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There are 11 new travel-related cases today with four in Orange, three in Hillsborough, two in Osceola, one in Seminole and one involving a pregnant women. Please visit our website to see the full list of travel-related cases. There are four new non-travel related cases today in Miami-Dade County. Three of the four are associated with the Miami Beach investigation. The department is investigating the other case to determine where exposure occurred in Miami-Dade.

Infection Type Infection Count Travel-Related Infections of Zika 671 Non-Travel Related Infections of Zika 89 Infections Involving Pregnant Women 87 Out of State Cases (not Florida Residents) 10 Total 857 http://www.floridahealth.gov/newsroom/2016/09/092016-zika-update.html

Infection Type Infection Count Travel-Related Infections of Zika 671 Non-Travel Related Infections of Zika 89 Infections Involving Pregnant Women 87 Out of State Cases (not Florida Residents) 10 Total 857 http://www.floridahealth.gov/newsroom/2016/09/092016-zika-update.html

Cases notified on 20 Sep 2016 (as at 3pm) 3 E-week 35 (28 Aug - 3 Sep 2016) E-week 36 (4 Sep - 10 Sep 2016) E-week 37 (11 Sep 2016 - 17 Sep 2016) E-week 37 (18 Sep 2016 - 20 Sep 2016 as at 3pm) 215 103 62 3 http://www.nea.gov.sg/public-health/vector-control/overview/zika-clusters

week conf discard untested total weekly increase 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 Review 16 September 2016 Among the epidemiological weeks 01 to 36 of 2016 have been confirmed forty (40) cases associated with microcephaly Zika virus, 195 cases were dismissed and 216 cases are in study. http://www.ins.gov.co/boletin-epidemiologico/Boletn Epidemiolgico/2016 Boletin epidemiologico semana 36.pdf

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 Review September 2, 2016 Among the epidemiological weeks 01 to 35 of 2016 have confirmed forty (40) cases associated with microcephaly Zika virus, 190 cases were discarded and 209 cases are in study. http://www.ins.gov.co/boletin-epidemiologico/Boletn Epidemiolgico/2016 Boletin epidemiologico semana 35.pdf

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

September 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 is one new travel-related case today in Polk County. Please visit our website to see the full list of travel-related cases. There are two new non-travel related cases today in Miami-Dade County. One case is associated with the Miami Beach investigation. The department is investigating the other case to determine where exposure occurred in Miami-Dade. On Friday evening, Governor Scott announced the area of active transmission in Miami Beach expanded to approximately 4.5 square miles from 8th Street to 63rdStreet as four new non-travel related cases were identified in the expanded area. Today, Governor Rick Scott announced that following 45 days with no evidence of active Zika transmission, the entire Wynwood zone, which was originally about one square mile, has been lifted. The department advises residents and visitors in Wynwood to remain vigilant about mosquito bite protection by draining all sources of standing water to keep mosquitoes from breeding and wearing bug repellent to help keep Wynwood Zika free. DOH continues door-to-door outreach and targeted testing in Pinellas, 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 661 Non-Travel Related Infections of Zika 85 Infections Involving Pregnant Women 86 Out of State Cases (not Florida Residents) 10 Total 842 The department is currently conducting 10 active investigations. The department has closed 15 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 7,734 people statewide. Florida currently has the capacity to test 4,944 people for active Zika virus and 8,452 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 86. 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 6,314 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 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 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 is one new travel-related case today in Polk County. Please visit our website to see the full list of travel-related cases. There are two new non-travel related cases today in Miami-Dade County. One case is associated with the Miami Beach investigation. The department is investigating the other case to determine where exposure occurred in Miami-Dade. On Friday evening, Governor Scott announced the area of active transmission in Miami Beach expanded to approximately 4.5 square miles from 8th Street to 63rdStreet as four new non-travel related cases were identified in the expanded area. Today, Governor Rick Scott announced that following 45 days with no evidence of active Zika transmission, the entire Wynwood zone, which was originally about one square mile, has been lifted. The department advises residents and visitors in Wynwood to remain vigilant about mosquito bite protection by draining all sources of standing water to keep mosquitoes from breeding and wearing bug repellent to help keep Wynwood Zika free. DOH continues door-to-door outreach and targeted testing in Pinellas, 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 661 Non-Travel Related Infections of Zika 85 Infections Involving Pregnant Women 86 Out of State Cases (not Florida Residents) 10 Total 842 The department is currently conducting 10 active investigations. The department has closed 15 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 7,734 people statewide. Florida currently has the capacity to test 4,944 people for active Zika virus and 8,452 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 86. 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 6,314 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 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 is one new travel-related case today in Polk County. Please visit our website to see the full list of travel-related cases. There are two new non-travel related cases today in Miami-Dade County. One case is associated with the Miami Beach investigation. The department is investigating the other case to determine where exposure occurred in Miami-Dade. On Friday evening, Governor Scott announced the area of active transmission in Miami Beach expanded to approximately 4.5 square miles from 8th Street to 63rdStreet as four new non-travel related cases were identified in the expanded area.

There are two new non-travel related cases today in Miami-Dade County. One case is associated with the Miami Beach investigation. The department is investigating the other case to determine where exposure occurred in Miami-Dade. On Friday evening, Governor Scott announced the area of active transmission in Miami Beach expanded to approximately 4.5 square miles from 8th Street to 63rdStreet as four new non-travel related cases were identified in the expanded area.

Infection Type Infection Count Travel-Related Infections of Zika 661 Non-Travel Related Infections of Zika 85 Infections Involving Pregnant Women 86 Out of State Cases (not Florida Residents) 10 Total 842 http://www.floridahealth.gov/newsroom/2016/09/091916-zika-update.html

Infection Type Infection Count Travel-Related Infections of Zika 661 Non-Travel Related Infections of Zika 85 Infections Involving Pregnant Women 86 Out of State Cases (not Florida Residents) 10 Total 842 http://www.floridahealth.gov/newsroom/2016/09/091916-zika-update.html

Pennsylvania Blood Tests Submitted for Zika TestingInformation updated Mondays at 2 p.m. Confirmed Infections: 112 Last update: 09/19/2016 http://www.health.pa.gov/My Health/Diseases and Conditions/U-Z/Zikavirus/Pages/ZikaVirusHomePage.aspx#.V-A2p_ArJad

Pennsylvania Blood Tests Submitted for Zika TestingInformation updated Mondays at 2 p.m. Confirmed Infections: 112 Last update: 09/19/2016

Allegheny County Residents Approved for Zika Testing: 191 CDC Confirmed Cases: 10 Unspecified Flavivirus Infections: 1* (as of September 19, 2016) *- specific virus (dengue/zika) cannot be identified

The following table provides the number of travel-associated infections with Zika virus in California residents in 2015 and 2016. CDPH is following CDC testing guidelines. This table is updated every Friday. As of September 16, 2016, there have been 282 travel-associated Zika virus infections in California. • Total infections: 282 • New infections reported this week: 22 • Cumulative number of infections due to sexual transmission: 2 • Cumulative number of infections in pregnant women: 35a o Liveborn infants with birth defects: 2b o Pregnancy losses with birth defects: 0c Zika virus infections in California, 2015-2016d (as of September 16, 2016) County Travel-associated e Locally acquired f Alameda (City of Berkeley) 18g (2) 0 Contra Costa 12 0 Fresno 1 0 Humboldt 2 0 Kern 3 0 Lake 1 0 Los Angeles (City of Long Beach) 72h (3) 0 Marin 4 0 Merced 3 0 Monterey 2 0 Napa 2 0 Orange 20 0 Riverside 7 0 Sacramento 5 0 San Bernardino 11 0 San Diego 40i 0 San Francisco 23 0 San Joaquin 5 0 San Mateo 6 0 Santa Barbara 3 0 Santa Clara 19 0 Santa Cruz 2 0 Solano 1 0 Sonoma 6 0 Stanislaus 2 0 Tulare 3 0 Ventura 3 0 Yolo 4 0 Yuba 1 0 Total 282 0 a Local Health Departments and CDPH are monitoring all pregnant women and their infants b Includes microcephaly, calcium deposits in the brain indicating possible brain damage, excess fluid in the brain cavities and surrounding the brain, absent or poorly formed brain structures, abnormal eye development, or other problems resulting from damage to the brain that affects nerves, muscles and bones, such as clubfoot or inflexible joints. c Includes miscarriage, stillbirths, and terminations with evidence of the birth defects mentioned above d Total number includes laboratory-confirmed and probable infections as defined by the CSTE Position Statement e Persons exposed through travel to an affected area or contact with a traveler f Presumed local mosquito-borne transmission g Includes two residents of the City of Berkeley h Includes three resident of the City of Long Beach I Includes one non-resident https://www.cdph.ca.gov/HealthInfo/discond/Documents/TravelAssociatedCasesofZikaVirusinCA.pdf

Zika Clusters Cases notified on 19 Sep 2016 (as at 3pm) 0 E-week 35 (28 Aug - 3 Sep 2016) E-week 36 (4 Sep - 10 Sep 2016) E-week 37 (11 Sep 2016 - 17 Sep 2016) E-week 37 (18 Sep 2016 - 19 Sep 2016 as at 3pm) 215 103 63* 0 *12 cases were notified over the weekend. Location of Active Zika Clusters (Map data is updated at 1am. Kindly clear your internet browser cache after each visit, in order to view the latest information.) As of 19 Sep 2016 S/N Locality 1 Aljunied Cres (Blk 95,97,98,99,101,102,103,104,105,106,107,108,109,110,111,112) / Aljunied Rd / Aljunied Rd (Blk 125) / Circuit Rd (Blk 61,85) / Geylang East Ave 1 (Blk 126) / Geylang East Ctrl (Blk 1 22) / Lor 21A,23,25 Geylang / Paya Lebar Way (Blk 120,121,122,123) / Pipit Rd (Blk 56, 92A) / Sims Dr (Blk 42A,43,44) / Sims Pl (Blk 52,53) (286 cases as of 19 Sep 2016, of which 19 cases with onset in the last 2 weeks) 2 Bedok Nth Ave 2 (Blk 514) / Bedok Nth Ave 3 (404,405,507) / Bedok Nth St 3 (Blk 525) (5 cases as of 19 Sep 2016, of which 1 case with onset in the last 2 weeks) 3 Joo Seng Rd (Blk 17, 18, 21) / Vernon Pk (4 cases as of 19 Sep 2016, of which 1 case with onset in the last 2 weeks) 4 Bishan St 12 (Blk 122, 123, 134) (5 cases as of 19 Sep 2016, of which 0 cases with onset in the last 2 weeks) 5 Elite Ter / Fidelio St / Jln Tua Kong (Park East) / Tua Kong Green / Siglap Road (Flamingo Valley) (13 cases as of 19 Sep 2016, of which 7 cases with onset in the last 2 weeks) 6 Ubi Ave 1, Cres (4 cases as of 19 Sep 2016, of which 2 cases with onset in the last 2 weeks) 7 Balam Rd (Blk 29) / Circuit Rd (Blk 35) / Jln Raya (3 cases as of 19 Sep 2016, of which 1 case with onset in the last 2 weeks) 8 Sengkang Ctrl (Blk 272C) / Sengkang East Ave (Blk 279C) (2 cases as of 19 Sep 2016, of which 1 case with onset in the last 2 weeks) 9 Hougang Ave 7 (Blk 325) (2 cases as of 19 Sep 2016, of which 1 case with onset in the last 2 weeks) http://www.nea.gov.sg/public-health/vector-control/overview/zika-clusters

Cases notified on 19 Sep 2016 (as at 3pm) 0 E-week 35 (28 Aug - 3 Sep 2016) E-week 36 (4 Sep - 10 Sep 2016) E-week 37 (11 Sep 2016 - 17 Sep 2016) E-week 37 (18 Sep 2016 - 19 Sep 2016 as at 3pm) 215 103 63* 0 http://www.nea.gov.sg/public-health/vector-control/overview/zika-clusters

Media Contact: Michael Hernandez [email protected] 305-375-1545 Stephanie Severino [email protected] 305-375-1545 Statement from Mayor Carlos A. Gimenez regarding expanded local-transmission area in Miami Beach MIAMI (September 17, 2016) — Last night, Governor Rick Scott announced that the Florida Department of Health has confirmed locally-acquired Zika cases in an expanded area of Miami Beach beyond the 1.5-square-mile area of 8th street to 28th Street. As a result of these findings, the Department of Health has expanded the area of local transmission to a 4.5-square-mile area from 8th Street to 63rd Street. At this time, Miami-Dade County will not expand aerial spraying beyond the 1.5-square-mile area of local transmission. Our Mosquito Control team will continue our aggressive on-the-ground and truck spraying into next week in the 4.5-square-mile area. All decisions that we make to keep our community safe from the Zika virus are made in direct consultation with the Centers for Disease Control and Prevention, the Florida Departments of Health and Agriculture, and our municipal partners. We will review the epidemiological and trap data over the weekend, and consult with our health and environmental experts, and the City of Miami Beach, before making further decisions about the best way to break the cycle of transmission in the expanded area. We continue to rely on our residents and visitors to help us stop the spread of Zika by draining any standing water, wearing mosquito repellant, covering up with long sleeves and pants when going outdoors, and practicing safe sex. http://www.miamidade.gov/releases/2016-09-17-mayor-statement-expanded-area.asp