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Feb. 25, 2016 Surgeon General Dr. John Armstrong’s Daily Zika Update - Three New Cases Confirmed in Miami-Dade and Orange CountiesContact: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. As of today, three new Zika cases have been confirmed with one in Orange County and two in Miami-Dade County. Of the travel-related cases confirmed in Florida, only 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 three have tested positive for a history of Zika virus infection. The CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. Out of respect of the privacy of these women, no counties or additional information will be shared. 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 4 Hillsborough 3 Lee 3 Miami-Dade 13 Orange 3 Osceola 1 Santa Rosa 1 Seminole 1 St. Johns 1 Cases involving pregnant women* 3 Total 35 *Counties of pregnant women will not be shared. Yesterday, after learning of three pregnant women in Florida who tested positive for Zika virus after traveling from outside the U.S., Governor Rick Scott requested the CDC send 250 additional Zika antibody tests to the state. 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 727 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 11 effected counties – Alachua, Brevard, Broward, Hillsborough, Lee, Miami-Dade, Orange, Osceola, 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 4,767 people for active Zika virus and 1,153 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.Last week, 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 websitehere.For more information on Zika virus, click here http://www.floridahealth.gov/newsroom/2016/02/022516-zika-update-16.html

As of today, three new Zika cases have been confirmed with one in Orange County and two in Miami-Dade County. Of the travel-related cases confirmed in Florida, only 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 three have tested positive for a history of Zika virus infection. The CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. Out of respect of the privacy of these women, no counties or additional information will be shared. 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 4 Hillsborough 3 Lee 3 Miami-Dade 13 Orange 3 Osceola 1 Santa Rosa 1 Seminole 1 St. Johns 1 Cases involving pregnant women* 3 Total 35 *Counties of pregnant women will not be shared.

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Maine Reports First Confirmed Case of Zika VirusFebruary 25, 2016 Human Services The Maine Center for Disease Control and Prevention (Maine CDC) announced today that a mature adult (age 65 or older) from Hancock County has tested positive for the Zika virus. AUGUSTA – The Maine Center for Disease Control and Prevention (Maine CDC) announced today that a mature adult (age 65 or older) from Hancock County has tested positive for the Zika virus. The individual traveled to a Zika-affected country and experienced symptoms after returning home. Hospitalization was not required and recovery continues at home. To date, 25 samples for residents across the state who have traveled have been or are being tested. Of the tests that have been completed, this is the first positive test result. “The common link to this virus is travel, and this finding is not unexpected,” said Dr. Siiri Bennett, Maine’s state epidemiologist. “Several countries in the Caribbean, Central, and South America are experiencing outbreaks and Mainers like to travel to warm places in the winter.” “It’s important for the public to understand that the aedes mosquito that transmits the Zika virus is not found in Maine,’’ Bennett said “and that your neighbor who has come home from a trip to South America cannot transmit the virus to you. ” Though less common, Zika can be transmitted through sexual contact from a male to his partner. The World Health Organization and U.S. CDC are investigating a potential link between Zika virus and an increase in microcephaly, a birth defect in which the size of a baby’s head is smaller than expected. This link is not well understood, and out of an abundance of caution Maine CDC is recommending that all pregnant women and men who are sexually active with a woman who is pregnant or trying to become pregnant who have traveled to a Zika-affected area be tested for the virus. “Pregnant women and their male partners with whom they are sexually intimate who travel to a tropical and sub-tropical climate where the aedes mosquitoes are found should not only take precautions against being bitten while traveling, but they should be tested and take appropriate steps to prevent sexual transmission of the virus,’’ Dr. Bennett said. Only one in five people infected with Zika show symptoms and the symptoms resolve on their own. Symptoms include fever, rash, joint pain, conjunctivitis, muscle pain and headache. The mosquitoes that can transmit Zika virus are actively biting during the day. It is recommended that Mainers who travel to Zika-affected countries: Wear long sleeves and long pantsUse an EPA-approved repellent on skin and clothesStay in places with air conditioning or the use screens on the windows and doors to help keep mosquitoes out.Sleep under a mosquito bed net if you are overseas and outside To stay up to date on the number of tests being conducted on Mainers and the results, visit http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/zika/index.shtml . This data is updated every two weeks. - See more at: http://www.maine.gov/tools/whatsnew/index.php?topic=Portal+News&id=670614&v=article-2015#sthash.b9lSkO3A.dpuf

The Maine Center for Disease Control and Prevention (Maine CDC) announced today that a mature adult (age 65 or older) from Hancock County has tested positive for the Zika virus. The individual traveled to a Zika-affected country and experienced symptoms after returning home. Hospitalization was not required and recovery continues at home. - See more at: http://www.maine.gov/tools/whatsnew/index.php?topic=Portal+News&id=670614&v=article-2015#sthash.b9lSkO3A.dpuf

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IMPORTED ZIKA CASE CONFIRMED IN TARRANT COUNTY Tarrant County - Home > Public Health > News Releases > News Releases 2016 > Imported Zika Case Confirmed in Tarrant CountyFOR IMMEDIATE RELEASE Kelly Hanes Senior Public Information Officer Tarrant County Public Health 817-321-5306 direct 817-401-5967 mobile Imported Zika Case Confirmed in Tarrant CountyNo local transmission reported at this time February 25, 2016 (Tarrant County, TX) – Tarrant County Public Health (TCPH) has identified the first imported case of Zika virus in the county, in a positive sample tested in TCPH’s North Texas Regional Laboratory. The patient traveled to a Caribbean country with known local transmission of the disease. No other health information will be released at this time to protect the identity of the patient. Zika virus is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is typically mild with symptoms lasting for several days to a week. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. Sexual transmission of Zika virus can also occur and is of particular concern during pregnancy. TCPH is encouraging healthcare providers to remain alert for Zika virus, especially in patients with recent travel to countries with local transmission of the disease.If a person infected with Zika virus is bit by an Aedes mosquito, that mosquito may later bite another person and spread the virus further. “The most important thing residents can do is to eliminate mosquito breeding sites around their home,” said TCPH Health Director Vinny Taneja. “When we stop the breeding cycle, we help stop the spread of mosquito-borne diseases.” Although the beginning of mosquito season is still several weeks away, residents are encouraged to maintain their properties to reduce mosquito breeding sites. Residents should: Routinely dump standing water on their property,Overturn all small containers,Dispose of any trash or debris that can contain small amounts of water.TCPH has produced a video to help residents Eliminate Mosquito Breeding Sites. County residents can also call the health department’s Zika Hotline (817-248-6299), if they have questions about this disease. For more information on Zika virus and for other useful tips, visit our Zika virus web page.

Tarrant County Public Health (TCPH) has identified the first imported case of Zika virus in the county, in a positive sample tested in TCPH’s North Texas Regional Laboratory. The patient traveled to a Caribbean country with known local transmission of the disease http://access.tarrantcounty.com/en/public-health/news/2016/imported-zika-case-confirmed-in-tarrant-county.html

Zika Virus InformationAs of February 24, 2016 there are no confirmed cases of Zika virus in South Carolina.

Zika Virus UpdateAs of Thursday, February 25, VDH has confirmed Zika virus disease (via laboratory testing provided through the CDC) in three (3) adult residents of Virginia (1 in Northwest Region, 1 in Northern Region, 1 in Eastern Region). All are travel associated. 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.

Zika Virus – Feb. 25, 2016 Texas has 13 cases of Zika virus disease. 12 are travelers who were infected abroad and diagnosed after they returned home. One case involves a Dallas County resident who had sexual contact with someone who acquired the Zika infection while traveling abroad. Case counts by county: Bexar County – 3Dallas County – 2Harris County – 7Travis County - 1

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https://www.odh.ohio.gov/odhprograms/bid/zdp/diseases/zika.aspxZika VirusZika virus cases in Ohio:

Zika VirusZika virus cases in Ohio:

14 new NZ Zika cases reportedBy Lucy Warhurst Thursday 25 Feb 2016 5:47 p.m. Another 14 cases of Zika have been reported in the past week. There have now been a total of 61 confirmed cases in New Zealand this year. All of them were infected overseas, most of them in Tonga and Samoa. A further three probable cases are being investigated. The mosquito-borne virus can cause a fever, rash, joint pain and conjunctivitis. The Zika outbreak has been linked to a surge in cases of the birth defect microcephaly in Brazil, although it is yet to be scientifically proven. On February 1, the World Health Organisation declared the outbreak to be a Public Health Emergency. The Ministry of Health recommends that women who are pregnant or plan to become pregnant in the near term consider delaying travel to affected countries. All travellers should take precautions to avoid mosquito bites. Newshub. Read more: http://www.newshub.co.nz/nznews/14-new-nz-zika-cases-reported-2016022517#ixzz41By5gSQV

Another 14 cases of Zika have been reported in the past week. There have now been a total of 61 confirmed cases in New Zealand this year. All of them were infected overseas, most of them in Tonga and Samoa. Read more: http://www.newshub.co.nz/nznews/14-new-nz-zika-cases-reported-2016022517#ixzz41BxJdSKg

Zika virus makes its way into HarrisonburgMakena Rafferty-Lewis | The Breeze 10 hrs ago (0) At the beginning of this month, the CDC verified that a resident of Harrisonburg had contracted the Zika virus while on a trip to Guatemala. Dr. Stephen Rodgers, the medical director at the JMU University Health Center, said that although there’s only one case of confirmed Zika in Harrisonburg and about 50 throughout the U.S., there has yet to be a case where the virus originated in the country. Dr. Parag Patel, an infectious disease specialist at Sentara RMH Medical Center, said that, because Zika is spread by the mosquito, it has a minimal chance of spreading locally in the U.S. “We are not expecting an outbreak,” Patel said. Heather Baker is the 41-year-old resident of Harrisonburg who contracted the Zika virus while she was on a mission trip to Guatemala in November. “I returned home on the 29th of November and by the 2nd of December I was presenting with symptoms,” Baker said. Baker originally thought she had a virus called Chikungunya, which has many symptoms in common with the Zika virus. “I went to a local urgent care facility and was tested and that came back negative,” Baker said. “And at the point that the test was returned I was in contact with the people in Guatemala and they said that the virus was present there.” Baker said that she endured a month of Zika symptoms before she was finally advised to go to the Rockingham Harrisonburg Health Department. Jason Good, the director of study abroad at JMU, said some countries are taking preventive measures to decrease the number of mosquito bites and the spread of Zika. “I think El Salvador had the most recommendations about that,” Good said. The Zika virus is transmitted through mosquitos to humans and other primates. The spread of this virus began in May 2015 and is mainly found in Central and South America and Africa. According to Rodgers, the Zika virus originated in monkeys in 1947. “Most people have symptoms for a week or 10 days, then usually they do fine,” Patel said. Rodgers said that the most common of the Zika symptoms include fever, red eyes or conjunctivitis, a non-distinct rash and joint pain. Rodgers also said that 80 percent of people who get the virus don’t know they have it because they don’t have symptoms. Despite what many doctors are saying, Baker said that some of her symptoms have lasted much longer and are still ongoing. “The majority of the symptoms were just a couple of weeks,” Baker said. “For right now, almost three months later I am still dealing with fatigue, joint pain and headaches.” Despite Baker’s individual reaction to Zika, Good believes that there’s not a major risk for students studying abroad because the symptoms of Zika are mild and the risk for adults is very low. The study abroad office is not canceling any programs at this time. “There is a risk of contracting the disease of course, as any other disease when you travel, but we would discourage anyone who was pregnant or planning to get pregnant on the trip to attend,” Good said. “But we don’t feel that any students fit that criteria. But we are educating all groups who are going on the trip.” The Student Health Center at JMU offers information and vaccinations for students going abroad. “We have a specialized time of the week; it’s not every week, but we have the travel clinic,” Rodgers said. Students can make an appointment for the travel clinic through the University Health Center’s website. They then answer questions about where they will be traveling. The doctor or physician’s assistant will look at where the student is going and inform them on what vaccines they need or what preventative medicines they should take beforehand, Rodgers said. The office will also give students going to Latin America, the Caribbean or other mosquito hot zones information about how to avoid mosquito bites. “Unfortunately this species of mosquito [that carries Zika] is day and night,” Rodgers said. “It is not our American view of a mosquito that comes out at dusk. There is a long list of recommendations of wearing long sleeves, of using insect repellents, sleeping with screens or if possible in air conditioning or where everything is closed up.” Although students do need to pay for their own vaccines, they are at a reduced cost. “So what we have to pay for it is what we transfer to students,” Rodgers said. “Most things are double if you went to the medical market, if you went to your private doctor. And most preventative things are not covered in insurance.” The JMU study abroad offices feels it is equipped to handle the spread of Zika. “We had an Ebola breakout in Western Africa two years ago, we have malaria concerns, we have dengue fever, we have yellow fever,” Good said. “But because of the lack of severity of the symptoms, Zika has not been a major concern.” Good said that trips wouldn’t be canceled unless more information came to light that stated that Zika stayed in the host body for a longer period of time than is seen now, which is about a week. “I don’t want to diminish the concern,” Good said. “It is an old virus but it is a relatively new rapid increase in the number of cases. It is now just being studied more.” Baker is struggling to find someone who knows more about Zika. She feels that because it is taking place in developing countries, there is not as much reliable research as there would be if the epicenter of the problem was in the U.S. “I am on this quest to connect with someone somewhere who has studied it and knows something about it but I’m realizing that may never happen,” Baker said. According to Patel, the CDC is working to do more research on the virus; specifically on its connection to microcephaly and Guillain-Barré, an autoimmune disease. Baker said that once she receives the green light from her doctors, she will continue going to South America on mission trips, despite having contracted the Zika virus. This, however, could take a while because so much is still unknown about the virus. According to Rodgers, the JMU Pandemic Task Force will meet on Friday to discuss the Zika virus impact. This task force includes heads of all the departments on campus and started after the massive H1N1 influenza outbreak in 2009. The task force works with JMU and the Harrisonburg community. “We have relationships with the community and the emergency and disaster planning so we can help the community and the community can help us,” Rodgers said. Rodgers said that, because there is no preventative vaccine for Zika, the most important thing is to avoid being bitten by a mosquito. Baker believes that being educated about the virus will help keep people safe. “I just want to raise awareness,” Baker said. “My message is be wise and use caution.” Contact Makena Rafferty-Lewis at [email protected].

At the beginning of this month, the CDC verified that a resident of Harrisonburg had contracted the Zika virus while on a trip to Guatemala. Dr. Stephen Rodgers, the medical director at the JMU University Health Center, said that although there’s only one case of confirmed Zika in Harrisonburg http://www.breezejmu.org/news/zika-virus-makes-its-way-into-harrisonburg/article_65627e22-db70-11e5-bcca-eba440931d5a.html

OverviewThe main mode of Zika virus transmission is through infected Aedes mosquitoes. However, current widespread transmission of the virus has raised questions as to whether transmission can also occur during breastfeeding, a practice essential to infant and young child survival and development. The purpose of this document is to provide interim recommendations to guide breastfeeding practices in the context of Zika virus. A systematic review of evidence will be conducted in March 2016 to revise and update these recommendations. Related linksAll publications, technical guidances on Zika virusMicrocephaly/Zika virus

Breastfeeding in the context of Zika virusInterim guidanceShare PrintAuthors: World Health Organization Publication detailsNumber of pages: 2 Publication date: 25 February 2016 Languages: English WHO reference number:WHO/ZIKV/MOC/16.5 DownloadsBreastfeeding in the context of Zika virus

OverviewMicrocephaly is a condition where a baby has a head that is smaller when compared with other babies of the same sex and age. Microcephaly is a clinical sign and not a disease. Babies born with microcephaly are at risk of developmental delay and intellectual disability and may also develop convulsions and physical disabilities including hearing and vision impairment. However, a proportion of these infants will have normal neurological development. This document aims to provide interim guidance on standard measurement of head circumference, growth reference standards, clinical assessment and investigations required to establish a diagnosis of microcephaly and if any neurological abnormalities are associated. Related linksAll publications, technical guidances on Zika virusMicrocephaly/Zika virus

Assessment of infants with microcephaly in the context of Zika virusInterim guidanceShare PrintAuthors: World Health Organization Publication detailsNumber of pages: 2 Publication date: 25 February 2016 Languages: English WHO reference number:WHO/ZIKV/MOC/16.3 DownloadsAssessment of infants with microcephaly in the context of Zika virushttp://www.who.int/csr/resources/publications/zika/assessment-infants/en/