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Alabama Residents Tested for Zika Virus as of September 6, 2016 Number of Submissions Positive Test Results for Zika or Flavivirus, unspecified (likely Zika) 245 32

Aug 29 update where 5 AI 5 pending samples eliminated ACTIVE INVESTIGATIONS The department is currently conducting 10 active investigations. 1) Identified one-square mile in Miami-Dade – Two (2) original cases Total # of Samples Collected Negative Samples Positive Samples Pending Results 519 492 26 1 Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going. The department has cleared nearly the entire perimeter of the one-square mile as no additional people tested positive in that area. The CDC continues to monitor the area per their guidelines. 2) First Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results* 21 21 0 0 *Awaiting confirmatory testing from CDC to rule out infection. 3) One (1) case in Palm Beach County: Total # of Samples Collected Negative Samples Positive Samples Pending Results 3 3 0 0 4) Second Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest. 5) Third Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 6 5 0 0 6) Fourth Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 27 24 0 3 7) Sixth Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest 8) Miami-Beach Investigation: Five index cases, three are out of state The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest Total # of Samples Collected Negative Samples Positive Samples Pending Results 133 110 1 17 9) Pinellas Investigation: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 39 13 0 26 10) Second Palm Beach County Investigation: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 5 0 0 5 CLOSED INVESTIGATIONS The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). On Aug. 23, the department had enough information to close two of the ongoing investigations in Miami-Dade County, both were determined to be single cases with no additional transmission or linkage to areas of active transmission. Data as of Aug. 29, 2016 - 6:03pm EST

Aug 25 update where AI 2 pending cases updated to negative ACTIVE INVESTIGATIONS The department is currently conducting 10 active investigations. 1) Identified one-square mile in Miami-Dade – Two (2) original cases Total # of Samples Collected Negative Samples Positive Samples Pending Results 519 492 27 0 Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going. The department has cleared three portions within the one-square mile as no additional people tested positive in those areas. The CDC continues to monitor the area per their guidelines. 2) First Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results* 21 21 0 0 *Awaiting confirmatory testing from CDC to rule out infection. 3) One (1) case in Palm Beach County: Total # of Samples Collected Negative Samples Positive Samples Pending Results 3 3 0 0 4) Second Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest. 5) Third Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 6 1 0 5 6) Fourth Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 27 24 0 3 7) Sixth Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest 8) Miami-Beach Investigation: Five index cases, 3 are out of state The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest Total # of Samples Collected Negative Samples Positive Samples Pending Results 97 0 0 97 9) Pinellas Investigation: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 3 0 0 3 10) Second Palm Beach County Investigation: One (1) case The investigation is beginning in Palm Beach County. Mosquito abatement and reduction activities will take place around the area of interest. CLOSED INVESTIGATIONS The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). On Aug. 23, the department had enough information to close two of the ongoing investigations in Miami-Dade County, both were determined to be single cases with no additional transmission or linkage to areas of active transmission. http://www.floridahealth.gov/diseases-and-conditions/zika-virus/index.html?utm_source=flhealthIndex Data as of Aug. 25, 2016 - 6:15pm EST

Aug 24 update (with asterisk on AI 2) ACTIVE INVESTIGATIONS The department is currently conducting 10 active investigations. 1) Identified one-square mile in Miami-Dade – Two (2) original cases Total # of Samples Collected Negative Samples Positive Samples Pending Results 519 492 27 0 Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going. The department has cleared three portions within the one-square mile as no additional people tested positive in those areas. The CDC continues to monitor the area per their guidelines. 2) First Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results* 21 19 0 2 *Awaiting confirmatory testing from CDC to rule out infection. 3) One (1) case in Palm Beach County: Total # of Samples Collected Negative Samples Positive Samples Pending Results 3 3 0 0 4) Second Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest. 5) Third Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 6 1 0 5 6) Fourth Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 27 24 0 3 7) Sixth Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest. 8) Miami-Beach Investigation: Five index cases, 3 are out of state The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest. 9) Pinellas Investigation: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 3 0 0 3 10) Second Palm Beach County Investigation: One (1) case The investigation is beginning in Palm Beach County. Mosquito abatement and reduction activities will take place around the area of interest. CLOSED INVESTIGATIONS The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). On Aug. 23, the department had enough information to close two of the ongoing investigations in Miami-Dade County, both were determined to be single cases with no additional transmission or linkage to areas of active transmission. Data as of Aug. 24, 2016 - 12:58pm EST

August 23 explanation of change in status for the 4 pending samples in the Wynwood investigation: There are five new non-travel related cases today, including four in Miami-Dade and one in Pinellas County. The four individuals in Miami-Dade were identified within the Wynwood area and experienced symptoms of Zika in mid-July. However, the cases are being announced today following confirmatory antibody testing to rule out other mosquito-borne illness such as Dengue and Chikungunya. http://www.floridahealth.gov/newsroom/2016/08/082316-zika-update.html

August 23 AI page with the 4 pending samples changed to positive: ACTIVE INVESTIGATIONS The department is currently conducting eight active investigations. 1) Identified one-square mile in Miami-Dade – Two (2) original cases Total # of Samples Collected Negative Samples Positive Samples Pending Results 519 492 29 0 Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going. The department has cleared three portions within the one-square mile as no additional people tested positive in those areas. The CDC continues to monitor the area per their guidelines. 2) First Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 21 19 0 2 3) One (1) case in Palm Beach County: Total # of Samples Collected Negative Samples Positive Samples Pending Results 3 3 0 0 4) Second Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest. 5) Third Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 6 1 0 5 6) Fourth Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 26 6 0 20 7) Sixth Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest 8) Miami-Beach Investigation: Five index cases, 3 are out of state The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest 9) Pinellas Investigation: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 3 0 0 3 CLOSED INVESTIGATIONS The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). On Aug. 23, the department had enough information to close two of the ongoing investigations in Miami-Dade County, both were determined to be single cases with no additional transmission or linkage to areas of active transmission. Data as of Aug. 23, 2016 - 8:05pm EST

On August 23 the Florida Department of Health (DoH) issued a press release that included four new Zika positives for cases in Wynwood noting that the four cases had been symptomatic in mid-July and were Zika IgM antibody positive, but were not classified as positive until confirmatory data was received from the CDC that ruled out infection by Dengue or Chikungunya, which could have contributed to the positive Zika antibodies, The four positives led to re-classifications in the "Active Investigations" page which moved four samples from the "Pending Results" column under the Wywood investigation (Active Investigation #1, AI 1) to the "Positive Sample" column. These four samples had been the only samples in the Wynwood pending column since August 12. However, three other investigations also had samples in the pending column for extended time periods and the following day, the pending column for AI 2 had an asterisk indicating *Awaiting confirmatory testing from CDC to rule out infection. This description indicated that like the 4 Wynwood samples, 2 of the samples from AI 2 were Zika antibody positive, but had not yet been confirmed by the CDC that the Zika antibody was not due to a recent infection by Dengue or Chikungunya. An infection by another flavivirus was unlikely since all reported Chikunguya cases in the US in 2016 had been due to travelers infected in another country and there had not been recent reports of Dengue in Miami-Dade County. Moreover, there was more than one pending sample for AI 2, which was also the case for AI 5 (with five pending) and AI 6 (with two pending). Although infections by Dengue or Chikunguya in contacts of a local Zika confirmed case is unlikely, on August 25 the two pending samples in AI 2 were changed from pending to negative without explanation, but the asterisk and definition remained. Similarly, on August 29 the pending column on AI 5 was reduced from 5 to 0 and the negative column was increased from 1 to 5, creating an internal inconsistency, since 6 samples were collected. Again there was no explanation for the conversion of the antibody positive samples from pending to negative. The Active Investigation (AI) page was not changed on August 30 or 31, and on September 1 all metrics were pulled from the AI page

The latest press release (Sept 1) includes link to testing procedures, which notes that samples that are PCR negative but antibody positive samples are send to CDC for PRNT assay (neutralization test using multiple flavivirus targets) http://www.floridahealth.gov/diseases-and-conditions/zika-virus/_documents/zika-testing-process-final.pdf.

Singapore Zika cases hit 275; new potential cluster at Bishan found Posted 06 Sep 2016 18:51 Updated 06 Sep 2016 19:07 Zika, which is spread mainly by the Aedes mosquito, has been detected in 67 countries and territories including hard-hit Brazil. (Photo: AFP/Roslan Rahman) ENLARGE CAPTION ? Email More A A SINGAPORE: 17 new cases of locally transmitted were confirmed on Tuesday (Sep 6), bringing the total number of confirmed cases in Singapore to 275. Authorities added that there is a potential new cluster at Bishan Street 12, involving a previously reported case and a new case today. In a joint statement, the Ministry of Health (MOH) and National Environment Agency (NEA) added that of the 17 new cases, 10 are linked to the Aljunied Crescent / Sims Drive / Kallang Way / Paya Lebar Way cluster. Apart from the Bishan Street 12 case, the other six cases have no known links to any existing cluster. NEA said it will be carrying out vector control operations and outreach efforts at the new potential cluster at Bishan Street 12. The agency added that it has been continuing with vector control operations and outreach efforts in Aljunied Crescent, Sims Drive, Paya Lebar Way and Kallang Way, and that it has expanded operations and outreach efforts at the periphery of this cluster at Circuit Road, Geylang East Central, Geylang East Avenue 1. As of Sep 5, 65 breeding habitats – comprising 38 in homes and 27 in common areas or other premises – have been detected and destroyed, it said. The agency added that it is continuing with vector control operations and outreach efforts in Bedok North Avenue. As of Sep 5, 67 breeding habitats – comprising 56 in homes and 11 in common areas and other premises – have been detected and destroyed. Mosquito control measures are ongoing. NEA said vector control operations and outreach efforts at Joo Seng Road are ongoing. As of Sep 5, two instances of breeding in common areas or other premises have been detected and destroyed. The agency added that it would continue to work with stakeholders and the community to reduce mosquito breeding, as vector control is key to reducing the transmission of Zika in the community. Earlier on Tuesday, Prime Minister Lee Hsien Loong told ASEAN leaders at the group's summit in Laos that, given the presence of the Aedes mosquito, Zika may become endemic in the region, like dengue, and called for the 10-member grouping to join hands in fighting a possibly extended campaign against the virus. - CNA/dt http://www.channelnewsasia.com/news/singapore/singapore-zika-cases-hit-275-new-potential-cluster-at-bishan/3105264.html

Zika outbreak: 17 new cases; potential new cluster in Bishan MOH and NEA reported 17 new cases of Zika in Singapore as of noon on Sept 6, 2016, and identified a potential new cluster in Bishan.ST PHOTO: LIM YAOHUI PUBLISHED 16 MIN AGO UPDATED 5 MIN AGO FACEBOOKTWITTEREMAIL Shea Driscoll SINGAPORE - There are 17 new cases of Zika in Singapore as of noon on Tuesday (Sept 6), the Health Ministry (MOH) and National Environment Agency (NEA) have confirmed, as a potential new cluster emerged in Bishan. Of the new cases, 10 are linked to the Aljunied Crescent, Sims Drive, Paya Lebar Way and Kallang Way cluster, Singapore's biggest. One new patient lives in the Bishan Street 12 area, where a previously-reported case also lives. The area is a potential new cluster, the MOH and NEA said in an update on Tuesday evening. The other six cases have no known links to any existing cluster. The total number of locally-transmitted Zika cases stands at 275 as of Tuesday. Sixteen had been reported on Monday, 11 fewer than Sunday's 27. In its vector control update, the NEA said that it has been continuing operations in the Aljunied Crescent, Sims Drive, Paya Lebar Way and Kallang Way cluster, which accounts for more than 200 of the current cases. It has also expanded its efforts to the periphery of the cluster, at Circuit Road, Geylang East Central and Geylang East Avenue 1. http://www.straitstimes.com/singapore/health/zika-outbreak-potential-new-cluster-in-bishan-17-new-cases

17 new cases of Zika in Singapore; new potential cluster in Bishan A NEA worker conducts thermal fogging during a demonstration at the Paya Lebar Way area on vector control operations and inspection of premises to check for mosquito breeding at the Paya Lebar Way area on Sept 1, 2016. Photo: Nuria Ling/TODAY mail print View all 0 comments PUBLISHED: 6:50 PM, SEPTEMBER 6, 2016 UPDATED: 6:55 PM, SEPTEMBER 6, 2016 SINGAPORE — There is a potential new Zika cluster at the Bishan Street 12 area, with two cases living in the area, said the Ministry of Health (MOH) and National Environment Agency (NEA) on Tuesday (Sept 6). Another 17 new cases were confirmed as of 12pm, bringing the total to 275 cases of locally transmitted Zika virus infection in Singapore. Of these 17 cases, 10 are linked to the Aljunied Crescent/ Sims Drive/ Kallang Way/ Paya Lebar Way cluster, while six have no known links to any existing cluster. Of the two cases at the Bishan Street 12 area, one is a new case and the other was previously reported. The NEA will be carrying out vector control operations and outreach efforts at Bishan Street 12, the joint statement said. Vector control operations and outreach efforts are continuing at Aljunied Crescent / Sims Drive / Paya Lebar Way / Kallang Way, and have also been expanded to the periphery of this cluster at Circuit Road, Geylang East Central, Geylang East Avenue 1. As of Monday (Sept 5), 65 breeding habitats (38 in homes and 27 in common areas/other premises) have been detected and destroyed. At Bedok North Avenue and Joo Seng, vector control operations and outreach efforts are also ongoing. As of Monday, 67 breeding habitats (56 in homes and 11 in common areas/other premises) were destroyed at Bedok North Avenue, while two instances of breeding in common areas/other premises were destroyed at Joo Seng. http://www.todayonline.com/singapore/17-new-cases-zika-singapore-new-potential-cluster-bishan

Joint MOH-NEA statment (6 September 2016) Tags: Joint MOH-NEA statement (6 September) 1. As of 12pm, 6 September, MOH has confirmed 17 new cases of locally transmitted Zika virus infection in Singapore. Of these, 10 cases are linked to the Aljunied Crescent/ Sims Drive/ Kallang Way/ Paya Lebar Way cluster. 2. There is a potential new cluster involving one previously reported case and a new case today. They both live in the Bishan Street 12 area. The other six cases have no known links to any existing cluster. Vector Control Update 3. NEA has been continuing with vector control operations and outreach efforts in Aljunied Crescent / Sims Drive / Paya Lebar Way / Kallang Way. NEA has also expanded operations and outreach efforts at the periphery of this cluster at Circuit Road, Geylang East Central, Geylang East Avenue 1. As of 5 September, 65 breeding habitats – comprising 38 in homes and 27 in common areas/other premises – have been detected and destroyed. 4. NEA is continuing with vector control operations and outreach efforts in Bedok North Avenue. As of 5 September, 67 breeding habitats – comprising 56 in homes and 11 in common areas/other premises – have been detected and destroyed. Mosquito control measures are ongoing. 5. Vector control operations and outreach efforts at Joo Seng Road are ongoing. As of 5 September, two instances of breeding in common areas/other premises have been detected and destroyed. 6. NEA will be carrying out vector control operations and outreach efforts at Bishan Street 12. 7. Aligned to our dengue control approach, NEA will continue to work with stakeholders and the community to reduce mosquito breeding, as vector control is key to reducing the transmission of Zika in the community. https://www.moh.gov.sg/content/moh_web/home/pressRoom/pressRoomItemRelease/2016/joint-moh-nea-statment--6-september-2016-.html

week conf discard untested total weekly increase 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 14 2 15 16 33 0

intensified surveillance of microcephaly Review September 2, 2016 Among the epidemiological weeks 01 to 34 of 2016 have been confirmed thirty-eight (38) cases associated with microcephaly Zika virus, 168 cases were dismissed and 220 cases are in study. http://www.ins.gov.co/boletin-epidemiologico/Boletn Epidemiolgico/2016 Boletin epidemiologico semana 34.pdf

Aug 24 update with asterisk for AI 2 pending column with definition ACTIVE INVESTIGATIONS The department is currently conducting 10 active investigations. 1) Identified one-square mile in Miami-Dade – Two (2) original cases Total # of Samples Collected Negative Samples Positive Samples Pending Results 519 492 27 0 Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going. The department has cleared three portions within the one-square mile as no additional people tested positive in those areas. The CDC continues to monitor the area per their guidelines. 2) First Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results* 21 19 0 2 *Awaiting confirmatory testing from CDC to rule out infection. 3) One (1) case in Palm Beach County: Total # of Samples Collected Negative Samples Positive Samples Pending Results 3 3 0 0 4) Second Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest. 5) Third Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 6 1 0 5 6) Fourth Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 27 24 0 3 7) Sixth Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest. 8) Miami-Beach Investigation: Five index cases, 3 are out of state The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest. 9) Pinellas Investigation: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 3 0 0 3 10) Second Palm Beach County Investigation: One (1) case The investigation is beginning in Palm Beach County. Mosquito abatement and reduction activities will take place around the area of interest. CLOSED INVESTIGATIONS The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). On Aug. 23, the department had enough information to close two of the ongoing investigations in Miami-Dade County, both were determined to be single cases with no additional transmission or linkage to areas of active transmission. Data as of Aug. 24, 2016 - 12:58pm EST

August 23 press release explaining why 4 pending samples in Wynwood were reclassified to positive: There are five new non-travel related cases today, including four in Miami-Dade and one in Pinellas County. The four individuals in Miami-Dade were identified within the Wynwood area and experienced symptoms of Zika in mid-July. However, the cases are being announced today following confirmatory antibody testing to rule out other mosquito-borne illness such as Dengue and Chikungunya. http://www.floridahealth.gov/newsroom/2016/08/082316-zika-update.html

August 23 Active Investigations page showing Wynwood (AI #!) reduced pending samples from 4 to 0 and increased positives from 23 to 29 creating internal inconsistency (521 classified samples when only 519 were collected) ACTIVE INVESTIGATIONS The department is currently conducting eight active investigations. 1) Identified one-square mile in Miami-Dade – Two (2) original cases Total # of Samples Collected Negative Samples Positive Samples Pending Results 519 492 29 0 Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going. The department has cleared three portions within the one-square mile as no additional people tested positive in those areas. The CDC continues to monitor the area per their guidelines. 2) First Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 21 19 0 2 3) One (1) case in Palm Beach County: Total # of Samples Collected Negative Samples Positive Samples Pending Results 3 3 0 0 4) Second Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest. 5) Third Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 6 1 0 5 6) Fourth Miami-Dade investigation outside of Wynwood: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 26 6 0 20 7) Sixth Miami-Dade investigation outside of Wynwood: One (1) case The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest 8) Miami-Beach Investigation: Five index cases, 3 are out of state The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest 9) Pinellas Investigation: One (1) case Total # of Samples Collected Negative Samples Positive Samples Pending Results 3 0 0 3 CLOSED INVESTIGATIONS The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). On Aug. 23, the department had enough information to close two of the ongoing investigations in Miami-Dade County, both were determined to be single cases with no additional transmission or linkage to areas of active transmission. Data as of Aug. 23, 2016 - 8:05pm EST

Current "data" on Active Investigations http://www.floridahealth.gov/diseases-and-conditions/zika-virus/index.html?utm_source=flhealthIndex ACTIVE INVESTIGATIONS The department is conducting 13 active investigations, including 10 in Miami-Dade, one in Pinellas and two in Palm Beach counties. The department 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. The department has closed out three investigations including two in Miami-Dade County and one in Broward County. These cases were determined to be single cases with no additional transmission or linkage to areas of active transmission.

On Thursday, September 1 the Florida Department of Health pulled all of the metrics on the Zika investigations. The number of local transmission investigations had grown to 12 (10 of which were active) by August 29, the date of the last update ( 2 new investigations announced on August 30 and another on August 31 were not added to the Active Investigation page), and the postings in 5 of the final 7 days prior to the pull had numbers that were internally inconsistent (the number of designated samples - positive, negative, or pending did not match the number of samples collected). However, it was the absence of any samples (or minimal collections) in four of the active investigations, coupled with samples pending for 10 or more days in four additional investigations, that raised serious transparency issues and questions regarding the Florida DoH “belief” that there were only two active areas of local Zika transmission in Florida. Although the media actively ignored these inconsistencies, the problems were becoming increasingly obvious as the number of local transmissions continued to increase, along with the time frame associated with no or limited sample collections. Moreover, the Florida MoH began to claim CDC failures to confirm Florida DoH positive antibody data, which was problematic. The data/transparency issues began their dramatic slide on August 23 when Florida DoH announced four confirmed cases for Wynwood. As cited in the press release, these four cases had been symptomatic in mid-July, but were considered pending until the CDC confirmed that the Zika antibody positive data showed that the Zika positive was not due to cross reactivity due to a current or prior infection with Dengue or Chikingunya. The use of a “pending “ designation was in contrast to initial contacts, which were also positive in the DoH test, but were reported as positives (with the caveat that the CDC had not yet confirmed). These cases were dependent on the antibody test because urine samples were not collected when they were symptomatic in mid-July, and reliable positives based on PCR testing of urine are limited to collection of samples within two weeks of symptoms. The conversion of the four pending Wynwood samples to positive raised significant questions about samples in other investigations, which had been pending for 10 or more days. Like the Wynwood samples, these appeared to be positives awaiting CDC confirmation, and the CDC confirmation would create additional areas of active transmission, leading to a map of the area and pressure to collect additional samples in the active transmission area. Moreover, CDC would be forced to issue more travel warnings, to the designated areas, Miami Dade County, or a larger portion of Florida. On the following day, August 24, the DoH added an asterisk to the pending column for Active Investigation #2 (AI 2) where 21 samples had been collected and 2 had been pending since August `15. The asterisk was designated as “*Awaiting confirmatory testing from CDC to rule out infection." indicating the two pending samples had been Zika antibody confirmed by the DoH, and like the four pending Wynwood samples, were pending CDC confirmation. Moreover, there were 5 samples in Active Investigation #5 (AI 5) that had been pending since August 17 (out of 6 collected), which was also true for 2 samples in Active Investigation #6 (AI 6). These pending samples in 3 active investigations strongly suggested that there were at least 5 areas in Miami Dade County that had active Zika transmission in contrast to the DoH “belief” that active Zika transmission was limited to two areas (Wynwood and Miami Beach). However, in the August 25 update the two pending samples in AI 2 where updated to negative and the pending samples were reduce to 0, although the asterisk on the pending column and explanation remained. The press release provided no explanation for the failure of the CDC to confirm the DoH positive result. In the August 29 update the number of pending samples in AI 5 was reduced from 5 to 0, while the number of negative samples was increased from 1 to 5, creating an internal inconsistency between the 6 samples collected and the 5 samples designated. Thus, on September 1 Florida DoH pulled the Zika active investigation detail because the widespread transmission was becoming very obvious.

Zika In India serum 1954 Neutralizing Antibodies Against Certain Viruses in the Sera of Residents of IndiaJ Immunol 1954 72:248-257 http://www.jimmunol.org/content/72/4/248.long

Woman from Iloilo positive for Zika virus September 5, 2016 | Filed under: Slider,Top Stories | Posted by: Reymar Latoza A woman from Iloilo tested positive for the Zika virus, the Department of Health (DOH) confirmed on Monday, September 5. A woman from Iloilo tested positive for the Zika virus, the Department of Health (DOH) confirmed on Monday, September 5. She is the 6th Zika victim in the Philippines, according to DOH Undersecretary Gerardo Bayugo. The DOH refused to divulge her identity. DOH Secretary Paulyn Jean B. Russel-Ubial, in a press release, said “the case was most likely due to local transmission since [the patient has] no history of travel to any affected country in the past two weeks.” “On August 31, she presented with skin rash and joint pains not accompanied by fever. She was confined in a local hospital where urine and blood were collected. She was subsequently discharged the following day. She tested positive for both specimens,” Ubial explained. “Currently, she is at home recovering from her mild illness. The tests were done at RITM. The DOH expects additional cases after intensifying its surveillance efforts,” she added. Zika, like dengue fever and chikungunya, is transmitted by Aedes aegypti and Aedes albopictus mosquitoes, the DOH said. It can also be transmitted through sexual contact. Symptoms of Zika include fever, skin rashes, conjunctivitis, muscle and joint pain, headache and malaise. According to the World Health Organization (WHO), “there is no specific treatment or vaccine for Zika. “People sick with Zika virus should get plenty of rest, drink a lot of fluids and treat pain and fever with common medicines.” Ubial said, “The key to Zika prevention is heightened vigilance and stronger community efforts of every household.”IMT http://www.iloilometropolitantimes.com/woman-from-iloilo-positive-for-zika-virus/

DOH confirms 6th case of Zika infection in PHL Published September 5, 2016 4:03pm Department of Health (DOH) Undersecretary Gerardo Bayugo confirmed on Monday that a Filipino from Iloilo has been infected with Zika virus, the sixth case in the Philippines. Bayugo said in a press conference that the Filipina was examined abroad and came to the Philippines already positive with Zika. "[She was] examined abroad and turned out positive for Zika," he said. Bayugo, meanwhile, clarified that there is no outbreak of the virus in the country. "The Zika events that we have are sporadic. These are not considered outbreak," he said. "Our people in the region (6) are competent (to handle the case)," he added. In a recent press conference, DOH Secretary Dr. Paulyn Rosell-Ubial maintained that the Philippines has yet to record its first locally-transmitted Zika case. Ubial had clarified that all Zika cases in the Philippines, recorded from 2012, are not locally-transmitted and the victims got the virus overseas. "Yun pong na-record na five cases before are what we call imported. Ibig sabihin, nakuha nila yung infection sa ibang bansa at nag-punta sila dito sa Pilipinas," she said. The announcement came after Singapore and Malaysia report their first cases of locally-transmitted Zika virus infections. —Bianca Rose Dabu/ALG, GMA News - See more at: http://www.gmanetwork.com/news/story/580188/news/nation/doh-confirms-6th-case-of-zika-infection-in-phl#sthash.4HgXOJ55.dpuf