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Pregnant New York resident likely infected by sexual transmission.

As of Thursday, March 10, VDH has reported 6 cases of Zika virus disease in Virginia residents to the CDC (2 in Northwest Region, 1 in Northern Region, 1 in Eastern Region, 1 in Central Region and 1 in Southwest Region). CDC has issued a travel alert (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing.

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Zika virus cases in Canada, as of March 10, 2016 http://www.healthycanadians.gc.ca/diseases-conditions-maladies-affections/disease-maladie/zika-virus/surveillance-eng.php?id=zikacases#s1 CountryLocally acquiredTravel-relatedCanada022

Zika virus cases in Canada, as of March 10, 2016CountryLocally acquiredTravel-relatedCanada022

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DHHR Press Release -- State Confirms First Case of Zika Virus3/10/2016 The West Virginia Department of Health and Human Resources, Bureau for Public Health (BPH) today received laboratory confirmation of the State’s first case of the Zika virus.“With the number of Zika outbreaks occurring in many parts of the world where West Virginians travel for vacation, business or mission work, the likelihood of a finding a Zika case in our State was foreseeable,” said Dr. Rahul Gupta, State Health Officer and Commissioner for the Bureau for Public Health. “The confirmed case involves an adult male and resident of Clay County who traveled to Haiti. He is no longer exhibiting symptoms and has made a full recovery.”Currently, there has been no local transmission of disease reported in the United States. Cases in the U.S. have only been found in return travelers who were bitten by the infected mosquito while traveling abroad. “It’s important to remember that four out of five persons who have the Zika virus experience no symptoms at all, and of those who do experience symptoms they are usually mild and recover fully,” said Gupta. “However, if you are pregnant or are considering becoming pregnant around the time you will be traveling to parts of the world where Zika virus is occurring, you should consider postponing trips to those areas at this time. Other travelers should be vigilant in taking appropriate mosquito bite preventive actions such as using repellents and wearing pants and long sleeves.Concern surrounding the Zika virus is focused on pregnant women who could have babies with microcephaly, a neurodevelopmental disorder, where an infant’s head is significantly smaller than children of the same age. Residents who are concerned that they may be infected with the Zika virus should contact their healthcare provider if they develop the symptoms described above following a visit to an area overseas where Zika is found. Zika virus is not circulating in West Virginia.Zika virus is spread to people primarily through the bite of an infected Aedes species mosquito. For those who become ill, the most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito. As part of preparations for the State’s first case of Zika virus, BPH has been working with Centers for Disease Control and Prevention (CDC) and other federal partners to monitor Zika virus testing and guidance to ensure health care providers and local health departments have the appropriate information. Contact InformationMedia contact: [email protected] or (304) 558-7899

The West Virginia Department of Health and Human Resources, Bureau for Public Health (BPH) today received laboratory confirmation of the State’s first case of the Zika virus.“With the number of Zika outbreaks occurring in many parts of the world where West Virginians travel for vacation, business or mission work, the likelihood of a finding a Zika case in our State was foreseeable,” said Dr. Rahul Gupta, State Health Officer and Commissioner for the Bureau for Public Health. “The confirmed case involves an adult male and resident of Clay County who traveled to Haiti. He is no longer exhibiting symptoms and has made a full recovery.” http://www.dhhr.wv.gov/News/2016/Pages/DHHR-Press-Release----State-Confirms-First-Case-of-Zika-Virus.aspx

Zika outbreak: ‘The more we learn, the worse things seem to get’By Lena H. Sun March 10 at 1:58 PM Puerto Rico becoming a breeding ground for the Zika virus in the U.S.View PhotosCases of the virus are expected to rise on the island in coming months. And that raises the likelihood of transfer to the mainland.The top U.S. health officials leading the response to the mosquito-borne Zika virus sweeping through the hemisphere said its growing links to a broad array of birth defects and neurological disorders are worse than they originally suspected, increasing the risk for devastating harm during pregnancy. Until Zika, "there has never been a mosquito-borne virus that could cause serious defects on a such a large scale," Thomas Frieden, director of the Centers for Disease Control and Prevention, said Thursday during a conference call with reporters. [Why Puerto Rico's rising Zika cases are alarming for rest of U.S.] ADVERTISING Puerto Rico is a Zika target that has Frieden "very concerned." He expects hundreds of thousands of people there will be infected by year's end, including thousands of pregnant women. The U.S. territory is on the "front lines of the battle," he said. Moreover, the latest research findings underscore the rising number of unanswered and very disturbing questions, said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "As the weeks and months go by, we learn more and more about how much we don't know, and the more we learn the worse things seem to get," Fauci told reporters. The two experts cited a study last week in the New England Journal of Medicine that examined the pregnancies of a group of Brazilian women who tested positive for Zika infection. Ultrasounds for about 29 percent of them showed fetal anomalies with "grave outcomes," which likely means many more complications that won't show up until after birth, Fauci said. "That's an alarming finding and shows the negative impact on the fetus even if the mother is infected later on in pregnancy," he acknowledged. [Zika likely behind more birth defects, problems than researchers realized, study shows] Both men said U.S. efforts are underway to develop a vaccine, come up with new technologies to control mosquitoes, and monitor and protect pregnant women and their babies. But those efforts cannot be sustained over the long term without the $1.9 billion in emergency funding sought by the Obama administration. Congress has balked at approving the request. With the approach of the rainy season in Puerto Rico and warmer temperatures in the rest of the United States, Frieden and Fauci said it is critical that the emergency funding be approved. For now, the CDC and NIH have been moving resources from existing programs. The CDC has about 750 of its staff working full-time on Zika. That includes its Dengue Branch in Puerto Rico, which has completely shifted from dengue, a related virus that is the leading cause of illness and death in the tropics and subtropics. The agency's Fort Collins, Colo., office also has stopped working on some new tick-borne viruses to focus on Zika, Frieden said. [Scientists discover how Zika virus can attack fetal brain] At the NIH, the researchers trying to accelerate a Zika vaccine are part of a team that is also developing vaccines for flu, HIV/AIDS and respiratory illness. "There may be a point where we have to slow down at least one or maybe all three of those until we can get money," Fauci said. "It's a give and take. ... You have to slow down or stop. We try very hard not to stop things." The cost of caring for one child with birth defects can be $1 million or more, Frieden said. In Puerto Rico, which is already facing an enormous fiscal crisis, fighting Zika is going to be an uphill battle, he noted. https://www.washingtonpost.com/news/to-your-health/wp/2016/03/10/zika-outbreak-the-more-we-learn-the-worse-things-seem-to-get/

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March 10, 2016 SURGEON GENERAL DR. JOHN ARMSTRONG'S DAILY ZIKA UPDATE: SIX NEW CASES CONFIRMED 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, State Surgeon General and Secretary of Health Dr. John Armstrong 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 six new cases today with three in Miami-Dade County, two in Osceola County and one in Broward County. Of the cases confirmed in Florida, four 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, four 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 1 Brevard 1 Broward 8 Hillsborough 3 Lee 3 Miami-Dade 27 Orange 3 Osceola 3 Polk 2 Santa Rosa 1 Seminole 1 St. Johns 1 Cases involving pregnant women* 4 Total 58 *Counties of pregnant women will not be shared. Yesterday, following news of the first confirmation of a sexually transmitted Zika case in Polk County from an individual who traveled out of the country, Governor Rick Scott asked the CDC to host another conference call with Florida healthcare workers on how Zika is spread, its symptoms, treatments and proper precautions. On Feb. 12, Governor Scott directed State Surgeon General Dr. John Armstrong 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 988 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. State Surgeon General and Secretary of Health Dr. John Armstrong 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 State Surgeon General and Secretary of Health Dr. John Armstrong to issue a Declaration of Public Health Emergency for the counties of residents with travel-associated cases of Zika.The Declaration currently includes the 12 affected counties – Alachua, Brevard, Broward, Hillsborough, Lee, Miami-Dade, Orange, Osceola, 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.Florida currently has the capacity to test 4,430 people for active Zika virus and 1,449 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 are examining a possible link between the virus and harm to unborn babies exposed during pregnancy.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 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.

There are six new cases today with three in Miami-Dade County, two in Osceola County and one in Broward County. Of the cases confirmed in Florida, four 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, four 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. http://www.floridahealth.gov/newsroom/2016/03/031016-zika-update.html County Number of Cases (all travel related) Alachua 1 Brevard 1 Broward 8 Hillsborough 3 Lee 3 Miami-Dade 27 Orange 3 Osceola 3 Polk 2 Santa Rosa 1 Seminole 1 St. Johns 1 Cases involving pregnant women* 4 Total 58

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Zika Virus in Clallam County0 inShare0Today at 8:26AMPORT ANGELES, Wash. – Clallam County Department of Health and Human Services, working with Washington State Department of Health (DOH) and the Centers for Disease Control and Prevention (CDC) confirmed Zika virus infection in a U.S. citizen diagnosed in Clallam County, Washington. The individual is a young woman, and was traveling in a region of Central America where Zika transmission is occurring. She has recovered from the illness without complications. Zika virus is almost always a very mild illness. About 80 percent of those infected never show symptoms of the disease, while about 1 in 5 people will have only mild symptoms, including fever, rash, joint pain, and red eyes that last a few days to a week. However, for pregnant women infection with Zika virus has been linked to a serious birth defect of the brain called microcephaly. “For pregnant women or women who may become pregnant, this is an important reminder to consider delaying travel to regions with Zika,” said Dr. Christopher Frank, Clallam County Health Officer. “In Washington we are fortunate that we don’t have the species of mosquito that transmits the Zika virus so a widespread outbreak is very unlikely.” This is the third confirmed case of Zika virus infection in a returning traveler to Washington State. The first was in a Mason County, a Washington man who recently traveled to a Zika affected area. The second case was a woman in Spokane who was tested based on CDC guidance that all pregnant women who traveled to a place with a Zika outbreak during pregnancy receive antibody testing for the virus. There is no vaccine to prevent Zika virus disease and no specific medical treatment for people who are infected. Zika virus can be spread from a pregnant woman to her fetus and has been linked to a serious birth defect of the brain called microcephaly. CDC recommends special precautions for pregnant women. Pregnant women should consider delaying travel to areas with Zika. If they must travel to one of these areas, they should strictly follow steps to prevent mosquito bites during their trip. The mosquitoes that transmit Zika virus are daytime biters, so it is important to apply prevention measures throughout the day as well as during the evening hours. Men returning from an area with Zika who have a pregnant partner, or who have a partner whose pregnancy status is not known, should use a condom during sex or not have sex during pregnancy. The Washington State Department of Health recommends travelers protect themselves against mosquito bites by:  Applying EPA-registered insect repellants to skin following label instructions.  Wearing long-sleeved shirts and pants and closed shoes or boots instead of sandals.  Using bed nets in remote locations lacking window screens and/or air conditioning. These should reach the floor or be tucked under the mattress.  Avoiding perfumes, colognes and products with fragrances that might attract mosquitoes.  Using clothing, shoes, bed nets and camping gear that contain permethrin. Permethrin-treated clothing repels and kills mosquitoes and other pests and retains this effect after repeated washing. Some clothing is available pretreated with permethrin; permethrin should not be used directly on skin. While public health and medical professionals know a lot about many mosquito-borne diseases, there is still much that is not known about Zika. The list of Zika-affected areas includes many countries in the Caribbean and South and Central America. The Centers for Disease Control and Prevention keep an updated list and travel recommendations on their Website.

Clallam County Department of Health and Human Services, working with Washington State Department of Health (DOH) and the Centers for Disease Control and Prevention (CDC) confirmed Zika virus infection in a U.S. citizen diagnosed in Clallam County, Washington. The individual is a young woman, and was traveling in a region of Central America where Zika transmission is occurring. She has recovered from the illness without complications. http://www.forksforum.com/news/371672341.html

Zika Confirmed Cases County Cases* Mason1Spokane1Washington State Total 2* Confirmed travel-associated cases in WA as of 3/1/16 **US citizen diagnosed in Spokane County, not a resident of Spokane

Zika virus, Microcephaly and Guillain-Barré syndromeRead the full situation reportSummary The second meeting of the Emergency Committee was convened by the Director-General under the International Health Regulations (2005) on 8 March 2016. The Committee advised that the clusters of microcephaly cases and other neurological disorders in some areas affected by Zika virus continue to constitute a Public Health Emergency of International Concern, and that there is increasing evidence that there is a causal relationship with Zika virus.Between 1 January 2007 and 9 March 2016, a total of 52 countries and territories have reported autochthonous (local) transmission or indication of transmission of Zika virus (41 since 1 January 2015). The Philippines is the latest to report autochthonous transmission of Zika virus. Five of these countries and territories reported a Zika virus outbreak that is now over. In addition, three countries have reported locally acquired infection in the absence of any known mosquito vectors, probably through sexual transmission.The geographical distribution of Zika virus has steadily widened since the virus was first detected in the Americas in 2014. Autochthonous Zika virus transmission has been reported in 31 countries and territories of this region.So far an increase in microcephaly and other neonatal malformations has only been reported in Brazil and French Polynesia, although two cases linked to a stay in Brazil were detected in the United States of America and Slovenia. Reported cases of microcephaly and/or congenital malformation in Colombia are under investigation.In the context of Zika virus circulation, nine countries or territories have reported an increased incidence of Guillain-Barré syndrome (GBS) and/or laboratory confirmation of a Zika virus infection among GBS cases.A recently published cohort study in Brazil shows an increased risk of microcephaly and other congenital abnormalities associated with a Zika virus infection during pregnancy and provides further information to support the possible causal relationship between Zika virus and microcephaly and other congenital abnormalities.The global prevention and control strategy launched by WHO as a Strategic Response Framework encompasses surveillance, response activities and research, and this situation report is organized under those headings. Enlarge imageEnlarge image

Zika situation report10 March 2016http://www.who.int/emergencies/zika-virus/situation-report/10-march-2016/en/ Enlarge image

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First case of Zika reported in KentuckyUPDATED 11:58 AM EST Mar 10, 2016coniferconifer - flickrFRANKFORT, Ky. —A Kentucky resident tested positive for Zika virus after traveling in a Central American country where the virus is circulating, the Kentucky Department for Public Health said Thursday. The male patient recently returned to the Louisville area from Central America. He is doing well and expected to fully recover from the illness. “Many areas, including most of our surrounding states, are reporting Zika cases. For now, these positive results have only occurred in individuals who have traveled outside the country to places where the virus is currently spreading,” Dr. Kraig Humbaugh, DPH senior deputy commissioner, said. READ: Additional Zika information Humbaugh said the DPH advises anyone planning to travel to countries where Zika is circulating to take precautions to protect themselves. READ: Zika travel information Except in pregnant women, Zika is almost always a very mild illness and for most people testing is not necessary. Most infected individuals do not show symptoms. Zika has been increasing in recognition in Brazil, Mexico, Puerto Rico, Haiti and the U.S. Virgin Islands. (Full list of areas with Zika) The Centers for Disease Control and Prevention advises travelers to protect themselves and their family members from mosquito bites when traveling to affected countries.

A Kentucky resident tested positive for Zika virus after traveling in a Central American country where the virus is circulating, the Kentucky Department for Public Health said Thursday. The male patient recently returned to the Louisville area from Central America. He is doing well and expected to fully recover from the illness. http://www.wlky.com/news/First-case-of-Zika-reported-in-Kentucky/38441792

ABSTRACT We describe the epidemic of microcephaly in Brazil, its detection and attempts to control it, the suspected causal link with Zika virus infection during pregnancy, and possible scenarios for the future. In October 2015, in Pernambuco, Brazil, an increase in the number of newborns with microcephaly was reported. Mothers of the affected newborns reported rashes during pregnancy and no exposure to other potentially teratogenic agents. Women delivering in October would have been in the first trimester of pregnancy during the peak of a Zika epidemic in March. By the end of 2015, 4180 cases of suspected microcephaly had been reported. Zika spread to other American countries and, in February 2016, the World Health Organization declared the Zika epidemic a public health emergency of international concern. This unprecedented situation underscores the urgent need to establish the evidence of congenital infection risk by gestational week and accrue knowledge. There is an urgent call for a Zika vaccine, better diagnostic tests, effective treatment, and improved mosquito-control methods. Read More: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303113