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September 1, 2016 Department of Health Daily Zika Update http://www.floridahealth.gov/newsroom/2016/09/090116-zika-update.html 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 seven new travel related cases today, three in Miami-Dade, two in Broward, one in Osceola and one in Sarasota. 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 is associated with the area in Miami-Beach. The other is associated with Wynwood and experienced symptoms in July. CDC results to rule out other mosquito-borne illness were just received. 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 small identified areas in Wynwood and Miami Beach in Miami-Dade County, see maps 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 576 Non-Travel Related Infections of Zika 49 Infections Involving Pregnant Women 80 The department is currently conducting 13 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 4,452 people statewide. Florida currently has the capacity to test 5,755 people for active Zika virus and 6,852 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 80. 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 5,329 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. State of Florida Miami-Dade County About the Florida Department of Health The department, nationally accredited by the Public Health Accreditation Board, works to protect, promote, and improve the health of all people in Florida through integrated state, county and community efforts. Follow us on Twitter at @HealthyFla and on Facebook. For more information about the Florida Department of Health, please visit www.FloridaHealth.gov.

There are two new non-travel related cases today in Miami-Dade County. One is associated with the area in Miami-Beach. The other is associated with Wynwood and experienced symptoms in July. CDC results to rule out other mosquito-borne illness were just received.

September 1, 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 seven new travel related cases today, three in Miami-Dade, two in Broward, one in Osceola and one in Sarasota. 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 is associated with the area in Miami-Beach. The other is associated with Wynwood and experienced symptoms in July. CDC results to rule out other mosquito-borne illness were just received. 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 small identified areas in Wynwood and Miami Beach in Miami-Dade County, see maps 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 576 Non-Travel Related Infections of Zika 49 Infections Involving Pregnant Women 80 The department is currently conducting 13 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 4,452 people statewide. Florida currently has the capacity to test 5,755 people for active Zika virus and 6,852 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 80. 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 5,329 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. State of Florida Miami-Dade County 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.

Infection Type Infection Count Travel-Related Infections of Zika 576 Non-Travel Related Infections of Zika 49 Infections Involving Pregnant Women 80 http://www.floridahealth.gov/newsroom/2016/09/090116-zika-update.html

Pregnant Women with Any Laboratory Evidence of Possible Zika Virus Infection US States and the District of Columbia* 624 *Includes aggregated data reported to the US Zika Pregnancy Registry as of August 25, 2016 US Territories** 971 **Includes aggregated data from the US territories reported to the US Zika Pregnancy Registry and data from Puerto Rico reported to the Zika Active Pregnancy Surveillance System as of August 25, 2016

As of August 31, 2016 (5 am EST) Zika virus disease and Zika virus congenital infection are nationally notifiable conditions. This update from the CDC Arboviral Disease Branch includes provisional data reported to ArboNET for January 01, 2015 – August 31, 2016. US States Locally acquired mosquito-borne cases reported: 35 Travel-associated cases reported: 2,686 Laboratory acquired cases reported: 1 Total: 2,722 Sexually transmitted: 23 Guillain-Barré syndrome: 7 MAPS OF ZIKA IN THE US More US Territories Locally acquired cases reported: 14,059 Travel-associated cases reported: 51 Total: 14,110* Guillain-Barré syndrome: 32 *Sexually transmitted cases are not reported for US territories because with local transmission of Zika virus it is not possible to determine whether infection occurred due to mosquito-borne or sexual transmission. Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of August 31, 2016)§ States Travel-associated cases* No. (% of cases in states) (N=2,687) Locally acquired cases† No. (% of cases in states) (N=35) Alabama 24 (1) 0 (0) Arizona 20 (1) 0 (0) Arkansas 9 (<1) 0 (0) California 152 (6) 0 (0) Colorado 27 (1) 0 (0) Connecticut 52 (2) 0 (0) Delaware 11 (<1) 0 (0) District of Columbia 11 (<1) 0 (0) Florida 507 (19) 35 (100) Georgia 69 (3) 0 (0) Hawaii 11 (<1) 0 (0) Idaho 2 (<1) 0 (0) Illinois 51 (2) 0 (0) Indiana 31 (1) 0 (0) Iowa 14 (1) 0 (0) Kansas 13 (<1) 0 (0) Kentucky 20 (1) 0 (0) Louisiana 26 (1) 0 (0) Maine 11 (<1) 0 (0) Maryland 85 (3) 0 (0) Massachusetts 65 (2) 0 (0) Michigan 43 (2) 0 (0) Minnesota 40 (1) 0 (0) Mississippi 18 (1) 0 (0) Missouri 23 (1) 0 (0) Montana 7 (<1) 0 (0) Nebraska 8 (<1) 0 (0) Nevada 13 (<1) 0 (0) New Hampshire 8 (<1) 0 (0) New Jersey 91 (3) 0 (0) New Mexico 3 (<1) 0 (0) New York 625 (23) 0 (0) North Carolina 48 (2) 0 (0) North Dakota 1 (<1) 0 (0) Ohio 33 (1) 0 (0) Oklahoma 20 (1) 0 (0) Oregon 19 (1) 0 (0) Pennsylvania†† 90 (3) 0 (0) Rhode Island 28 (1) 0 (0) South Carolina 31 (1) 0 (0) South Dakota 1 (<1) 0 (0) Tennessee 37 (1) 0 (0) Texas 136 (5) 0 (0) Utah 10 (<1) 0 (0) Vermont 7 (<1) 0 (0) Virginia 75 (3) 0 (0) Washington 26 (1) 0 (0) West Virginia 11 (<1) 0 (0) Wisconsin 24 (1) 0 (0) Territories Travel-associated cases* No. (% of cases in territories) (N=51) Locally acquired cases† No. (% of cases in territories) (N=14,059) American Samoa 0 (0) 47 (<1) Puerto Rico 50 (98) 13,791 (98) US Virgin Islands 1 (2) 221 (2) §Only includes cases meeting the probable or confirmed CSTE case definition and does not include asymptomatic infections unless the case is a pregnant woman with a complication of pregnancy *Travelers returning from affected areas, their sexual contacts, or infants infected in utero †Presumed local mosquito-borne transmission †† One additional case acquired through laboratory transmission Page last reviewed: February 4, 2016 Page last updated: August 31, 2016

Zika-infected mosquitoes found in Miami Beach ALAN DIAZ/APA Miami-Dade mosquito control inspector sprays a chemical mist into a storm drain in Miami Beach, Fla. By ANDREW JOSEPH @DrewQJoseph SEPTEMBER 1, 2016 Florida officials have found mosquitoes in Miami Beach infected with Zika, the first time the virus has been detected in mosquitoes in the continental United States. Officials had already announced that Zika is circulating in a portion of Miami Beach and a neighborhood in Miami after deducing that some Zika cases could only have been acquired from local mosquitoes. But discovering Zika-positive mosquitoes amounts to what authorities have described as a smoking gun that local Zika transmission is indeed occurring. So far, federal health officials have identified the two zones in Miami Beach and Miami as the only spots of active Zika transmission in the United States and have recommended pregnant woman avoid traveling to those areas if possible. As of Wednesday, Florida had seen 47 local Zika cases. It has had 569 cases related to people traveling to other regions where Zika is spreading, including 80 involving pregnant women. The three Zika-positive mosquito samples came from a small area in Miami Beach, the state’s Department of Agriculture and Consumer Services announced Thursday. A mosquito sample typically consists of material from more than a dozen individual mosquitoes. Officials ramped up their trapping and testing of mosquitoes after local spread was identified, and the department said that 95 additional mosquito samples from the area have tested negative for Zika since infected mosquitoes were identified. Since May, the state has tested more than 40,000 mosquitoes, the department said. The Zika virus, which has spread rapidly through much of Latin America and the Caribbean, is transmitted mainly by mosquitoes, but can also be passed through sex. It typically causes mild symptoms or none at all, but it can cause severe birth defects in fetuses when it infects pregnant women. Since the discovery of local Zika spread in Miami-Dade County, officials have expanded their mosquito control efforts, with particular focus in the two areas where transmission is active. One challenge in fighting mosquitoes in Miami Beach is the city’s famous high rises, which create wind tunnels and prevent planes from flying low enough to dispense insecticide effectively. Andrew Joseph can be reached at [email protected] Follow Andrew on Twitter @DrewQJoseph https://www.statnews.com/2016/09/01/florida-mosquitoes-zika-miami-beach/?s_campaign=tw&utm_content=buffer21695&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

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

SEPTEMBER 1, 2016 11:43 AM Mosquitoes test positive for Zika in South Beach 1 of 2 BY JOEY FLECHAS AND DANIEL CHANG [email protected] LINKEDIN GOOGLE+ PINTEREST REDDIT PRINT ORDER REPRINT OF THIS STORY For the first time in the U.S., mosquitoes trapped in a zone where Zika virus is being actively transmitted have tested positive for the virus. Three Zika-positive moquitoes were sampled in South Beach, where a 1.5-square mile zone has been designated as an area of active transmission of the virus, The Florida Department of Agriculture and Consumer Services confirmed Thursday morning. One of the areas with a positive test is the Miami Beach Botanical Garden. FACEBOOK TWITTER EMAIL SHARE Gov. Rick Scott declares Zika zone in Miami Beach Gov. Rick Scott and Florida Surgeon General Dr. Celeste Philip announce on Friday, Aug. 19, 2016, that there are five known Zika cases in Miami Beach, in a 1.5-square-mile transmission zone in the city. Emily Michot [email protected] The announcement of the zone was followed by a travel advisory warning pregnant women to avoid the area, which stretches from Fifth Street north to 28th Street, and from Biscayne Bay east to the Atlantic Ocean. County and city officials have ramped up mosquito control efforts both in South Beach, the heart of the area’s tourism industry, and Wynwood. Mosquito counts have decreased. But the Beach, a dense urban environment with lots of landscaping that can serve as breeding grounds, presents a challenge for officials. Read more here: http://www.miamiherald.com/news/local/community/miami-dade/miami-beach/article99246602.html#storylink=cpy http://www.miamiherald.com/news/local/community/miami-dade/miami-beach/article99246602.html

Miami-Dade Mosquitoes Test Positive for Zika Sep 1, 2016 TALLAHASSEE, Fla. — The Florida Department of Agriculture and Consumer Services has detected Zika in three mosquito samples from a small area in Miami Beach. The mosquitoes from Miami Beach that tested positive for Zika are from an area where increased trapping and intensified mosquito control measures are occurring due to the investigation of local transmission led by the Florida Department of Health. Ninety-five additional samples have been submitted by Miami-Dade County after the date of the positive submission, and the mosquitoes have tested negative for Zika. “This find is disappointing, but not surprising. Florida is among the best in the nation when it comes to mosquito surveillance and control, and this detection enables us to continue to effectively target our resources. Miami-Dade County, the City of Miami Beach, and state and federal partners will continue to work aggressively to prevent the spread of Zika,” stated Commissioner of Agriculture Adam H. Putnam. “Miami-Dade County's Mosquito Control team continues its proactive and aggressive response to reducing the mosquito population throughout the County,” said Miami-Dade County Mayor Carlos A. Gimenez. “As it has been from the beginning, our goal is to eliminate the cycle of transmission by eliminating the mosquitoes. In the 1.5-square-mile area of Miami Beach where locally-acquired cases of Zika were confirmed, Miami-Dade County's Mosquito Control team conducted nearly 2,000 proactive inspections, abatement and treatment of mosquito breeding and adult mosquito activity, and three truck sprayings throughout the area, and in an additional extended area. I am confident that by working together with our community, with the City of Miami Beach and Mayor Levine, the Department of Agriculture, the Florida Department of Health, and the Centers for Disease Control and Prevention, we will continue to reduce the mosquito population and keep our community safe.” "Miami Beach will continue to take a hardline in our fight against Zika. We are aggressively working to eliminate any and all potential mosquito breeding grounds. We are also working closely with our partners at the state and the county to ensure all resources are effectively deployed. Together we can contain and eliminate all cases of Zika. We need Congress to do its part to provide the necessary emergency resources to properly combat the spread of this virus," stated Miami Beach Mayor Philip Levine. The positive mosquito pools were collected in Miami Beach within the current zone that has been treated for local transmission. Scientists with the Florida Department of Agriculture and Consumer Services tested the samples at the Bronson Animal Disease Diagnostic Laboratory in Kissimmee, and the samples were then sent to the Centers for Disease Control and Prevention and Florida Gulf Coast University for confirmation. Florida's proactive efforts, which are conducted by local mosquito control programs and supported by the expertise provided by the Florida Department of Agriculture and Consumer Services, include: eliminating larval habitats by emptying standing water, treating water-holding containers with long-lasting larvicide, providing outdoor residual and spatial insecticide treatments to reduce adult vectors, and conducting adult mosquito surveillance to evaluate the effectiveness of treatments. Now that Zika-positive mosquitoes have been identified in surveillance traps in Miami Beach, Miami-Dade County's Mosquito Control team will continue to conduct inspections to reduce mosquito breeding and perform spray treatments as necessary in a 1/8-mile radius around the trap location. Floridians can help prevent the spread of Zika by eliminating mosquito breeding grounds by draining standing water around their homes, businesses and communities. On February 2, 2016, the Florida Surgeon General declared a public health emergency in regards to the Zika virus. Floridians can assist in Zika-related response efforts by draining standing water and allowing officials who are conducting mosquito control efforts to access their property. The Florida Department of Agriculture and Consumer Services has tested more than 2,470 mosquito samples, consisting of more than 40,000 mosquitoes, since May, and these three samples are the first to test positive. Access a copy of the mosquito declaration [ 939.54 KB ]. For more information on the Zika virus, visit the Florida Department of Health's website at FloridaHealth.gov.

The Florida Department of Agriculture and Consumer Services has detected Zika in three mosquito samples from a small area in Miami Beach. The mosquitoes from Miami Beach that tested positive for Zika are from an area where increased trapping and intensified mosquito control measures are occurring due to the investigation of local transmission led by the Florida Department of Health. Ninety-five additional samples have been submitted by Miami-Dade County after the date of the positive http://www.freshfromflorida.com/News-Events/Press-Releases/2016-Press-Releases/Miami-Dade-Mosquitoes-Test-Positive-for-Zika

All sample data has been removed from Active Investigation page 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.

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As of August 31, 2016 in South Carolina: Travel-associated cases reported: 44 Pregnant women: 0 Sexually transmitted: 1* Locally acquired vector-borne cases reported: 0 Total cases: 44 http://www.scdhec.gov/Health/DiseasesandConditions/InfectiousDiseases/InsectAnimalBorne/ZikaVirus/

As of August 31, 2016 in South Carolina: Travel-associated cases reported: 44 Pregnant women: 0 Sexually transmitted: 1* Locally acquired vector-borne cases reported: 0 Total cases: 44

SC DoH indicated Myrtle Beach case was infected outside of US.

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Confirmed Zika Cases Oregon, 2016 Travel-associated cases: 26 Oregon mosquito-acquired cases: 0 Total: 26 Updated August 30, 2016 https://public.health.oregon.gov/DiseasesConditions/DiseasesAZ/Zika/Pages/index.aspx

Confirmed Zika Cases Oregon, 2016 Travel-associated cases: 26 Oregon mosquito-acquired cases: 0 Total: 26 Updated August 30, 2016

Reported Cases of Zika in New York City as of 8/26/2016 [Español (PDF)] Positive NYC Residents Case Type Number of Cases Locally acquired mosquito-borne reported† 0 Travel-associated* 489 Sexually transmitted: 5 Guillain-Barre syndrome: 3 Infants with birth defects: 1 Laboratory acquired 0 Pending Verification of Travel 42 Total 531 Gender Number of Cases Female 376 Pregnant: 56 Male 155 Age Average Age (Range) 38 (1-78) Positive NYC Resident by Borough Number of Cases Bronx 189 Brooklyn 125 Manhattan 111 Queens 102 Staten Island 4 Unknown 0 Most Common Countries Visited Number of Cases Dominican Republic 273 Jamaica 44 Puerto Rico 44 Guyana 18 Trinidad and Tobago 16 Saint Lucia 11 Grenada 11 Colombia 10 Saint Vincent and the Grenadines 10 Barbados 7 Mexico 7 Honduras 6 †Presumed local mosquito-borne transmission *Travelers returning from affected areas, their sexual contacts, or infants infected in utero

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Zika Cases in New Jersey New Jersey County Confirmed Travel-Related Cases Bergen 22 Passaic 18 Hudson 12 Essex 9 Union 8 Middlesex 8 Burlington 5 Morris 5 Mercer 5 Camden 4 Somerset 3 Hunterdon 2 Monmouth 2 Ocean 2 Gloucester 1 Cumberland 1 Warren 1 TOTAL 108 Last Updated: August 30, 2016 http://www.nj.gov/health/cd/zika/case_count.shtml

Zika Cases in New Jersey New Jersey County Confirmed Travel-Related Cases Bergen 22 Passaic 18 Hudson 12 Essex 9 Union 8 Middlesex 8 Burlington 5 Morris 5 Mercer 5 Camden 4 Somerset 3 Hunterdon 2 Monmouth 2 Ocean 2 Gloucester 1 Cumberland 1 Warren 1 TOTAL 108 Last Updated: August 30, 2016

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