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Number of confirmed cases of microcephaly in Brazil rises to 5834UOL's in Sao Paulo 02/23/2016 17h3 http://noticias.uol.com.br/saude/ultimas-noticias/redacao/2016/02/23/numero-de-casos-confirmados-de-microcefalia-no-brasil-sobe-para-583.htm

US investigates 14 possible cases of sexually transmitted Zika virusOfficials look into cases of men who visited areas affected by virus and who may have infected their female partners A model of a mosquito is pictured in a laboratory in Hamburg, Germany. Zika is typically transmitted by mosquito bites, but researchers are investigating possible sexually transmitted cases. Photograph: Christian Charisius/EPAAssociated Press in New York Tuesday 23 February 2016 17.56 ESTLast modified on Tuesday 23 February 201618.00 EST Share on PinterestShare on LinkedInShare on Google+Shares24Comments6 Save for laterUS health officials are investigating more than a dozen possible Zika infections that may have been spread through sex. The 14 cases all involve men who visited areas with Zika outbreaks, and who may have infected their female sex partners, who had not travelled to those areas. Zika virus is mainly spread by mosquito bites, and sexual transmission has been considered rare. There have been two reported cases, including a recent one in Texas, and at least two other reports of the Zika virus found in semen. Mosquito-borne Zika outbreaks have erupted across most of Latin America and the Caribbean in the last year. So far, all the 82 Zika infections diagnosed in the US have involved people who travelled to outbreak regions. On Tuesday, the Centers for Disease Control and Prevention said the 14 possible cases of sexual transmission in the US include two pregnant women whose infections have been confirmed. Tests have not been completed for their male partners. In four other cases, preliminary tests indicate women were infected but confirmatory tests are pending. Eight other cases are still being investigated, according to a CDC statement. The agency said there is no evidence that women can spread the virus to their sex partners, but more research is needed. In most people, Zika causes mild or no symptoms – fever, joint pain, rash and red eyes – that last about a week. But in Brazil, health officials are investigating a possible connection between the virus and babies born with brain defects and abnormally small heads. The link has not been confirmed but the possibility has prompted health officials to take cautionary steps to protect fetuses from the virus. Research is also under way into a possible link between Zika infection and a paralyzing condition in adults called Guillain-Barré syndrome. The CDC is advising men who have recently been to a Zika outbreak area to use a condom when they have sex with a pregnant women, or to abstain from sex during the pregnancy. It has also recommended that pregnant women postpone trips to more than 30 destinations with outbreaks. The CDC on Tuesday expanded its Zika travel advisory to two more places – the Marshall Islands, and Trinidad & Tobago. There is no vaccine for Zika. Researchers are scrambling to develop one, as well as better diagnostic tests. Two Texas hospitals say they have developed first rapid tests for Zika virus Read moreThe Zika virus is mostly spread by the same kind of mosquito that transmits other tropical diseases, including dengue and chikungunya. That same mosquito is found in the southern US and officials expect they will eventually spread the virus, too. But they don’t expect to see major outbreaks. The CDC recommends that all travellers use insect repellent while in Zika outbreak areas, and continue to use it for three weeks after travel in case they might be infected but not sick. That is to prevent mosquitoes from biting them and possibly spreading Zika to others in the US. http://www.theguardian.com/world/2016/feb/23/zika-virus-sexually-transmitted-disease-us-cases

Update: Interim Guidelines for Prevention of Sexual Transmission of Zika Virus — United States, 2016 Recommend on FacebookTweet This is an official CDC HEALTH ADVISORY Distributed via the CDC Health Alert NetworkFebruary 23, 2016, 14:15 EST (2:15 PM EST)CDCHAN-00388 Summary: The Centers for Disease Control and Prevention (CDC) recently published recommendations for protecting people against sexual transmission of Zika virus (1). As stated in that report, information about possible sexual transmission of Zika virus was based on one published report of transmission from a man to a woman, one published report in which Zika virus was detected in semen of a man with hematospermia, and one case of possible sexual transmission then under investigation in Texas. An additional case of Zika virus detected in semen in a man was reported after the CDC recommendations were published (2). As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several involving pregnant women. While additional investigations are being completed, CDC is issuing this HAN Advisory as a strong reminder to state, local, and US territorial public health departments, clinicians, and the public to be aware of and adhere to current recommendations for preventing sexual transmission of Zika virus, particularly for men with pregnant partners. These recommendations may change as more information becomes available. Background CDC is working with state, local, and US territorial public health departments, US Government agencies, and international partners in response to outbreaks of Zika virus disease (Zika) in multiple territories and countries in the Americas. Accumulating evidence links maternal Zika virus infection with congenital microcephaly, miscarriages, and other adverse fetal outcomes (3). In addition, there are reports of a possible association with Guillain-Barré syndrome (4). No vaccine or specific antiviral drug is currently available to prevent or treat Zika. Zika virus is spread primarily by the bite of infected Aedes species mosquitoes (most commonly, Aedes aegypti). In areas where Zika virus transmission is ongoing, people should follow precautions to prevent mosquito bites (http://www.cdc.gov/zika/prevention/). Sexual transmission of Zika virus also can occur and is of particular concern during pregnancy. In early February 2016, the Dallas County Department of Health and Human Services announced an occurrence of sexually transmitted Zika infection (5). On February 5, 2016, following the confirmation of this Texas sexual transmission event, CDC published interim guidelines for preventing sexual transmission of Zika virus (1). As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several events involving possible transmission to pregnant women. In two of these new suspected sexual transmission events that have been investigated to date, Zika virus infection has been confirmed in women whose only known risk factor was sexual contact with an ill male partner who had recently travelled to an area with local Zika virus transmission; testing for the male partners is pending. For four additional suspected sexual transmission events, preliminary laboratory evidence (IgM antibody test) is available for the women, but confirmatory testing is still pending. For eight suspected events, the investigation is ongoing. In all events for which information is available, travelers reported symptom onset within 2 weeks prior to their non-traveling female partner’s symptom onset. Because these reports suggest sexual transmission may be a more likely means of transmission for Zika virus than previously considered, CDC is issuing this HAN Advisory to underscore the importance of adhering to the interim guidance published on February 5 and outlined below. The recommendations, which apply to men who reside in or have traveled to areas with active Zika virus transmission (http://wwwnc.cdc.gov/travel/notices/) and their sex partners, will be revised as more information becomes available. Recommendations for men and their pregnant partners Men who reside in or have traveled to an area of active Zika virus transmission who have a pregnant partner should abstain from sexual activity or consistently and correctly use condoms during sex (i.e., vaginal intercourse, anal intercourse, or fellatio) for the duration of the pregnancy. Pregnant women should discuss their male partner’s potential exposures to mosquitoes and history of Zika-like illness (http://www.cdc.gov/zika/symptoms) with their health care provider; providers can consult CDC’s guidelines for evaluation and testing of pregnant women (6). Recommendations for men and their nonpregnant sex partners Men who reside in or have traveled to an area of active Zika virus transmission who are concerned about sexual transmission of Zika virus might consider abstaining from sexual activity or using condoms consistently and correctly during sex. Couples considering this personal decision should take several factors into account. Most infections are asymptomatic, and when illness does occur, it is usually mild with symptoms lasting from several days to a week; severe disease requiring hospitalization is uncommon. The risk for acquiring vector-borne Zika virus in areas of active transmission depends on the duration and extent of exposure to infected mosquitoes and the steps taken to prevent mosquito bites (http://www.cdc.gov/zika/prevention). After infection, Zika virus might persist in semen when it is no longer detectable in blood; studies to determine the duration of persistence in semen are not yet completed. Accumulating evidence of sexual transmission suggests that exposure to Zika virus includes unprotected sexual contact with a symptomatic male partner who resides in or has traveled to an area of active Zika virus transmission. Zika virus testing is currently recommended to establish a diagnosis of infection in exposed persons with signs or symptoms consistent with Zika virus disease, and may be offered to asymptomatic pregnant women with possible exposure to Zika virus (6). However, interpretation of results is complex, and health care providers should contact their state, local, or territorial health department for assistance with arranging testing and interpreting results. At this time, testing of exposed, asymptomatic men for the purpose of assessing risk for sexual transmission is not recommended. Sexual transmission of Zika virus from infected women to their sex partners has not been documented, nor has transmission from persons who are asymptomatically infected. Sexual transmission of many infections, including those caused by other viruses, is reduced by consistent and correct use of latex condoms. As we learn more about the incidence and duration of seminal shedding from infected men and the utility and availability of testing in this context, recommendations to prevent sexual transmission of Zika virus will be updated. References Oster AM, Brooks JT, Stryker JE, et al. Interim Guidelines for prevention of sexual transmission of Zika virus — United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:120–121. http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e1.htmAtkinson B, Hearn P, Afrough B, et al. Detection of Zika virus in semen [letter]. Emerg Infect Dis. 2016 May [cited February 22, 2016].http://dx.doi.org/10.3201/eid2205.160107Martines RB, Bhatnagar J, Keating MK, et al. Evidence of Zika virus infection in brain and placental tissues from two congenitally infected newborns and two fetal losses — Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65 (Early Release)(06):1-2. http://www.cdc.gov/mmwr/volumes/65/wr/mm6506e1.htm?s_cid=mm6506e1_e. Published February 19, 2016.European Centre for Disease Prevention and Control. Rapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome – 10 December 2015. http://ecdc.europa.eu/en/publications/Publications/zika-virus-americas-association-with-microcephaly-rapid-risk-assessment.pdf. Published 2015. Accessed Feb 1, 2016.Dallas County Health and Human Services. DCHHS reports first Zika virus case in Dallas County acquired through sexual transmission. February 2, 2016. http://www.dallascounty.org/department/hhs/press/documents/PR2-2-16DCHHSReportsFirstCaseofZikaVirusThroughSexualTransmission.pdfOduyebo T, Petersen EE, Rasmussen SA, et al. Update: interim guidelines for health care providers caring for pregnant women and women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65.http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e2.htm?s_cid=mm6505e2_eFor More Information General information about Zika virus and disease: http://www.cdc.gov/zika/Zika virus information for clinicians: http://www.cdc.gov/zika/hc-providers/index.htmlProtection against mosquitoes: http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/protection-against-mosquitoes-ticks-other-arthropodsTravel notices related to Zika virus: http://wwwnc.cdc.gov/travel/noticesInformation about Zika virus for travelers and travel health providers: http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/zikaHAN Advisory: Recognizing, managing, and reporting Zika virus infections in travelers returning from Central America, South America, the Caribbean, and Mexico. January 15, 2016. http://emergency.cdc.gov/han/han00385.aspPan American Health Organization PAHO): http://www.paho.org/hq/index.php?option=com_content&view=article&id=11585&Itemid=41688〈=enApproximate distribution of Aedes aegypti and Ae. albopictus mosquitoes in the United States:http://www.cdc.gov/chikungunya/resources/vector-control.htmlThe Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations. DEPARTMENT OF HEALTH AND HUMAN SERVICEShttp://emergency.cdc.gov/han/han00388.asp

Update: Interim Guidelines for Prevention of Sexual Transmission of Zika Virus — United States, 2016 Recommend on FacebookTweet This is an official CDC HEALTH ADVISORY Distributed via the CDC Health Alert NetworkFebruary 23, 2016, 14:15 EST (2:15 PM EST)CDCHAN-00388 Summary: The Centers for Disease Control and Prevention (CDC) recently published recommendations for protecting people against sexual transmission of Zika virus (1). As stated in that report, information about possible sexual transmission of Zika virus was based on one published report of transmission from a man to a woman, one published report in which Zika virus was detected in semen of a man with hematospermia, and one case of possible sexual transmission then under investigation in Texas. An additional case of Zika virus detected in semen in a man was reported after the CDC recommendations were published (2). As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several involving pregnant women. While additional investigations are being completed, CDC is issuing this HAN Advisory as a strong reminder to state, local, and US territorial public health departments, clinicians, and the public to be aware of and adhere to current recommendations for preventing sexual transmission of Zika virus, particularly for men with pregnant partners. These recommendations may change as more information becomes available. Background CDC is working with state, local, and US territorial public health departments, US Government agencies, and international partners in response to outbreaks of Zika virus disease (Zika) in multiple territories and countries in the Americas. Accumulating evidence links maternal Zika virus infection with congenital microcephaly, miscarriages, and other adverse fetal outcomes (3). In addition, there are reports of a possible association with Guillain-Barré syndrome (4). No vaccine or specific antiviral drug is currently available to prevent or treat Zika. Zika virus is spread primarily by the bite of infected Aedes species mosquitoes (most commonly, Aedes aegypti). In areas where Zika virus transmission is ongoing, people should follow precautions to prevent mosquito bites (http://www.cdc.gov/zika/prevention/). Sexual transmission of Zika virus also can occur and is of particular concern during pregnancy. In early February 2016, the Dallas County Department of Health and Human Services announced an occurrence of sexually transmitted Zika infection (5). On February 5, 2016, following the confirmation of this Texas sexual transmission event, CDC published interim guidelines for preventing sexual transmission of Zika virus (1). As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several events involving possible transmission to pregnant women. In two of these new suspected sexual transmission events that have been investigated to date, Zika virus infection has been confirmed in women whose only known risk factor was sexual contact with an ill male partner who had recently travelled to an area with local Zika virus transmission; testing for the male partners is pending. For four additional suspected sexual transmission events, preliminary laboratory evidence (IgM antibody test) is available for the women, but confirmatory testing is still pending. For eight suspected events, the investigation is ongoing. In all events for which information is available, travelers reported symptom onset within 2 weeks prior to their non-traveling female partner’s symptom onset. Because these reports suggest sexual transmission may be a more likely means of transmission for Zika virus than previously considered, CDC is issuing this HAN Advisory to underscore the importance of adhering to the interim guidance published on February 5 and outlined below. The recommendations, which apply to men who reside in or have traveled to areas with active Zika virus transmission (http://wwwnc.cdc.gov/travel/notices/) and their sex partners, will be revised as more information becomes available. Recommendations for men and their pregnant partners Men who reside in or have traveled to an area of active Zika virus transmission who have a pregnant partner should abstain from sexual activity or consistently and correctly use condoms during sex (i.e., vaginal intercourse, anal intercourse, or fellatio) for the duration of the pregnancy. Pregnant women should discuss their male partner’s potential exposures to mosquitoes and history of Zika-like illness (http://www.cdc.gov/zika/symptoms) with their health care provider; providers can consult CDC’s guidelines for evaluation and testing of pregnant women (6). Recommendations for men and their nonpregnant sex partners Men who reside in or have traveled to an area of active Zika virus transmission who are concerned about sexual transmission of Zika virus might consider abstaining from sexual activity or using condoms consistently and correctly during sex. Couples considering this personal decision should take several factors into account. Most infections are asymptomatic, and when illness does occur, it is usually mild with symptoms lasting from several days to a week; severe disease requiring hospitalization is uncommon. The risk for acquiring vector-borne Zika virus in areas of active transmission depends on the duration and extent of exposure to infected mosquitoes and the steps taken to prevent mosquito bites (http://www.cdc.gov/zika/prevention). After infection, Zika virus might persist in semen when it is no longer detectable in blood; studies to determine the duration of persistence in semen are not yet completed. Accumulating evidence of sexual transmission suggests that exposure to Zika virus includes unprotected sexual contact with a symptomatic male partner who resides in or has traveled to an area of active Zika virus transmission. Zika virus testing is currently recommended to establish a diagnosis of infection in exposed persons with signs or symptoms consistent with Zika virus disease, and may be offered to asymptomatic pregnant women with possible exposure to Zika virus (6). However, interpretation of results is complex, and health care providers should contact their state, local, or territorial health department for assistance with arranging testing and interpreting results. At this time, testing of exposed, asymptomatic men for the purpose of assessing risk for sexual transmission is not recommended. Sexual transmission of Zika virus from infected women to their sex partners has not been documented, nor has transmission from persons who are asymptomatically infected. Sexual transmission of many infections, including those caused by other viruses, is reduced by consistent and correct use of latex condoms. As we learn more about the incidence and duration of seminal shedding from infected men and the utility and availability of testing in this context, recommendations to prevent sexual transmission of Zika virus will be updated. References Oster AM, Brooks JT, Stryker JE, et al. Interim Guidelines for prevention of sexual transmission of Zika virus — United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:120–121. http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e1.htmAtkinson B, Hearn P, Afrough B, et al. Detection of Zika virus in semen [letter]. Emerg Infect Dis. 2016 May [cited February 22, 2016].http://dx.doi.org/10.3201/eid2205.160107Martines RB, Bhatnagar J, Keating MK, et al. Evidence of Zika virus infection in brain and placental tissues from two congenitally infected newborns and two fetal losses — Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65 (Early Release)(06):1-2. http://www.cdc.gov/mmwr/volumes/65/wr/mm6506e1.htm?s_cid=mm6506e1_e. Published February 19, 2016.European Centre for Disease Prevention and Control. Rapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome – 10 December 2015. http://ecdc.europa.eu/en/publications/Publications/zika-virus-americas-association-with-microcephaly-rapid-risk-assessment.pdf. Published 2015. Accessed Feb 1, 2016.Dallas County Health and Human Services. DCHHS reports first Zika virus case in Dallas County acquired through sexual transmission. February 2, 2016. http://www.dallascounty.org/department/hhs/press/documents/PR2-2-16DCHHSReportsFirstCaseofZikaVirusThroughSexualTransmission.pdfOduyebo T, Petersen EE, Rasmussen SA, et al. Update: interim guidelines for health care providers caring for pregnant women and women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65.http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e2.htm?s_cid=mm6505e2_eFor More Information General information about Zika virus and disease: http://www.cdc.gov/zika/Zika virus information for clinicians: http://www.cdc.gov/zika/hc-providers/index.htmlProtection against mosquitoes: http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/protection-against-mosquitoes-ticks-other-arthropodsTravel notices related to Zika virus: http://wwwnc.cdc.gov/travel/noticesInformation about Zika virus for travelers and travel health providers: http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/zikaHAN Advisory: Recognizing, managing, and reporting Zika virus infections in travelers returning from Central America, South America, the Caribbean, and Mexico. January 15, 2016. http://emergency.cdc.gov/han/han00385.aspPan American Health Organization PAHO): http://www.paho.org/hq/index.php?option=com_content&view=article&id=11585&Itemid=41688〈=enApproximate distribution of Aedes aegypti and Ae. albopictus mosquitoes in the United States:http://www.cdc.gov/chikungunya/resources/vector-control.htmlThe Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations. DEPARTMENT OF HEALTH AND HUMAN SERVICEShttp://emergency.cdc.gov/han/han00388.asp

The CDC is warning about sexually transmitted Zika as more possible US cases pop upUpdated by Julia Belluz on February 23, 2016, 4:30 p.m. ET @juliaoftoronto [email protected] TWEET SHARE (12) + As researchers learn more about Zika, they're answering some very basic questions about the virus — such as how exactly it spreads. Evidence is mounting that it's not just mosquitoes that can pass the disease from person to person: Zika can be spread through sex, too. The Centers for Disease Control and Prevention just announced it's investigating 14 cases of sexual transmission of Zika in the United States. The cases all involved male travelers who recently visited a region with a Zika outbreak and then returned to the United States, where they reportedly passed on the virus to their female partners. Several of the cases include pregnant women, which is worrisome considering Zika hasbeen linked with a birth defect called microcephaly. All together, the CDC suggested sexually transmitted Zika may be more common than researchers previously believed. Researchers have a lot of questions about sexually transmitted ZikaThere have already been several cases in the medical literature that suggest Zika can be spread through sex. In one case, a man who traveled to Senegal in 2008 and contracted Zika gave it to his wife through intercourse after he returned home to Colorado. In another, Zika was found in semen. The first case of sexual transmission in the United States during this current outbreak was documented in Dallas in February. A traveler returned from Venezuela, where the virus was circulating, and infected his or her partner. But there's still a lot of uncertainty here. Researchers aren't sure how long Zika can remain in semen, when people are most at risk of passing on the virus, or what types of sex acts are more likely to spread the virus. They also don't know how commonly Zika is spread sexually as compared with mosquito bites, though they think it's relatively rare. Sexual transmission is also thought to spread only from men to women (not vice versa). Again, that information might change as we learn more. Men coming from Zika-affected regions should avoid unprotected sex with pregnant partnersFor now, the CDC has issued interim guidance on safe sex during a Zika outbreak: Men who have traveled or lived in countries where Zika is circulating and have female partners who are pregnant should either avoid sex or use condoms for vaginal, anal, and oral sex for the duration of the pregnancy. For couples who aren't pregnant, the CDC still recommends considering condoms or abstaining if the male has traveled or lived in a place with Zika. "The science is not clear on how long the risk should be avoided," the CDC said in its announcement. That's because researchers don't know how long the virus can live in the semen — and how long it remains infectious. In the UK, researchers found virus in a man's semen 62 days after he got sick. Pregnant women have been advised to avoid Zika hot spotsMeanwhile, American women who are pregnant have been advised to stay out of countries where the Zika virus is circulating. The CDC also issued guidance on how to care for pregnant women during a Zika outbreak, safe sex, and when to get tested for Zika. (See our graphic above.) If you're trying to get pregnant, proceed with caution if visiting these areas. The CDC recommends consulting your doctor before your trip and following steps to prevent mosquito bites during the trip. If you'd like to get pregnant in the more distant future, however, there appears to be no need to worry. Zika does not seem to pose a risk of birth defects for future pregnancies. As best researchers can tell, the virus clears itself from the body pretty quickly, remaining in the blood for only about a week after infection. (If you want more information, see ourZika pregnancy explainer.) Mosquitoes are still thought to be the main disease vectorRight now, researchers believe you're most likely to get Zika through a mosquito bite. The virus is mainly carried by a specific type of mosquito called Aedes aegypti, which spreads the disease through bites. Aedes mosquitoes bite during the day and are incredibly well-adapted to thrive alongside humans. They can breed and rest in small pools of water and moist environments around people's homes and apartments. (You can see examples of the mosquito's main aquatic habitats here, ranging from rain-filled cavities in trees to outdoor pots and animal drinking pans.) There's also some evidence that suggests the Asian tiger mosquito (Aedes albopictus) can transmit the virus, too. This is a worry because the Aedes albopictus has a much larger range in the United States, reaching at least 32 states, though researchers think this mosquito doesn't spread the virus as efficiently. http://www.vox.com/2016/2/23/11101500/zika-sexual-transmission

World | Wed Feb 24, 2016 3:20am ISTRelated: WORLDZika may have been sexually transmitted in 14 cases - U.S. CDC Aedes aegypti mosquitoes are seen inside Oxitec laboratory in Campinas, Brazil, February 2, 2016.REUTERS/PAULO WHITAKER The Zika virus may have been sexually transmitted in 14 new U.S. cases, including several involving pregnant women, the Centers for Disease Control and Prevention said on Tuesday about the disease linked to thousands of birth defects in Brazil. In two of the suspected cases, the infection has been confirmed in women whose only known risk factor was sexual contact with an ill male partner who had recently travelled to an area where the virus is present, the agency said. The reports suggest sexual transmission may be a more likely means of spreading Zika than previously considered, the CDC said. Testing of the male partners is still pending, the CDC said. Mosquito bites remain the primary way the virus is spread, although sexual transmission from men to women is possible, the agency added. Condoms can help prevent transmission. There is no evidence that women can transmit Zika virus to their sex partners, CDC said. There is no cure or treatment for Zika and much remains unknown, including whether the virus actually causes the birth defect microcephaly, a condition marked by unusually small heads that can result in developmental problems. Brazil on Tuesday raised the number of microcephaly cases linked to Zika. It has confirmed 583 cases of microcephaly, up from 508 a week earlier. Suspected cases rose to 4,107 from 3,935. The first known case of Zika virus transmission in the United States was reported in Texas in early February by local health officials, who said it likely was contracted through sex and not a mosquito bite. Zika has caused outbreaks in at least 29 countries in the Americas. The CDC added Trinidad and Tobago and Marshall Islands to its travel advisory on Tuesday. The agency in early February revised its guidelines for pregnant women to include a recommendation that even those without symptoms of the Zika virus should be tested after returning from affected areas. (Reporting by Natalie Grover and Ankur Banerjee in Bengaluru; Editing by Sriraj Kalluvila, Bernard Orr) http://in.reuters.com/article/health-zika-cdc-idINKCN0VW2D4

Update: Interim Guidelines for Prevention of Sexual Transmission of Zika Virus — United States, 2016 Recommend on FacebookTweet This is an official CDC HEALTH ADVISORY Distributed via the CDC Health Alert Network February 23, 2016, 14:15 EST (2:15 PM EST) CDCHAN-00388 Summary: The Centers for Disease Control and Prevention (CDC) recently published recommendations for protecting people against sexual transmission of Zika virus (1). As stated in that report, information about possible sexual transmission of Zika virus was based on one published report of transmission from a man to a woman, one published report in which Zika virus was detected in semen of a man with hematospermia, and one case of possible sexual transmission then under investigation in Texas. An additional case of Zika virus detected in semen in a man was reported after the CDC recommendations were published (2). As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several involving pregnant women. While additional investigations are being completed, CDC is issuing this HAN Advisory as a strong reminder to state, local, and US territorial public health departments, clinicians, and the public to be aware of and adhere to current recommendations for preventing sexual transmission of Zika virus, particularly for men with pregnant partners. These recommendations may change as more information becomes available. Background CDC is working with state, local, and US territorial public health departments, US Government agencies, and international partners in response to outbreaks of Zika virus disease (Zika) in multiple territories and countries in the Americas. Accumulating evidence links maternal Zika virus infection with congenital microcephaly, miscarriages, and other adverse fetal outcomes (3). In addition, there are reports of a possible association with Guillain-Barré syndrome (4). No vaccine or specific antiviral drug is currently available to prevent or treat Zika. Zika virus is spread primarily by the bite of infected Aedes species mosquitoes (most commonly, Aedes aegypti). In areas where Zika virus transmission is ongoing, people should follow precautions to prevent mosquito bites (http://www.cdc.gov/zika/prevention/). Sexual transmission of Zika virus also can occur and is of particular concern during pregnancy. In early February 2016, the Dallas County Department of Health and Human Services announced an occurrence of sexually transmitted Zika infection (5). On February 5, 2016, following the confirmation of this Texas sexual transmission event, CDC published interim guidelines for preventing sexual transmission of Zika virus (1). As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several events involving possible transmission to pregnant women. In two of these new suspected sexual transmission events that have been investigated to date, Zika virus infection has been confirmed in women whose only known risk factor was sexual contact with an ill male partner who had recently travelled to an area with local Zika virus transmission; testing for the male partners is pending. For four additional suspected sexual transmission events, preliminary laboratory evidence (IgM antibody test) is available for the women, but confirmatory testing is still pending. For eight suspected events, the investigation is ongoing. In all events for which information is available, travelers reported symptom onset within 2 weeks prior to their non-traveling female partner’s symptom onset. Because these reports suggest sexual transmission may be a more likely means of transmission for Zika virus than previously considered, CDC is issuing this HAN Advisory to underscore the importance of adhering to the interim guidance published on February 5 and outlined below. The recommendations, which apply to men who reside in or have traveled to areas with active Zika virus transmission (http://wwwnc.cdc.gov/travel/notices/) and their sex partners, will be revised as more information becomes available. Recommendations for men and their pregnant partners Men who reside in or have traveled to an area of active Zika virus transmission who have a pregnant partner should abstain from sexual activity or consistently and correctly use condoms during sex (i.e., vaginal intercourse, anal intercourse, or fellatio) for the duration of the pregnancy. Pregnant women should discuss their male partner’s potential exposures to mosquitoes and history of Zika-like illness (http://www.cdc.gov/zika/symptoms) with their health care provider; providers can consult CDC’s guidelines for evaluation and testing of pregnant women (6). Recommendations for men and their nonpregnant sex partners Men who reside in or have traveled to an area of active Zika virus transmission who are concerned about sexual transmission of Zika virus might consider abstaining from sexual activity or using condoms consistently and correctly during sex. Couples considering this personal decision should take several factors into account. Most infections are asymptomatic, and when illness does occur, it is usually mild with symptoms lasting from several days to a week; severe disease requiring hospitalization is uncommon. The risk for acquiring vector-borne Zika virus in areas of active transmission depends on the duration and extent of exposure to infected mosquitoes and the steps taken to prevent mosquito bites (http://www.cdc.gov/zika/prevention). After infection, Zika virus might persist in semen when it is no longer detectable in blood; studies to determine the duration of persistence in semen are not yet completed. Accumulating evidence of sexual transmission suggests that exposure to Zika virus includes unprotected sexual contact with a symptomatic male partner who resides in or has traveled to an area of active Zika virus transmission. Zika virus testing is currently recommended to establish a diagnosis of infection in exposed persons with signs or symptoms consistent with Zika virus disease, and may be offered to asymptomatic pregnant women with possible exposure to Zika virus (6). However, interpretation of results is complex, and health care providers should contact their state, local, or territorial health department for assistance with arranging testing and interpreting results. At this time, testing of exposed, asymptomatic men for the purpose of assessing risk for sexual transmission is not recommended. Sexual transmission of Zika virus from infected women to their sex partners has not been documented, nor has transmission from persons who are asymptomatically infected. Sexual transmission of many infections, including those caused by other viruses, is reduced by consistent and correct use of latex condoms. As we learn more about the incidence and duration of seminal shedding from infected men and the utility and availability of testing in this context, recommendations to prevent sexual transmission of Zika virus will be updated. References Oster AM, Brooks JT, Stryker JE, et al. Interim Guidelines for prevention of sexual transmission of Zika virus — United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:120–121. http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e1.htmAtkinson B, Hearn P, Afrough B, et al. Detection of Zika virus in semen [letter]. Emerg Infect Dis. 2016 May [cited February 22, 2016].http://dx.doi.org/10.3201/eid2205.160107Martines RB, Bhatnagar J, Keating MK, et al. Evidence of Zika virus infection in brain and placental tissues from two congenitally infected newborns and two fetal losses — Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65 (Early Release)(06):1-2. http://www.cdc.gov/mmwr/volumes/65/wr/mm6506e1.htm?s_cid=mm6506e1_e. Published February 19, 2016.European Centre for Disease Prevention and Control. Rapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome – 10 December 2015. http://ecdc.europa.eu/en/publications/Publications/zika-virus-americas-association-with-microcephaly-rapid-risk-assessment.pdf. Published 2015. Accessed Feb 1, 2016.Dallas County Health and Human Services. DCHHS reports first Zika virus case in Dallas County acquired through sexual transmission. February 2, 2016. http://www.dallascounty.org/department/hhs/press/documents/PR2-2-16DCHHSReportsFirstCaseofZikaVirusThroughSexualTransmission.pdfOduyebo T, Petersen EE, Rasmussen SA, et al. Update: interim guidelines for health care providers caring for pregnant women and women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65.http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e2.htm?s_cid=mm6505e2_eFor More Information General information about Zika virus and disease: http://www.cdc.gov/zika/Zika virus information for clinicians: http://www.cdc.gov/zika/hc-providers/index.htmlProtection against mosquitoes: http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/protection-against-mosquitoes-ticks-other-arthropodsTravel notices related to Zika virus: http://wwwnc.cdc.gov/travel/noticesInformation about Zika virus for travelers and travel health providers: http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/zikaHAN Advisory: Recognizing, managing, and reporting Zika virus infections in travelers returning from Central America, South America, the Caribbean, and Mexico. January 15, 2016. http://emergency.cdc.gov/han/han00385.aspPan American Health Organization PAHO): http://www.paho.org/hq/index.php?option=com_content&view=article&id=11585&Itemid=41688〈=enApproximate distribution of Aedes aegypti and Ae. albopictus mosquitoes in the United States: http://www.cdc.gov/chikungunya/resources/vector-control.htmlThe Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations. DEPARTMENT OF HEALTH AND HUMAN SERVICEShttp://emergency.cdc.gov/han/han00388.asp

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

Update: Interim Guidelines for Prevention of Sexual Transmission of Zika Virus — United States, 2016 Recommend on FacebookTweet This is an official CDC HEALTH ADVISORY Distributed via the CDC Health Alert Network February 23, 2016, 14:15 EST (2:15 PM EST) CDCHAN-00388 Summary: The Centers for Disease Control and Prevention (CDC) recently published recommendations for protecting people against sexual transmission of Zika virus (1). As stated in that report, information about possible sexual transmission of Zika virus was based on one published report of transmission from a man to a woman, one published report in which Zika virus was detected in semen of a man with hematospermia, and one case of possible sexual transmission then under investigation in Texas. An additional case of Zika virus detected in semen in a man was reported after the CDC recommendations were published (2). As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several involving pregnant women. While additional investigations are being completed, CDC is issuing this HAN Advisory as a strong reminder to state, local, and US territorial public health departments, clinicians, and the public to be aware of and adhere to current recommendations for preventing sexual transmission of Zika virus, particularly for men with pregnant partners. These recommendations may change as more information becomes available. Background CDC is working with state, local, and US territorial public health departments, US Government agencies, and international partners in response to outbreaks of Zika virus disease (Zika) in multiple territories and countries in the Americas. Accumulating evidence links maternal Zika virus infection with congenital microcephaly, miscarriages, and other adverse fetal outcomes (3). In addition, there are reports of a possible association with Guillain-Barré syndrome (4). No vaccine or specific antiviral drug is currently available to prevent or treat Zika. Zika virus is spread primarily by the bite of infected Aedes species mosquitoes (most commonly, Aedes aegypti). In areas where Zika virus transmission is ongoing, people should follow precautions to prevent mosquito bites (http://www.cdc.gov/zika/prevention/). Sexual transmission of Zika virus also can occur and is of particular concern during pregnancy. In early February 2016, the Dallas County Department of Health and Human Services announced an occurrence of sexually transmitted Zika infection (5). On February 5, 2016, following the confirmation of this Texas sexual transmission event, CDC published interim guidelines for preventing sexual transmission of Zika virus (1). As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several events involving possible transmission to pregnant women. In two of these new suspected sexual transmission events that have been investigated to date, Zika virus infection has been confirmed in women whose only known risk factor was sexual contact with an ill male partner who had recently travelled to an area with local Zika virus transmission; testing for the male partners is pending. For four additional suspected sexual transmission events, preliminary laboratory evidence (IgM antibody test) is available for the women, but confirmatory testing is still pending. For eight suspected events, the investigation is ongoing. In all events for which information is available, travelers reported symptom onset within 2 weeks prior to their non-traveling female partner’s symptom onset. Because these reports suggest sexual transmission may be a more likely means of transmission for Zika virus than previously considered, CDC is issuing this HAN Advisory to underscore the importance of adhering to the interim guidance published on February 5 and outlined below. The recommendations, which apply to men who reside in or have traveled to areas with active Zika virus transmission (http://wwwnc.cdc.gov/travel/notices/) and their sex partners, will be revised as more information becomes available. Recommendations for men and their pregnant partners Men who reside in or have traveled to an area of active Zika virus transmission who have a pregnant partner should abstain from sexual activity or consistently and correctly use condoms during sex (i.e., vaginal intercourse, anal intercourse, or fellatio) for the duration of the pregnancy. Pregnant women should discuss their male partner’s potential exposures to mosquitoes and history of Zika-like illness (http://www.cdc.gov/zika/symptoms) with their health care provider; providers can consult CDC’s guidelines for evaluation and testing of pregnant women (6). Recommendations for men and their nonpregnant sex partners Men who reside in or have traveled to an area of active Zika virus transmission who are concerned about sexual transmission of Zika virus might consider abstaining from sexual activity or using condoms consistently and correctly during sex. Couples considering this personal decision should take several factors into account. Most infections are asymptomatic, and when illness does occur, it is usually mild with symptoms lasting from several days to a week; severe disease requiring hospitalization is uncommon. The risk for acquiring vector-borne Zika virus in areas of active transmission depends on the duration and extent of exposure to infected mosquitoes and the steps taken to prevent mosquito bites (http://www.cdc.gov/zika/prevention). After infection, Zika virus might persist in semen when it is no longer detectable in blood; studies to determine the duration of persistence in semen are not yet completed. Accumulating evidence of sexual transmission suggests that exposure to Zika virus includes unprotected sexual contact with a symptomatic male partner who resides in or has traveled to an area of active Zika virus transmission. Zika virus testing is currently recommended to establish a diagnosis of infection in exposed persons with signs or symptoms consistent with Zika virus disease, and may be offered to asymptomatic pregnant women with possible exposure to Zika virus (6). However, interpretation of results is complex, and health care providers should contact their state, local, or territorial health department for assistance with arranging testing and interpreting results. At this time, testing of exposed, asymptomatic men for the purpose of assessing risk for sexual transmission is not recommended. Sexual transmission of Zika virus from infected women to their sex partners has not been documented, nor has transmission from persons who are asymptomatically infected. Sexual transmission of many infections, including those caused by other viruses, is reduced by consistent and correct use of latex condoms. As we learn more about the incidence and duration of seminal shedding from infected men and the utility and availability of testing in this context, recommendations to prevent sexual transmission of Zika virus will be updated. References Oster AM, Brooks JT, Stryker JE, et al. Interim Guidelines for prevention of sexual transmission of Zika virus — United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:120–121. http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e1.htmAtkinson B, Hearn P, Afrough B, et al. Detection of Zika virus in semen [letter]. Emerg Infect Dis. 2016 May [cited February 22, 2016].http://dx.doi.org/10.3201/eid2205.160107Martines RB, Bhatnagar J, Keating MK, et al. Evidence of Zika virus infection in brain and placental tissues from two congenitally infected newborns and two fetal losses — Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65 (Early Release)(06):1-2. http://www.cdc.gov/mmwr/volumes/65/wr/mm6506e1.htm?s_cid=mm6506e1_e. Published February 19, 2016.European Centre for Disease Prevention and Control. Rapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome – 10 December 2015. http://ecdc.europa.eu/en/publications/Publications/zika-virus-americas-association-with-microcephaly-rapid-risk-assessment.pdf. Published 2015. Accessed Feb 1, 2016.Dallas County Health and Human Services. DCHHS reports first Zika virus case in Dallas County acquired through sexual transmission. February 2, 2016. http://www.dallascounty.org/department/hhs/press/documents/PR2-2-16DCHHSReportsFirstCaseofZikaVirusThroughSexualTransmission.pdfOduyebo T, Petersen EE, Rasmussen SA, et al. Update: interim guidelines for health care providers caring for pregnant women and women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65.http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e2.htm?s_cid=mm6505e2_eFor More Information General information about Zika virus and disease: http://www.cdc.gov/zika/Zika virus information for clinicians: http://www.cdc.gov/zika/hc-providers/index.htmlProtection against mosquitoes: http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/protection-against-mosquitoes-ticks-other-arthropodsTravel notices related to Zika virus: http://wwwnc.cdc.gov/travel/noticesInformation about Zika virus for travelers and travel health providers: http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/zikaHAN Advisory: Recognizing, managing, and reporting Zika virus infections in travelers returning from Central America, South America, the Caribbean, and Mexico. January 15, 2016. http://emergency.cdc.gov/han/han00385.aspPan American Health Organization PAHO): http://www.paho.org/hq/index.php?option=com_content&view=article&id=11585&Itemid=41688〈=en Approximate distribution of Aedes aegypti and Ae. albopictus mosquitoes in the United States: http://www.cdc.gov/chikungunya/resources/vector-control.htmlThe Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations. DEPARTMENT OF HEALTH AND HUMAN SERVICES

References Oster AM, Brooks JT, Stryker JE, et al. Interim Guidelines for prevention of sexual transmission of Zika virus — United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:120–121. http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e1.htmAtkinson B, Hearn P, Afrough B, et al. Detection of Zika virus in semen [letter]. Emerg Infect Dis. 2016 May [cited February 22, 2016].http://dx.doi.org/10.3201/eid2205.160107Martines RB, Bhatnagar J, Keating MK, et al. Evidence of Zika virus infection in brain and placental tissues from two congenitally infected newborns and two fetal losses — Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65 (Early Release)(06):1-2. http://www.cdc.gov/mmwr/volumes/65/wr/mm6506e1.htm?s_cid=mm6506e1_e. Published February 19, 2016.European Centre for Disease Prevention and Control. Rapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome – 10 December 2015. http://ecdc.europa.eu/en/publications/Publications/zika-virus-americas-association-with-microcephaly-rapid-risk-assessment.pdf. Published 2015. Accessed Feb 1, 2016.Dallas County Health and Human Services. DCHHS reports first Zika virus case in Dallas County acquired through sexual transmission. February 2, 2016. http://www.dallascounty.org/department/hhs/press/documents/PR2-2-16DCHHSReportsFirstCaseofZikaVirusThroughSexualTransmission.pdfOduyebo T, Petersen EE, Rasmussen SA, et al. Update: interim guidelines for health care providers caring for pregnant women and women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65.http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e2.htm?s_cid=mm6505e2_eFor More Information General information about Zika virus and disease: http://www.cdc.gov/zika/Zika virus information for clinicians: http://www.cdc.gov/zika/hc-providers/index.htmlProtection against mosquitoes: http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/protection-against-mosquitoes-ticks-other-arthropodsTravel notices related to Zika virus: http://wwwnc.cdc.gov/travel/noticesInformation about Zika virus for travelers and travel health providers: http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/zikaHAN Advisory: Recognizing, managing, and reporting Zika virus infections in travelers returning from Central America, South America, the Caribbean, and Mexico. January 15, 2016. http://emergency.cdc.gov/han/han00385.aspPan American Health Organization PAHO): http://www.paho.org/hq/index.php?option=com_content&view=article&id=11585&Itemid=41688〈=en Approximate distribution of Aedes aegypti and Ae. albopictus mosquitoes in the United States: http://www.cdc.gov/chikungunya/resources/vector-control.htmlThe Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Recommendations for men and their nonpregnant sex partners Men who reside in or have traveled to an area of active Zika virus transmission who are concerned about sexual transmission of Zika virus might consider abstaining from sexual activity or using condoms consistently and correctly during sex. Couples considering this personal decision should take several factors into account. Most infections are asymptomatic, and when illness does occur, it is usually mild with symptoms lasting from several days to a week; severe disease requiring hospitalization is uncommon. The risk for acquiring vector-borne Zika virus in areas of active transmission depends on the duration and extent of exposure to infected mosquitoes and the steps taken to prevent mosquito bites (http://www.cdc.gov/zika/prevention). After infection, Zika virus might persist in semen when it is no longer detectable in blood; studies to determine the duration of persistence in semen are not yet completed. Accumulating evidence of sexual transmission suggests that exposure to Zika virus includes unprotected sexual contact with a symptomatic male partner who resides in or has traveled to an area of active Zika virus transmission. Zika virus testing is currently recommended to establish a diagnosis of infection in exposed persons with signs or symptoms consistent with Zika virus disease, and may be offered to asymptomatic pregnant women with possible exposure to Zika virus (6). However, interpretation of results is complex, and health care providers should contact their state, local, or territorial health department for assistance with arranging testing and interpreting results. At this time, testing of exposed, asymptomatic men for the purpose of assessing risk for sexual transmission is not recommended. Sexual transmission of Zika virus from infected women to their sex partners has not been documented, nor has transmission from persons who are asymptomatically infected. Sexual transmission of many infections, including those caused by other viruses, is reduced by consistent and correct use of latex condoms. As we learn more about the incidence and duration of seminal shedding from infected men and the utility and availability of testing in this context, recommendations to prevent sexual transmission of Zika virus will be updated.

Recommendations for men and their pregnant partners Men who reside in or have traveled to an area of active Zika virus transmission who have a pregnant partner should abstain from sexual activity or consistently and correctly use condoms during sex (i.e., vaginal intercourse, anal intercourse, or fellatio) for the duration of the pregnancy. Pregnant women should discuss their male partner’s potential exposures to mosquitoes and history of Zika-like illness (http://www.cdc.gov/zika/symptoms) with their health care provider; providers can consult CDC’s guidelines for evaluation and testing of pregnant women (6).

Background CDC is working with state, local, and US territorial public health departments, US Government agencies, and international partners in response to outbreaks of Zika virus disease (Zika) in multiple territories and countries in the Americas. Accumulating evidence links maternal Zika virus infection with congenital microcephaly, miscarriages, and other adverse fetal outcomes (3). In addition, there are reports of a possible association with Guillain-Barré syndrome (4). No vaccine or specific antiviral drug is currently available to prevent or treat Zika. Zika virus is spread primarily by the bite of infected Aedes species mosquitoes (most commonly, Aedes aegypti). In areas where Zika virus transmission is ongoing, people should follow precautions to prevent mosquito bites (http://www.cdc.gov/zika/prevention/). Sexual transmission of Zika virus also can occur and is of particular concern during pregnancy. In early February 2016, the Dallas County Department of Health and Human Services announced an occurrence of sexually transmitted Zika infection (5). On February 5, 2016, following the confirmation of this Texas sexual transmission event, CDC published interim guidelines for preventing sexual transmission of Zika virus (1). As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several events involving possible transmission to pregnant women. In two of these new suspected sexual transmission events that have been investigated to date, Zika virus infection has been confirmed in women whose only known risk factor was sexual contact with an ill male partner who had recently travelled to an area with local Zika virus transmission; testing for the male partners is pending. For four additional suspected sexual transmission events, preliminary laboratory evidence (IgM antibody test) is available for the women, but confirmatory testing is still pending. For eight suspected events, the investigation is ongoing. In all events for which information is available, travelers reported symptom onset within 2 weeks prior to their non-traveling female partner’s symptom onset. Because these reports suggest sexual transmission may be a more likely means of transmission for Zika virus than previously considered, CDC is issuing this HAN Advisory to underscore the importance of adhering to the interim guidance published on February 5 and outlined below. The recommendations, which apply to men who reside in or have traveled to areas with active Zika virus transmission (http://wwwnc.cdc.gov/travel/notices/) and their sex partners, will be revised as more information becomes available.

Summary: The Centers for Disease Control and Prevention (CDC) recently published recommendations for protecting people against sexual transmission of Zika virus (1). As stated in that report, information about possible sexual transmission of Zika virus was based on one published report of transmission from a man to a woman, one published report in which Zika virus was detected in semen of a man with hematospermia, and one case of possible sexual transmission then under investigation in Texas. An additional case of Zika virus detected in semen in a man was reported after the CDC recommendations were published (2). As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several involving pregnant women. While additional investigations are being completed, CDC is issuing this HAN Advisory as a strong reminder to state, local, and US territorial public health departments, clinicians, and the public to be aware of and adhere to current recommendations for preventing sexual transmission of Zika virus, particularly for men with pregnant partners. These recommendations may change as more information becomes available.

Update: Interim Guidelines for Prevention of Sexual Transmission of Zika Virus — United States, 2016 Recommend on FacebookTweet This is an official CDC HEALTH ADVISORY Distributed via the CDC Health Alert Network February 23, 2016, 14:15 EST (2:15 PM EST) CDCHAN-00388 http://emergency.cdc.gov/han/han00388.asp

E-mail from NY Department of Health indicates Zika cases in NY State are now 21.

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

The CDC press release describes 14 additional clusters involving local transmission of Zika via sexual encounters.These are in addition to the initial confirmation in Dallas Texas. If all encounters are confirmed for both partners,the number local transmission in the US will increase from 1 to 15 and the number of people involved in these clusters will increase from 2 to 30,which is a significant percentage of the US Zika cases.

Feb. 23, 2016 SURGEON GENERAL DR. JOHN ARMSTRONG'S DAILY ZIKA UPDATE 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. As of today, one new Zika cases have been confirmed in Seminole County and the Declaration of Public Health Emergency has been expanded to include the county. County Number of Cases (all travel related) Alachua 1 Brevard 1 Broward 4 Hillsborough 3 Lee 3 Miami-Dade 11 Orange 2 Osceola 1 Santa Rosa 1 Seminole 1 St. Johns 1 Total 29 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 648 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. None of the confirmed cases involve pregnant women. 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: Last week, 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 eight effected counties – Alachua, Broward, Hillsborough, Lee, Miami-Dade, Osceola, Santa Rosa and St. Johns – and will be updated as needed. 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.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.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.Florida currently has the capacity to test 5,079 people for active Zika virus and 1,402 for Zika antibodies.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.

As of today, one new Zika cases have been confirmed in Seminole County and the Declaration of Public Health Emergency has been expanded to include the county. http://www.floridahealth.gov/newsroom/2016/02/022316-zika-update-14.html County Number of Cases (all travel related) Alachua 1 Brevard 1 Broward 4 Hillsborough 3 Lee 3 Miami-Dade 11 Orange 2 Osceola 1 Santa Rosa 1 Seminole 1 St. Johns 1 Total 29