United States, week ending April 23, 2016 (WEEK 16)†http://wonder.cdc.gov/mmwr/mmwr_2016.asp?mmwr_year=2016&mmwr_week=16&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.16) Anthrax-------1 Arboviral diseases ¶,**: Chikungunya virus ††-242808NNNNNNNN Eastern equine encephalitis virus---688154 Jamestown Canyon virus §§---8112223 La Crosse virus §§---55808578130 Powassan virus--07812716 St. Louis encephalitis virus--01910136 Western equine encephalitis virus-------- Botulism, total2394189161152168153 foodborne-41371542724 infant231213212713612397PA (1 ), KY (1 ) other(wound & unspecified)-402019121832 Brucellosis1203119929911479LA (1 ) Chancroid-3015--158 Cholera--025141740 Cyclosporiasis **191634388784123151NYC (1 ) Diphtheria--0-1-1- Haemophilus influenzae, invasive disease (age <5 yrs) ¶¶: serotype b-712640313014 nontypeable serotype159413612814111593WA (1 ) other serotype-381123266233263230 unknown serotype-58419739343748 Hansen's disease **-1128488818282 Hantavirus Infections **: Hantavirus infection (non-HPS) ††---1NNNNNNNN Hantavirus pulmonary syndrome (HPS)-411732213023 Hemolytic uremic syndrome, post-diarrheal **1364245250329274290ID (1 ) Hepatitis B, virus infection perinatal-7134474840NP Influenza-associated pediatric mortality **, ***454313014116052118NH (1 ), OR (1 ), CA (1 ), TN (1 ) Leptospirosis **2703638NNNNNNNYC (2 ) Listeriosis511711743769735727870NY (1 ), FL (1 ), TN (1 ), MS (1 ), WA (1 ) Measles †††-5518566718755220 Meningococcal disease, invasive §§§: serogroup ACWY2314103123142161257TX (1 ), WA (1 ) serogroup B-213978999110159 other serogroup-402225172020 unknown serogroup3575151196298260323NY (1 ), VA (1 ), FL (1 ) Novel influenza A virus infections ¶¶¶-10632131314 Plague--01310443 Poliomyelitis, paralytic-----1-- Polio virus infection, nonparalytic **-------- Psittacosis **-1068622 Q fever total **:-163147168170135134 acute-123126132137113110 chronic-402136332224 Rabies, human--011216 SARS CoV-------- Smallpox-------- Streptococcal toxic shock syndrome **23886291259224194168ME (1 ), VT (1 ), OH (1 ), GA (20 ) Syphilis, congenital ****-767457458348322360 Toxic shock syndrome (staphylococcal) **-615359716578 Trichinellosis **-401114221815 Tularemia1142307180203149166ID (1 ) Typhoid fever4717362349338354390NYC (1 ), OH (1 ), FL (1 ), WA (1 ) Vancomycin-intermediate Staphylococcus aureus **131417121224813482MO (1 ) Vancomycin-resistant Staphylococcus aureus **---1--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 infection---NNNNNNNNNN Zika virus disease, non-congenital infection-381-45NNNNNNNN [ Export This Table ] [ Next Part ] [ NNDSS Interactive Tables ] [ Mortality Interactive Tables ] -: No reported cases N: Not reportable. 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). Data are not available (NA) because 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

Zika ††,§§§§ Zika virus congenital infection---NNNNNNNNNN Zika virus disease, non-congenital infection-381-45NNNNNNNN

April 27, 2016 DEPARTMENT OF HEALTH DAILY ZIKA UPDATE: NO NEW 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 no new cases today. Of the cases confirmed in Florida, two cases are still exhibiting symptoms. According to the CDC, symptoms associated with the Zika virus last between seven to 10 days. Based on CDC guidance, several pregnant women who have traveled to countries with local-transmission of Zika have received antibody testing, and of those, five have tested positive for the Zika virus. The CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. It is recommended that women who are pregnant or thinking of becoming pregnant postpone travel to Zika affected areas. County Number of Cases (all travel related) Alachua 4 Brevard 2 Broward 15 Clay 1 Collier 1 Hillsborough 3 Lee 4 Miami-Dade 39 Orange 5 Osceola 4 Palm Beach 5 Polk 3 Santa Rosa 1 Seminole 1 St. Johns 1 Cases involving pregnant women* 5 Total 94 *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 1,530 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 15 counties included in the declaration– Alachua, Brevard, Broward, Clay, Collier, Hillsborough, Lee, Miami-Dade, Orange, Osceola, Palm Beach, Polk, Santa Rosa, Seminole and St. Johns – 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 the 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.Florida currently has the capacity to test 6,615 people for active Zika virus and 1,434 for Zika antibodies.Federal Guidance on Zika: According to the 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.The CDC has put out guidance related to the sexual transmission of the Zika virus. This includes the 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. http://www.floridahealth.gov/newsroom/2016/04/042716-zika-update.html

Zika Virus – April 27, 2016. Texas has had 31 confirmed cases of Zika virus disease. Of those, 30 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 – 3Dallas – 6Denton – 1Fort Bend – 2Grayson – 1Harris – 12Tarrant – 3Travis – 2Wise – 1

UF study: Zika in Haiti before ID'd in Brazil Staff reportPublished: Tuesday, April 26, 2016 at 4:37 p.m.Last Modified: Tuesday, April 26, 2016 at 4:37 p.m.The Zika virus was present in Haiti several months before the first Zika cases were identified in Brazil, new research by infectious-disease specialists at the University of Florida shows. The finding confirms that the virus was present in the Americas before March 2015, when the virus was first identified in Brazil, and suggests that the spread of Zika in the Americas was likely more complicated than early theories believed. Although the findings suggest that the Zika virus was circulating in the Americas before 2015, it remains unclear exactly what caused the virus to take off in Brazil. The findings were published Monday in Public Library of Science's Neglected Tropical Diseases. Researchers hope to shed light on the factors that led to the spread of Zika in Brazil as well as the sharp rise in the number of birth defects in that nation in cases where pregnant women were infected with the then-uncommon virus. Zika illness is generally mild with a rash, fever and joint pain. It is spread primarily through the bite of an infected mosquito, according to the Centers for Disease Control. Zika infection during pregnancy can cause a serious birth defect called microcephaly. http://www.gainesville.com/article/20160426/ARTICLES/160429757

Colombia Confirms More Birth Defects Linked to ZikaBy EZRA KAPLAN and DONALD G. McNEIL Jr.APRIL 26, 2016 Continue reading the main storyShare This PageShareTweetEmailMoreSaveBOGOTÁ, Colombia — Colombian health officials said on Tuesday that they had confirmed two more cases of babies born with brain damage to mothers who had Zika during pregnancy, but said overall cases of the mosquito-borne virus were decreasing in the country. “We are absolutely certain that Zika is on the decrease in Colombia,” said Fernando Ruiz, Colombia’s vice minister of Health, during a briefing here. At the briefing, officials said they had now confirmed a total of four cases ofmicrocephaly, a condition in which babies are born with unusally small heads and damaged brains, and that they expect to see many more over the next three months as women who contracted Zika during an outbreak this year begin to give birth. They said they were studying 22 more newborns with microcephaly to determine if Zika was the cause. They also announced a total of 304 cases of Guillain-Barré syndrome — a condition that can causeparalysis, usually temporary — that are suspected to have been caused by Zika Separately this week, a new study published in the journal PLoS Neglected Tropical Diseases reported that the Zika virus has been circulating in Haiti at least since 2014, and possibly since 2013, well before an outbreak in Brazil raised the alarm of public health officials around the world. Researchers at the University of Florida found Zika gene sequences in the blood of three children from different rural towns who had visited clinics in the Gressier-Léogâne region of Haiti in December 2015. Comparisons with Zika DNA from elsewhere suggested the virus could have been in Haiti for months. The Zika virus was confirmed in Brazil only in May 2015, but the new finding does not mean that it arrived in Haiti first. Instead, the authors said, the virus probably went from French Polynesia to Easter Island, then around the Americas, circulating for far longer than has been realized. In recent weeks, according to various state health departments, more than a dozen Americans in five states have returned from missionary work in Haiti with confirmed Zika infections. http://www.nytimes.com/2016/04/27/health/zika-virus-haiti.html?_r=0

NEWSSCIENCE & WELLNESSZika present in Americas longer than previously thoughtAPRIL 26, 2016EVAN BARTON EPIThe Zika virus was present in Haiti several months before the first Zika cases were identified in Brazil, according to new research by infectious-disease specialists at the University of Florida. This finding confirms that the Zika virus was present in the Americas prior to March 2015, when the virus was first identified in Brazil, and suggests that the spread of Zika virus in the Americas was likely more complicated than early theories presumed. “We know that the virus was present in Haiti in December of 2014,” said Dr. Glenn Morris, M.D., M.P.H., a professor of medicine and the director of UF’s Emerging Pathogens Institute. “And, based on molecular studies, it may have been present in Haiti even before that date.” Although the findings suggest that the Zika virus was circulating in the Americas prior to 2015, what remains unclear is exactly what confluence of factors caused the virus to take off in Brazil. The findings were published Monday in PLOS Neglected Tropical Diseases. Researchers hope further inquiry will shed light on the factors that led to the proliferation of Zika virus in Brazil as well as the sharp rise in the number of birth defects in that nation in cases where pregnant women were infected with the then-uncommon flavivirus. Scientists from UF’s environmental and global health department and the Emerging Pathogens Institute isolated the Zika virus from three patients while studying the transmission of dengue and chikungunya in Haiti in 2014. School children exhibiting febrile illness within the Gressier/Leogane region of Haiti were taken to a free outpatient clinic, where blood samples were drawn and screened for dengue, chikungunya and malaria. Upon isolation, the viruses were first considered “mystery” viruses, as PCR-based tests indicated they were neither dengue nor chikungunya viruses, and little attention had been paid to the possibility that Zika virus might be present in the Caribbean. Using a sophisticated RT-PCR based method that potentially amplifies any RNA, the researchers produced PCR amplicons that were subsequently sequenced and identified as Zika virus sequences. The plasma samples that yielded Zika virus were taken three months before March 2015, when Brazilian scientists first confirmed via genetic analysis that Zika virus was present in Brazil and causing a significant disease burden in the South American nation. The Zika virus was virtually unknown outside of public health circles prior to the 2007 outbreak in the Yap Islands, a small group of islands in Micronesia where an estimated 73 percent of residents 3 years of age and older were infected with the virus. Questions still remain regarding how it came to the Americas. “The Brazilian and Haitian strains are genetically similar,” said John Lednicky, Ph.D., an associate professor in the UF College of Public Health and Health Professions’ department of environmental and global health and an associate researcher at the Emerging Pathogens Institute. Lednicky designed the project’s virus isolation work and identified and sequenced the Haitian Zika virus isolates. Lednicky said the genetic sequences of the Haitian isolates from 2014 are more similar to those of the French Polynesian strains than to many of the Brazilian Zika virus strains. Lednicky thinks this may be because the Haitian 2014 strain is slightly older than the isolates from Brazil in 2015. Morris echoed Lednicky’s suggestion that Zika virus had been in the Americas for a period of time before it began causing a noticeable level of illness. “There is a possibility that this virus had been moving around the Caribbean before it hit the right combination of conditions in Brazil and took off,” Morris said. “By using the sophisticated culturing and sequencing capabilities that we have here at the Emerging Pathogens Institute, we were able to begin to fill in some of the unknown areas in the history of the Zika virus, leading us toward a better understanding of what caused this outbreak to suddenly occur at the magnitude that it did in Brazil.” http://news.ufl.edu/articles/2016/04/zika-present-in-americas-longer-than-previously-thought.php

Brazil has 1,198 confirmed cases of microcephaly Of the 7,228 cases reported so far to the Ministry of Health, 3,710 are still under investigation and 2,320 were discarded Until April 23, it was confirmed 1,198 cases of microcephaly and other nervous system disorders, suggestive of congenital infection, throughout the country. In all, 7,228 suspected cases have been reported since the start of the investigation in October 2015, and 2,320 were discarded. Other 3,710 are under investigation. The information is the new epidemiological bulletin of the Ministry of Health, released on Tuesday (26), containing the information passed on by state health departments. Of the total confirmed cases, 194 had laboratory confirmation to the Zika virus. However, the Ministry of Health points out that this figure does not represent adequately the total number of cases related to the virus. That is, the folder considers that there was infection Zika most of the mothers who had babies with a final diagnosis of microcephaly. The 1,198 confirmed cases occurred in 435 municipalities located in 22 Brazilian states: Alagoas, Bahia, Ceará, Maranhão, Paraíba, Pernambuco, Piauí, Rio Grande do Norte, Sergipe, Espírito Santo, Minas Gerais, Rio de Janeiro, Amapá, Amazonas , Pará, Rondônia, Distrito Federal, Goiás, Mato Grosso, Mato Grosso do Sul, Parana and Rio Grande do Sul. Already 2,320 cases were discarded because of normal examinations or submit microcefalias and / or changes in the central nervous system causes no infectious. In the same period, there were 251 suspected deaths of microcephaly and / or alteration of the central nervous system after birth or during pregnancy (miscarriage or stillbirth). Of these, 54 were confirmed to microcephaly and / or alteration of the central nervous system. Other 167 are still under investigation and 30 were discarded. It should be noted that the Ministry of Health 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 can be caused, many infectious agents, in addition to Zika, as Syphilis, Toxoplasmosis, Other Infectious Agents, Rubella, Cytomegalovirus and Herpes Viral. The Ministry of Health advises pregnant women to adopt measures to reduce the presence of the mosquito Aedes aegypti , with the elimination of breeding sites , and protect themselves from mosquito exposure, keeping doors and closed or screened windows, wear pants and long-sleeved shirt and use repellents allowed for pregnant women. Distribution of reported cases of microcephaly by UF until 23 of April of 2016 Regions and Federative Units Microcephaly cases and / or malformations suggestive of congenital infection Total accumulated1 of reported cases from 2015 to 2016 research confirmed 2.3 discarded 4 Brazil 3,710 1,198 2,320 7,228 Alagoas 83 57 140 280 Bahia 652 221 175 1,048 Ceará 238 84 134 456 Maranhão 101 99 42 242 Paraíba 382 112 370 864 Pernambuco 733 334 816 1,883 Piauí 22 74 61 157 large northern river 297 86 34 417 Sergipe 163 31 17 211 Northeast 2,671 1,098 1,789 5,558 Holy Spirit 100 7 24 131 Minas Gerais 51 two 50 103 Rio de Janeiro 288 42 85 415 Sao Paulo 161 to 0 108 269 Southeast region 600 51 267 918 Acre 18 0 17 35 Amapá two 4 1 7 Amazon 9 4 4 17 For 26 1 0 27 Rondônia 4 3 5 12 Roraima 22 0 0 22 Tocantins 118 3 17 b 138 North region 199 15 44 258 Federal district two 4 31 37 Goiás 82 9 37 128 Mato Grosso 116 15 74 205 Mato Grosso do Sul two two 14 18 Midwest region 202 30 156 388 Paraná 6 two 25 33 Santa Catarina two 0 3 5 Rio Grande do Sul 30 two 36 68 South region 38 4 64 106 Source: Health Departments of the States and the Federal District (updated data until 04/09/2016). 1 Cumulative number of reported cases that met the definition of previous operating case (33 cm), and the definitions adopted in Surveillance Protocol (from 12/09/2015) that defined the Head Circumference 32 cm for newborns 37 or more weeks of gestation and other protocol definitions. 2 present typical changes: indicative of congenital infection, such as intracranial calcifications, dilation of cerebral ventricles or changes in posterior fossa and other clinical signs observed by any imaging method or identification of Zika virus in laboratory tests. 3 were confirmed 194 cases by specific laboratory criteria for Zika (PCR and serology technique) virus. 4 Discarded have normal exams by presenting microcephaly and / or congenital malformations confirmed by non-infectious causes or does not meet the case definitions. The. As reported by the Epidemiological Surveillance Center "Prof. Alexandre Vranjac ", the State Secretary of Health of São Paulo, 161 cases are under investigation for congenital infection. Of these, 39 are possibly associated with infection by Zika virus, but have not yet been finalized investigations. B. Reduction in value after review and correction (typo, classification) By Alexandre Penido, the Agency Health Care to press (61) 3315-2898 / 3580 http://combateaedes.saude.gov.br/noticias/599-saude-confirma-1-198-casos-de-microcefalia-no-pais

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Two additional cases of the mosquito-linked Zika virus have been confirmed in Arkansas, bringing the total number of in-state cases to four, according to the Arkansas Department of Health. Department spokesman Meg Mirivel said one of the Arkansas residents had traveled to central/south America, while the other contracted the virus during a trip to the Pacific islands. The dates of those trips were not immediately known. In January, the first Arkansas resident tested positive for Zika, the Arkansas Democrat-Gazettepreviously reported. A second case was confirmed in the state earlier this month. According to the Centers for Disease Control and Prevention, the virus is spread through mosquito bites and through sexual contact by a man to his partner. Pregnant women who contract the Zika virus are most at risk for complications, according to the health department.

2 additional cases of Zika virus confirmed in Arkansas; total at 40 By Brandon Riddle This article was published April 26, 2016 at 4:42 p.m. A researcher holds a container with female Aedes aegypti mosquitoes at the Biomedical Sciences Institute in the Sao Paulo's University, in Sao Paulo, Brazil, Monday, Jan. 18, 2016. The Aedes aegypti is a vector for transmitting the Zika virus. (AP Photo/Andre Penner) CommentsaAFont SizeTwo additional cases of the mosquito-linked Zika virus have been confirmed in Arkansas, bringing the total number of in-state cases to four, according to the Arkansas Department of Health. Department spokesman Meg Mirivel said one of the Arkansas residents had traveled to central/south America, while the other contracted the virus during a trip to the Pacific islands. The dates of those trips were not immediately known. http://www.arkansasonline.com/news/2016/apr/26/2-additional-cases-zika-virus-confirmed-arkansas-t/

Thursday, Apr 7, 2016Second Arkansas Resident Tests Positive for Zika VirusDownload attachments:The following readers may be required for linked documents: Adobe Reader | MS Word ViewerDownload MS Excel DocumentLittle Rock, Ark. - The Centers for Disease Control and Prevention (CDC) has confirmed that a second Arkansas resident has tested positive for Zika virus. This individual recently traveled out of the country to Central America and had a mild case of Zika. The Arkansas Department of Health cautions travelers and women who are pregnant or planning to become pregnant to take important steps to guard against Zika transmission.http://www.arkansas.gov/health/newsroom/index.php?do:newsDetail=1&news_id=1153

April 26, 2016 DEPARTMENT OF HEALTH DAILY ZIKA UPDATE: NO NEW 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 no new cases today. Of the cases confirmed in Florida, three cases are still exhibiting symptoms. According to the CDC, symptoms associated with the Zika virus last between seven to 10 days. Based on CDC guidance, several pregnant women who have traveled to countries with local-transmission of Zika have received antibody testing, and of those, five have tested positive for the Zika virus. The CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. It is recommended that women who are pregnant or thinking of becoming pregnant postpone travel to Zika affected areas. County Number of Cases (all travel related) Alachua 4 Brevard 2 Broward 15 Clay 1 Collier 1 Hillsborough 3 Lee 4 Miami-Dade 39 Orange 5 Osceola 4 Palm Beach 5 Polk 3 Santa Rosa 1 Seminole 1 St. Johns 1 Cases involving pregnant women* 5 Total 94 *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 1,517 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 15 counties included in the declaration– Alachua, Brevard, Broward, Clay, Collier, Hillsborough, Lee, Miami-Dade, Orange, Osceola, Palm Beach, Polk, Santa Rosa, Seminole and St. Johns – 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 the 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.Florida currently has the capacity to test 6,615 people for active Zika virus and 1,434 for Zika antibodies.Federal Guidance on Zika: According to the 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.The CDC has put out guidance related to the sexual transmission of the Zika virus. This includes the 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. http://www.floridahealth.gov/newsroom/2016/04/042616-zika-update.html