Zika virus disease update Dr Susan Hills Arboviral Diseases Branch September 26, 2016

Laboratory-confirmed Zika virus disease cases reported to ArboNET by states — United States, 2015–2016 (as of Sept 21) Overall 3,358 Zika virus disease cases Travel-associated cases: 3,314 Locally acquired mosquito-borne cases: 43 Laboratory acquired cases: 1 Among the 3,358 cases Sexually transmitted: 28 Guillain-Barré syndrome: 8

Laboratory-confirmed Zika virus disease cases reported to ArboNET by territories — United States, 2015–2016 (as of Sept 21) Overall 19,777 Zika virus disease cases Locally-acquired cases: 19,706 Travel-associated cases: 71 Among the 19,777 cases Guillain-Barré syndrome: 37

State of residence for reported Zika virus disease cases — U. S State of residence for reported Zika virus disease cases — U.S. states, Jan–Jul 2016 (as of Sept 7) State (N=2,382) NY 558 (23%) FL 483 (20%) CA 147 (6%) TX 117 (5%) NJ 90 (4%) PA 74 (3%)

Month of illness onset for reported Zika virus disease cases — U. S Month of illness onset for reported Zika virus disease cases — U.S. states, Jan-Jul 2016 (as of Sept 7) *Travelers returning from affected areas or their sexual contacts

Age group for reported Zika virus disease cases — U. S Age group for reported Zika virus disease cases — U.S. states, Jan-Jul 2016 (N=2,382)

Region where reported U. S Region where reported U.S. travel-associated Zika virus disease cases were acquired, Jan–Jul 2016* Region Percent Caribbean 65% Central America 18% South America 9% North America 5% Southeast Asia and Pacific Islands <1% *10 persons traveled to >1 region; No direct travel and unknown not listed (<3%)

Zika virus reports to PAHO from countries and territories in the Americas Over past 2–4 weeks, most countries have reported a decreasing trend in the numbers of Zika virus disease cases Unclear how much may be due to changes or delays in reporting Over the full course of the outbreak in 2015–2016 15 countries or territories have reported confirmed cases of congenital syndrome associated with Zika virus infection 7 countries or territories have reported laboratory-confirmed Guillain-Barre syndrome cases associated with Zika virus infection