niman

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intensified surveillance of microcephaly Review 19 August 2016 Among the epidemiological weeks 01 to 32 of 2016 have been 29 confirmed cases of microcephaly associated virus Zika, 102 cases were dismissed and 254 cases are under consideration. http://www.ins.gov.co/boletin-epidemiologico/Boletn Epidemiolgico/2016 Boletin epidemiologico semana 32.pdf

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Two more in Allegheny County infected with Zika August 23, 2016 9:11 AM James Gathany/Centers for Disease Control and Prevention via AP A female Aedes aegypti mosquito in the process of acquiring a blood meal from a human host. Pittsburgh Post-Gazette Nine Allegheny County residents have been diagnosed with the Zika virus since early this year, the county health department said Monday. That's up from seven cases as of last week. All but one are linked to travel in Zika-stricken areas outside the continental United States, health department spokeswoman Melissa Wade said. The exception was at the University of Pittsburgh, where a laboratory accident infected a worker who has since recovered. Statewide, patient tests have confirmed 82 cases of the mosquito-borne virus, according to the Pennsylvania Department of Health. Public health officials have tied nearly all Zika cases on the U.S. mainland to travel outside the continental U.S. Within the continental states, mosquitoes carrying Zika have been found only in the Miami area. Most infected people show no symptoms, although the illness in pregnant women can lead to birth defects. Common symptoms include a fever, rash and joint pain. The disease also can spread through sexual contact. http://www.post-gazette.com/news/health/2016/08/23/Two-more-in-Allegheny-County-infected-with-Zika-pennsylvania/stories/201608230065

Allegheny County Residents Approved for Zika Testing: 163 CDC Confirmed Cases: 9(as of August 22) http://www.achd.net/topic-zika.html

Allegheny County Residents Approved for Zika Testing: 163 CDC Confirmed Cases: 9(as of August 22)

South Florida doctors treat baby girl born with Zika virus Child's mother contracted virus while traveling to Venezuela By Hatzel Vela - Reporter Posted: 6:15 PM, August 22, 2016Updated: 10:16 AM, August 23, 2016 2K 2K 1 Comment MIAMI - A baby girl who tested positive for the Zika virus is being treated by doctors in South Florida. The baby's mother contracted the Zika virus while traveling while pregnant off the coast of Venezuela. More Zika Virus Headlines 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 No aerial spraying over Zika zone in Miami Beach 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. She said the past months have been filled with anxiety, not knowing the fate of her baby, Micaela, who is now nearly two months old. "This baby luckily has very little changes in the retina," Berrocal said. But Micaela does have some calcifications in her brain left behind by the virus. "It just tells us that there was a bacteria or a virus in the brain and that virus has left us with some calcifications," Berrocal said. "Babies with early intervention and the right support, sometimes they compensate for those changes that we find early." Berrocal recently spent time in Brazil working with 25 other babies who have severe microcephaly. The scars in those babies' retinas are larger and closer to the center than Micaela's, evidence of what is likely long-term damage. "Finding changes in the eyes indicates that we must have something in the brain of that child," Berrocal said. Still, Berrocal said Micaela will likely have "almost normal visual development." Ramirez Bolivar is thankful that her daughter's condition is not worse, and gave her the middle name Milagros (Miracle), because she believes her daughter is a miracle child. "Don't go to places where there is Zika," Ramirez Bolivar warned other mothers, saying sometimes she hasn't been able to sleep, worrying about her young daughter's future. Micaela, who was born June 28, is Ramirez Bolivar's fourth child. She also has a 13-year-old daughter and 9-year-old twin boys. http://www.local10.com/health/zika-virus/south-florida-doctors-treat-baby-girl-born-with-zika-virus

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Miami Mother Copes With Zika-Related Effects In Newborn August 22, 2016 11:31 PM By Lauren Pastrana Filed Under: Babies, Health, Lauren Pastrana, Women, Zika 43 Follow CBSMIAMI.COM: Facebook | Twitter MIAMI (CBSMiami) – Maria Mendoza is your typical doting new mom. She gives her baby plenty of attention, and so do her doctors. That’s because Mendoza’s daughter, Micaela, was born with health issues related to the Zika virus. Seven-week-old Micaela has scarring on her retina and calcifications on her brain. Doctors say Zika is to blame. Zika 101: Prevent Spread By Protecting Yourself Mendoza was infected when she was three months pregnant. “I cried a lot,” she said. “One always thinks the worst is going to happen because you don’t know what part of the brain was damaged.” Mendoza contracted Zika in Venezuela and gave birth in Miami. Dr. Marcelo Laufer, an infectious disease specialist at Nicklaus Children’s Hospital, has evaluated Micaela. “She has cerebral calcifications, which are pieces of calcifying tissue in the brain, which means at some point that part of the brain was infected,” he said. Every day, Micaela’s mother does physical therapy with her, to make sure she develops good muscle tone. She said the doctors are optimistic that with therapy and constant monitoring, Micaela will be fine, but they’ll have to monitor her for effects of the infection for years. CBS News has learned 69 pregnant women in Florida have the Zika virus, but state health officials aren’t saying if those infections were contracted locally or while traveling abroad. Miami mother-to-be Christina Frigo isn’t taking any chances. “I was just terrified,” she told CBS4’s sister station WBBM in Chicago. So, at 32 weeks pregnant, Frigo and her husband uprooted their lives in South Florida to ride out the rest of her pregnancy more than a thousand miles away in Chicago, at Frigo’s mom’s house. Frigo says one pregnant friend thought she was overreacting. “She was surprised to hear that I was taking such a drastic step,” she said. “She’s on her way to Boston right now.” Both Frigo and her husband tested negative for the virus. While not everyone can just pack up and leave, Mendoza says expectant mothers should be taking extra precautions. “I would say to them to not leave their homes because it’s a situation that’s impossible to cope with,” she said. “It’s an anguish that will keep you awake.” Lauren Pastranafacebook Lauren Pastrana is the co-anchor of CBS4 News This Morning airing Monday-Friday, from 5 to 7 AM. She joined CBS Miami in April 2012 as a reporter. She is an Emmy nominated, multimedia journalist with experience in television, radio and web-based ...

Mendoza’s daughter, Micaela, was born with health issues related to the Zika virus. Seven-week-old Micaela has scarring on her retina and calcifications on her brain. Doctors say Zika is to blame. Mendoza was infected when she was three months pregnant. “I cried a lot,” she said. “One always thinks the worst is going to happen because you don’t know what part of the brain was damaged.” Mendoza contracted Zika in Venezuela and gave birth in Miami. Dr. Marcelo Laufer, an infectious disease specialist at Nicklaus Children’s Hospital, has evaluated Micaela. “She has cerebral calcifications, which are pieces of calcifying tissue in the brain, which means at some point that part of the brain was infected,” he said. http://miami.cbslocal.com/2016/08/22/miami-mother-copes-with-zika-related-effects-in-newborn/

August 23, 2016, 7:16 AM Pregnant women cope with fears of Zika virus in Florida 1 Comment Share Tweet Stumble Email Two tourist areas in Miami-DadeCounty, Florida – the Wynwood neighborhood and South Beach, one of the most popular vacation spots in the world – are home to at least 37 locally transmitted Zika cases. There are 69 pregnant women in Florida who have been infected with Zika, which has been linked to babies born with microcephaly and can impact the size of a child’s head. The disease could potentially cause seizures, developmental delays, and additional mental and physical problems. Christina Frigo is from the Miami area, but relocated to Chicago earlier this month. She plans to stay there for the remainder of her pregnancy. Play VIDEO Beachgoers wary of Zika “You could put a box on a map but you can’t keep the mosquitoes in that box,” Frigo said. “You just inconvenience yourself so that your baby is safe.” The two areas in Miami-Dade County are designated Zika zones, but concerns about Zika spread far beyond them, reports CBS News correspondent David Begnaud. Katrina Barnard’s third child is due in December. Although she lives outside the Zika zones, she’s scared to leave her Miami-Dade County home. Florida students in Zika zone begin school year amid outbreak Florida students in Zika zone begin school year amid outbreak Zika virus in school: Miami officials make tough decisions “This isn’t a cold; it’s life or death,” Barnard said. “Seeing all of these poor babies with microcephaly and seeing women having to make the choice to either not continue their pregnancy or to just be dealt a really hard hand,” Barnard said. Florida Governor Rick Scott is facing criticism for his handling of information about Zika. For the third day in a row, Miami Beach Mayor Philip Levine took aim at Scott for failing to tell city leaders about Zika cases on Miami Beach before he notified the public. “What the governor did is, he not only blindsided me; he blindsided our administration,” Levine said. “I think it would be more useful in the future to let the elected leaders, let the administrations, know what’s going on so we can take the necessary steps.” Scott fired back, saying he had reached out to Mayor Levine, who “unfortunately didn’t return my phone call.” As the peak of hurricane season nears, any standing water left from those storms could help the spread of Zika. In fact, officialsare so concerned that Miami-Dade County has started fining for standing water, but even a little could be a problem – the mosquito that spreads the disease only needs a bottle cap to spawn. http://www.cbsnews.com/news/zika-virus-florida-miami-dade-county-pregnant-women-microcephaly-fears/

August 22 show on active and passive testing of local Zika cases in Florida

1-Aug asymp 52 contact 26 2-Aug asymp 52 contact 26 3-Aug asymp 52 contact 26 4-Aug asymp 52 contact 26 5-Aug asymp 52 contact 26 Invest date collect negative positive pending MD1 1-Aug 54 54 0 0 B1 1-Aug 70 70 0 0 Wyn 8-Aug 437 418 11 8 9-Aug 455 424 17 14 10-Aug 498 424 16 46 11-Aug 511 480 19 12 12-Aug 517 492 21 4 15-Aug 518 492 22 4 16-Aug 518 492 22 4 17-Aug 518 492 23 4 18-Aug 519 492 23 4 19-Aug 519 492 23 4 22-Aug 519 492 23 4 MD2 5-Aug 11 8-Aug 19 16 0 3 9-Aug 19 16 0 3 10-Aug 19 18 0 1 11-Aug 19 18 0 1 12-Aug 19 19 0 0 15-Aug 21 19 0 2 16-Aug 21 19 0 2 17-Aug 21 19 0 2 18-Aug 21 19 0 2 19-Aug 21 19 0 2 22-Aug 21 19 0 2 PB 8-Aug 1 0 0 1 9-Aug 1 0 0 1 10-Aug 3 0 0 3 11-Aug 3 2 0 1 12-Aug 3 3 0 0 15-Aug 3 3 0 0 16-Aug 3 3 0 0 17-Aug 3 3 0 0 18-Aug 3 3 0 0 19-Aug 3 3 0 0 22-Aug 3 3 0 0 MD3 17-Aug 18-Aug 19-Aug 22-Aug MD4 15-Aug 5 1 0 4 16-Aug 5 1 0 4 17-Aug 6 1 0 5 18-Aug 6 1 0 5 19-Aug 6 1 0 5 22-Aug 6 1 0 5 MD5 17-Aug 2 0 0 2 18-Aug 2 0 0 2 19-Aug 2 0 0 2 22-Aug 8 6 0 2 MD6 17-Aug 18-Aug 19-Aug 22-Aug comb MD7 18-Aug 19-Aug 22-Aug MD8 18-Aug 19-Aug 22-Aug comb MD9 19-Aug 22-Aug comb

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 23 4 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: (Announced on Aug. 8) 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 8 6 0 2 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 9) 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 Data as of Aug. 22, 2016 - 6:16pm EST

August 22, 2016 Department of Health Daily Zika Update No New Cases Today http://www.floridahealth.gov/newsroom/2016/08/160822-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 continue to issue a Zika virus update each week day. Updates will include a CDC-confirmed Zika case count by county and information to better keep Floridians prepared. The department has conducted testing for the Zika virus for more than 3,818 people statewide. Florida currently has the capacity to test 4,803 people for active Zika virus and 2,655 for Zika antibodies. Per the Governor’s direction on August 3, all county health departments are now offering free Zika risk assessment and testing to any pregnant woman who would like to be tested. There are seven new travel-related cases with four in Miami-Dade, two in Osceola and one involving a pregnant woman. Please visit our website to see the full list of travel-related cases. There are no new non-travel related case today, however, our case count was updated to reflect a case announced at the press conference Friday. 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 494 Non-Travel Related Infections of Zika 37 Infections Involving Pregnant Women 69 The department is currently conducting eight active investigations. We have moved the information regarding the investigations outside the Wynwood area to the Zika webpage, here. As of Friday, the department had cleared 17 blocks within the Wynwood area of active transmission. A map detailing the area is below. The CDC’s travel advisory remains in place, per their guidelines. CLOSED INVESTIGATIONS The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). Today, the department has 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. If investigations reveal additional areas of likely active transmission, the department will announce a defined area of concern. One case does not mean active transmission is taking place and that’s why the department conducts a thorough investigation by sampling close contacts and community members around each case to determine if additional people are infected. If the department finds evidence that active transmission is occurring in an additional area, we will notify the media and the public. CDC recommends that women who are pregnant or thinking of becoming pregnant postpone travel to areas with widespread Zika infection. 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 since January. The total number of pregnant women who have been or are being monitored is 69. 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 4,410 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.

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Number of cases reported County/Area Today Year to Date (8/19-22/16) Albany 0 4 Broome 0 2 Clinton 0 1 Columbia 0 1 Delaware 0 1 Dutchess 0 5 Erie 0 4 Lewis 0 1 Monroe 0 7 Nassau 1 37 Niagara 0 1 Oneida 0 3 Onondaga 0 5 Ontario 0 3 Orange 1 6 Otsego 0 1 Putnam 0 1 Rockland 0 8 St Lawrence 0 1 Schenectady 0 1 Suffolk 0 36 Tompkins 0 2 Warren 1 1 Wayne 0 2 Westchester 2 19 NYS (ex NYC) 5 153 NYC 11 513 NYS Total Confirmed 16 666 NYS Pregnant Registry 0 25 NYS Total 16 691

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--- PRESS RELEASE --- For Immediate Release DCHHS Reports the 29th and 30th Zika Virus Cases in Dallas County DALLAS (Aug. 22, 2016) – Dallas County Health and Human Services (DCHHS) is reporting the 29th and 30th cases of Zika virus in Dallas County in 2016. These cases were confirmed through testing in the DCHHS lab and a private lab. DCHHS has submitted the cases for review to the Texas Department of State Health Services. The 29th case is a 48 year-old resident of Garland who was infected with the virus during recent travel to Guatemala. The 30th case is a 38 year-old resident of Irving who was infected with the virus during recent travel to Mexico. For medical confidentiality and personal privacy reasons, DCHHS does not provide additional identifying information. While sexual transmission of Zika virus is possible, it is primarily transmitted to people by Aedes species mosquitoes. The most common symptoms of Zika virus are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting several days to a week. DCHHS advises individuals with symptoms to see a healthcare provider if they visited an area where Zika virus is present or had sexual contact with a person who traveled to an area where Zika virus is present. There is no specific medication available to treat Zika virus and there is not a vaccine. The best ways to avoid Zika virus are to avoid mosquito bites and sexual contact with a person who has Zika virus. There are currently no reports of Zika virus being locally-transmitted by mosquitoes in Dallas County. However, imported cases make local spread by mosquitoes possible because the mosquitoes that can transmit the virus are found locally. DCHHS advises recent travelers with Zika virus symptoms as well as individuals diagnosed with the virus to protect themselves from further mosquito bites. # For additional information, contact: YaMonica Sadberry, Administrative [email protected] 214.819.6070 (office) Zachary Thompson, Director 214.755.9299 (cell)

The 29th case is a 48 year-old resident of Garland who was infected with the virus during recent travel to Guatemala. The 30th case is a 38 year-old resident of Irving who was infected with the virus during recent travel to Mexico.

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