title: Zika Virus Disease Cases - 50 States and the District of Columbia, January 1-July 31, 2016.
abstract: Zika virus is a mosquito-borne flavivirus primarily transmitted to humans by Aedes aegypti mosquitoes (1). Zika virus infections have also been documented through intrauterine transmission resulting in congenital infection; intrapartum transmission from a viremic mother to her newborn; sexual transmission; blood transfusion; and laboratory exposure (1-5). Most Zika virus infections are asymptomatic (1,6). Clinical illness, when it occurs, is generally mild and characterized by acute onset of fever, maculopapular rash, arthralgia, or nonpurulent conjunctivitis. However, Zika virus infection during pregnancy can cause adverse outcomes such as fetal loss, and microcephaly and other serious brain anomalies (1-3). Guillain-Barré syndrome, a rare autoimmune condition affecting the peripheral nervous system, also has been associated with Zika virus infection (1). Following the identification of local transmission of Zika virus in Brazil in May 2015, the virus has continued to spread throughout the Region of the Americas, and travel-associated cases have increased (7). In 2016, Zika virus disease and congenital infections became nationally notifiable conditions in the United States (8). As of September 3, 2016, a total of 2,382 confirmed and probable cases of Zika virus disease with symptom onset during January 1-July 31, 2016, had been reported from 48 of 50 U.S. states and the District of Columbia. Most cases (2,354; 99%) were travel-associated, with either direct travel or an epidemiologic link to a traveler to a Zika virus-affected area. Twenty-eight (1%) cases were reported as locally acquired, including 26 associated with mosquito-borne transmission, one acquired in a laboratory, and one with an unknown mode of transmission. Zika virus disease should be considered in patients with compatible clinical signs or symptoms who traveled to or reside in areas with ongoing Zika virus transmission or who had unprotected sex with someone who traveled to those areas. Health care providers should continue to educate patients, especially pregnant women, about the importance of avoiding infection with Zika virus, and all pregnant women should be assessed for possible Zika virus exposure at each prenatal visit (2).
authors.forename: William L
authors.initials: WL
authors.lastname: Walker
authors.forename: Nicole P
authors.initials: NP
authors.lastname: Lindsey
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Lehman
authors.forename: Elisabeth R
authors.initials: ER
authors.lastname: Krow-Lucal
authors.forename: Ingrid B
authors.initials: IB
authors.lastname: Rabe
authors.forename: Susan L
authors.initials: SL
authors.lastname: Hills
authors.forename: Stacey W
authors.initials: SW
authors.lastname: Martin
authors.forename: Marc
authors.initials: M
authors.lastname: Fischer
authors.forename: J Erin
authors.initials: JE
authors.lastname: Staples
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D014195:Travel / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult; D000071244:Zika Virus / Q000302:isolation & purification*; D000071243:Zika Virus Infection / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission