niman

U.S. | Wed Oct 19, 2016 | 6:41pm EDT U.S. health officials create color-coded Zika zones in Florida A map showing the active Zika zone is on display at the Borinquen Health Care Center in Miami, Florida, U.S. on August 9, 2016. REUTERS/Chris Keane/File Photo By Julie Steenhuysen | CHICAGO U.S. health officials introduced a new color-coding system on Tuesday for Florida's Miami-Dade County to distinguish between areas of active transmission that present a significant risk of transmission and areas where there is a possible risk of being infected. The new system, announced by the U.S. Centers for Disease Control, casts all of Miami-Dade County as a yellow cautionary area with the exception of Miami Beach and a one square mile area of Miami known as the Little River neighborhood, which are high-risk red zones. Miami is a major tourist destination. Previously, the CDC had warned pregnant women to consider avoiding non-essential travel to Miami-Dade County to reduce their risk infection with Zika, a mosquito-borne virus that has been linked with severe birth defects. "Zika continues to pose a threat to pregnant women living in or traveling to Miami-Dade County," said Dr. Lyle Petersen, director of CDC's Division of Vector-Borne Diseases. "Our guidance today strengthens our travel advice and testing recommendations for pregnant women to further prevent the spread of the infection among those most vulnerable.” Based on the new guidelines, the CDC said it recommends pregnant women consider postponing travel to yellow areas of Miami-Dade County, and they should specifically avoid red areas because they pose "a significant risk to pregnant women." A map of the Zika warning areas can be found here ALSO IN U.S. 'Walking while trans' can be a death sentence in the U.S. Jury to begin deliberations in conspiracy trial of Oregon militants The CDC urged pregnant women who have lived in, traveled to, or had unprotected sex with someone who lived in or traveled to Miami-Dade County since August 1, 2016, to be tested for Zika. Some infectious disease experts have criticized the piecemeal approach to warning women about the risk of Zika in Florida, a state with a multibillion dollar tourism industry. (Reporting by Julie Steenhuysen) http://www.reuters.com/article/us-health-zika-florida-idUSKCN12J2R3

HEALTH ZIKA VIRUS OUTBREAK OCT 19 2016, 8:38 PM ET CDC's New Miami Zika 'Red Zone' Means Stay Out for Pregnant Women by MAGGIE FOX SHARE Federal health officials have made a new color-coded map for Miami and say pregnant women should stay out of the "red zone" — where Zika virus is actively infecting new people daily. And they say pregnant women should consider postposing all travel to Miami-Dade county for the time being, designating the entire county a "yellow zone." Miami-Dade County, FL. Red shows areas where pregnant women should not travel. Yellow shows areas where pregnant women should consider postponing travel. CDC "Pregnant women should specifically avoid travel to red areasbecause the intensity of Zika virus transmission confirmed in these areas is a significant risk to pregnant women," the CDC said in a statement. Related: New Zika Zone Found in Miami Last week, Florida health officials declared a new Zika zone — a one square mile area where the Zika virus is actively infecting people — in Miami. It's the third zone of active transmission, although home-grown cases have been found in several parts of the state. "PREGNANT WOMEN SHOULD SPECIFICALLY AVOID TRAVEL TO RED AREAS BECAUSE THE INTENSITY OF ZIKA VIRUS TRANSMISSION CONFIRMED IN THESE AREAS IS A SIGNIFICANT RISK TO PREGNANT WOMEN." Florida remains the only U.S. state with verified local transmission of the virus. Florida has 174 locally transmitted cases, including 19 in out-of-state visitors. The state has 1,044 total cases of Zika, most related to travel. And 110 of those infected are pregnant women. Zika normally causes mild illness at worst. But it's bad news if pregnant women get it. There's no doubt among experts that Zika causes microcephaly, other types of brain damage and other birth defects. The virus has been shown to go directly to developing brain cells; it gets through the placenta and into a developing fetus. It's been found in the brain and other organs of babies with microcephaly and other brain damage. "Zika continues to pose a threat to pregnant women living in or traveling to Miami-Dade County," said the CDC's Dr. Lyle Petersen. "Our guidance today strengthens our travel advice and testing recommendations for pregnant women, to further prevent the spread of the infection among those most vulnerable." Related: There's No Doubt Zika Causes Birth Defects The CDC also says any pregnant woman with a connection to the area should get tested for Zika, even if she doesn't have symptoms. "Pregnant women who have lived in, traveled to, or had unprotected sex with someone who lived in or traveled to Miami-Dade County since August 1, 2016, should be tested for Zika virus," the CDC advises. "Pregnant women who have lived in, traveled to, or had unprotected sex with someone who lived in or traveled to the 4.5-square-mile area of Miami Beach with active spread of Zika virus since July 14, 2016, should be tested for Zika virus." "PREGNANT WOMEN WHO HAVE LIVED IN, TRAVELED TO, OR HAD UNPROTECTED SEX WITH SOMEONE WHO LIVED IN OR TRAVELED TO MIAMI-DADE COUNTY SINCE AUGUST 1, 2016, SHOULD BE TESTED FOR ZIKA VIRUS." The CDC will use the new map going forward. A red area is "a geographic area where local, state, and CDC officials have determined that the intensity of Zika virus transmission presents a significant risk to pregnant women," the CDC said. "The intensity of Zika virus transmission is determined by several factors, including geographic distribution of cases, number of cases identified, known or suspected links between cases and population density." A yellow area has had local transmission, but not intense transmission. "Although the specific level of risk in yellow areas is unknown, pregnant women are still considered to be at risk," the CDC said. "Also, areas adjacent or close to red areas may have a greater likelihood of active spread of Zika virus and are considered to pose a risk to pregnant women." The Aedes mosquitoes that transmit Zika do not themselves travel far, but infected people do, and they can pass the virus to mosquitoes in new areas. "Currently, a 4.5-square-mile area of Miami Beach and one-square-mile area in Little River located in Miami-Dade County are red areas. The rest of Miami-Dade County is a yellow area," the CDC said. Related: Questions About Pregnancy and Zika CDC also has detailed guidelines for women planning to get pregnant. "Given the limited available information about how long Zika virus can stay in body fluids and the chances of harm to a pregnancy when a woman is infected with Zika virus around the time of conception, some couples in which one or both partners have had a possible Zika virus exposure may choose to wait longer or shorter than the recommended period to conceive, depending on individual circumstances like age, fertility, and the details of possible exposure, and their risk tolerance," the CDC said. http://www.nbcnews.com/storyline/zika-virus-outbreak/cdc-s-new-miami-zika-red-zone-means-stay-out-n669401

CDC Updates Guidance for Pregnant Women and Women and Men of Reproductive Age for Zika Virus Infection Related to the Ongoing Investigation of Local Mosquito-borne Zika Virus Transmission in Miami-Dade County, Florida Recommend on FacebookTweet Distributed via the CDC Health Alert Network October 19, 2016, 1700 ET (5:00 PM ET) CDCHAN-00398 Summary The U.S. Centers for Disease Control and Prevention (CDC) previously issued travel, testing, and other guidance related to areas of active Zika virus transmission in Florida. Because local transmission of Zika virus continues to be reported in Miami-Dade County, CDC is strengthening travel recommendations for pregnant women to Miami-Dade County and also reinforcing recommendations for use of protective measures to prevent exposure to Zika. CDC is updating recommendations to emphasize testing for pregnant women with an epidemiologic link to Miami-Dade County. An epidemiologic link means that they lived in, traveled to, or had unprotected sex with someone who lived in or traveled to, the designated area. In addition, CDC has made specific recommendations for areas of identified active transmission. The Florida Department of Health (FL DOH) has identified a new area where local, state, and CDC officials have determined that the intensity of Zika virus transmission presents a significant risk to pregnant women in a designated one-square-mile area located in Miami-Dade County (NW 79th St. to the north, NW 63rd St. to the south, NW 10th Ave. to the west and N. Miami Ave. to the east). Pregnant women should consider postponing travel to all areas of Miami-Dade County. Pregnant women should specifically avoid travel to the previously identified 4.5-square-mile area of Miami Beach and one-square-mile area in Little River located in Miami-Dade County (http//www.cdc.gov/zika/intheus/florida-update.html). Pregnant women who have an epidemiologic link to any area of Miami-Dade County after August 1, 2016 should be tested for Zika virus in accordance with CDC guidance (http://www.cdc.gov/mmwr/volumes/65/wr/mm6529e1.htm?s_cid=mm6529e1_e). Pregnant women with an epidemiologic link to the 4.5-square-mile area of Miami Beach with active Zika virus transmission, after July 14, 2016, should be tested for Zika virus. Because the incubation period for Zika virus infection is up to two weeks and many people infected with Zika virus will not have symptoms or will only have mild symptoms, investigating cases may take several weeks. Data collected during the ongoing investigation indicate the period of time since August 1 represents the timeframe with the highest transmission in Miami-Dade County. FL DOH and CDC continue to work together on this ongoing investigation to learn more about active Zika virus transmission in Miami-Dade County. CDC will update these recommendations as more information becomes available. Healthcare providers should visit CDC’s Zika website (http://www.cdc.gov/zika/) frequently for the most up-to-date recommendations. Recommendations Red and Yellow Area Designation CDC has defined two types of geographic areas within the continental United States and Hawaii to implement measures to prevent Zika virus transmission: Zika active transmission areas (designated as red) and Zika cautionary areas (designated as yellow). A red area is a geographic area where local, state, and CDC officials have determined that the intensity of Zika virus transmission presents a significant risk to pregnant women. The intensity of Zika virus transmission is determined by several factors including geographic distribution of cases, number of cases identified, known or suspected links between cases and population density. A yellow area is a geographic area where local transmission has been identified, but evidence is lacking on whether the intensity of transmission is comparable to that in a red area. Although the level of risk in yellow areas is unknown, pregnant women are still at risk. Additionally, areas adjacent to or in proximity to red areas may have a greater likelihood of local transmission and, therefore, risk to pregnant women. Currently, a 4.5-square-mile area of Miami Beach and one-square-mile area in Little River located in Miami-Dade County (http//www.cdc.gov/zika/intheus/florida-update.html) are red areas and the rest of Miami-Dade County is a yellow area. Because this investigation is ongoing and the designation of areas is likely to change over time, please frequently check the website (http//www.cdc.gov/zika/intheus/florida-update.html) for the most up-to-date designation of red and yellow areas. Recommendations for Miami-Dade County Travel Recommendations for Pregnant Women Pregnant women should consider postponing travel to yellow areas of Miami-Dade County. Pregnant women should specifically avoid travel to red areas (http//www.cdc.gov/zika/intheus/florida-update.html) because the intensity of Zika virus transmission confirmed in these areas presents a significant risk to pregnant women. Testing Recommendations for Pregnant Women Pregnant women with an epidemiologic link to Miami-Dade County after August 1, 2016, should be tested for Zika virus infection in accordance with CDC guidance. Pregnant women with an epidemiologic link to the 4.5-square-mile area of Miami Beach with active Zika virus transmission after July 14, 2016, should be tested for Zika virus (http://www.cdc.gov/mmwr/volumes/65/wr/mm6529e1.htm?s_cid=mm6529e1_e). Pregnant women with symptoms of Zika virus disease should be tested according to CDC guidance, which is based on the time of evaluation relative to symptom onset. Pregnant women with ongoing exposure (who live in or frequently travel [e.g., daily, weekly]) to Miami-Dade County and who are without symptoms of Zika virus disease should consult with their healthcare provider to obtain testing for Zika virus infection in the first and second trimesters of pregnancy. Pregnant women who have had limited travel to or had sex without using a condom with a partner who lives in or has traveled to Miami-Dade County should be tested for Zika virus infection. This testing should be performed based on the time of evaluation relative to last possible exposure in accordance with CDC guidance. Healthcare providers should contact their state, local, or territorial health department to coordinate testing and interpret results. Healthcare providers should discuss the limitations of laboratory tests used to diagnose Zika virus infection with pregnant women and their partners. Protective Measures Recommendations for Pregnant Women Pregnant women and their partners living in or traveling to Miami-Dade County should be aware of active Zika virus transmission and should strictly follow steps to prevent mosquito bites. (http://www.cdc.gov/zika/prevention/prevent-mosquito-bites.html). Women and men who live in or travel to Miami-Dade County should be aware of active Zika virus transmission, and those who are pregnant or have a pregnant sex partner should consistently and correctly use condoms to prevent Zika virus infection during sex or should not have sex during the pregnancy. Women and Men Who are Planning to Conceive Women and men who are planning to conceive in the near future should consider avoiding nonessential travel to red areas. Women with an epidemiologic link to the red areas and who do not have ongoing risks for exposure should wait at least eight weeks after symptom onset (if symptomatic) or after last possible exposure (if asymptomatic) to attempt conception. Men with an epidemiologic link to the red areas who do not have ongoing risks for exposure should wait at least six months after symptom onset (if symptomatic) or last possible exposure (if asymptomatic) to attempt conception. Women with an epidemiologic link to the yellow areas who do not have ongoing risks for exposure may consider waiting at least eight weeks from symptom onset (if symptomatic) or last possible exposure (if asymptomatic) to attempt conception. Although the level of risk in yellow areas is unknown, pregnant women are still at risk. Additionally, areas adjacent to or in proximity to red areas may have a greater likelihood of local transmission, so there may be a greater risk to pregnant women. Men with an epidemiologic link to the yellow areas who do not have ongoing risks for exposure may consider waiting at least six months from symptom onset (if symptomatic) or last possible exposure (if asymptomatic) to attempt conception. Although the level of risk in yellow areas is unknown, pregnant women are still at risk. Additionally, areas adjacent to or in proximity to red areas may have a greater likelihood of local transmission, so there may be a greater risk to pregnant women. People living in an area with possible Zika virus transmission should be counseled on the possible risk for Zika virus infection during the periconception period. Women and men should discuss their reproductive life plans with their healthcare provider in the context of potential and ongoing Zika virus exposure. Women and men with ongoing risks for exposure who are diagnosed with Zika virus disease should wait at least eight weeks and at least six months respectively, after symptom onset before attempting conception. There are limited data about the persistence of Zika virus RNA in body fluids, and the risk for adverse pregnancy outcomes associated with maternal Zika virus infection around the time of conception is currently not known. Given this information, some couples in which one or both partners have had a possible Zika virus exposure might choose to wait longer or shorter than the recommended period to conceive, depending on individual circumstances (e.g., age, fertility, details of possible exposure) and risk tolerance. Women and men attempting conception living in or traveling to the Miami-Dade County should be aware of active Zika virus transmission and should strictly follow steps to prevent mosquito bites. (http://www.cdc.gov/zika/prevention/prevent-mosquito-bites.html). Additional Recommendations For the yellow area, additional Zika-related interventions (e.g., testing of symptomatic non-pregnant persons) may be implemented depending on local circumstances. Background Zika virus is spread to people primarily through the bite of an infected Aedes species mosquito (Ae. aegypti and Ae.albopictus). Zika virus can also be sexually transmitted. Zika virus infection during pregnancy is a cause of microcephaly and severe fetal brain defects and has been associated with other adverse pregnancy outcomes. Most people infected with Zika virus will not have symptoms; infants with microcephaly and other birth defects have been born to women with Zika virus infection who did not report symptoms. For pregnant women who report clinical illness consistent with Zika virus disease (symptomatic pregnant women), CDC's testing recommendations are the same for those with ongoing risk and those with limited risk for possible Zika virus exposure. Symptomatic pregnant women who are evaluated less than two weeks after symptom onset should receive serum and urine Zika virus RNA nucleic acid test (NAT) testing. Symptomatic pregnant women who are evaluated 2 to 12 weeks after symptom onset should first receive a Zika virus immunoglobulin (Ig) M antibody test; if the IgM antibody test result is positive or equivocal (unclear), serum and urine RNA NAT testing should be performed. If the RNA NAT result is negative, a positive or equivocal (unclear) Zika virus IgM antibody test result should be followed by plaque reduction neutralization testing (PRNT). Interpretation of serologic results has been described (http://www.cdc.gov/mmwr/volumes/65/wr/mm6521e1.htm). Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. For asymptomatic pregnant women with ongoing risk for possible exposure who are evaluated less than two weeks after last possible exposure, RNA NAT testing should be performed. If the RNA NAT result is negative, a Zika virus IgM antibody test should be performed 2 to 12 weeks after the exposure. Asymptomatic pregnant women with limited risk for possible exposure who are first evaluated 2 to 12 weeks after their last possible exposure should first receive a Zika virus IgM antibody test; if the IgM antibody test result is positive or equivocal (unclear), serum and urine RNA NAT should be performed. Asymptomatic pregnant women with ongoing risk for possible exposure to Zika virus should receive Zika virus IgM antibody testing as part of routine obstetric care during the first and second trimesters; immediate RNA NAT testing should be performed when IgM antibody test results are positive or equivocal (unclear). Further information on the interpretation of laboratory test results and clinical management of pregnant women with laboratory evidence of possible Zika virus infection are available below. For More Information Interim Guidance for Health Care Providers Caring for Pregnant Women: MMWR: http://www.cdc.gov/mmwr/volumes/65/wr/mm6529e1.htm?s_cid=mm6529e1_w Summary: http://www.cdc.gov/zika/hc-providers/pregnant-woman.html Fact Sheet with Testing Algorithms: http://www.cdc.gov/zika/pdfs/testing_algorithm.pdf Update: Interim Guidance for Preconception Counseling and Prevention of Sexual Transmission of Zika Virus for Persons with Possible Zika Virus Exposure — United States, September 2016 | MMWR Updated information on active transmission of Zika virus from the Florida Department of Health:http://www.flgov.com/2016/08/01/gov-scott-florida-calls-on-cdc-to-activate-emergency-response-team-following-confirmed-mosquito-borne-transmissions/ https://emergency.cdc.gov/han/han00398.asp

ACTIVE INVESTIGATIONS Information on Active Investigations When a local case of Zika virus is confirmed through laboratory testing, the department conducts a thorough investigation around the case to determine if additional people are infected. The department interviews and tests close contacts and community members around the case. Knowing if additional people are infected helps the department determine if there is a zone where mosquitoes are transmitting the virus. Not every case results in a designation of active transmission in an area. In some instances, a case of Zika is an isolated incident with no additional people infected. For more information on the department’s testing and investigation process, click here. paragraph break Current Number of Active Investigations: 9 Miami-Dade County: 6 open investigations Palm Beach: 1 open investigations Unknown: 2 open investigations *Note: Exposure occurred in Miami Beach and overseas in an area with widespread transmission of Zika. paragraph break Current Number of Closed Investigations: 33 Miami-Dade County: 26 closed investigations Palm Beach County: 5 closed investigation Broward County: 1 closed investigation Pinellas: 1 closed investigation paragraph break Sampling Activities For Active Investigations Miami Beach in Miami-Dade County (Area of Active Transmission) Total # of Samples Collected Positive Negative Pending Results 1,061 69 992 0 paragraph break One-square mile area within NW 79th St. to the North, NW 63rd St. to the South, NW 10th Ave. to the West and N. Miami Ave. to the East in Miami-Dade County (Area of Active Transmission) Total # of Samples Collected Positive Negative Pending Results 45 4 39 2 paragraph break Palm Beach County – 1 Investigation Total # of Samples Collected Positive Negative Pending Results 0 0 0 0 paragraph break Miami-Dade Investigations Outside of Areas of Active Transmission– 6 Investigations Total # of Samples Collected Positive Negative Pending Results 29 0 29 0 paragraph break Wynwood Area in Miami-Dade County – Note: This investigation is closed, but the department is providing the sampling results below for reference. Total # of Samples Collected Positive Negative Pending Results 525 33 491 0 Data as of Oct. 19, 2016 - 2:26 PM ET

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

Ocotber 19, 2016 Department of Health 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, the department will issue a Zika virus update each week day. Updates will include a Zika case count by county and information to keep Floridians informed and prepared. In order to keep the public informed, the department has posted our investigation process here. There are two travel related cases today with one in Sarasota County and one involving a pregnant woman. Please visit ourwebsite to see the full list of travel-related cases. There are two new non-travel related cases today. Both are in Miami-Dade County and are linked to the Miami Beach investigation. DOH continues door-to-door outreach and targeted testing in Miami-Dade County and mosquito abatement and reduction activities are also taking place around the locations that are being investigated. DOH believes ongoing transmission is only taking place within the identified areas in Miami-Dade County. One case does not mean ongoing active transmission is taking place. DOH conducts a thorough investigation by sampling close contacts and community members around each case to determine if additional people are infected. If DOH finds evidence that active transmission is occurring in an area, the media and the public will be notified. For a complete breakdown of non-travel and travel-related Zika infections to-date, please see below. Infection Type Infection Count Travel-Related Infections of Zika 745 Non-Travel Related Infections of Zika 165 Infections Involving Pregnant Women 110 Out of State Cases (not Florida Residents) 19 Undetermined 5 Total 1,044 The timelines below are as of Oct. 13 and will be updated every Friday. Note: Asymptomatic cases are not reflected as they do not have symptom on-set dates. click image above to enlarge click image above to enlarge click image above to enlarge The department is currently conducting 9 active investigations. The department has closed 33 investigations. Information regarding the investigations can be found here. If investigations reveal additional areas of active transmission, the department will announce a defined area of concern. The department has conducted Zika virus testing for more than 9,241 people statewide. Florida currently has the capacity to test 9,133 people for active Zika virus and 6,775 for Zika antibodies. At Governor Scott’s direction, all county health departments offer free Zika risk assessment and testing to pregnant women. Florida’s small case clusters is not considered widespread transmission, however, pregnant women are advised to avoid non-essential travel to the impacted areas in Miami-Dade County (see maps below). If you are pregnant and must travel or if you live or work in the impacted area, protect yourself from mosquito bites by wearing insect repellent, long clothing and limiting your time outdoors. According to CDC guidance, providers should consider testing all pregnant women with a history of travel to a Zika affected area for the virus. It is also recommended that all pregnant women who reside in or travel frequently to the area where active transmission is likely occurring be tested for Zika in the first and second trimester. Pregnant women in the identified area can contact their medical provider or their local county health department to be tested and receive a Zika prevention kit. CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. Additionally, the department is working closely with the Healthy Start Coalition of Miami-Dade County to identify pregnant women in the impacted areas to ensure they have access to resources and information to protect themselves. CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. Pregnant women can contact their local county health department for Zika risk assessment and testing hours and information. A Zika risk assessment will be conducted by county health department staff and blood and/or urine samples may be collected and sent to labs for testing. It may take one to two weeks to receive results. Florida has been monitoring pregnant women with evidence of Zika regardless of symptoms. The total number of pregnant women who have been or are being monitored is 106. On Feb. 12, Governor Scott directed the State Surgeon General 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 more than 6,950 callers since it launched. The number for the Zika Virus Information Hotline is 1-855-622-6735. The department 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. For more information on DOH action and federal guidance, please click here. For resources and information on Zika virus, click here. click image above to enlarge click image above to enlarge About the Florida Department of Health The department, nationally accredited by the Public Health Accreditation Board, 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.

Ocotber 19, 2016 Department of Health 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, the department will issue a Zika virus update each week day. Updates will include a Zika case count by county and information to keep Floridians informed and prepared. In order to keep the public informed, the department has posted our investigation process here. There are two travel related cases today with one in Sarasota County and one involving a pregnant woman. Please visit ourwebsite to see the full list of travel-related cases. There are two new non-travel related cases today. Both are in Miami-Dade County and are linked to the Miami Beach investigation. DOH continues door-to-door outreach and targeted testing in Miami-Dade County and mosquito abatement and reduction activities are also taking place around the locations that are being investigated. DOH believes ongoing transmission is only taking place within the identified areas in Miami-Dade County. One case does not mean ongoing active transmission is taking place. DOH conducts a thorough investigation by sampling close contacts and community members around each case to determine if additional people are infected. If DOH finds evidence that active transmission is occurring in an area, the media and the public will be notified. For a complete breakdown of non-travel and travel-related Zika infections to-date, please see below. Infection Type Infection Count Travel-Related Infections of Zika 745 Non-Travel Related Infections of Zika 165 Infections Involving Pregnant Women 110 Out of State Cases (not Florida Residents) 19 Undetermined 5 Total 1,044 The timelines below are as of Oct. 13 and will be updated every Friday. Note: Asymptomatic cases are not reflected as they do not have symptom on-set dates. click image above to enlarge click image above to enlarge click image above to enlarge The department is currently conducting 9 active investigations. The department has closed 33 investigations. Information regarding the investigations can be found here. If investigations reveal additional areas of active transmission, the department will announce a defined area of concern. The department has conducted Zika virus testing for more than 9,241 people statewide. Florida currently has the capacity to test 9,133 people for active Zika virus and 6,775 for Zika antibodies. At Governor Scott’s direction, all county health departments offer free Zika risk assessment and testing to pregnant women. Florida’s small case clusters is not considered widespread transmission, however, pregnant women are advised to avoid non-essential travel to the impacted areas in Miami-Dade County (see maps below). If you are pregnant and must travel or if you live or work in the impacted area, protect yourself from mosquito bites by wearing insect repellent, long clothing and limiting your time outdoors. According to CDC guidance, providers should consider testing all pregnant women with a history of travel to a Zika affected area for the virus. It is also recommended that all pregnant women who reside in or travel frequently to the area where active transmission is likely occurring be tested for Zika in the first and second trimester. Pregnant women in the identified area can contact their medical provider or their local county health department to be tested and receive a Zika prevention kit. CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. Additionally, the department is working closely with the Healthy Start Coalition of Miami-Dade County to identify pregnant women in the impacted areas to ensure they have access to resources and information to protect themselves. CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds. Pregnant women can contact their local county health department for Zika risk assessment and testing hours and information. A Zika risk assessment will be conducted by county health department staff and blood and/or urine samples may be collected and sent to labs for testing. It may take one to two weeks to receive results. Florida has been monitoring pregnant women with evidence of Zika regardless of symptoms. The total number of pregnant women who have been or are being monitored is 106. On Feb. 12, Governor Scott directed the State Surgeon General 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 more than 6,950 callers since it launched. The number for the Zika Virus Information Hotline is 1-855-622-6735. The department 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. For more information on DOH action and federal guidance, please click here. For resources and information on Zika virus, click here. click image above to enlarge click image above to enlarge About the Florida Department of Health The department, nationally accredited by the Public Health Accreditation Board, works to protect, promote, and improve the health of all people in Florida through integrated state, county and community efforts. Follow us on Twitter at @HealthyFla and on Facebook. For more information about the Florida Department of Health, please visit www.FloridaHealth.gov.

There are two travel related cases today with one in Sarasota County and one involving a pregnant woman. Please visit ourwebsite to see the full list of travel-related cases. There are two new non-travel related cases today. Both are in Miami-Dade County and are linked to the Miami Beach investigation.

There are two new non-travel related cases today. Both are in Miami-Dade County and are linked to the Miami Beach investigation.

Infection Type Infection Count Travel-Related Infections of Zika 745 Non-Travel Related Infections of Zika 165 Infections Involving Pregnant Women 110 Out of State Cases (not Florida Residents) 19 Undetermined 5 Total 1,044 http://www.floridahealth.gov/newsroom/2016/10/101916-zika-update.html

Infection Type Infection Count Travel-Related Infections of Zika 745 Non-Travel Related Infections of Zika 165 Infections Involving Pregnant Women 110 Out of State Cases (not Florida Residents) 19 Undetermined 5 Total 1,044 http://www.floridahealth.gov/newsroom/2016/10/101916-zika-update.html

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

As of Oct. 18, 2016 91 confirmed travel-related Zika cases in Georgia http://dph.georgia.gov/

As of Oct. 18, 2016 91 confirmed travel-related Zika cases in Georgia

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of October 5, 2016)§ States Travel-associated cases* No. (% of cases in states) (N=3,713) Locally acquired cases† No. (% of cases in states) (N=105) Alabama 27 (1) 0 (0) Arizona 36 (1) 0 (0) Arkansas 10 (<1) 0 (0) California 277 (7) 0 (0) Colorado 36 (1) 0 (0) Connecticut 58 (2) 0 (0) Delaware 15 (<1) 0 (0) http://www.cdc.gov/zika/geo/united-states.html

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

County Cases Angelina 1 Bell 6 Bexar 17 Brazoria 1 Brazos 3 Burnet 1 Cameron 3 Collin 5 Dallas 39 Denton 9 El Paso 3 Ellis 1 Fort Bend 9 Frio 1 Galveston 7 Gray 1 Grayson 1 Gregg 1 Hamilton 1 Harris 63 Jackson 1 Jefferson 2 Jones 1 Lee 1 Lubbock 1 Matagorda 1 Medina 1 Midland 1 Montgomery 1 Palo Pinto 1 Parker 1 Randall 1 Rusk 1 Tarrant 23 Travis 10 Upshur 1 Val Verde 1 Walker 1 Williamson 5 Webb 3 Wise 1 Total 232 Dallas Pregnant Registry 18 Texas Preg Reg excl Dallas 46 Total 296

Zika Virus – October 19, 2016 Texas has had 232 reported cases of illness due to Zika virus. All the cases were associated with travel to an area where Zika is being spread. This count includes 14 pregnant women, two infants infected before birth, and two people who had sexual contact with travelers. Texas Zika Cases by County: County Cases Angelina 1 Bell 6 Bexar 17 Brazoria 1 Brazos 3 Burnet 1 Cameron 3 Collin 5 Dallas 39 Denton 9 El Paso 3 Ellis 1 Fort Bend 9 Frio 1 Galveston 7 Gray 1 Grayson 1 Gregg 1 Hamilton 1 Harris 63 Jackson 1 Jefferson 2 Jones 1 Lee 1 Lubbock 1 Matagorda 1 Medina 1 Midland 1 Montgomery 1 Palo Pinto 1 Parker 1 Randall 1 Rusk 1 Tarrant 23 Travis 10 Upshur 1 Val Verde 1 Walker 1 Williamson 5 Webb 3 Wise 1 Total 232

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ