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Results in 10 of these patients have been reported previously (4,5); however, these prior publications were not of sufficiently large sample size to provide estimates of the types of abnormalities seen in infected neonates, and the images were not formally reviewed by multiple fetal and neonatal imaging experts. Prenatal and/or postnatal Zika virus infection investigations were performed on the patients’ fluids (blood, urine, amniotic fluid, and/or cord blood) or tissues (placenta or brain and other organ tissue at autopsy), as described previously (4). In the group with confirmed infection, viral infection was confirmed by means of serologic findings or reverse transcription polymerase chain reaction (RT-PCR). An assay (Rapid Test DPP Zika IgM/IgG Assay; Chembio, Medford, NY) was used to detect immunoglobulin G and immunoglobulin M against Zika virus in the fluids. Virus genome was identified in fluids and/or tissues with RT-PCR by using specific primers and probes to identify the region of Zika virus (13). Dengue virus and chikungunya virus infection were excluded by using enzyme-linked immunosorbent assay and RT-PCR. The patients tested negative for toxoplasmosis, syphilis, varicella-zoster virus, Parvovirus B19, rubella, Cytomegalovirus, and herpes virus (TORCH) infection, as well as human immunodeficiency virus. As described previously (4,5), prenatal US was performed by fetal medicine specialists using either a Voluson E8 unit (General Electric, Milwaukee, Wis) with transvaginal probes or a Samsung XG or WS80 unit (Samsung, Seoul, South Korea) with 2–9-MHz probes. MR imaging of the fetus was performed with a 3-T Skyra unit (Siemens Healthcare, Erlangen, Germany) or a 1.5-T Espree unit (Siemens Healthcare) with an eight-channel body coil and standard acquisition protocols (Table E1 [online]). Postnatal head CT was performed with a 16-section CT scanner (Siemens Healthcare). Postnatal MR imaging was performed with a 1.5-T Espree brain MR imaging unit (Siemens Healthcare). Postmortem brain examination was performed in stillborns or neonates who died within 48 hours of birth after obtaining parental consent to perform autopsy. Brain tissue images were acquired with a 64-channel multisection CT scanner (GE Healthcare) and a 3-T MR imaging unit (Achieva; Philips, Best, the Netherlands). Neurological findings on prenatal MR images and postnatal CT and MR images were subjectively described by four radiologists with experience in fetal and/or neonatal neuroradiology (D.L., an obstetric and fetal MR imager with 20 years of experience; R.R. and F.T.M., pediatric neuroradiologists with 20 and 16 years of experience, respectively; and P.S.d.O.S., a neuroradiologist with 12 years of experience). Findings were agreed on in consensus. In a minority of cases, select images from obstetric US were also available for review.

Figure 1: Flowchart for subject inclusion and exclusion in the confirmed and presumed Zika virus(ZikV) infection cohorts. * = Gestational ages for fetal MR examinations were 26 weeks (with a second MR examination at 30 weeks), 29 weeks, 29 weeks (with a second MR examination at 37 weeks), 32 weeks, 34 weeks, and four examinations at 36 weeks (one in a set of twins). Open in Image Viewer

Materials and Methods Section: ChooseChoose Top of page Abstract Introduction Materials and Methods << Results Discussion References prevnext This retrospective review includes imaging and autopsy data from an institutional review board–approved study that allowed for imaging and follow-up of presumed Zika virus infection in pregnant women and their neonates. Written informed consent was obtained from the pregnant women and/or the parents of newborns. From June 2015 to May 2016, 438 patients were referred to theIPESQ for one or more of the following: (a) pregnancy with rash, (b) fetal central nervous system (CNS) abnormalities at prenatal ultrasonography (US), and/or (c) postnatal microcephaly or other CNS malformation that was believed to be characteristic of congenital infection. During this period, 384 pregnant women with a rash or a history of CNS abnormality at US (group 1) and 47 neonates with postnatal physical examination findings suggestive of microcephaly (head circumference < 33 cm) (group 2) were enrolled in this protocol. Group 1 exclusion criteria included not returning for imaging at IPESQ, no CNS abnormality identified at US examination at IPESQ, classic findings of isolated CNS abnormality not characteristic of infection, diagnosis of a genetic syndrome or aneuploidy, and lack of postnatal images for review. Group 2 exclusion criteria included not returning for computed tomography (CT) or magnetic resonance (MR) imaging examination at IPESQ and no calcification on postnatal images. Initially, we used a head circumference criterion of 32.5 cm for microcephaly as an exclusion criterion for the postnatal diagnosis, but after review of the imaging findings, there was a newborn with normal head circumference but severe ventriculomegaly and calcifications similar to those seen in the other confirmed and presumed Zika virus infections; therefore, this neonate was included in our population with presumed Zika virus infection. After exclusions, there were imaging studies of 31 fetuses in 30 pregnant women (which included one set of twins) and 45 neonates (which included the 31 fetuses that underwent prenatal imaging, as well as an additional 14 neonates that were enrolled postnatally; Fig 1).

Introduction Section: ChooseChoose Top of page Abstract Introduction << Materials and Methods Results Discussion References prevnext Much has been written recently regarding Zika virus in pregnancy and the increased risk of microcephaly in fetuses exposed to the virus. The outbreak of infection in Brazil, especially in the northeast part of the country (1), has been of particular concern. The virus has been found in the fluids of pregnant mothers and during autopsy in the brains of neonates with microcephaly (2–5). Much of the concern in the media regarding the teratogenicity of Zika virus infection has focused on brain findings of microcephaly. However, as documented in many case series, there are a variety of brain abnormalities that can be found in fetuses exposed to intrauterine Zika virus infection (2–11). These include abnormalities in ventricular size, gray and white matter volume loss, brainstem abnormalities, and calcifications. Although the current outbreak has centered in Brazil, according to the U.S. Centers for Disease Control and Prevention, there are currently 51 countries or territories in which active transmission of Zika virus has been reported (12). It is important for radiologists to understand the type of abnormalities associated with congenital Zika virus infection to aid in recognition of disease and appropriate counseling of patients. The purpose of this special report is to document the imaging findings associated with congenital Zika virus infection as found in patients seen at the Instituto de Pesquisa in Campina Grande State Paraiba (IPESQ) in northeastern Brazil.

Purpose To document the imaging findings associated with congenital Zika virus infection as found in the Instituto de Pesquisa in Campina Grande State Paraiba (IPESQ) in northeastern Brazil, where the congenital infection has been particularly severe. Materials and Methods From June 2015 to May 2016, 438 patients were referred to the IPESQ for rash occurring during pregnancy or for suspected fetal central nervous system abnormality. Patients who underwent imaging at IPESQ were included, as well as those with documented Zika virus infection in fluid or tissue (n = 17, confirmed infection cohort) or those with brain findings suspicious for Zika virus infection, with intracranial calcifications (n = 28, presumed infection cohort). Imaging examinations included 12 fetal magnetic resonance (MR) examinations, 42 postnatal brain computed tomographic examinations, and 11 postnatal brain MR examinations. Images were reviewed by four radiologists, with final opinion achieved by means of consensus. Results Brain abnormalities seen in confirmed (n = 17) and presumed (n = 28) congenital Zika virus infections were similar, with ventriculomegaly in 16 of 17 (94%) and 27 of 28 (96%) infections, respectively; abnormalities of the corpus callosum in 16 of 17 (94%) and 22 of 28 (78%) infections, respectively; and cortical migrational abnormalities in 16 of 17 (94%) and 28 of 28 (100%) infections, respectively. Although most fetuses underwent at least one examination that showed head circumference below the 5th percentile, head circumference could be normal in the presence of severe ventriculomegaly (seen in three fetuses). Intracranial calcifications were most commonly seen at the gray matter–white matter junction, in 15 of 17 (88%) and 28 of 28 (100%) confirmed and presumed infections, respectively. The basal ganglia and/or thalamus were also commonly involved with calcifications in 11 of 17 (65%) and 18 of 28 (64%) infections, respectively. The skull frequently had a collapsed appearance with overlapping sutures and redundant skin folds and, occasionally, intracranial herniation of orbital fat and clot in the confluence of sinuses. Conclusion The spectrum of findings associated with congenital Zika virus infection in the IPESQ in northeastern Brazil is illustrated to aid the radiologist in identifying Zika virus infection at imaging. © RSNA, 2016 Online supplemental material is available for this article.

Patricia Soares de Oliveira-Szejnfeld, MD, Deborah Levine, MD, Adriana Suely de Oliveira Melo, MD, PhD, Melania Maria Ramos Amorim, MD, PhD, Alba Gean M. Batista, MD, Leila Chimelli, MD, PhD, Amilcar Tanuri, MD, PhD, Renato Santana Aguiar, PhD,Gustavo Malinger, MD, PhD, Renato Ximenes, MD, Richard Robertson, MD, Jacob Szejnfeld, MD, PhD, Fernanda Tovar-Moll, MD, PhD From the Dept of Diagnostic Imaging, Federal Univ of São Paulo, São Paulo, Brazil (P.S.d.O.S., R.X., J.S.); Foundation Inst for Education and Research in Diagnostic Imaging, Dept of Diagnostic Imaging, Federal Univ of São Paulo, São Paulo, Brazil (P.S.d.O.S., J.S.); Dept of Radiology, Beth Israel Deaconess Medical Ctr, Harvard Medical School, Boston, Mass (D.L.); Instituto de Pesquisa Professor Amorim Neto, Campina Grande, PB, Brazil (A.S.d.O.M., M.M.R.A.); Instituto de Saúde Elpidio de Almeida, Campina Grande, PB, Brazil (A.S.d.O.M., M.M.R.A.); Faculdade de Ciências Médicas de Campina Grande, Campina Grande, PB, Brazil (A.S.d.O.M.); Hosp Municipal Pedro I, Serviço Municipal de Atendimento Transdisciplinar a Gestantes e Bebês com Infecção Congênita por Zika Virus, Campina Grande, PB, Brazil (A.S.d.O.M., A.G.M.B.); Universidade Federal de Campina Grande, PB, Brazil (M.M.R.A.); Laboratory of Neuropathology, State Inst of Brain, Rio de Janeiro, Brazil (L.C.); Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (A.T., R.S.A.); Div of Ultrasound in Obstetrics & Gynecology, Lis Maternity Hosp, Tel Aviv Sourasky Medical Ctr, Sackler Faculty of Medicine, Tel Aviv Univ, Tel Aviv, Israel (G.M.); Fetal Medicine Foundation Latinamerica–FMFLA, Centrus–Fetal Medicine, Campinas, Brazil (R.X.); Boston Children’s Hosp, Boston, Mass (R.R.); Inst of Biomedical Sciences and National Ctr for Structural Biology and Bioimaging, Federal Univ of Rio de Janeiro, Rio de Janeiro, Brazil (F.T.M.); and D’Or Inst for Research and Education, Rua Diniz Cordeiro 30, Botafogo, Rio de Janeiro, RJ, Brazil 22881-100 (F.T.M.). Address correspondence to F.T.M. (e-mail: [email protected]). DOI: http://dx.doi.org/10.1148/radiol.2016161584

Original Research Special Report Congenital Brain Abnormalities and Zika Virus: What the Radiologist Can Expect to See Prenatally and Postnatally http://pubs.rsna.org/doi/full/10.1148/radiol.2016161584

PUBLIC HEALTH Florida Announces Zika Case Hundreds of Miles from Miami The virus appears to have been acquired locally August 23, 2016 Credit: USDA, Flickr By Julie Steenhuysen Florida officials on Tuesday announced the first case of Zika transmitted by mosquitoes in Pinellas County, located some 265 miles (425 km) from Miami, where the first locally transmitted U.S. cases were reported. Steve Huard, acting spokesman for Florida Department of Health in Pinellas County, said the case involves a woman without a significant travel history, indicating the virus was contracted locally. He did not know the timeline on the case, only that it had been confirmed within the past day. He did not have any more details on the patient's illness. "At this point, it’s a single case. It’s a one off,” Huard said. “We don’t know where it originated, and we are doing appropriate testing and medical surveillance.” Florida Governor Rick Scott said the state department of health has begun door-to-door outreach in Pinellas County, testing individuals to find other cases. Pinellas County is home to St. Petersburg, Clearwater and a number of Gulf Coast beaches that are popular tourist destinations. Scott said the health department and Pinellas County Mosquito Control have begun "aggressive spraying and mosquito abatement efforts," and he said any pregnant woman who wants a free Zika test or a Zika prevention kit should contact the health department. The Zika virus was first detected in Brazil last year and has since spread across the Americas. The virus poses a risk to pregnant women because it can cause severe birth defects. It has been linked to more than 1,800 cases of microcephaly in Brazil. Federal health officials on Friday warned pregnant women not to travel to Miami Beach after Florida confirmed that the mosquito-borne Zika virus was active in the popular tourist destination, becoming the second area in Miami to be affected after Wynwood. Mara Gambineri, a spokeswoman for the Florida Department of Health said the department believes ongoing local transmission is only occurring in the small areas identified in Miami-Dade County. On Tuesday, Florida also announced four new cases of Zika in the Wynwood neighborhood, where officials have been aggressively spraying for the mosquitoes that carry the virus for weeks. Gambineri said in an email the cases of individuals in Wynwood experienced Zika symptoms in mid-July, prior to the start of an aerial spraying campaign. Gambineri said the cases were only announced today because the individuals required antibody testing to rule out other mosquito-borne illness, such as dengue and Chikungunya. Dr. Amesh Adalja, an infectious diseases expert at the University of Pittsburgh Medical Center, said Florida needs to make it clear that "anywhere these mosquitoes are present is at risk.” Adalja said while knowing the exact area of transmission is important for issuing travel warnings to pregnant women, he said the entire state needs to be vigilant. Adalja expects multiple counties in Florida will be affected, as well as areas in Texas and Louisiana, though these outbreaks will be limited to discreet areas. http://www.scientificamerican.com/article/florida-announces-zika-case-hundreds-of-miles-from-miami/

Florida probes non-travel Zika case on Gulf Coast Tuesday, August 23, 2016 | 12:27 PM FLORIDA, United States (AFP) — Officials are investigating a new non-travel related case of Zika virus near the port city of Tampa, suggesting the local spread of Zika in Florida may have reached the state's Gulf Coast, the governor said Tuesday. A statement from Governor Rick Scott's office said only that the Florida Department of Health "is investigating one new individual with non-travel related Zika in Pinellas County," but did not say where and gave no further details. Pinellas County includes the cities of Clearwater and St Petersburg -- both of which are west of Tampa -- about 300 miles (480 kilometres) northwest of Miami. The Department of Health (DOH) "has begun door-to-door outreach and sampling in Pinellas County and mosquito abatement and reduction activities are also taking place," said a statement from Scott's office. Sponsored Links Why This Razor Is Causing So Many Guys To SwitchHarry's You Won't Believe Who Simone Bile's Mother IsBrain Smuggler Meanwhile, four more new non-travel related cases of Zika have been identified in the Wynwood neighbourhood of Miami, which was the first area to report local transmission of the virus in late July, he said. "DOH still believes ongoing active transmission is only taking place within the small identified areas in Wynwood and Miami Beach in Miami-Dade County," the governor's statement said. The five new cases bring Florida's total of locally transmitted Zika infections to 42. The US Centers for Disease Control and Prevention last week urged pregnant women to avoid areas of Miami Beach and Wynwood where mosquitoes are believed to be spreading the virus, which can cause birth defects. CDC chief Tom Frieden also said pregnant women and their partners may want to consider avoiding Miami-Dade County entirely. Zika can be spread by the bite of an infected mosquito, or by sexual contact. In four out of five cases, those who are infected show no symptoms. Others may experience a rash, pink eye, and body pain -- all of which clear up within a week to 10 days. However, the virus is particularly dangerous for pregnant women because it can cross the placenta and infect the baby's developing brain, leading to a condition known as microcephaly. http://www.jamaicaobserver.com/news/Florida-probes-non-travel-Zika-case-on-Gulf-Coast

HEALTH ZIKA VIRUS OUTBREAK AUG 23 2016, 12:58 PM ET New Zika Outbreak Found in Florida's St. Petersburg by MAGGIE FOX SHARE Florida's got a third outbreak of Zika virus, this one on the Gulf coast, state officials said Tuesday. At least one person has been infected locally in Pinellas County, which includes St. Petersburg and Clearwater, Gov. Rick Scott said. And the state reported four more cases in Wynwood, an area north of Miami where the first continental U.S. Zika outbreak was seen. ames Bernat and Michelle Albelo, City of Miami police officers, give out cans of insect repellent as they help people near the Miami Rescue Mission prevent mosquito bites that may infect them with the Zika virus on August 2, in Miami, Fla. A reported 14 individuals have been infected with the Zika virus by local mosquitoes. Joe Raedle / Getty Images "Today, we learned that the Florida Department of Health is investigating one new individual with non-travel related Zika in Pinellas County," Scott said. In all, 42 people have caught Zika in Florida, and not from travelers. Related: Images Show Zika's Destruction of Babies' Brains "While this investigation is ongoing, DOH (the Department of Health) still believes that ongoing active transmissions are only occurring in the two previously identified areas in Wynwood and Miami Beach." Testing can show that someone is actively infected with Zika, or it can show that someone was infected in the past and has recovered. When a doctor reports a patient with Zika infection, health officials then try to test people living with or near that patient to see if they're infected, too. If people are actively infected, and haven't traveled to another Zika-affected area, that suggests active local transmission. If they have antibodies to the virus but are not currently infected, that could support the idea that active transmission is not still going on. "ANY PREGNANT WOMAN WHO WOULD LIKE TO RECEIVE A FREE ZIKA TEST OR A ZIKA PREVENTION KIT SHOULD CONTACT THE FLORIDA DEPARTMENT OF HEALTH IN PINELLAS COUNTY." One case doesn't technically make for an outbreak, but if a person was infected and has had no contact with a traveler from an affected area, it strongly suggests mosquitoes locally are infected and can spread the virus. Related: Should I Worry About Zika? Scott has said he is worried about the effect of Zika on local businesses and especially on tourism. Florida's popular Miami Beach, including parts of South Beach, are at the center of one of the outbreaks. "In Pinellas County, the Department of Health and Pinellas County Mosquito Control are already working together and have begun aggressive spraying and mosquito abatement efforts," Scott said. "Any pregnant woman who would like to receive a free Zika test or a Zika prevention kit should contact the Florida Department of Health in Pinellas County. We remain fully committed to ensuring that every county has all of the resources they need to combat this virus and stand ready to assist residents and visitors in the impacted communities." South Florida provides a nearly year-round home to the Aedes aegypti mosquitoes that spread Zika. That species has been reported in 26 statesand Washington, D.C. A related species, Aedes albopictus, can also spread Zika and it's found in 40 states. People also spread Zika virus. A mosquito gets infected by biting an infected person -- they cannot fly very far. People can also spread the virus sexually. Related: Rare Zika Complication Hots 30 in Puerto Rico With 40 million people traveling back and forth to Latin America by air every year, health experts say, that makes the odds of someone carrying Zika back very high. The Centers for Disease Control and Prevention has reports of more than 2,200 travel-related cases of Zika --with many thousands more almost certainly having gone unreported. And 529 pregnant women have been infected. http://www.nbcnews.com/storyline/zika-virus-outbreak/new-zika-outbreak-found-florida-s-st-petersburg-n636571

Fears as Zika spreads HUNDREDS of miles away: Patient diagnosed with local infection 5 hours from Miami Patient in Pinellas County 'has caught Zika from local mosquitoes' It is an ominous sign that the virus could be rapidly scaling the US Another 4 local infections also reported in Miami's Wynwood area By MIA DE GRAAF FOR DAILYMAIL.COM PUBLISHED: 11:30 EST, 23 August 2016 | UPDATED: 11:38 EST, 23 August 2016 e-mail 3 View comments Zika has spread hundreds of miles north of Miami, officials fear. A patient has been diagnosed with the mosquito-borne infection in Pinellas County. The area just outside Tampa is 265 miles away from Miami on the other side of the peninsula from the original outbreak zone. The news, announced on Tuesday, is an ominous sign that the virus could be on the cusp of a rapid spread across the country. +1 The five new cases bring Florida's total of locally transmitted Zika infections to 42 HOW SCHOOLS ARE BRACED FOR ZIKA TO STRIKE Miami schools are giving long-sleeved shirts and pants to children to protect them from the Zika virus. Classes started for fall on Monday in the city, the only place in mainland America with a local outbreak of the mosquito-borne infection. During the first day, another two non-travel-related infections were reported by the state health department, bringing the total number to 37. Throughout summer families have been warned to protect themselves and their children with bug spray and clothing. But now the onus falls on teachers to protect the 7,600 students attending school in the two outbreak zones. Speaking at a press conference, Florida Governor Rick Scott also said there were four new cases of Zika in Wynwood, the Miami neighborhood where doctors first spotted the virus. Officials have been aggressively spraying Wynwood for the mosquitoes that carry the virus since mid-July. Despite their efforts, non-travel-related infections have now been detected in the tourist hotspot of Miami Beach. And now, it seems efforts to contain Zika have been scuppered. The state department of health has begun door-to-door outreach in Pinellas County, testing individuals to find other cases, Scott said in a statement. He added that mosquito abatement and reduction activities are also taking place. Pinellas County is home to St Petersburg, a popular tourist destination. 'DOH still believes ongoing active transmission is only taking place within the small identified areas in Wynwood and Miami Beach in Miami-Dade County,' the goveronor's statement said. The five new cases bring Florida's total of locally transmitted Zika infections to 42. The US Centers for Disease Control and Prevention last week urged pregnant women to avoid areas of Miami Beach and Wynwood where mosquitoes are believed to be spreading the virus, which can cause birth defects. CDC chief Tom Frieden also said pregnant women and their partners may want to consider avoiding Miami-Dade County entirely. Zika can be spread by the bite of an infected mosquito, or by sexual contact. In four out of five cases, those who are infected show no symptoms. RELATED ARTICLES Previous 1 Next Miami school district handing out long-sleeved shirts and...Zika HAS spread in Florida: Governor confirms 'new outbreak... SHARE THIS ARTICLE Share Others may experience a rash, pink eye, and body pain -- all of which clear up within a week to 10 days. However, the virus is particularly dangerous for pregnant women because it can cross the placenta and infect the baby's developing brain, leading to a condition known as microcephaly. One mosquito bite could rapidly fuel the spread. Whenever a mosquito bites someone with Zika, they pick up the virus. As they bite someone, that person likely gets it. This is most likely the way the virus has spread out of the original outbreak zone - Wynwood - to Miami Beach. A spokesman for the National Health Institute warned on Sunday that the virus will probably stay floating around the US for another couple of years. 'It would not be surprising we would see additional cases perhaps in other Gulf Coast states,' Dr. Anthony Fauci, director of the allergy and infectious diseases unit of the National Institutes of Health (NIH), said in an interview on Sunday morning with ABC News. The possibility of transmission in Gulf States such as Louisiana and Texas will likely fuel concerns that the virus could spread across the continental United States, even though officials have played down such an outcome. Scientists are still learning about the impacts of the virus on adults and healthy children. The most severe effect of the disease that we know of currently is its impact on unborn babies, causing severe birth defects including microcephaly. On Monday, Miami Beach Mayor Philip Levine asked for more federal resources to combat the spread of the Zika virus in South Florida. The mayor said 'we need the federal government to step up' at a news conference Monday. President Barack Obama requested $1.9 billion in emergency funds in February to develop a vaccine and control the mosquitoes that carry the virus. But Republicans tied the funding to a dispute over abortion, and lawmakers left Washington for a seven-week recess without approving the money. http://www.dailymail.co.uk/health/article-3755043/Fears-Zika-spreads-HUNDREDS-miles-away-Patient-diagnosed-local-infection-5-hours-Miami.html

Zika zone in Wynwood shrinks as new non-travel-related case reported in Pinellas County Wynwood Zika zone cover about half-square mile By Derek Shore - Reporter Posted: 12:43 PM, August 23, 2016Updated: 12:43 PM, August 23, 2016 MIAMI - The Zika zone in Wynwood has shrunk as aerial larvicide spraying has decreased the amount of Zika virus-infected mosquitoes in the area, but new locally acquired cases in Florida at still being reported. According to Gov. Rick Scott's office, a case of non-travel-related Zika has been found in Pinellas County. More Zika Virus Headlines South Florida doctors treat baby girl born with Zika virus Miami Beach residents worry about Zika virus spreading in city Miami Beach mayor says governor 'blindsided' him with Zika virus announcement Mayor Philip Levine unhappy with governor's response to Zika virus in… CDC issues travel advisory for Miami Beach Health officials said they are investigating where that case originated from and said they have already started aggressive spraying. Meanwhile, the Zika zone in Wynwood shrunk Tuesday to about a half a square mile. In total, health officials have shrunk the Zika zone down by 76 blocks. Still the governor said four new cases in the area have been reported, but sources told Local 10 News that these are likely old cases from earlier this month, that just recently got confirmed. Some business leaders in Wynwood told Local 10 News reporter Derek Shore that they are happy that officials have shrunk the Zika zone, but think that there shouldn't be a Zika zone at all and that officials should be focusing on all of Miami-Dade County. http://www.local10.com/health/zika-virus/zika-zone-in-wynwood-shrinks-as-new-non-travel-related-case-reported-in-pinellas-county

Non-travel related Zika case reported in Pinellas By Jamel Lanee' and Jeff PattersonPublished: August 23, 2016, 10:55 am Updated: August 23, 2016, 12:31 pm Click to share on Twitter (Opens in new window) Click to share on Google+ (Opens in new window) 199Share on Facebook (Opens in new window)199 Click to share on Pinterest (Opens in new window) Image courtesy OneBlood PINELLAS COUNTY, Fla. (WFLA) — Non-travel related cases of Zika virus are no longer confined to the Miami area. Pinellas County has its first case of non-travel related Zika, Florida Governor Rick Scott said on Tuesday. Scott made the announcement during a Zika virus roundtable held Tuesday morning in Clearwater. “Today, we learned that the Florida Department of Health is investigating one new individual with non-travel related Zika in Pinellas County. While this investigation is ongoing, the DOH still believes that ongoing active transmissions are only occurring in the two previously identified areas in Wynwood and Miami Beach,” said Governor Scott. Scott went on to clarify and said efforts are underway to control mosquitoes. “Now, just because we have one case here doesn’t mean we have local transmission. The next step is the department of health, the local department of health, working with mosquito control efforts, they will start doing aggressive mosquito control and they will be doing aggressive testing to find out if we have local transmission,” Scott added. RELATED: Tampa obstetrician has Zika warning for women: ‘Delay getting pregnant’ The governor said that the Department of Health and Pinellas County Mosquito Control are already working together and have begun aggressive spraying and mosquito abatement efforts in Pinellas County. Scott said that pregnant women will be able to get a free Zika test kit. “Any pregnant woman who would like to receive a free Zika test or a Zika prevention kit should contact the Florida Department of Health in Pinellas County. We remain fully committed to ensuring that every county has all of the resources they need to combat this virus and stand ready to assist residents and visitors in the impacted communities,” said Scott. Any Pinellas County resident who would like to request mosquito control services for their residence or business should contact Pinellas County Mosquito Control. More details are here. Governor Scott also said that there are four new non-travel related cases of Zika virus in the Miami-Dade area. Scott has been traveling around the state hosting weekly discussions about the Zika virus. http://wfla.com/2016/08/23/non-travel-related-zika-case-reported-in-pinellas/

Non-travel related Zika case reported in Pinellas County 10News WTSP staff and Emerald Morrow, WTSP 10:09 AM. EST August 23, 2016 CONNECT TWEET PINTEREST CLEARWATER, Fla. (WTSP) -- Following a roundtable discussion with Bay area health leaders Tuesday morning, Gov. Scott announced that the Florida Department of Health (DOH) is investigating five new non-travel related cases of Zika. One of these cases is in Pinellas County and four cases are in the impacted area in Wynwood. The DOH has begun door-to-door outreach and sampling in Pinellas County. “In Pinellas County, the Department of Health and Pinellas County Mosquito Control are already working together and have begun aggressive spraying and mosquito abatement efforts. Any pregnant woman who would like to receive a free Zika test or a Zika prevention kit should contact the Florida Department of Health in Pinellas County. We remain fully committed to ensuring that every county has all of the resources they need to combat this virus and stand ready to assist residents and visitors in the impacted communities,” Gov. Scott said Tuesday. Any Pinellas County resident who would like to request mosquito control services for their residence or business should contact Pinellas County Mosquito Control. The DOH still believes ongoing active transmission is only taking place within the small identified areas in Wynwood and Miami Beach in Miami-Dade County. Gov. Scott also said that following further testing and no evidence of continued active transmission, the DOH is able to clear nearly the entire perimeter of the area in Wynwood. The total area that the DOH has cleared in Wynwood is now 76 blocks. This makes the impacted area in Wynwood now approximately 0.5 square miles. Original Wynwood perimeter included for reference. Smaller shaded area in Wynwood remains under investigation. The total number of local transmissions of Zika in Florida is 42. http://www.wtsp.com/news/local/florida/gov-scott-continues-zika-discussion-in-tampa-bay/305650767

Gov. Scott: Non-travel related Zika case in Pinellas County First Coast News , WTLV 9:45 AM. EST August 23, 2016 CONNECT TWEET LINKEDIN GOOGLE+ PINTEREST CLEARWATER, Fla. -- On Tuesday, Governor Rick Scott announced that the Florida Department of Health (DOH) is investigating five new non-travel related cases of Zika. One of these cases is in Pinellas County and four cases are in the impacted area in Wynwood. Governor Rick Scott said, “Today, we learned that the Florida Department of Health is investigating one new individual with non-travel related Zika in Pinellas County. While this investigation is ongoing, DOH still believes that ongoing active transmissions are only occurring in the two previously identified areas in Wynwood and Miami Beach. As we’ve seen in Wynwood, our aggressive mosquito control and public education efforts are working which is why DOH was able to clear a significant area in Wynwood today, bringing the total cleared area to 76 blocks. This means that we have now cleared half of the area in Wynwood where we believe ongoing active transmission of Zika is occurring. This is great news and we hope to continue reducing this area." “In Pinellas County, the Department of Health and Pinellas County Mosquito Control are already working together and have begun aggressive spraying and mosquito abatement efforts. Any pregnant woman who would like to receive a free Zika test or a Zika prevention kit should contact the Florida Department of Health in Pinellas County. We remain fully committed to ensuring that every county has all of the resources they need to combat this virus and stand ready to assist residents and visitors in the impacted communities.” Any Pinellas County resident who would like to request mosquito control services for their residence or business should contact Pinellas County Mosquito Control HERE. http://www.firstcoastnews.com/news/health/gov-scott-non-travel-related-zika-case-in-pinellas-county/305727092

Non-travel Zika virus case reported in Pinellas County Arek Sarkissian, [email protected]; 850-559-762011:31 a.m. EDT August 23, 2016 (Photo: AP) TALLAHASSEE -- There were five new non-travel related cases of the Zika virus reported in Florida on Tuesday, one of them in Pinellas County, Gov. Rick Scott announced. Four other cases of non-travel related to Zika were reported in the Wynwood neighborhood of Miami. That was the first area where Florida Department of Health officials identified as a place where local transmissions of the virus were taking place. Scott said the state DOH does not believe the case in Pinellas County was not an active transmission. Active transmissions are only occurring in Wynwood and Miami Beach, which was officially identified on Friday. “In Pinellas County, the Department of Health and the Pinellas County Mosquito Control are already working together and have begun aggressive spraying and mosquito abatement efforts,” Scott said in a news release sent from Clearwater. The state DOH reported on Monday there were 37 non-travel related Zika cases around the state. Another 494 cases were travel related. The difference between the two classifications is where the person contracted the disease. People were previously contracting Zika while traveling to tropical areas where it is prevalent. By the end of June, the first Florida-grown cases were being reported. There were eight travel-related Zika cases reported in Lee County as of Tuesday and there were another four in Collier County. Zika can be transmitted by sexual contact and a certain type of mosquito more common in South Florida. Areas like Wynwood, where locally transmitted cases first appeared, have seen heavy mosquito abatement measures, and those measures have now been spread to a heavily populated stretch of Miami Beach and Pinellas County. Scott’s official schedule has been dominated by updates on Zika preparedness around the state. He also has a Tuesday phone conference scheduled with Visit Florida that is not open to the public. County health departments are offering free Zika tests to pregnant women. There are also free Zika preparedness kits that include bug spray, condoms and insect nets. http://www.naplesnews.com/story/news/health/2016/08/23/non-travel-zika-virus-case-reported-pinellas-county/89200692/

Florida confirms 5 new cases of Zika, 1 reported outside transmission zones Published August 23, 2016 FoxNews.com Facebook Twitter livefyre Email Print NOW PLAYING Zika infection zone continues to grow in South Florida Florida Gov. Rick Scott said Tuesday that the state has confirmed five new non-travel related cases of Zika, including one in the Tampa Bay area, though officials have not declared that a zone of active local transmission. Scott said at a Zika roundtable held in the Tampa area’s Pinellas County that four new cases were connected to mosquitoes in Miami’s Wynwood arts district. He says the fifth was diagnosed in a Pinellas County resident who hasn’t traveled internationally. Officials are looking into the possibility that the Pinellas County resident was infected with the virus in a neighboring county. The news comes just a day after Scott called on federal health officials to send the state more resources to fight the growing transmission of Zika virus. The Miami Herald reported that Florida is still waiting for the Centers for Disease Control and Prevention (CDC) to send the state an additional 5,000 Zika antibody tests and 10,000 Zika prevention kits, as well as a promised $5 million in funding, to help combat Zika. The number of locally transmitted cases in Wynwood and Miami Beach had reached 37, but Tuesday’s addition of four new cases brings the total to 41. State officials had predicted Monday that the number will rise in the coming weeks without swift mosquito eradication in the area. The CDC is expected to fulfill Scott’s order for the additional supplies on Tuesday, the Herald reported. More on this... Miami students return to school amid Zika outbreak NIH official: Gulf Coast states most vulnerable to Zika virus Officials identify Miami's South Beach as second site of Zika virus transmission On Monday at a senior center in Wynwood, the neighborhood where the continental U.S. saw its first local Zika transmission earlier this summer, Scott met with U.S. Reps. Frederica Wilson (D), Carlos Curbelo (R), Miami-Dade County Mayor Carlos Gimenez and Miami Beach Mayor Philip Levine. The Herald reported that among the conversations that took place during the meeting, Levine criticized Scott for not keeping the city informed of new local Zika cases as they arise. “It’s important that myself, the city manager, [and] our counterparts at the county are getting timely, accurate information as fast as possible,” Levine said during the meeting, according to the Herald. “As you know, we have our constituents. We have our businesses ... we’ve just got to have that information.” Scott had told reporters a few hours earlier that he had publicly announced the Miami Beach cases within hours of their confirmation Friday morning. He responded to Levine’s concerns after the meeting by criticizing him for not attending previous local meetings organized to address Zika. http://www.foxnews.com/health/2016/08/23/as-zika-concerns-grow-florida-governor-pressures-feds-for-more-resources.html

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

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

Florida: 5 new Zika cases including 1 in the Tampa Bay area Comment Print Email Published: Tue, August 23, 2016 @ 11:33 a.m. ST. PETERSBURG, Fla. (AP) — Florida’s governor says that state has confirmed five new non-travel-related cases of Zika, including one in the Tampa Bay area, though officials aren’t so far declaring that a zone of active local transmission. Gov. Rick Scott said at a Zika roundtable in the Tampa area’s Pinellas County that four new cases were connected to mosquitoes in Miami’s Wynwood arts district. He says the fifth was diagnosed in a Pinellas County resident who hasn’t traveled internationally. Last week health officials announced five cases of Zika were linked to mosquitoes in Miami Beach. Officials are looking into the possibility that the Pinellas County resident was infected with the virus in a neighboring county. Zika can cause severe brain-related birth defects, including a dangerously small head, if women are infected during pregnancy. - See more at: http://www.vindy.com/news/2016/aug/23/florida-5-new-zika-cases-including-1-tampa-bay-are/?nw#sthash.f3YaVFkI.dpuf

GOV. SCOTT: DOH IDENTIFIES LOCAL TRANSMISSION OF ZIKA IN PINELLAS COUNTY; SIGNIFICANTLY REDUCES WYNWOOD AREA On August 23, 2016, in News Releases, by Staff CLEARWATER, Fla. – Today, Governor Rick Scott announced that the Florida Department of Health (DOH) is investigating five new non-travel related cases of Zika. One of these cases is in Pinellas County and four cases are in the impacted area in Wynwood. DOH has begun door-to-door outreach and sampling in Pinellas County and mosquito abatement and reduction activities are also taking place. DOH still believes ongoing active transmission is only taking place within the small identified areas in Wynwood and Miami Beach in Miami-Dade County. More details will be announced when the Pinellas County investigation concludes. Governor Scott also announced that following further testing and no evidence of continued active transmission, DOH is able to clear nearly the entire perimeter of the area in Wynwood. The total area that DOH has cleared in Wynwood is now 76 blocks (see maps below). This makes the impacted area in Wynwood now approximately 0.5 square mile. The total number of local transmissions of Zika in Florida is 42. Governor Rick Scott said, “Today, we learned that the Florida Department of Health is investigating one new individual with non-travel related Zika in Pinellas County. While this investigation is ongoing, DOH still believes that ongoing active transmissions are only occurring in the two previously identified areas in Wynwood and Miami Beach. As we’ve seen in Wynwood, our aggressive mosquito control and public education efforts are working which is why DOH was able to clear a significant area in Wynwood today, bringing the total cleared area to 76 blocks. This means that we have now cleared half of the area in Wynwood where we believe ongoing active transmission of Zika is occurring. This is great news and we hope to continue reducing this area. “In Pinellas County, the Department of Health and Pinellas County Mosquito Control are already working together and have begun aggressive spraying and mosquito abatement efforts. Any pregnant woman who would like to receive a free Zika test or a Zika prevention kit should contact the Florida Department of Health in Pinellas County. We remain fully committed to ensuring that every county has all of the resources they need to combat this virus and stand ready to assist residents and visitors in the impacted communities.” Any Pinellas County resident who would like to request mosquito control services for their residence or business should contact Pinellas County Mosquito Control HERE. Click HERE to see a detailed timeline of actions taken by Governor Scott to combat the Zika virus in Florida. STATE OF FLORIDA (Original Wynwood perimeter included for reference. Smaller shaded area in Wynwood remains under investigation.) MIAMI-DADE COUNTY (Original Wynwood perimeter included for reference. Smaller shaded area in Wynwood remains under investigation.)

Today, Governor Rick Scott announced that the Florida Department of Health (DOH) is investigating five new non-travel related cases of Zika. One of these cases is in Pinellas County and four cases are in the impacted area in Wynwood. DOH has begun door-to-door outreach and sampling in Pinellas County and mosquito abatement and reduction activities are also taking place. DOH still believes ongoing active transmission is only taking place within the small identified areas in Wynwood and Miami Beach in Miami-Dade County. More details will be announced when the Pinellas County investigation concludes. http://www.flgov.com/2016/08/23/gov-scott-doh-identifies-local-transmission-of-zika-in-pinellas-county-significantly-reduces-wynwood-area/

Gov. Scott: We Will Provide $5 Million in Additional Zika Preparedness Funding to Miami-Dade County GOV. SCOTT: DOH IDENTIFIES LOCAL TRANSMISSION OF ZIKA IN PINELLAS COUNTY; SIGNIFICANTLY REDUCES WYNWOOD AREA On August 23, 2016, in News Releases, by Staff CLEARWATER, Fla. – Today, Governor Rick Scott announced that the Florida Department of Health (DOH) is investigating five new non-travel related cases of Zika. One of these cases is in Pinellas County and four cases are in the impacted area in Wynwood. DOH has begun door-to-door outreach and sampling in Pinellas County and mosquito abatement and reduction activities are also taking place. DOH still believes ongoing active transmission is only taking place within the small identified areas in Wynwood and Miami Beach in Miami-Dade County. More details will be announced when the Pinellas County investigation concludes. Governor Scott also announced that following further testing and no evidence of continued active transmission, DOH is able to clear nearly the entire perimeter of the area in Wynwood. The total area that DOH has cleared in Wynwood is now 76 blocks (see maps below). This makes the impacted area in Wynwood now approximately 0.5 square mile. The total number of local transmissions of Zika in Florida is 42. Governor Rick Scott said, “Today, we learned that the Florida Department of Health is investigating one new individual with non-travel related Zika in Pinellas County. While this investigation is ongoing, DOH still believes that ongoing active transmissions are only occurring in the two previously identified areas in Wynwood and Miami Beach. As we’ve seen in Wynwood, our aggressive mosquito control and public education efforts are working which is why DOH was able to clear a significant area in Wynwood today, bringing the total cleared area to 76 blocks. This means that we have now cleared half of the area in Wynwood where we believe ongoing active transmission of Zika is occurring. This is great news and we hope to continue reducing this area. “In Pinellas County, the Department of Health and Pinellas County Mosquito Control are already working together and have begun aggressive spraying and mosquito abatement efforts. Any pregnant woman who would like to receive a free Zika test or a Zika prevention kit should contact the Florida Department of Health in Pinellas County. We remain fully committed to ensuring that every county has all of the resources they need to combat this virus and stand ready to assist residents and visitors in the impacted communities.” Any Pinellas County resident who would like to request mosquito control services for their residence or business should contact Pinellas County Mosquito Control HERE. Click HERE to see a detailed timeline of actions taken by Governor Scott to combat the Zika virus in Florida. STATE OF FLORIDA (Original Wynwood perimeter included for reference. Smaller shaded area in Wynwood remains under investigation.) MIAMI-DADE COUNTY (Original Wynwood perimeter included for reference. Smaller shaded area in Wynwood remains under investigation.)

Today, Governor Rick Scott announced that the Florida Department of Health (DOH) is investigating five new non-travel related cases of Zika. One of these cases is in Pinellas County and four cases are in the impacted area in Wynwood. DOH has begun door-to-door outreach and sampling in Pinellas County and mosquito abatement and reduction activities are also taking place. DOH still believes ongoing active transmission is only taking place within the small identified areas in Wynwood and Miami Beach in Miami-Dade County. More details will be announced when the Pinellas County investigation concludes. http://www.flgov.com/2016/08/23/gov-scott-doh-identifies-local-transmission-of-zika-in-pinellas-county-significantly-reduces-wynwood-area/

The baby has not been diagnosed with microcephaly, but doctors said the child is suffering from other Zika-related side effects. Photos taken inside the baby girl's eyes at the Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine help give doctors a clearer vision of how to treat the baby. "You can see that here we have the changes in pigment. So this is what we think is the Zika infection in this child," pediatric retina specialist Dr. Audina Berrocal said while examining a photo. The baby's mother, Maria Ramirez Bolivar, contracted the virus at the end of her first trimester, while on a family Christmas vacation on the island of Margarita off the coast of Venezuela. The island is about 290 miles east of Caracas. "They thought it was the sun," Ramirez Bolivar said in Spanish about the rashes she started getting followed by red eyes and stomach issues. She said she felt terrible to hear the news and then her "world collapsed." Ramirez Bolivar, who is from Venezuela, but now lives in Doral, said she saw three doctors and then waited for the results. http://www.local10.com/health/zika-virus/south-florida-doctors-treat-baby-girl-born-with-zika-virus