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There are three new non-travel related cases today. One of the individuals was exposed in the less than one-square mile in Miami-Dade County where DOH believes active transmissions are occurring. The other two new non-travel related infections are located outside of the one-square mile area in Miami-Dade County. http://www.floridahealth.gov/newsroom/2016/08/081716-zika-update.html

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Aug. 17, 2016 DEPARTMENT OF HEALTH DAILY ZIKA UPDATE http://www.floridahealth.gov/newsroom/2016/08/081716-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 3,536 people statewide. Florida currently has the capacity to test 5,177 people for active Zika virus and 2,853 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 12 new travel-related cases today with two in Palm Beach, two in Polk, one in Broward, one in Duval, one in Lake, one in Martin, one in Pinellas and three involving pregnant women. Please visit our website to see the full list of travel-related cases. There are three new non-travel related cases today. One of the individuals was exposed in the less than one-square mile in Miami-Dade County where DOH believes active transmissions are occurring. The other two new non-travel related infections are located outside of the one-square mile area in Miami-Dade County. While the department is continuing to investigate areas in Miami-Dade and Palm Beach Counties where local transmissions of Zika may have occurred, the department still believes active transmissions are still only occurring in the area that is less than one square mile in Miami-Dade County. 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 461 Non-Travel Related Infections of Zika 33 Infections Involving Pregnant Women 63 ACTIVE INVESTIGATIONS The department is currently conducting seven active investigations. We have moved the information regarding the investigations outside the Wynwood area to the Zika webpage, here. Identified one-square mile in Miami-Dade – Two (2) original cases Total # of Samples Collected Negative Samples Positive Samples Pending Results 518 492 23 4 Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going. On August 4, the department announced we have completed testing in a 10 block area of the northwest quadrant of the one-square mile area and no people within the 10 block radius tested positive. On August 11, the department announced that it completed testing in an additional four block area and no people within that four block area tested positive. A map detailing the area is below. The CDC continues to monitor the area per their guidelines. CLOSED INVESTIGATIONS The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). The department tested 124 close contacts and individuals from the community and found no additional positives. The department still believes active transmissions of the Zika virus are occurring in one small area in Miami-Dade County, just north of downtown. The exact location is within the boundaries of the following area: NW 5th Avenue to the west, US 1 to the east, NW/NE 38th Street to the north and NW/NE 20thStreet to the south. This area is about one square mile and a map is below to detail the area. This remains the only area of the state where the department has confirmed there are local transmissions of Zika. 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. The department has not yet determined where the individual in Palm Beach County or the three individuals outside the one-square mile in Miami-Dade County likely contracted Zika and will share more details as the investigations progress. If the department finds evidence that active transmission is occurring in an 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 one square mile area 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 63. 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 4,158 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. 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 461 Non-Travel Related Infections of Zika 33 Infections Involving Pregnant Women 63

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Wed Aug 17, 2016 3:15pm EDT Guatemala confirms first case of newborn with microcephaly linked to Zika Guatemalan authorities on Wednesday confirmed the Central American country's first case of a baby born with microcephaly linked to Zika. Carlos Mejia, director of the infectious diseases department at Guatemala City's Hospital Roosevelt, said two other suspected cases were also being analyzed. U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly, a birth defect marked by small head size that can lead to severe developmental problems in babies. The connection between Zika and microcephaly first came to light last fall in Brazil, which has now confirmed more than 1,600 cases of microcephaly that it considers to be related to Zika infections in the mothers. (Reporting by Sofia Menchu) http://www.reuters.com/article/us-health-zika-idUSKCN10S22P?utm_campaign=Contact+SNS+For+More+Referrer&utm_medium=twitter&utm_source=snsanalytics

TABLE I. Provisional cases of selected* infrequently reported notifiable diseases (<1,000 cases reported during the preceding year), United States, week ending August 13, 2016 (WEEK 32)† http://wonder.cdc.gov/mmwr/mmwr_2016.asp?mmwr_year=2016&mmwr_week=32&mmwr_table=1&request=Submit&mmwr_location= Disease Total cases reported for previous years Current week Cum 2016 5-year weekly average§ 2015 2014 2013 2012 2011 States reporting cases during current week (No.32) Anthrax - - - - - - - 1 Arboviral diseases ¶,**: Chikungunya virus †† - 63 7 896 NN NN NN NN Eastern equine encephalitis virus - 1 1 6 8 8 15 4 Jamestown Canyon virus §§ - 2 0 11 11 22 2 3 La Crosse virus §§ - 2 2 55 80 85 78 130 Powassan virus - 2 0 7 8 12 7 16 St. Louis encephalitis virus - - 0 23 10 1 3 6 Western equine encephalitis virus - - - - - - - - Botulism, total - 107 3 195 161 152 168 153 foodborne - 25 1 37 15 4 27 24 infant - 70 2 138 127 136 123 97 other(wound & unspecified) - 12 0 20 19 12 18 32 Brucellosis 3 69 3 126 92 99 114 79 OH (1 ), TN (1 ), TX (1 ) Chancroid - 8 0 11 - - 15 8 Cholera - - 0 2 5 14 17 40 Cyclosporiasis ** 17 249 28 645 388 784 123 151 NY (5 ), NYC (1 ), MD (1 ), VA (1 ), FL (2 ), TX (5 ), AZ (1 ), CA (1 ) Diphtheria - - - - 1 - 1 - Haemophilus influenzae, invasive disease (age <5 yrs) ¶¶: serotype b 1 11 1 29 40 31 30 14 KY (1 ) nontypeable serotype - 92 2 175 128 141 115 93 other serotype - 76 1 135 266 233 263 230 unknown serotype 2 130 3 167 39 34 37 48 MD (1 ), CA (1 ) Hansen's disease ** 2 26 2 89 88 81 82 82 FL (2 ) Hantavirus Infections **: Hantavirus infection (non-HPS) †† - 2 0 1 NN NN NN NN Hantavirus pulmonary syndrome (HPS) - 9 0 17 32 21 30 23 Hemolytic uremic syndrome, post-diarrheal ** 2 109 10 274 250 329 274 290 OH (1 ), OR (1 ) Hepatitis B, virus infection perinatal 1 16 1 37 47 48 40 NP PA (1 ) Influenza-associated pediatric mortality **, *** - 79 0 130 141 160 52 118 Leptospirosis ** 1 18 1 40 38 NN NN NN VT (1 ) Listeriosis 2 316 22 766 769 735 727 870 PA (1 ), AZ (1 ) Measles ††† - 49 2 188 667 187 55 220 Meningococcal disease, invasive §§§: serogroup ACWY - 57 2 120 123 142 161 257 serogroup B 1 46 1 111 89 99 110 159 OH (1 ) other serogroup - 11 0 21 25 17 20 20 unknown serogroup 3 118 3 120 196 298 260 323 NYC (1 ), TN (1 ), OR (1 ) Novel influenza A virus infections ¶¶¶ 4 7 11 6 3 21 313 14 MI (2), OH (2) Plague - - 0 13 10 4 4 3 Poliomyelitis, paralytic - - - - - 1 - - Polio virus infection, nonparalytic ** - - - - - - - - Psittacosis ** - 3 0 4 8 6 2 2 Q fever total **: - 67 3 156 168 170 135 134 acute - 57 3 122 132 137 113 110 chronic - 10 1 34 36 33 22 24 Rabies, human - - 0 1 1 2 1 6 SARS CoV - - - - - - - - Smallpox - - - - - - - - Streptococcal toxic shock syndrome ** 2 162 2 335 259 224 194 168 OH (2 ) Syphilis, congenital **** - 187 7 489 458 348 322 360 Toxic shock syndrome (staphylococcal) ** - 18 2 64 59 71 65 78 Trichinellosis ** 1 7 0 11 14 22 18 15 NY (1 ) Tularemia - 106 7 314 180 203 149 166 Typhoid fever 3 175 8 367 349 338 354 390 OH (1 ), VA (1 ), FL (1 ) Vancomycin-intermediateStaphylococcus aureus ** - 60 3 183 212 248 134 82 Vancomycin-resistant Staphylococcus aureus ** - - 0 1 - - 2 - Viral hemorrhagic Fevers ††††: Crimean-Congo hemorrhagic fever - - - - NP NP NP NP Ebola hemorrhagic fever - - - - 4 NP NP NP Guanarito hemorrhagic fever - - - - NP NP NP NP Junin hemorrhagic fever - - - - NP NP NP NP Lassa fever - - - - 1 NP NP NP Lujo virus - - - - NP NP NP NP Machupo hemorrhagic fever - - - - NP NP NP NP Marburg fever - - - - NP NP NP NP Sabia-associated hemorrhagic fever - - - - NP NP NP NP Yellow fever - - - - - - - - Zika ††,§§§§ Zika virus congenital infection NA NA NA NN NN NN NN NN Zika virus disease, non-congenital infection 3 2,194 - NN NN NN NN NN NYC (1 ), MD (1 ), TN (1 ) [ Export This Table ] [ Next Part ] [ NNDSS Interactive Tables ] [ Mortality Interactive Tables ] -: No reported cases N: Not reportable. NA: Not Available NN: Not Nationally Notifiable. NP: Nationally notifiable but not published. Cum: Cumulative year-to-date counts. * Case counts for reporting years 2015 and 2016 are provisional and subject to change. Data for years 2011 through 2014 are finalized. For further information on interpretation of these data, seehttp://wwwn.cdc.gov/nndss/document/ProvisionalNationaNotifiableDiseasesSurveillanceData20100927.pdf. † This table does not include cases from the U.S. territories. Three low incidence conditions, rubella, rubella congenital, and tetanus, are in Table II to facilitate case count verification with reporting jurisdictions. § Calculated by summing the incidence counts for the current week, the 2 weeks preceding the current week, and the 2 weeks following the current week, for a total of 5 preceding years. Additional information is available athttp://wwwn.cdc.gov/nndss/document/5yearweeklyaverage.pdf. ¶ Includes both neuroinvasive and nonneuroinvasive. Updated weekly reports from the Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases (ArboNET Surveillance). Data for West Nile virus are available in Table II. ** Not reportable in all reporting jurisdictions. Data from states where the condition is not reportable are excluded from this table, except for the arboviral diseases and influenza-associated pediatric mortality. Reporting exceptions are available athttp://wwwn.cdc.gov/nndss/downloads.html. †† Office of Management and Budget approval of the NNDSS Revision #0920-0728 on January 21, 2016, authorized CDC to receive data for these conditions. CDC is in the process of soliciting data for these conditions (except Zika virus, congenital infection). CDC and the U.S. states are still modifying the technical infrastructure needed to collect and transmit data for Zika virus congenital infections. §§ Jamestown Canyon virus and Lacrosse virus have replaced California serogroup diseases. ¶¶ Data for Haemophilus influenzae (all ages, all serotypes) are available in Table II. *** Please refer to the MMWR publication for weekly updates to the footnote for this condition. ††† Please refer to the MMWR publication for weekly updates to the footnote for this condition. §§§ Data for meningococcal disease (all serogroups) are available in Table II. ¶¶¶ Please refer to the MMWR publication for weekly updates to the footnote for this condition. **** Updated weekly from reports to the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. †††† Please refer to the MMWR publication for weekly updates to the footnote for this condition. §§§§ All cases reported have occurred in travelers returning from affected areas, with their sexual contacts, or infants infected in utero. National Notifiable Diseases Surveillance System (NNDSS) MMWR web application provided by CDC WONDER, http://wonder.cdc.gov

Zika ††,§§§§ Zika virus congenital infection NA NA NA NN NN NN NN NN Zika virus disease, non-congenital infection 3 2,194 - NN NN NN NN NN NYC (1 ), MD (1 ), TN (1 )

The recent cluster of Zika cases in Wynwood coupled with local transmissions in Broward, Palm Beach, and four Miami-Dade county cases raised concerns that Florida would begin exporting Zika cases, signaling a dire local situation. The initial reports on Wynwood cited Zika PCR detection in 6 urine samples from 52 asymptomatic residents. Subsequent reports indicated some employees at the index location showed symptoms in early June, so PCR testing of August samples would have missed infections in June and early July. Reports also noted that 14 of 30 employees at the index location had shown symptoms, also signaling a major Zika outbreak that was missed due to a focus on testing cases with recent travel to countries with local Zika cases. Moreover, investigations of new local cases has been limited. Instead testing focused on areas at the edge of the 1 mile transmission zone and press releases cited Florida;s beliefs that active transmission was limited to Wynwood, where 22 Zika cases have been lab confirmed. Now Zika exports have been reported in El Paso, Texas as well as New Taipai City in Taiwan. Both cases had been in Miami-Dade Country prior to development of symptoms. Yesterday, after the case in El Paso, the Florida update showed that no samples had been collected or tested in the local cases, both outside and inside of Winwood

Disease control authorities confirm 6th Zika case in New Taipei woman The China Post news staff August 18, 2016, 12:12 am TWN TAIPEI, Taiwan -- Disease control authorities yesterday said they had confirmed Taiwan's sixth Zika case in a local woman who had recently returned from a trip to Florida. The Centers for Disease Control (CDC) said the 44-year-old New Taipei resident had visited Miami on a business trip from July 31 to Aug. 11. She sought medical attention upon returning to Taiwan, and tests by a CDC laboratory confirmed the presence of the Zika virus, the authorities said. The woman is not pregnant and all her symptoms have subsided, the CDC said, adding that she was in good health and had been asked to stay home, avoid mosquito bites and isolate herself until Aug. 23 to prevent further spread of the virus. Neither of the two colleagues who traveled with her nor any of her family members who live with her have exhibited symptoms of infection, authorities said. The CDC has implemented various prevention measures, including eliminating vector breeding sites, investigating the mosquito population density around the homes of people confirmed to have contracted Zika and providing their family members with relevant health information. Taiwan reported its first imported Zika case in January. The patient was a Thai national coming to work in Taiwan. The fifth imported case was confirmed last week to be a 27-year-old Taiwanese man who is believed to have contracted the disease in the Caribbean, the CDC said. According to the CDC, the latest patient returned to Taiwan on Friday and began experiencing soreness in the fingers on her right hand. She developed a rash and sought medical attention the following day. The patient was in the U.S. in the incubation period, during which she visited Florida's Broward and Miami-Dade counties, the CDC said, adding that it had issued a Level 2 travel alert for both counties. As of Monday, a total of 30 non-travel-related Zika cases had been confirmed in Florida, and Texas had confirmed Zika in a patient who had traveled to Miami, the CDC said. The CDC said the U.S. and Taiwan had been working closely together to jointly tackle the spread of Zika. The U.S. Centers for Disease Control and Prevention has shared an isolate of the virus with Taiwanese researchers. http://www.chinapost.com.tw/health/infectious-diseases/2016/08/18/475828/Disease-control.htm

China appears first six cases Jingwaiyiru Zika infection cases went to Miami, Florida Travel Zhihuizhongxin Publication . 6 Li Jingwaiyiru Zika virus infection cases, this living in New Taipei City's 44 -year-old woman in . 7 Yue 31 Ri Zhi . 8 Yue . 11 Ri business trip to the United States in Miami, Florida, after the repatriation of the legs and abdomen rash doctor, after laboratory tests confirmed that the Department of disease control, Zika virus infection. The woman is not pregnant, the symptoms have subsided and in good health, will be home to mosquito isolation . 8 Yue 23 days, according to follow-up and " 2226 " the principle of self-protection, the United States and the case of two fellow colleagues and family members are currently no symptoms of infection, local health units have been the first time to go home to start preventive measures around cases. Case 12 Ri right tip knuckle pain case occurred after the repatriation of the body the next day due to rash have access to medical treatment. Since the latency of cases in the United States, and the place had been on a business trip in Florida Bulaowode county ( Broward ) and Miami County ( Miami-Dade ), the two counties are all disease outbreaks recommend two UNDCP travel warning area, it should be judged US infection. As . 8 Yue 15 on the US, Florida has a total of 30 cases of non-travel-related cases; also informed of another Texas 1 who had to travel to Miami case. Zhihuizhongxin said Taiwan and the United States is very close cooperation in epidemic prevention, the United States has been our previous points for the Zika virus, also this year, 4 Yue 13 Ri Zhi 15 Ri and the United States under the "Global Cooperation and Training Framework" handle "Zika virus test diagnosis international camp "and a total of 12 countries 24 participants; the other tube current disease epidemic Chenmeng Yu Department also sent doctors to the United States CDC training and actual participation Zika epidemic investigation, Taiwan and the US epidemic prevention information flow, our country has been through the international health regulations counterparts ( IHR National Focal Point ) notify the United States and World Health Organization. Cumulative global 66 countries / territories appear Zika local cases, illness UNDCP has been or is likely to have a local epidemic spread of 56 countries or territories, including Asia, Thailand, the Philippines, Vietnam, Indonesia 4 State and Miami, Florida County and Cloth Lao Wode County, tourism epidemic is recommended as a warning ( the alert ); other Asian Cambodia, Malaysia, Laos, Bangladesh, Maldives and Gabon in Africa and other 10 countries, in 2007 Zhi , 2015 there were years of the epidemic, but 2016 years yet reported cases, the epidemic is recommended as a travel note ( the Watch ). Zhihuizhongxin said the general Zika virus infection in adults with mild symptoms, but the infection in pregnant women may result in fetal death or microcephaly, reminding pregnant women and women planning pregnancy deferred to endemic areas. As people leave endemic areas, please follow the " 2226principles" for protection measures, regardless of women with and without suspected symptoms should be delayed 2 months of pregnancy; if no men suspected symptoms appear, 2 within months should avoid sex or use proper safety sets, if there is suspected of being infected, at least . 6 months should avoid sex or use condoms correctly. People go to Zika virus endemic areas be sure to take precautionary measures; the time of entry, such as repatriation conscious Zika virus suspected of being infected, should take the initiative to inform the airport quarantine officers; within two weeks after return home if unwell, seek medical advice and inform the doctor-speed travel history. Information to be disease UNDCP WWW or call toll-free vaccination Line 1922 (or 0800-001922 ) contact. http://www.cdc.gov.tw/info.aspx?treeid=45DA8E73A81D495D&nowtreeid=1BD193ED6DABAEE6&tid=32FA92BA668EE711

Taiwan confirms sixth imported Zika case in Taiwanese traveler who visited Miami, Florida( 2016-08-17 ) On August 17, 2016, the Central Epidemic Command Center for Zika Virus (CECC for Zika Virus) announced the sixth imported Zika case identified in Taiwan.　The case is a 44-year-old female who resides in New Taipei City and visited Miami, Florida, US during July 31 and August 11, 2016 for business. After she returned to Taiwan, she sought medical attention after developing rash on her legs and abdomen. Infection with Zika virus was confirmed in the case by the Taiwan for Centers for Disease Control (Taiwan CDC) laboratory. The case is not pregnant and all her symptoms have subsided. She is currently in good health.　The case has been asked to stay home, prevent mosquito bites, and isolate herself till August 23 and follow the “2226 Principle” to prevent further spread of the virus. None of the other two colleagues who went on the business trip with her to Miami and her family members who reside in the same household have developed symptoms. The local health authority has promptly implemented various prevention measures, including cleaning of vector breeding sites, investigating the mosquito population density around the case’s residence, and providing the case’s family members with relevant health education. According to the epidemiological investigation, after the case returned to Taiwan on August 12, she developed sore in her distal phalanges on her right hand. On the following day, she sought medical attention after developing rash. During the incubation period, the case was in the U.S. and visited Broward and Miami-Dade counties, Florida, both of which Taiwan CDC has issued a travel notice of Level 2: Alert for Zika virus for. Hence, it is determined that the case contracted Zika virus in the U.S. As of August 15, 2016, a cumulative total of 30 non-travel related Zika cases have been confirmed in Florida, U.S. and Texas has reported one Zika case who traveled to Miami. CECC for Zika virus pointed out that the U.S. and Taiwan have been working closely together to jointly tackle global public health issues. Previously, the U.S. Centers for Disease Control and Prevention (US CDC) has shared an isolate of Zika virus with Taiwan.　In addition, during April 13 and 15, 2016, under the US-Taiwan Global Cooperation Training Framework (GCTF), the U.S. and Taiwan co-organized the International Training Workshop on Molecular Diagnosis for Zika, which was participated by 24 laboratory professionals from 12 countries. On top of that, Taiwan CDC has sent a medical officer to US CDC to attend relevant training and participate in actual investigation concerning Zika virus. Communication regarding the prevention and control of infectious diseases between the two countries has been smooth. Taiwan has notified the U.S. and the World Health Organization (WHO) concerning this latest imported Zika case through the National IHR Focal Point. Thus far, at least 66 countries, areas and/or territories worldwide, primarily in Latin America and the Caribbean region, have reported local outbreaks of Zika virus infection. Taiwan CDC has issued a travel notice of Level 2: Alert for Zika virus for 56 countries and territories with ongoing outbreaks or possible local transmission of Zika virus, including 4 countries in Asia: Thailand, the Philippines, Vietnam and Indonesia, as well as Broward and Miami-Dade counties, Florida. Moreover, during 2007 and 2015, about 10 countries, including Cambodia, Malaysia, Laos, Bangladesh, Maldives and Gabon, reported Zika outbreaks. Nonetheless, thus far in 2016, no Zika cases have been reported in those 10 countries. Hence, Taiwan CDC has issued a travel notice of Level 1: Watch for Zika virus for those countries.　 Current scientific evidence has proved that Zika virus infection is usually mild in adults and suggested the occurrence of congenital microcephaly and even deaths in babies of mothers who were infected with Zika virus while pregnant. Therefore, pregnant women and women planning pregnancy are advised to postpone all unnecessary travels to Zika-affected areas. CECC for Zika Virus urges travelers returning to Taiwan from Zika-affected areas to follow the “2226 Principle” to prevent Zika transmission. The “2226 Principle” specifies that female travelers are urged to seek immediate medical attention if they develop suspected Zika symptoms within 2 weeks of their return from an affected-area and postpone pregnancy 2 months after their return regardless whether they develop suspected Zika symptoms, and male travelers, if they do not develop suspected Zika symptoms, are urged to avoid sex or use condoms correctly for 2 months after their return from an affected-area and if they develop suspected Zika symptoms, they are urged to avoid sex or use condoms correctly for 6 months after their return. Travelers visiting affected areas are urged to take precautions against mosquito bites such as wearing light-colored clothing, long sleeves and long pants, applying officially approved mosquito repellent to exposed parts of the body, staying at accommodations installed with window screens, screen doors or air conditioners. Further, Taiwan CDC urges travelers returning from affected areas to proactively contact the quarantine officer at the fever screening station at the airport when suspected symptoms develop. If symptoms develop within two weeks of their return, please seek immediate medical attention and inform the physician of their travel history. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline,1922 (or 0800-001922).　 Last modified at 2016-08-17 Data from Division of Planning and Coordination http://www.cdc.gov.tw/english/info.aspx?treeid=BC2D4E89B154059B&nowtreeid=EE0A2987CFBA3222&tid=E285278D5A2EE5A6

Taiwan reports sixth imported Zika infection 2016/08/17 21:49:37 Taipei, Aug. 17 (CNA) Taiwan has confirmed its sixth imported case of Zika virus infection, involving a 44-year-old female national who appeared to have contracted the disease in Miami, Florida, the country's Centers for Disease Control (CDC) said Wednesday. The woman, who resides in New Taipei City, visited Miami between July 31 and August 11, 2016 for business, the CDC said, adding that after she returned to Taiwan, she sought medical attention after developing a rash on her legs and abdomen. The patient, who is not pregnant and whose symptoms have subsided, was confirmed to have been infected with the Zika virus by the CDC laboratory, it said. She is currently in good health. She has been asked to stay home, prevent mosquito bites, and isolate herself until August 23 and follow the "2226 Principle" to prevent further spread of the virus, the CDC said in a press release. The "2226 Principle" specifies that female travelers are urged to seek immediate medical attention if they develop suspected Zika symptoms within two weeks of their return from an affected-area, postpone pregnancy two months after their return regardless of whether they develop suspected Zika symptoms, and take precautions against mosquito bites. Neither of the other two colleagues who went on the business trip with her to Miami nor her family members who reside in the same household have developed symptoms, it said. Taiwan's five previous Zika cases were reported on Jan. 19, May 21, June 6, Aug. 4 and Aug. 12, respectively, involving two Thai nationals, a fishery worker from Indonesia and two local citizens. Taiwan has notified the U.S. and the World Health Organization (WHO) concerning this latest imported Zika case through the National IHR Focal Point, it said. (By Yu Hsiao-han and Romulo Huang) enditem/ke

Taipei, Aug. 17 (CNA) Taiwan has confirmed its sixth imported case of Zika virus infection, involving a 44-year-old female national who appeared to have contracted the disease in Miami, Florida, the country's Centers for Disease Control (CDC) said Wednesday.The woman, who resides in New Taipei City, visited Miami between July 31 and August 11, 2016 for business, the CDC said, adding that after she returned to Taiwan, she sought medical attention after developing a rash on her legs and abdomen. http://focustaiwan.tw/news/asoc/201608170022.aspx

Taiwan reports sixth imported Zika infection 2016/08/17 21:49:37 Taipei, Aug. 17 (CNA) Taiwan has confirmed its sixth imported case of Zika virus infection, involving a 44-year-old female national who appeared to have contracted the disease in Miami, Florida, the country's Centers for Disease Control (CDC) said Wednesday. The woman, who resides in New Taipei City, visited Miami between July 31 and August 11, 2016 for business, the CDC said, adding that after she returned to Taiwan, she sought medical attention after developing a rash on her legs and abdomen. The patient, who is not pregnant and whose symptoms have subsided, was confirmed to have been infected with the Zika virus by the CDC laboratory, it said. She is currently in good health. She has been asked to stay home, prevent mosquito bites, and isolate herself until August 23 and follow the "2226 Principle" to prevent further spread of the virus, the CDC said in a press release. The "2226 Principle" specifies that female travelers are urged to seek immediate medical attention if they develop suspected Zika symptoms within two weeks of their return from an affected-area, postpone pregnancy two months after their return regardless of whether they develop suspected Zika symptoms, and take precautions against mosquito bites. Neither of the other two colleagues who went on the business trip with her to Miami nor her family members who reside in the same household have developed symptoms, it said. Taiwan's five previous Zika cases were reported on Jan. 19, May 21, June 6, Aug. 4 and Aug. 12, respectively, involving two Thai nationals, a fishery worker from Indonesia and two local citizens. Taiwan has notified the U.S. and the World Health Organization (WHO) concerning this latest imported Zika case through the National IHR Focal Point, it said. (By Yu Hsiao-han and Romulo Huang) enditem/ke

Taiwan has confirmed its sixth imported case of Zika virus infection, involving a 44-year-old female national who appeared to have contracted the disease in Miami, Florida, the country's Centers for Disease Control (CDC) said Wednesday. http://focustaiwan.tw/news/asoc/201608170022.aspx

08.17.16 1:00 AM ET Zika Hits Miami’s Outdoor Restaurants Wynwood Yard is an outdoor eatery and event space in a bustling Miami neighborhood. And three of its employees have been diagnosed with Zika. MIAMI — August is already a slow month in Miami. Between the oppressive heat, suffocating humidity, and frequent rain, the locals who haven’t already fled to a less tropical clime prefer to stay inside. Add news of a Zika outbreak to the mix and business can slow to a crawl. Especially if you’re right in the middle of the area outlined by the CDC as a potential danger zone for transmission of the virus. “It’s definitely very scary—especially at this time of year—to be running such a crazy budget with no revenue,” Della Heiman, the entrepreneur behind the open-air events space and food truck gathering spot Wynwood Yard, told The Daily Beast in an interview at a local juicery. That’s what Heiman had to do for a week during Miami’s homegrown Zika crisis. When the CDC announced additional cases of transmission in the Wynwood neighborhood on Aug. 1, Heiman was on the phone until 4 a.m. the next morning, ultimately deciding to close up shop temporarily. “Otherwise we could be exposing our team to a situation that’s unsafe and we could be exposing our customers to something that’s unsafe,” Heiman explained. She paid her employees to stay home for the rest of the week and encouraged her tenants in the space to do the same, all while abating rent payments. Most importantly, she held prevention trainings and encouraged all of her employees to get tested for Zika, with so many showing up that the health department was shocked. “They were like, ‘What did you do to coerce all of these people to come?’” Heiman laughed. Two years ago, Heiman had no idea she would be at the helm of a fully outdoor business, let alone staving off a Zika crisis. The Harvard Business School grad first came to Miami in 2014 hoping to open an indoor fresh food bowl restaurant but she was ultimately deterred by the city’s challenging real estate market. “I spent eight months trying to find a brick and mortar space and I just couldn’t find a single site that made sense,” she said. Going mobile wasn’t necessarily a viable option, either, as Miami zoning and permit requirements make it difficult for food truck operators to find space. But after meeting other restaurateurs who were facing the same barrier, Heiman acquired four vacant lots in the trendy Wynwood area and opened the Yard as a “culinary incubation space” last November. Now, the Yard plays host to several food trucks—with offerings ranging from omakase sushi to ice cream to fish and chips—all of whom have access to shared resources. At the middle of it all is a bar that gets its herbs from an on-site garden. “It feels like a little neighborhood,” said Heiman. “People walk up and say, ‘Can I borrow a lemon?’ or ‘Can I borrow an egg?’” The fully-outdoor space was part of the Yard’s appeal: Most Miami bars live or die by their patios anyway, so why not have a space that was all patio? As it turns out, however, the open-air operations have come with unexpected consequences. Two Yard employees fell ill in mid-to-late July. At the time, Heiman said, their doctors didn’t suspect the Zika virus, as there were not yet any documented cases of local transmission in the continental U.S. Then, the CDC’s August announcement came, along with more rigorous testing, which has revealed the full extent of the problem. So far, three Wynwood Yard employees have tested positive for Zika, with all of them reportedly doing well now. But the news came with consequences, like the perception that the Yard was “ground zero” for the virus, especially because there have only been 22 reported cases of local transmission to date. “Geographically, we might be close to ‘ground zero’ but chronologically, there’s no way,” Heiman said. “I think it would be a huge stretch unless there’s something I don’t know.” The CDC has stated that the suspected “ground zero” site is a small area in Wynwood witha 500-foot radius that includes two businesses. But Florida health officials have refused to give out the names of the businesses, as WSVN reported. The CDC has specified, however, that June 15 is the earliest possible date for mosquito-borne Zika in Wynwood, which falls about a month before the first two Yard employees got sick. And as employees have tested positive, the Yard has had to point out that these are notnewly-transmitted cases—a PR struggle that recalls Chipotle’s efforts to keep customers coming as the E. coli tally rose, even though the cases were not brand new. “Every time that it comes out, it looks to the public like it just happened,” said Heiman, stressing that the Yard has “had no one else get sick” since the CDC’s announcement. While the CDC has not yet lifted its travel advisory for pregnant women and their partners, Heiman decided to reopen the Yard on Aug. 10 after an intense week of spraying throughout Wynwood. Heiman has installed some countermeasures of her own. Like many local business, the Yard is giving free bug spray and mosquito repellent towelettes to customers. And thanks to a donation from her landlord, Heiman had an expensive MosquitoNix system installed, which mists the area with the non-synthetic insecticide pyrethrum. “We keep saying that Wynwood Yard is the safest place in Miami now because we’re so vigilant and we’re so concerned,” Heiman said. “That’s a very strong statement but it is quite safe.” Business remains slow after the reopening but Heiman is still planning an expansion in October with more tenants, a fine dining restaurant, and a revamped garden. “The pressure is still there and the losses are still there but [I’m] confident that we’re going to bounce back from this,” she said. And on that upbeat note, the interview came to a close. 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Haiti finds case of microcephaly linked to Zika virus left right 2/2 left right Gabriel Thimothe, director general at the ministry of public health and population, listens during an interview with Reuters in Port-au-Prince, Haiti, August 16, 2016. REUTERS/Andres Martinez Casares 1/2 left right 2/2 left right 1/2 By Makini Brice | PORT-AU-PRINCE Haiti has identified its first case of the birth defect microcephaly linked to the Zika virus, a senior health ministry official said on Tuesday. Gabriel Thimothe, director general at the ministry of public health and population, said the case was confirmed on Saturday by the U.S. Centers for Disease Control and Prevention (CDC). Haiti has confirmed 14 cases of the birth defect since March, up from previous reports of two cases, Raymond Grand Pierre, the director of the Department of Health and Family in the Ministry of Health, said. In the other 13 cases, authorities have not established a link to microcephaly although the number may indicate Zika is more widespread in Haiti than previously thought. According to a chart provided by the Centers for Disease Control, Haiti has recorded nearly 3,000 Zika cases. But the World Health Organization says the overwhelming majority of cases of the virus in the island nation are suspected and not confirmed. Thimothe said the baby with Zika-linked microcephaly was born in the city of Mirebalais earlier this summer. Boston-based Partners in Health and its sister organization, Haiti-based Zanmi Lasante, said in a statement on Aug. 9 that two babies had been born with microcephaly in their University Hospital Mirebalais. U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly. The World Health Organization has said there is strong scientific consensus that Zika can also cause Guillain-Barre, a rare neurological syndrome that causes temporary paralysis. The connection between Zika and microcephaly first came to light last fall in Brazil, which has now confirmed more than 1,600 cases of microcephaly that it considers to be related to Zika infections in the mothers. Haiti's healthcare system is still suffering from the fallout of the 2010 earthquake that killed about 300,000 people and a still-ongoing cholera epidemic that began shortly afterward, killing about 8,600 people and infecting 707,000. Health facilities were also paralyzed this year by a months-long strike by medical residents over pay and working conditions, which Thimothe said had largely ended. (Reporting by Makini Brice in Port-au-Prince; Editing by Sandra Maler and Cynthia Osterman) http://www.reuters.com/article/us-health-zika-haiti-idUSKCN10R2N1

MC Map Update https://www.google.com/maps/d/u/0/edit?mid=1RcVTrkYW6hax_iITjKUkEcBCVeI

intensified surveillance of microcephaly Review 12 August 2016 Among the epidemiological weeks 01 to 31, 2016 have been confirmed twenty-four (24) cases associated with microcephaly Zika virus, 101 cases were dismissed and 242 cases are in study. http://www.ins.gov.co/boletin-epidemiologico/Boletn Epidemiolgico/2016 Boletin epidemiologico semana 31.pdf

Haiti finds case of microcephaly linked to Zika virus left right 2/2 left right Gabriel Thimothe, director general at the ministry of public health and population, listens during an interview with Reuters in Port-au-Prince, Haiti, August 16, 2016. REUTERS/Andres Martinez Casares 1/2 left right 2/2 left right 1/2 By Makini Brice | PORT-AU-PRINCE Haiti has identified its first case of the birth defect microcephaly linked to the Zika virus, a senior health ministry official said on Tuesday. Gabriel Thimothe, director general at the ministry of public health and population, said the case was confirmed on Saturday by the U.S. Centers for Disease Control and Prevention (CDC). Haiti has confirmed 14 cases of the birth defect since March, up from previous reports of two cases, Raymond Grand Pierre, the director of the Department of Health and Family in the Ministry of Health, said. In the other 13 cases, authorities have not established a link to microcephaly although the number may indicate Zika is more widespread in Haiti than previously thought. According to a chart provided by the Centers for Disease Control, Haiti has recorded nearly 3,000 Zika cases. But the World Health Organization says the overwhelming majority of cases of the virus in the island nation are suspected and not confirmed. Thimothe said the baby with Zika-linked microcephaly was born in the city of Mirebalais earlier this summer. Boston-based Partners in Health and its sister organization, Haiti-based Zanmi Lasante, said in a statement on Aug. 9 that two babies had been born with microcephaly in their University Hospital Mirebalais. U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly. The World Health Organization has said there is strong scientific consensus that Zika can also cause Guillain-Barre, a rare neurological syndrome that causes temporary paralysis. The connection between Zika and microcephaly first came to light last fall in Brazil, which has now confirmed more than 1,600 cases of microcephaly that it considers to be related to Zika infections in the mothers. Haiti's healthcare system is still suffering from the fallout of the 2010 earthquake that killed about 300,000 people and a still-ongoing cholera epidemic that began shortly afterward, killing about 8,600 people and infecting 707,000. Health facilities were also paralyzed this year by a months-long strike by medical residents over pay and working conditions, which Thimothe said had largely ended. (Reporting by Makini Brice in Port-au-Prince; Editing by Sandra Maler and Cynthia Osterman) http://www.reuters.com/article/us-health-zika-haiti-idUSKCN10R2N1

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

Reported Cases of Zika in New York City as of 8/12/2016 [Español (PDF)] Positive NYC Residents Case Type Number of Cases Locally acquired mosquito-borne reported† 0 Travel-associated* 463 Sexually transmitted: 5 Guillain-Barre syndrome: 3 Infants with birth defects: 1 Laboratory acquired 0 Pending Verification of Travel 20 Total 483 Gender Number of Cases Female 340 Pregnant: 49 Male 143 Age Average Age (Range) 39 (1-78) Positive NYC Resident by Borough Number of Cases Bronx 176 Brooklyn 111 Manhattan 103 Queens 88 Staten Island 4 Unknown 1 Most Common Countries Visited Number of Cases Dominican Republic 268 Puerto Rico 41 Jamaica 38 Guyana 16 Trinidad and Tobago 14 Saint Lucia 11 Colombia 10 Saint Vincent and the Grenadines 10 Grenada 7 Barbados 6 †Presumed local mosquito-borne transmission *Travelers returning from affected areas, their sexual contacts, or infants infected in utero

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