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Florida DoH Zika Active Investigation Confusion


niman

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On August 30, the Florida MoH reported a record number of separate local cases in Miami-Dade county.  In addition to the Miami Beach cluster, 2 new local cases were cited as new investigations.  The press release stated that the new cases raised the number of active investigations to 12, with a link to the active investigation page, but the page was not update and only contained the data as of August 29, which had 10 active investigations.

The August 29 page had internal inconsistencies as well as a confusing notation of pending samples.  Several pending had been posted in the pending column for over a week, suggesting they were positive in Florida DoH Zika antibody tests and were awaiting confirmation by the CDC.  This interpretation was supported by FLorida DoH comments in the Aug 23 press release when four samples that had been pending for the Wynwood cluster were upgraded to positive.  The press release noted that these four samples had been from cases symptomatic in mid-July, but were classified as pending because the CDC had not yet ruled out cross reactivity due to a Dengue or Chikingunya, which was unlikely because these cases were linked to a confirmed Zika cluster.

Several other active investigations had similar samples which had been in the pending column for at least a week, including 2 samples in investigation #2 (21 samples had been collected, and 19 were negative, but 2 remained pending).  On August 24 the Florida DoH added an asterisk to the pending column indicating   " *Awaiting confirmatory testing from CDC to rule out infection." suggesting that these two samples had also been antibody positive.  

However, on August 25 the two pending samples were updated and moved to the negatively column, so all 21 collected samples were negative, but the asterisk remained on the pending column, which showed 0 pending samples.

On August 26 Recombinomics requested an explanation for the change in status for the two samples in investigation 2 as well as other samples that had been pending for over a week (5 samples in investigation 5 and 2 samples in investigation 6).  An explanation was promised, but still has not been received.

On August 29 the five samples were removed from the pending column.  The negative column was increased from 1 to 5, but the data for the investigation was the internally inconsistent with 6 samples collected and 5 classified (as negative).  The status of the sixth sample was no longer reflected in the table,

Similar internal inconsistencies were seen in investigation #8, where 133 were listed as collected, but status was given for 128 (110 negative, 1 positive, 17 pending).

These inconsistencies posted on August 29 remained current, since no August 30 update has been reported although the August 30 press release cited 3 new local cases and 12 active investigations.

http://www.floridahealth.gov/newsroom/2016/08/083016-zika-update.html

 

Edited by niman
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The department is currently conducting 12 investigations. Information regarding the investigations can be found here. If investigations reveal additional areas of active transmission, the department will announce a defined area of concern. 

http://www.floridahealth.gov/newsroom/2016/08/083016-zika-update.html

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From August 23 press release:

There are five new non-travel related cases today, including four in Miami-Dade and one in Pinellas County. The four individuals in Miami-Dade were identified within the Wynwood area and experienced symptoms of Zika in mid-July. However, the cases are being announced today following confirmatory antibody testing to rule out other mosquito-borne illness such as Dengue and Chikungunya.

http://www.floridahealth.gov/newsroom/2016/08/082316-zika-update.html

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August 23 AI update

The department is currently conducting eight active investigations.

 

1)    Identified one-square mile in Miami-Dade – Two (2) original cases

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

519

492

29

0

Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going.

The department has cleared three portions within the one-square mile as no additional people tested positive in those areas. The CDC continues to monitor the area per their guidelines.

2)    First Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

21

19

0

2

 

3)    One (1) case in Palm Beach County:

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

3

3

0

0

 

4) Second Miami-Dade investigation outside of Wynwood: One (1) case

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of  interest.

 

5) Third Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

6

1

0

5

 

6) Fourth Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

26

6

0

20

 

7) Sixth Miami-Dade investigation outside of Wynwood: One (1) case

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest

8) Miami-Beach Investigation: Five index cases, 3 are out of state

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest

9) Pinellas Investigation: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

3

0

0

3

 

CLOSED INVESTIGATIONS

  • The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). On Aug. 23, the department had enough information to close two of the ongoing investigations in Miami-Dade County, both were determined to be single cases with no additional transmission or linkage to areas of active transmission. 

 

 

Data as of Aug. 23, 2016 - 8:05pm EST

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August 24 AI Update

The department is currently conducting 10 active investigations.

1)    Identified one-square mile in Miami-Dade – Two (2) original cases

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

519

492

27

0

Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going.

The department has cleared three portions within the one-square mile as no additional people tested positive in those areas. The CDC continues to monitor the area per their guidelines.

2)    First Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results*

21

19

0

2

 *Awaiting confirmatory testing from CDC to rule out infection.

3)    One (1) case in Palm Beach County:

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

3

3

0

0

4) Second Miami-Dade investigation outside of Wynwood: One (1) case

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest.

5) Third Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

6

1

0

5

 
6) Fourth Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

27

24

0

3

7) Sixth Miami-Dade investigation outside of Wynwood: One (1) case

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest.

8) Miami-Beach Investigation: Five index cases, 3 are out of state

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest.

9) Pinellas Investigation: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

3

0

0

3

 

10) Second Palm Beach County Investigation: One (1) case

The investigation is beginning in Palm Beach County. Mosquito abatement and reduction activities will take place around the area of interest.

 

CLOSED INVESTIGATIONS

  • The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). On Aug. 23, the department had enough information to close two of the ongoing investigations in Miami-Dade County, both were determined to be single cases with no additional transmission or linkage to areas of active transmission.
 

Data as of Aug. 24, 2016 - 12:58pm EST

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August 25 AI update

The department is currently conducting 10 active investigations.

1)    Identified one-square mile in Miami-Dade – Two (2) original cases

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

519

492

27

0

Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going.

The department has cleared three portions within the one-square mile as no additional people tested positive in those areas. The CDC continues to monitor the area per their guidelines.

2)    First Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results*

21

21

0

0

 *Awaiting confirmatory testing from CDC to rule out infection.

3)    One (1) case in Palm Beach County:

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

3

3

0

0

4) Second Miami-Dade investigation outside of Wynwood: One (1) case

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest.

 5) Third Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

6

1

0

5

 
6) Fourth Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

27

24

0

3

7) Sixth Miami-Dade investigation outside of Wynwood: One (1) case

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest

8) Miami-Beach Investigation: Five index cases, 3 are out of state

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

97

0

0

97


9) Pinellas Investigation: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

3

0

0

3

 

10) Second Palm Beach County Investigation: One (1) case


The investigation is beginning in Palm Beach County. Mosquito abatement and reduction activities will take place around the area of interest.

 

CLOSED INVESTIGATIONS

  • The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). On Aug. 23, the department had enough information to close two of the ongoing investigations in Miami-Dade County, both were determined to be single cases with no additional transmission or linkage to areas of active transmission. 

http://www.floridahealth.gov/diseases-and-conditions/zika-virus/index.html?utm_source=flhealthIndex

 

Data as of Aug. 25, 2016 - 6:15pm EST

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Aug 26 AI Update

The department is currently conducting 10 active investigations.

1)    Identified one-square mile in Miami-Dade – Two (2) original cases

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

519

492

26

0

Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going.

The department has cleared three portions within the one-square mile as no additional people tested positive in those areas. The CDC continues to monitor the area per their guidelines.

2)    First Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results*

21

21

0

0

 *Awaiting confirmatory testing from CDC to rule out infection.

3)    One (1) case in Palm Beach County:

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

3

3

0

0

4) Second Miami-Dade investigation outside of Wynwood: One (1) case

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest.

 5) Third Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

6

1

0

5

 
6) Fourth Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

27

24

0

3

7) Sixth Miami-Dade investigation outside of Wynwood: One (1) case

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest

8) Miami-Beach Investigation: Five index cases, 3 are out of state

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

97

0

0

97


9) Pinellas Investigation: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

21

3

0

18

 

10) Second Palm Beach County Investigation: One (1) case


Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

5

0

0

5

 

CLOSED INVESTIGATIONS

  • The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). On Aug. 23, the department had enough information to close two of the ongoing investigations in Miami-Dade County, both were determined to be single cases with no additional transmission or linkage to areas of active transmission.
 

Data as of Aug. 26, 2016 - 3:09pm EST

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Aug 29 and current AI update 

The department is currently conducting 10 active investigations.

1)    Identified one-square mile in Miami-Dade – Two (2) original cases

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

519

492

26

1

Door to door outreach and sampling continue. Mosquito abatement and reduction activities are on-going.

The department has cleared nearly the entire perimeter of the one-square mile as no additional people tested positive in that area. The CDC continues to monitor the area per their guidelines.

2)    First Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results*

21

21

0

0

 *Awaiting confirmatory testing from CDC to rule out infection.

3)    One (1) case in Palm Beach County:

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

3

3

0

0

4) Second Miami-Dade investigation outside of Wynwood: One (1) case

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest.

 5) Third Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

6

5

0

0

 
6) Fourth Miami-Dade investigation outside of Wynwood: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

27

24

0

3

7) Sixth Miami-Dade investigation outside of Wynwood: One (1) case

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest

8) Miami-Beach Investigation: Five index cases, three are out of state

The investigation is beginning in this area in Miami-Dade County. Mosquito abatement and reduction activities will take place around the area of interest

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

133

110

1

17


9) Pinellas Investigation: One (1) case

Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

39

13

0

26

10) Second Palm Beach County Investigation: One (1) case


Total # of Samples Collected

Negative Samples

Positive Samples

Pending Results

5

0

0

5

 

CLOSED INVESTIGATIONS

  • The department has closed out the investigations into the first cases in Miami-Dade and Broward County (two cases). On Aug. 23, the department had enough information to close two of the ongoing investigations in Miami-Dade County, both were determined to be single cases with no additional transmission or linkage to areas of active transmission.
 

Data as of Aug. 29, 2016 - 6:03pm EST

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  • 2 weeks later...

On Sept. 7, the state health department, in response to questions from the Herald, said eight out-of-state residents have contracted Zika in Florida but are not included in the total count.

The agency also has stopped issuing details of active investigations into local Zika cases. On Sept. 1, the health department began reporting only a summary of the total number of investigations in each county. Previously, the agency had listed each investigation by county, with the number of people tested for Zika and the results of those tests.

Gambineri explained the change in an email: “The department is working to ensure the information is easy to understand. It had become confusing.”

http://www.miamiherald.com/news/health-care/article100939277.html

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  • 2 weeks later...

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