niman

Full Phylo tree with ZM 39

Sequence MetaData Scripps ID Patient ID Sample type Quality score % Coverage Average Depth Onset Collection Days post onset Local or travel Location of infection GE/ul RNA GE/mL sample Sequencing status Consensus name Merged Bam File ZF1 001 Saliva *** 99.71 46616.27 2016.03.18 2016.03.22 4 Travel Martinique 11 3.3E+03 coding-complete ZF1_01Sa_XX_2016-03-22 usa_ex_martinique ZF1.c1.Sa.a1.l1.l3.l4.r1 ZF8 008 Urine *** 90.07 35012.49 2016.06.15 2016.06.21 6 Travel Puerto Rico 4 1.1E+03 coding-complete ZF8_08U_XX_2016-06-21 usa_ex_puerto_rico ZF8.c1.UR.a1.l1.l2.r1 ZF10 010 Urine **** 97.69 55330.48 2016.06.17 2016.06.22 5 Local? Cuba 213 6.1E+04 coding-complete ZF10_10U_KX842499 2016-06-22 usa_ex_cuba ZF10.c1.UR.a1.l1.r1 ZF16 016 Urine *** 99.88 75158.72 2016.06.28 2016.07.03 5 Travel Puerto Rico 14 4.0E+03 coding-complete ZF16_16U_XX_2016-07-03 usa_ex_puerto_rico ZF16.c1.UR.a1.l1.l2.l3.l4.l5.r1 ZF21 021 Urine *** 97.45 52361.36 2016.07.09 2016.07.19 10 Local "Dade County Florida" 50 1.4E+04 coding-complete ZF21_21U_XX_2016-07-19 usa ZF21.c1.UR.a1.l1.l2.l3.r1 ZF22 022 Urine *** 97.77 51135.60 2016.07.16 2016.07.16 6 Local "Dade County Florida" 11 3.0E+03 coding-complete ZF22_22U_XX_2016-07-16 usa ZF22.c1.UR.a1.l1.l2.l3.l4.r1 ZF30 030 Urine *** 99.75 57779.63 2016.07.31 2016.08.02 2 Local "Dade County Florida" 36 1.0E+04 coding-complete ZF30_30U_XX_2016-08-02 usa ZF30.c1.UR.a1.l1.l2.l3.r1 ZF32 032 Urine *** 99.75 51483.94 2016.07.29 2016.08.05 7 Local "Dade County Florida" 75 2.1E+04 coding-complete ZF32_32U_XX_2016-08-05 usa ZF32.c1.UR.a1.l1.l2.l3.r1 ZF38 038 Urine *** 99.76 81750.77 2016.08.04 2016.08.05 1 Local Dade 38 1.1E+04 coding-complete ZF38_38U_XX_2016-08-05 usa ZF38.c1.UR.a1.l1.l2.l3.l4.r1 ZF39 039 Urine **** 99.75 70253.99 2016.08.12 2016.08.17 5 Local "Pinellas County Florida" 1276 3.6E+05 coding-complete ZF39_39U_XX_2016-08-17 usa ZF39.c1.UR.a1.l1.l2.l3.r1 ZL2 Hu0015 Saliva *** 99.75 89934.25 2016.08.19 2016.08.24 5 Local "Dade County Florida" 38 21610.23 coding-complete ZL2_Hu0015_KX832731 2016-08-22 usa ZL2.c1.SA.a1.l1.l2.r1 ZM1 7501 Mosquito **** 99.75 141038.31 2016.08.22 Local "Dade County Florida" 4563 9.1E+06 coding-complete Ae-aegypti_ZM1_7501_KX838904_2016-08-22_usa ZM1.c1.MO.a1.l1.l2.r1 ZM2 7719 Mosquito **** 99.74 137263.85 2016.08.23 Local "Dade County Florida" 279 5.6E+05 coding-complete Ae-aegypti_ZM2_7719_KX838905_2016-08-23_usa ZM2.c1.MO.a1.l1.l2.r1 ZM3 7727 Mosquito **** 99.83 139787.57 2016.08.23 Local "Dade County Florida" 22549 4.5E+07 coding-complete Ae-aegypti_ZM3_7727_KX838906_2016-08-23_usa ZM3.c1.MO.a1.l1.l2.r1 ZM4 16-10416 Mosquito **** 99.72 45505.39 2016.09.04 Local Dade - Miami Beach 102 4.4E+04 coding-complete Ae-aegypti_ZM4_16-10416_XX_2016-09-04_usa ZM4.c1.MO.a1.l1.l2.r1 ZM5 16-3125 Mosquito ** 96.63 5365.36 2016.09.09 Local Dade - Miami Beach 447 1.9E+05 missing part of 5' Ae-aegypti_ZM5_16-3125_XX_2016-09-09_usa ZM5.c1.MO.a1.l1.l2.r1 ZC188 423568715 Serum **** 98.26 29394.90 2016.01.16 Columbia 36 1.5E+04 coding-complete ZC188_423568715_XX_2016-01-16_colombia ZC188.c1.SR.a1.l3.l4.r1 ZC192 423401315 Serum **** 98.36 30396.29 2016.01.07 Columbia 39 1.7E+04 coding-complete ZC192_423401315_XX_2016-01-07_colombia ZC192.c1.SR.a1.l3.l4.r1 ZC204 424439915 Serum **** 99.74 29003.25 2016.01.06 Columbia 48 2.1E+04 coding-complete ZC204_424439915_XX_2016-01-05_colombia ZC204.c1.SR.a1.l1.l2.r1 ZC207 423217515 Serum **** 96.68 19477.70 2016.01.09 Columbia 16 6.7E+04 coding-complete ZC207_423217515_XX_2016-01-09_colombia ZC207.c1.SR.a1.l1.l2.r1 Quality **** Complete coding sequence, no apparent contamination in aligned bam file *** Complete coding sequence, some contamination in aligned bam file (confident in consensus) ** Partial coding sequence, no apparent contamination in aligned bam file * Partial coding sequence, some contamination in aligned bam file

Samples Scripps ID Patient ID Sample type Quality score % Coverage Location of infection ZF1 001 Saliva *** 99.71 Martinique ZF8 008 Urine *** 90.07 Puerto Rico ZF10 010 Urine **** 97.69 Cuba ZF16 016 Urine *** 99.88 Puerto Rico ZF21 021 Urine *** 97.45 "Dade County Florida" ZF22 022 Urine *** 97.77 "Dade County Florida" ZF30 030 Urine *** 99.75 "Dade County Florida" ZF32 032 Urine *** 99.75 "Dade County Florida" ZF38 038 Urine *** 99.76 Dade ZF39 039 Urine **** 99.75 "Pinellas County Florida" ZL2 Hu0015 Saliva *** 99.75 "Dade County Florida" ZM1 7501 Mosquito **** 99.75 "Dade County Florida" ZM2 7719 Mosquito **** 99.74 "Dade County Florida" ZM3 7727 Mosquito **** 99.83 "Dade County Florida" ZM4 16-10416 Mosquito **** 99.72 Dade - Miami Beach ZM5 16-3125 Mosquito ** 96.63 Dade - Miami Beach ZC188 423568715 Serum **** 98.26 Columbia ZC192 423401315 Serum **** 98.36 Columbia ZC204 424439915 Serum **** 99.74 Columbia ZC207 423217515 Serum **** 96.68 Columbia

The Pinellas Co Zika active investigation has been closed. However, although the precise location of Zika transmission was not identified, media reports noted that the case was a firefighter who worked in Hillsborough County (Tampa Bay), whose travel prior to disease onset was limited to Pinellas and Hillsborough Counties, which include Clearwater and St Petersburgh in Pinellas County as well as Tampa Bay in Hillisborough County. These sites are over 200 miles northwest of the outbreaks in Miami Dade (Wynwood and Miami Beach). The Andersen Lab at Scripps Clinic has been sequencing samples from humans and mosquitoes in Florida. Five of these sequences (3 human and 3 mosquito) have been released at Genbank and all five of these sequences fall into a well defined sub-clade, which includes full or partial Zika sequences from French Guyana, Dominican Republic, and Guadeloupe. In addition to the five full sequences at Genbank, the Anderson Lab has been posting additional sequences at their website. The recent update of the summary table (Location of Infection column) indicated that one of these sequences (ZM 39) was from the case in Pinellas County. The sequence relationship to the sequences from Miami Dade County raises concerns that Zika in Florida mosquitoes is widespread and has been circulating in Florida well in advance of reports of local transmission.

Pinnellas Zika sequece ZM 39 identified. Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

Taiwan reports 9th imported case of Zika infection Central News Agency 2016-10-01 05:53 PM Fonts Size Printer-Friendly 1 Taiwan reports 9th imported case of Zika infection Associated Press () Taipei, Oct. 1 (CNA) Taiwan has confirmed a new imported case of Zika virus infection, involving a 51-year-old Taiwanese man who developed the symptoms of fever, conjunctivitis and joint pain after returning from Vietnam in late September, the Centers for Disease Control (CDC) said Saturday. The man has become the ninth imported Zika case in Taiwan and the second imported case of the mosquito-borne disease from Vietnam, according to the CDC. The Southeast Asian country has reported at least three indigenous cases of Zika infection since April, it added. The man, who lives in New Taipei, was confirmed to have been infected with the disease Saturday. He developed symptoms of fever, cough, sore throat, joint pain and conjunctivitis after returning to Taiwan Sept. 23 from Vietnam, the CDC said. These are all common symptoms associated with Zika. He and his wife traveled to the province of Bac Lieu and Ho Chi Minh City, southern Vietnam, from Sept. 10-23, the CDC said. He later developed a rash and went to a clinic for treatment Sept. 25, it added. He went to another hospital three days later after seeing no improvement in his condition. The man, who has been resting at home, will now be kept in quarantine until Oct. 4, the CDC said. His mother and wife, who live with him, have not shown any Zika-related symptoms so far, it added. Meanwhile, the CDC noted that South Korea, Australia and Israel have all reported imported cases of Zika infection from Vietnam this year. With an increase in the number of mosquitoes during the rainy season in Southeast Asia, the number of cases of Zika infection is expected to rise, it said. Taiwan has reported nine confirmed Zika virus infection cases so far this year, all of which were imported cases, according to the CDC. Among them, two were from Thailand, another two from Vietnam, and one each from Indonesia, Saint Lucia, Saint Vincent and the Grenadines, Florida and Singapore, it said. Since 2015, at least 70 countries and territories around the world have reported indigenous Zika cases, with the situation in Central and South America the most severe, the CDC said. It warned people planning to visit Zika-affected areas to take proper precautions and suggested that pregnant women or women planning to get pregnant should avoid visiting those areas. Adults usually show only mild symptoms if infected, but pregnant women could give birth to deformed or stillborn babies if infected, it said. (By Elaine Hou)

Meanwhile, the CDC noted that South Korea, Australia and Israel have all reported imported cases of Zika infection from Vietnam this year. With an increase in the number of mosquitoes during the rainy season in Southeast Asia, the number of cases of Zika infection is expected to rise, it said. http://www.taiwannews.com.tw/etn/news_content.php?id=2987830

Taiwan reports 9th imported case of Zika infection Central News Agency 2016-10-01 05:53 PM Fonts Size Printer-Friendly 1 Taiwan reports 9th imported case of Zika infection Associated Press () Taipei, Oct. 1 (CNA) Taiwan has confirmed a new imported case of Zika virus infection, involving a 51-year-old Taiwanese man who developed the symptoms of fever, conjunctivitis and joint pain after returning from Vietnam in late September, the Centers for Disease Control (CDC) said Saturday. The man has become the ninth imported Zika case in Taiwan and the second imported case of the mosquito-borne disease from Vietnam, according to the CDC. The Southeast Asian country has reported at least three indigenous cases of Zika infection since April, it added. The man, who lives in New Taipei, was confirmed to have been infected with the disease Saturday. He developed symptoms of fever, cough, sore throat, joint pain and conjunctivitis after returning to Taiwan Sept. 23 from Vietnam, the CDC said. These are all common symptoms associated with Zika. He and his wife traveled to the province of Bac Lieu and Ho Chi Minh City, southern Vietnam, from Sept. 10-23, the CDC said. He later developed a rash and went to a clinic for treatment Sept. 25, it added. He went to another hospital three days later after seeing no improvement in his condition. The man, who has been resting at home, will now be kept in quarantine until Oct. 4, the CDC said. His mother and wife, who live with him, have not shown any Zika-related symptoms so far, it added. Meanwhile, the CDC noted that South Korea, Australia and Israel have all reported imported cases of Zika infection from Vietnam this year. With an increase in the number of mosquitoes during the rainy season in Southeast Asia, the number of cases of Zika infection is expected to rise, it said. Taiwan has reported nine confirmed Zika virus infection cases so far this year, all of which were imported cases, according to the CDC. Among them, two were from Thailand, another two from Vietnam, and one each from Indonesia, Saint Lucia, Saint Vincent and the Grenadines, Florida and Singapore, it said. Since 2015, at least 70 countries and territories around the world have reported indigenous Zika cases, with the situation in Central and South America the most severe, the CDC said. It warned people planning to visit Zika-affected areas to take proper precautions and suggested that pregnant women or women planning to get pregnant should avoid visiting those areas. Adults usually show only mild symptoms if infected, but pregnant women could give birth to deformed or stillborn babies if infected, it said. (By Elaine Hou) http://www.taiwannews.com.tw/etn/news_content.php?id=2987830

MIAMI INVADED BY ZIKA INFECTED MOSQUITOES OCTOBER 2, 2016 BY TROY RUBENSON 0 COMMENTS Follow Zika infected mosquitoes strike Miami Beach for the forth time this year. STATES CHRONICLE – Another outbreak of the Zika infected mosquitoes strikes Miami. The new wave of dangerous mosquitoes has infested a new area in Miami Beach. The scientists from the Florida Department of Agriculture argued that the Zika infected mosquitoes are visiting Miami for the fourth time. Last time the infected mosquitoes were caught in this area was two weeks ago. This virus is extremely dangerous for pregnant women who get infected. Zika virus can cause brain problems to the fetus and also head malformations. The same species of mosquitoes that spreads Zika is also responsible for infecting people with dengue fever. The Department of Agriculture stated that they have started testing the virus in May and since then they have collected more than four thousand mosquito samples. The Miami-Dade County Mosquito Control Division made public that only 6 of them were carrying the dangerous virus. The Zika infected mosquitoes have been first captured on September the first. These samples were tested by the representatives from the Department of Agriculture and Consumer Service at the Bronson Animal Disease Diagnostic Laboratory, Kissimmee. The results show that the Zika infected mosquitoes were discovered on September the first, 9th of September, 16th of September and October the first. These tests that revealed the presence of the Zika infected mosquitoes needed to be confirmed by the US Centers for Disease Control and Prevention. The research which confirmed the virus was conducted with the help of a trap situated at 575 W 49th St. on September 20. Treatments started to be spread in the nearest areas around that property where the trap was installed. The division that takes care of the mosquito control had also experienced times when tests revealed a false positive. After retesting, only two results were registered as negative. This mosquito control division is still working on isolating and eradicating the dangerous virus which infected so many people. They try to reduce mosquito breeding. Locals were asked to constantly drain the water on their properties, and they were advised to wear mosquito repellent when outdoors. If you live in one of those affected areas, or even near them, you should think about some ways to prevent your infection and to protect yourself. Think of the health of your family and yours as a top priority. http://stateschronicle.com/zika-infected-mosquitoes-17740.html

New Pool Of Miami Beach Mosquitoes Test Positive For Zika October 1, 2016 2:29 PM MIAMI BEACH (CBSMiami) — A new batch of Zika-carrying mosquitoes have been detected in the same small area of Miami Beach where five other samples had previously tested positive. “All samples have consisted of Aedes aeqypti mosquitoes and are from an area where increased trapping and intensified mosquito control measures have already been underway since the Florida Department of Health determined local transmission had occurred,” the Florida Department of Agriculture and Consumer Services announced Saturday. The positive sample came from a trap located at 575 W. 49th Street. Out of the nearly 4,000 mosquito samples tested since May, consisting of nearly 64,000 mosquitoes, these six samples are the only ones to test positive, the agency said. Scientists tested the latest sample at the Bronson Animal Disease Diagnostic Laboratory in Kissimmee. A summary of the six total positive mosquito samples to date is as follows: Oct. 1, 2016: One mosquito sample from a small area in Miami Beach tested positive for Zika. Sept. 16, 2016: One mosquito sample from a small area in Miami Beach tested positive for Zika. Sept. 9, 2016: One mosquito sample from a small area in Miami Beach tested positive for Zika. Sept. 1, 2016: Three mosquito samples from a small area in Miami Beach tested positive for Zika. http://miami.cbslocal.com/2016/10/01/new-pool-of-miami-beach-mosquitoes-test-positive-for-zika/#.V_EFW7gUGwE.twitter

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

Media Contact: Mike Hernandez [email protected] 305-375-1545305-798-2554 Gayle Love [email protected] 305-375-3508305-297-1857 Frank Calderon [email protected] 305-375-4815786-516-1001 James Richards [email protected] 305-375-2741305-632-6376 New pool of mosquitoes preliminarily test positive for Zika on Miami Beach Test results are preliminary and must be confirmed by the CDC MIAMI (October 01, 2016) — The Miami-Dade County Mosquito Control Division learned today that a pool of mosquitoes taken from Miami Beach has preliminarily tested positive for Zika. Testing was conducted by the Florida Department of Agriculture and Consumer Services (FDACS). The pool of mosquitoes was retrieved on September 20, 2016 from a trap located at 575 W 49th Street on Miami Beach, which is within the expanded zone of transmission as designated by the State. This information has been provided to the resident at the location of the trap, and inspection and treatment in the 1/8-mile area surrounding the property has taken place. It is extremely important to note that the results are preliminary and must be confirmed by the U.S. Centers for Disease Control and Prevention, as Miami-Dade has seen false positives on tested traps in the past. If confirmed, this would be the sixth pool, or batch, of mosquitoes testing positive for Zika on Miami Beach. Thus far, two subsequent test results received from this location have been negative. Miami-Dade Mosquito Control continues to conduct an aggressive program to reduce and eliminate mosquito breeding and adult mosquitoes in the entire zone of transmission on Miami Beach. Residents are reminded to do their part to help reduce mosquitoes and the spread of mosquito-borne diseases by draining standing water on their properties and wearing repellent when they go outdoors. Miami-Dade residents who wish to report a mosquito nuisance should call 311 or download the 311 app athttp://www.miamidade.gov/mobile-applications/. Information on the County’s Mosquito Control program is available atwww.miamidade.gov/mosquito.

MIAMI (October 01, 2016) — The Miami-Dade County Mosquito Control Division learned today that a pool of mosquitoes taken from Miami Beach has preliminarily tested positive for Zika. Testing was conducted by the Florida Department of Agriculture and Consumer Services (FDACS). The pool of mosquitoes was retrieved on September 20, 2016 from a trap located at 575 W 49th Street on Miami Beach, which is within the expanded zone of transmission as designated by the State. This information has been provided to the resident at the location of the trap, and inspection and treatment in the 1/8-mile area surrounding the property has taken place. http://www.miamidade.gov/releases/2016-10-01-solid-waste-zika-positive-trap.asp

Env tree

Env 2753 BP

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: 15 Miami-Dade County: 11 open investigations Palm Beach: 2 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: 24 Miami-Dade County: 18 closed investigations Palm Beach County: 4 closed investigation Broward County: 1 closed investigation Pinellas: 1 closed investigation paragraph break Sampling Activities For Active Investigations Miami Beach in Miami-Dade County Total # of Samples Collected Positive Negative Pending Results 1,043 49 992 2 paragraph break Palm Beach County – 2 Investigations Total # of Samples Collected Positive Negative Pending Results 3 0 3 0 paragraph break Miami-Dade Investigations Outside of Wynwood and Miami Beach – 10 Investigations Total # of Samples Collected Positive Negative Pending Results 2 1 0 1 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 524 33 491 0 Data as of Sep. 30, 2016 - 2:36 PM ET http://www.floridahealth.gov/diseases-and-conditions/zika-virus/index.html?utm_source=flhealthIndex

September 30, 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 11 new travel related cases today with three in Orange, two in Miami-Dade, one in Palm Beach and five involving pregnant women. Please visit our website to see the full list of travel-related cases. There are five new non-travel related cases today in Miami-Dade County. One case is a Miami-Dade County resident that had exposure in Miami Beach. Four cases are Miami-Dade County residents and the department is investigating where exposure occurred. DOH continues door-to-door outreach and targeted testing in Palm Beach and Miami-Dade counties 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 area in Miami Beach in Miami-Dade County, see map below. 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 711 Non-Travel Related Infections of Zika 124 Infections Involving Pregnant Women 97 Out of State Cases (not Florida Residents) 15 Undetermined 1 Total 948 The department is currently conducting 15 active investigations. The department has closed 24 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 8,560 people statewide. Florida currently has the capacity to test 6,323 people for active Zika virus and 7,505 for Zika antibodies. At Governor Scott’s direction, all county health departments now offer free Zika risk assessment and testing to pregnant women. Florida’s small case cluster is not considered widespread transmission, however, pregnant women are advised to avoid non-essential travel to the impacted area in Miami-Dade County (see map 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 97. 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 6,710 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. Miami Beach Map 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.

September 30, 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 11 new travel related cases today with three in Orange, two in Miami-Dade, one in Palm Beach and five involving pregnant women. Please visit our website to see the full list of travel-related cases. There are five new non-travel related cases today in Miami-Dade County. One case is a Miami-Dade County resident that had exposure in Miami Beach. Four cases are Miami-Dade County residents and the department is investigating where exposure occurred. DOH continues door-to-door outreach and targeted testing in Palm Beach and Miami-Dade counties 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 area in Miami Beach in Miami-Dade County, see map below. 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 711 Non-Travel Related Infections of Zika 124 Infections Involving Pregnant Women 97 Out of State Cases (not Florida Residents) 15 Undetermined 1 Total 948 The department is currently conducting 15 active investigations. The department has closed 24 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 8,560 people statewide. Florida currently has the capacity to test 6,323 people for active Zika virus and 7,505 for Zika antibodies. At Governor Scott’s direction, all county health departments now offer free Zika risk assessment and testing to pregnant women. Florida’s small case cluster is not considered widespread transmission, however, pregnant women are advised to avoid non-essential travel to the impacted area in Miami-Dade County (see map 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 97. 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 6,710 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. Miami Beach Map 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 five new non-travel related cases today in Miami-Dade County. One case is a Miami-Dade County resident that had exposure in Miami Beach. Four cases are Miami-Dade County residents and the department is investigating where exposure occurred.

There are 11 new travel related cases today with three in Orange, two in Miami-Dade, one in Palm Beach and five involving pregnant women. Please visit our website to see the full list of travel-related cases. There are five new non-travel related cases today in Miami-Dade County. One case is a Miami-Dade County resident that had exposure in Miami Beach. Four cases are Miami-Dade County residents and the department is investigating where exposure occurred.

Infection Type Infection Count Travel-Related Infections of Zika 711 Non-Travel Related Infections of Zika 124 Infections Involving Pregnant Women 97 Out of State Cases (not Florida Residents) 15 Undetermined 1 Total 948 http://www.floridahealth.gov/newsroom/2016/09/093016-zika-update.html

Infection Type Infection Count Travel-Related Infections of Zika 711 Non-Travel Related Infections of Zika 124 Infections Involving Pregnant Women 97 Out of State Cases (not Florida Residents) 15 Undetermined 1 Total 948 http://www.floridahealth.gov/newsroom/2016/09/093016-zika-update.html

Thailand reports two cases of Zika birth defects 01:58 By Aukkarapon Niyomyat | BANGKOK Thailand reported on Friday the first confirmed cases in Southeast Asia of microcephaly linked to mosquito-borne Zika, as the World Health Organization urged action against the virus across the region. The confirmation of two case of microcephaly, a birth defect marked by small head size, came a day after U.S. health officials recommended that pregnant women postpone non-essential travel to 11 Southeast Asian countries because of the risk of Zika. "We have found two cases of small heads linked to Zika, the first cases in Thailand," Prasert Thongcharoen, an adviser to the Department of Disease Control, told reporters in Bangkok. He declined to say where in Thailand the cases were found but officials have said they were not in Bangkok. The World Health Organisation (WHO) said the cases were the first of Zika-linked microcephaly in Southeast Asia and the virus infection represented a serious threat to pregnant women and their unborn children. "Countries across the region must continue to strengthen measures aimed at preventing, detecting and responding to Zika virus transmission," Dr Poonam Khetrapal Singh, the WHO's regional director, said in a statement. U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly, which can lead to severe developmental problems in babies. VIRUS SPREADING The connection between Zika and microcephaly first came to light last year in Brazil, which has confirmed more than 1,800 cases of microcephaly that it considers to be related to Zika infections in the mothers. Zika has spread extensively in Latin American and the Caribbean over the past year or so, and more recently it has been cropping up in Southeast Asia. Thailand has confirmed 349 Zika cases since January, including 33 pregnant women, and Singapore has recorded 393 Zika cases, including 16 pregnant women. left right 5/5 left right A city worker fumigates the area to control the spread of mosquitoes at a temple in Bangkok, Thailand, September 14, 2016. REUTERS/Chaiwat Subprasom 1/5 left right 2/5 left right 3/5 left right 4/5 left right 5/5 left right 1/5 Some health experts have accused Thai officials of playing down the risk of Zika to protect its thriving tourist industry, but Prasert dismissed that. "Thailand is not hiding anything and is ready to disclose everything," he said, adding that other countries in Southeast Asia might also have cases of Zika-linked microcephaly that they have not disclosed. The WHO said Thailand's response was an example for the region. "Thailand's diligence underscores the commitment of health authorities to the health and wellbeing of the Thai public, and provides a positive example to be emulated," Singh said. The U.S. Centers for Disease Control and Prevention (CDC) said on Thursday people should consider postponing travel to Brunei, Myanmar, Cambodia, Indonesia, Laos, Malaysia, Maldives, Philippines, Thailand, Timor-Leste (East Timor), and Vietnam. The CDC has already issued a "travel notice" for Singapore, and said such a warning would be considered for the new countries if the number of cases rose to the level of an outbreak. Thailand's confirmation of Zika-linked microcephaly comes ahead of China's week-long "Golden Week" holiday with Thailand expecting 220,000 Chinese visitors, up from 168,000 for the week in 2015, Tourism Authority of Thailand governor Yuthasak Supasorn told Reuters. NO VACCINE There is no vaccine or treatment for Zika. An estimated 80 percent of people infected have no symptoms, making it difficult for pregnant women to know whether they have been infected. There are also no specific tests to determine if a baby will be born with microcephaly, but ultrasound scans in the third trimester of pregnancy can identify the problem, according to the WHO. Zika is commonly transmitted through mosquitoes but can also be transmitted sexually. Another Thai health ministry adviser urged everyone to work to stop the spread of mosquitoes but said people should not panic. ALSO IN HEALTH NEWS Zika-related birth defects likely higher than anticipated: panel Regeneron's Eylea combination therapy fails mid-stage study "Don't have sex with a Zika-infected person. If you don't know if they are infected, then use a condom," the adviser, Pornthep Siriwanarangsan, told reporters. "We can't stop women from becoming pregnant ... but we mustn't panic." Health authorities in the region said they were stepping up monitoring, but there has been little testing and officials said the real number of cases was bound to be higher than the confirmed figure. "We do not test everybody, we test only those who are symptomatic," said Paulyn Jean Rosell-Ubia, health secretary in the Philippines, which has reported 12 Zika cases. "Yes, we are positive that the number is higher because we are not testing everyone." Malaysia, which has reported six cases of Zika, including two in pregnant women, said it would seek information from Thailand on the particular strain of the Zika virus there. "We are taking serious notice of the reports in Thailand, and we will reach out to the Thai authorities for more information ... so that we can be more prepared," Malaysia's health minister, Subramaniam Sathasivam, told Reuters. Authorities in Vietnam, which has reported three cases of Zika, ordered stepped up monitoring of pregnant women. In Indonesia's capital, Jakarta, head of disease outbreak and surveillance Dwi Oktavia said there had been no sign of any increase in birth defects there. Indonesia had one Zika case in 2015 but has confirmed none since then. Microcephaly in babies can lead to respiratory problems related to malformation of the brain, a serious threat to the lives of babies. Children with microcephaly face lifelong difficulties, including intellectual impairment. Zika was first identified in Uganda in 1947 and first isolated in Asia in the 1960s. It was unknown in the Americas until 2014. (Additional reporting by Amy Sawitta Lefevre, Juarawee Kittisilpa and Panarat Thepgumpanat, Kanupriya Kapoor in JAKARTA, Roxanna Latiff in KUALA LUMPUR, Karen Lima in MANILA and Pham Thi Huyen My in HANOI; Writing by Robert Birsel; Editing by Alex Richardson) http://www.reuters.com/article/us-health-zika-thailand-idUSKCN1200K9

The State Department of Public Health (DPH) today announced that the first case of Zika virus in Connecticut acquired in the continental United States. The patient had recently traveled to Miami-Dade County, Florida. http://www.ct.gov/dph/cwp/view.asp?Q=586108&A=4820

DPH Announces First Connecticut Case of Domestically Acquired Zika The State Department of Public Health (DPH) today announced that the first case of Zika virus in Connecticut acquired in the continental United States. The patient had recently traveled to Miami­Dade County, Florida. At this time, DPH reminds residents, particularly pregnant women and women planning to become pregnant, to avoid travel to regions that have been affected by Zika virus. Travelers to these areas should protect themselves from the virus by taking steps to prevent mosquito bites. When traveling to areas where Zika virus or other viruses spread by mosquitoes have been reported, use insect repellent, wear long sleeves and pants, and stay in places with air conditioning or that use window and door screens. Zika virus is spread to people primarily through mosquito bites, though it can also spread through sexual transmission. While illness is usually mild, the possible link with birth defects and miscarriages makes prevention of infection among pregnant women essential. To avoid infections in pregnant women recommendations include: 1) postponing travel to areas where Zika virus is circulating among mosquitoes, 2) adopting precautions to avoid mosquito bites if travel is necessary, 3) men who travel to affected areas should abstain from sexual activity with a pregnant partner, or use condoms, for the duration of the pregnancy. In Connecticut, surveillance for Zika virus began on February 15, 2016. To date, 85 patients have tested positive for the Zika virus in Connecticut, 5 of which were pregnant. According to the US Centers for Disease Control and Prevention (CDC) 3,358 cases of Zika have been reported in the United States. For more information about the Zika virus visit http://ct.gov/zika . Content Last Modified on 9/29/2016 12:52:51 PM