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

Allegheny County Residents Approved for Zika Testing: 211 CDC Confirmed Cases: 11 Probable Cases: 1 (as of October 17, 2016)

Pennsylvania Blood Tests Submitted for Zika TestingInformation updated Mondays at 2 p.m. Confirmed Infections: 125* Probable Cases: 27* *DOH adopted a new definition for Zika virus infections on 9/26/2016. The case counts have increased because the Centers for Disease Control and Prevention’s new definition includesprobable Zika infections. The new infection definition has been applied to all previous Zika tests in Pennsylvania. For greater detail on this new definition, click here. Last update: 10/03/2016 http://www.health.pa.gov/My Health/Diseases and Conditions/U-Z/Zikavirus/Pages/ZikaVirusHomePage.aspx#.WAeDveArLtR

Pennsylvania Blood Tests Submitted for Zika TestingInformation updated Mondays at 2 p.m. Confirmed Infections: 125* Probable Cases: 27* *DOH adopted a new definition for Zika virus infections on 9/26/2016. The case counts have increased because the Centers for Disease Control and Prevention’s new definition includesprobable Zika infections. The new infection definition has been applied to all previous Zika tests in Pennsylvania. For greater detail on this new definition, click here. Last update: 10/03/2016

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) District of Columbia 25 (1) 0 (0) Florida 707 (19) 105 (100) Georgia 86 (2) 0 (0) Hawaii 14 (<1) 0 (0) Idaho 3 (<1) 0 (0) Illinois 75 (2) 0 (0) Indiana 38 (1) 0 (0) Iowa 16 (<1) 0 (0) Kansas 15 (<1) 0 (0) Kentucky 24 (1) 0 (0) Louisiana 32 (1) 0 (0) Maine 11 (<1) 0 (0) Maryland 102 (3) 0 (0) Massachusetts 93 (3) 0 (0) http://www.cdc.gov/zika/geo/united-states.html

References Hayes EB. Zika virus outside Africa. Emerg Infect Dis. 2009;15:1347–50.DOIPubMed Hennessey M, Fischer M, Staples JE. Zika virus spreads to new areas—region of the Americas, May 2015–January 2016. MMWR Morb Mortal Wkly Rep. 2016;65:55–8.DOIPubMed Pan American Health Organization. Update on Zika virus in the Americas [cited 2016 Aug 11]. http://www.paho.org/hq/index.php?option=com_content&view=article&id=11603&Itemid=41696&lang=en Mlakar J, Korva M, Tul N, Popović M, Poljšak-Prijatelj M, Mraz J, Zika virus associated with microcephaly. N Engl J Med. 2016;374:951–8.DOIPubMed Brooks JT, Friedman A, Kachur RE, LaFlam M, Peters PJ, Jamieson DJ. Update: interim guidance for prevention of sexual transmission of Zika virus—United States, July 2016. MMWR Morb Mortal Wkly Rep. 2016;65:745–7.DOIPubMed Lanciotti RS, Kosoy OL, Laven JJ, Velez JO, Lambert AJ, Johnson AJ, Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis. 2008;14:1232–9.DOIPubMed Gurukumar KR, Priyadarshini D, Patil JA, Bhagat A, Singh A, Shah PS, Development of real time PCR for detection and quantitation of Dengue Viruses. Virol J. 2009;6:10.DOIPubMed Lanciotti RS, Kosoy OL, Laven JJ, Panella AJ, Velez JO, Lambert AJ, Chikungunya virus in US travelers returning from India, 2006. Emerg Infect Dis.2007;13:764–7.DOIPubMed Zhao H, Fernandez E, Dowd KA, Speer SD, Platt DJ, Gorman MJ, Structural basis of Zika virus-specific antibody protection. Cell.2016;166:1016–27.DOIPubMed Prisant N, Bujan L, Benichou H, Hayot PH, Pavili L, Lurel S, Zika virus in the female genital tract. Lancet Infect Dis. 2016;16:1000–1.DOIPubMed Dudley DM, Aliota MT, Mohr EL, Weiler AM, Lehrer-Brey G, Weisgrau KL, A rhesus macaque model of Asian-lineage Zika virus infection. Nat Commun. 2016;7:12204.DOIPubMed Yockey LJ, Varela L, Rakib T, Khoury-Hanold W, Fink SL, Stutz B, Vaginal exposure to Zika virus during pregnancy leads to fetal brain infection. Cell.2016;166:1247–1256.e4.DOIPubMed Lustig Y, Mendelson E, Paran N, Melamed S, Schwartz E. Detection of Zika virus RNA in whole blood of imported Zika virus disease cases up to 2 months after symptom onset, Israel, December 2015 to April 2016. Euro Surveill. 2016;21:30269.DOIPubMed Rios M, Daniel S, Chancey C, Hewlett IK, Stramer SL. West Nile virus adheres to human red blood cells in whole blood. Clin Infect Dis.2007;45:181–6.DOIPubMed Lanteri MC, Lee TH, Wen L, Kaidarova Z, Bravo MD, Kiely NE, West Nile virus nucleic acid persistence in whole blood months after clearance in plasma: implication for transfusion and transplantation safety. Transfusion. 2014;54:3232–41.DOIPubMed

Table Timeline of acute signs and symptoms and clinical progression/resolution for a 26-year-old woman infected with Zika virus who returned from Honduras to the United States Day after illness onset Signs and symptoms and clinical progression 0 Red, mottled, flat rash on stomach, back, and neck with pruritic progression over 24 h. Approximately 4 hours after first appearance of the rash, the patient became febrile (temperature 101.7°F), fatigued, and a headache developed. 1 Rash spread to the legs and upper arms, continuing to appear flat, mottled, and became pruritic. Fatigue persisted, along with headache with light sensitivity, myalgias (particularly in the back and shoulders), and nausea with anorexia. The patient reported that her eyes were painful to open, but upon examination, the eyes appeared normal with no redness or swelling. 3 The rash continued to progress to the entire body, but with decreasing pruritus and increasing papular appearance. Conjunctivitis and cervical adenopathy were noted on physician examination, and the patient reported increased myalgias and dysphagia, with development of painful vesicles throughout the oral mucosa. 5 Fever resolved 6 Rash and sore throat resolved 15 Desquamation was noted on palms of both hands and soles of both feet 17 Resolution of all signs and symptoms

Figure Figure. Quantitative reverse transcription PCR cycle threshold values over time (days after onset of illness) for whole blood, serum, urine, saliva, and vaginal mucosal swab specimens obtained from a 26-year-old woman infected with Zika virus who returned from Honduras to the United States. A cutoff value for a negative result was established at a cycle threshold of 40 (black horizontal line).

Conclusions Given recent concerns regarding the ongoing epidemic of Zika virus disease, there is an urgent need to document the natural history of infection and assess transmission risk through nonvector routes. We had the unique opportunity to prospectively monitor the clinical and virologic course of Zika virus infection in a patient starting on day 0. We detected viral shedding in vaginal secretions up to day 14. Only 1 human study reported Zika virus RNA in cervical mucous up to day 11 after onset of signs and symptoms (10). These findings are supported by recent results for 2 animal models. Zika virus (Asian lineage strain) RNA was detected in vaginal swab specimens obtained on days 1 and 7 postinfection of nonpregnant female rhesus macaques (11). Zika virus replication was also detected in vaginal mucosa of mice (12). We could not determine whether positive results by qRT-PCR indicated replicating virus. With the recent finding of possible female-to-male virus transmission (5), infectious virus might be present in the vaginal canal and could serve as a risk for sexual or intrapartum transmission. We detected viral RNA in serum up to 8 days and in whole blood up to 81 days after onset of illness. Diagnosis of infection currently relies mostly on PCR detection of Zika virus in serum. With concerns for Zika virus infection during pregnancy, screening of whole blood might be more sensitive in identifying infected patients, particularly if an asymptomatic patient has traveled from an area where exposure is a concern, had high-risk sexual contact, or is convalescing and PCR for a serum sample would probably yield a negative result. Our observation is further supported by another recent study that found whole blood samples positive for Zika virus by PCR up to 2 months postinfection (13). In our study, we confirmed that a positive result was attributed to the erythrocyte component of whole blood, similar to what has been found in studies of West Nile virus (14,15). One study found that West Nile virus adheres to erythrocytes and could infect Vero cells (14). Although we did not observe infectious virus associated with erythrocyte positivity for Zika virus at day 64, this finding is still of concern and requires further investigation. Because the last whole blood sample collected on day 81 was positive for Zika virus RNA, follow-up testing will continue to define the longevity of viremia in whole blood. In conclusion, this case study advances understanding of the natural history of Zika virus. It provides new findings, including detection of Zika virus RNA in vaginal secretions up to day 14 and in erythrocytes up to day 81, the longest reported duration of detection in this sample type. A desquamating rash developed on the hands and feet of the patient, which we presume was related to her infection. To our knowledge, this finding has not been previously described. Additional studies involving larger cohorts of acutely ill Zika virus–infected patients tested over a longer period would solidify our understanding of the natural history of infection, duration of viral detection, and clinical outcomes. These studies will enable further development of evidence-based policies regarding diagnosis and clinical management of Zika virus–infected patients. Dr. Murray is Associate Vice-Chair for Research and Associate Professor of Pediatric Tropical Medicine in the Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, and serves as Assistant Dean of the National School of Tropical Medicine. Her research interests are vectorborne and zoonotic diseases. Acknowledgments We thank the study participant for her willingness to provide multiple specimens over an extended period. Without her willingness to contribute to science, this study would not have been possible. We also thank Jim Dunn and Jim Versalovic for guidance in developing and validating our Zika virus qRT-PCR, Robert Tesh and Scott Weaver for Zika virus–positive controls, and Yongxian Xu and Vidisha Singh for technical assistance. This study was supported in part by a grant from the National Institutes of Health (R01AI091816-01) to K.O.M, Emory University School of Medicine discretionary funds to M.J.M., and the Georgia Research Alliance.

The Study This study was reviewed and approved by the Baylor College of Medicine Institutional Review Board (H-30533). A previously healthy, nonpregnant, 26 year-old non-Hispanic white woman returned to the United States from Tegucigalpa, Honduras, during mid-May 2016. Five days after her return (day 0), signs and symptoms consistent with Zika virus infection developed, beginning with rash and subsequent fever, headache, and conjunctivitis (Table). Fever and rash continued through day 5 and day 6, respectively. By day 15, desquamation was noted on the palms of both hands and soles of both feet. By day 17, all symptoms had resolved. Serial specimens were longitudinally collected for >11 weeks. The first specimens were collected on day 0, two hours after onset of rash and 2 h before development of fever. All remaining specimens were collected at 3, 8, 14, 21, 28, 35, 42, 53, 64, and 81 days after onset of illness. Specimens included serum, whole blood (EDTA anticoagulated), urine, saliva, and vaginal mucosa swabs. The patient was not menstruating when vaginal swab specimens were collected. RNA was extracted from serum, whole blood, and urine samples by using the QIAamp MinElute Virus Spin Kit (QIAGEN, Valencia, CA, USA) according to the manufacturer’s instructions. Oral and vaginal mucosal swab specimens were collected by using the BBL CultureSwab Collection and Transport System (Becton Dickinson, Franklin Lakes, NJ, USA). Specimens were incubated in 250 μL of AL/carrier RNA lysis buffer for 10 min at room temperature; 200 μL of phosphate-buffered saline was added before RNA extraction. Figure. Quantitative reverse transcription PCR cycle threshold values over time (days after onset of illness) for whole blood, serum, urine, saliva, and vaginal mucosal swab specimens obtained from a 26-year-old woman infected... Eluted RNA from all samples was tested in a quantitative reverse transcription quantitative PCR (qRT-PCR) that included a TaqMan Fast Virus 1-Step Master Mix (ThermoFisher Scientific, Foster City, CA, USA) and a TaqMan ZIKV 1107 assay (6) with appropriate positive and negative controls. We detected Zika virus RNA in serum up to day 8 after onset of illness and in body fluids up to day 14; whole blood samples remained positive up to day 81 (Figure). Results of qRT-PCR of saliva were negative after day 8, and results for urine and vaginal swab specimens did not become negative until after day 14. We tested a day 0 serum sample for dengue virus and chikungunya virus RNA by using TaqMan assays (7,8); all results were negative. Virus isolations were performed for Vero cells in complete Dulbecco’s modified Eagle’s medium containing 10% heat-inactivated fetal bovine serum. Cells were infected with day 0 serum samples (or mock-infected with cell culture medium) and observed for cytopathic effects. Cell culture supernatants were sampled 13 days after cell culture infection, and RNA was extracted and tested for Zika virus RNA. Supernatant was collected on day 14, and viral titer was 8.5 × 105 PFU/mL by plaque assay. Attempts to isolate virus from the day 64 erythrocyte fraction showed no evidence of cytopathic effects, and first and second passages were negative by qRT-PCR. Because the day 81 whole blood specimen was still positive by qRT-PCR, we used ficoll to separate peripheral blood mononuclear cells and erythrocytes and found that erythrocytes were the only fraction positive for Zika virus RNA. The partial sequence of the virus we isolated was submitted to GenBank under accession no. KX928077. On day 8, plasma was evaluated by using an ELISA (9) to assess IgM and IgG binding to Zika virus envelope protein (Zika Virus Envelope Recombinant Protein, #R01635; Meridian Life Sciences, Memphis, TN, USA); positive results were obtained. Plasma-neutralizing antibodies against Zika virus were detected (50% focus reduction neutralization test titer 1:1,438), but neutralization of dengue virus serotypes 1–4 was not detected. These findings indicated a robust Zika virus–specific humoral response.

Zika virus is a rapidly emerging mosquitoborne virus (1). In May 2015, Brazil reported autochthonous transmission of Zika virus (2). Over the course of 1 year, Zika virus spread to >50 countries and territories throughout the Americas (3). With the now confirmed link of Zika virus infection during pregnancy leading to fetal microcephaly (4) and reported cases transmitted by sexual contact (5), it is vital to understand the natural history of infection. We report an acute case of Zika virus infection in a traveler returning from Honduras to the United States and results from serial specimens collected for >11 weeks. These new data might serve as a potential guide for public health policy.

Abstract Infection with Zika virus is an emerging public health crisis. We observed prolonged detection of virus RNA in vaginal mucosal swab specimens and whole blood for a US traveler with acute Zika virus infection who had visited Honduras. These findings advance understanding of Zika virus infection and provide data for additional testing strategies.

Recommend on FacebookTweet Volume 23, Number 1—January 2017 Dispatch Prolonged Detection of Zika Virus in Vaginal Secretions and Whole Blood On This Page The Study Conclusions Suggested Citation Figures Figure Tables Table Downloads RIS[TXT - 2 KB] Altmetric Kristy O. Murray , Rodion Gorchakov, Anna R. Carlson, Rebecca Berry, Lilin Lai, Muktha Natrajan, Melissa N. Garcia, Armando Correa, Shital M. Patel, Kjersti Aagaard, and Mark J. Mulligan Author affiliations: Baylor College of Medicine, Houston, Texas, USA (K.O. Murray, R. Gorchakov, R. Berry, M.N. Garcia, A. Correa, S.M. Patel, K. Aagaard); Texas Children’s Hospital, Houston (K.O. Murray, R. Gorchakov, R. Berry, M.N. Garcia, A. Correa, S.M. Patel, K. Aagaard); Baylor St. Luke’s General Hospital, Houston (A.R. Carlson);Emory University School of Medicine, Atlanta, GA, USA (L. Lai, M. Natrajan, M.J. Mulligan)

Prolonged Detection of Zika Virus in Vaginal Secretions and Whole Blood http://wwwnc.cdc.gov/eid/article/23/1/16-1394_article

week conf discard untested total weekly increase 40 46 208 332 586 25 39 42 204 315 561 23 38 42 200 296 538 55 37 41 196 246 483 32 36 40 195 216 451 12 35 40 190 209 439 13 34 38 168 220 426 25 33 34 158 209 401 16 32 29 102 254 385 18 31 24 101 242 367 23 30 22 97 225 344 24 29 21 92 207 320 23 28 21 80 196 297 41 27 21 75 160 256 62 26 18 64 112 194 13 25 13 56 112 181 17 24 11 51 102 164 27 23 6 50 81 137 19 22 6 43 69 118 23 21 6 41 48 95 7 20 5 26 57 88 7 19 5 26 50 81 9 18 5 24 43 72 14 17 5 21 32 58 8 16 4 20 26 50 6 15 4 18 22 44 11

intensified surveillance of microcephaly and other defects Congenital CNS, Colombia, to epidemiological week 40 2016 (Revision to October 14, 2016) Among the epidemiological weeks 01 to 40 of 2016 have been confirmed forty-six (46) cases of microcephaly associated the Zika virus, 208 cases were dismissed and 332 cases are in study http://www.ins.gov.co/boletin-epidemiologico/Boletn Epidemiolgico/2016 Boletin epidemiologico semana 40.pdf

Eighth Pool Of Mosquitoes Test Positive For Zika In Miami Beach October 18, 2016 5:45 PM By Giovanna Maselli Filed Under: Florida, Health, Miami Beach, Zika Aedes aegypti mosquitos are transmitters of the Zika virus. (Photo by Mario Tama/Getty Images) 56 Follow CBSMIAMI.COM: Facebook | Twitter MIAMI BEACH (CBSMiami) — A new pool of mosquitoes have tested positive for the Zika virus in Miami Beach. Miami-Dade Mosquito Control officials confirmed the find on Tuesday. The pool was retrieved back on October 5th from a trap located at 1236 Drexel Avenue which is within the Zika transmission zone. Officials said residents at the location of the trap were made aware of the find. Mosquito control has inspected and treated the 1/8 mile area surrounding the property. Zika 101: Prevent Spread By Protecting Yourself Two additional mosquito samples collected from the same site have tested negative since the find, according to the Florida Department of Agriculture and Consumer Services. Tuesday’s announcement comes after Mosquito Control found a new batch of mosquitoes had the virus in Miami Beach earlier this month. The mosquitoes came from a trap located at 1810 Jefferson Avenue on September 23rd. At last check, the results for that trap needed to be confirmed by the Centers For Disease Control and Prevention (CDC). Related: Rep. Wilson: Liberty City Not Getting Enough Attention In Zika Fight So far, there have been eight pools of mosquitoes that have tested positive for Zika on Miami Beach since the first discovery back on September 1st. Mosquito Control says they are still aggressively trying to break the cycle of local transmission. This includes a program to reduce and eliminate mosquito breeding and adult mosquitoes in the entire zone of transmission on Miami Beach. Truck spray treatments using Bti larvicide and adulticide are being performed weekly in the areas with local transmission. Treatments are also being conducted in conjunction with property inspections. Miami-Dade officials say, to date, more than 19,000 inspections have occurred on Miami Beach with more than 1,000 in Little River. Related: Drones, Bacteria-Infected Mosquitoes & Sandals May Be Next Step In Zika Fight As of Tuesday, there were 163 non-travel related Zika infections in Florida and 744 travel-related cases. About 109 cases involved pregnant women. Miami-Dade residents who wish to report a mosquito nuisance should call 311. So far, the local transmission zones in Miami-Dade County are the following: Miami Beach Area – 28th Street to the north, 8th Street to the south, intercoastal water to the west and the Atlantic Ocean to the east. Miami Area – 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. http://miami.cbslocal.com/2016/10/18/another-pool-of-mosquitoes-test-positive-for-zika-in-miami-beach/

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 1,059 67 992 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. 18, 2016 - 5:00 PM ET

October 18, 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 six new travel related cases today with four in Broward County, one in Polk County and one involving a pregnant woman. Please visit our website to see the full list of travel-related cases. There are three new non-travel related cases today. All 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 744 Non-Travel Related Infections of Zika 163 Infections Involving Pregnant Women 109 Out of State Cases (not Florida Residents) 19 Undetermined 5 Total 1,040 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 9,206 people statewide. Florida currently has the capacity to test 9,260 people for active Zika virus and 6,846 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 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.

October 18, 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 six new travel related cases today with four in Broward County, one in Polk County and one involving a pregnant woman. Please visit our website to see the full list of travel-related cases. There are three new non-travel related cases today. All 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 744 Non-Travel Related Infections of Zika 163 Infections Involving Pregnant Women 109 Out of State Cases (not Florida Residents) 19 Undetermined 5 Total 1,040 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 9,206 people statewide. Florida currently has the capacity to test 9,260 people for active Zika virus and 6,846 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 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 three new non-travel related cases today. All are in Miami-Dade County and are linked to the Miami Beach investigation.

There are six new travel related cases today with four in Broward County, one in Polk County and one involving a pregnant woman. Please visit our website to see the full list of travel-related cases. There are three new non-travel related cases today. All are in Miami-Dade County and are linked to the Miami Beach investigation.

Infection Type Infection Count Travel-Related Infections of Zika 744 Non-Travel Related Infections of Zika 163 Infections Involving Pregnant Women 109 Out of State Cases (not Florida Residents) 19 Undetermined 5 Total 1,040 http://www.floridahealth.gov/newsroom/2016/10/101816-zika-update.html