Global & Disaster Medicine

Archive for July, 2016

Zika Update in the US


 Map of the United States showing Travel-associated and Locally acquired cases of the Zika virus. The locations and number of cases can be found in the table below.

As of July 27, 2016 (5 am EST)

  • Zika virus disease and Zika virus congenital infection are nationally notifiable conditions.
  • This update from the CDC Arboviral Disease Branch includes provisional data reported to ArboNET for January 01, 2015 – July 27, 2016.

US States

  • Locally acquired mosquito-borne cases reported: 0
  • Travel-associated cases reported: 1,657
  • Laboratory acquired cases reported:  1
  • Total: 1,658
    • Sexually transmitted: 15
    • Guillain-Barré syndrome: 5

US Territories

  • Locally acquired cases reported: 4,729
  • Travel-associated cases reported: 21
  • Total: 4,750*
    • Guillain-Barré syndrome: 17

Pregnant Women with Any Laboratory Evidence of Possible Zika Virus Infection

US States and the District of Columbia*:  433

*Includes aggregated data reported to the US Zika Pregnancy Registry as of July 21, 2016

US Territories**:  422

**Includes aggregated data from the US territories reported to the US Zika Pregnancy Registry and data from Puerto Rico reported to the Zika Active Pregnancy Surveillance System( as of July 21, 2016



Florida DOH

“…..The department continues its investigations into four possible non-travel related Zika virus cases, with two in Miami-Dade and two Broward counties. Door-to-door outreach and sample collection are ongoing in all cases. The department will share more details as they become available. Residents and visitors are urged to participate in requests for urine samples by the department in the areas of investigation. These results will help the department determine the number of people affected.

Zika prevention kits and repellent are being distributed in the areas of investigation, through local OBGYN offices and at both DOH-Broward and DOH-Miami-Dade…..”


Advice to Blood Collection Establishments on Non-Travel Related Cases of Zika Virus in Florida


July 27, 2016

The Office of the ‎Florida Department of Health State Surgeon General has announced that it is conducting an epidemiological investigation into a number of non-travel related cases of Zika virus in Miami-Dade and Broward Counties. These may be the first cases of local Zika virus transmission by mosquitoes in the continental United States. Miami-Dade County and Broward County are adjacent counties in South Florida.

In consideration of the possibility of an emerging local outbreak of Zika virus, and as a prudent measure to help assure the safety of blood and blood products, FDA is requesting that all blood establishments in Miami-Dade County and Broward County cease collecting blood immediately until the blood establishments implement testing of each individual unit of blood collected in the two counties with an available investigational donor screening test for Zika virus RNA or until the blood establishments implement the use of an approved or investigational pathogen inactivation technology.

Additionally, FDA recommends that adjacent and nearby counties implement the precautions above to help maintain the safety of the blood supply as soon as possible.

For blood collection establishments outside of this region, FDA suggests that donors who have traveled to Miami-Dade and Broward Counties during the previous 4 weeks be deferred.

FDA will continue to monitor this potential outbreak in cooperation with the Centers for Disease Control and Prevention (CDC) and Florida State public health authorities and provide updates as additional information becomes available.


South Sudan: 271 cholera cases in the past 2 weeks, including 14 deaths


WHO and Ministry of Health expand cholera response to minimize future risk

Juba, 25 July 2016 – In a move to prevent a cholera outbreak from spreading, the Ministry of Health of South Sudan with support from the World Health Organization (WHO) and health partners are ramping up disease surveillance and treatment efforts. Across the country, 271 cholera cases have been reported, including 14 deaths since 12 July 2016.

“Cholera is an acute diarrhoeal disease that causes massive loss of body fluids and can be deadly within hours if not adequately treated. WHO is taking all the necessary control measures to support the Ministry of Health to respond to the situation urgently, and put an end to this outbreak,” says Dr Abdulmumini Usman, WHO Representative to South Sudan.

“This work is vital because the conditions are favourable for transmitting the disease. These include increased population displacement, overcrowding, poor hygiene and sanitation. WHO is working with the Ministry of Health and other partners on ground to contain and prevent further spread of the disease,” added Dr Abdulmumini.
WHO has reinforced its cholera outbreak response capability to prevent the spread of the disease. A National Cholera Taskforce (comprising the Ministry of Health, WHO, UNICEF, MSF and other partners) has been activated and is providing oversight and coordination for the response to the cholera outbreak.

With more than 270 cholera cases, providing swift treatment is essential. WHO, with support from partners, has established a cholera treatment centre capable of treating 100 patients at Juba Teaching Hospital. To improve access to timely rehydration, eight oral rehydration points have been established by Health Link South Sudan with support from UNICEF. Priority locations for oral rehydration points in Juba include Gurei, Munuki, Kator, Lologo, Mahad, Nyakuron and Gumbo. Additional points are being set-up in El Sabah, Giada and Gorom.

WHO has strengthened disease surveillance and comprehensive disease investigation, including following up on people who may have come into contact with the disease.

As a proactive preventive measure, WHO along with the Ministry of Health and partners are planning to conduct an oral cholera vaccination campaign to reach over 14 000 people. The campaign is set to start on 26 July 2016 at various sites including communities in Gorom and Giada and special populations such as internally displaced people in Tomping.

Additionally, WHO and partners are supporting social mobilization and community engagement activities. The media is currently airing cholera prevention messages and a toll-free phone line to report cholera cases has been activated.

WHO and partners have delivered supplies including tents and cholera kits that provide treatment for 400 people. To improve case detection and treatment of cholera, WHO has also distributed cholera preparedness and response guidelines.

WHO is appealing to all partners to strengthen preventive and control measures before the disease spreads to other camps and host communities. This outbreak further exacerbates an already weak health system which is also battling malnutrition, measles and malaria.

“The risk of further spread of diseases is a major concern. With the coming rains, it is realistic to expect an increase in malaria and water-borne diseases. Consequently, we can expect medical needs to increase in an environment where WHO and partners are already working hard to keep up with existing health needs,” says Dr Abdulmumini.

With 4.4 million people in need of health assistance, funding is urgently needed to respond to the rising needs. The South Sudan Humanitarian Response Plan launched earlier this year requests US$ 110 million, of which US$ 31.3 million has been received (71% funding gap). Of this amount, WHO requires US$ 17.5 million for 2016, of which only US$ 4.3 million has been received. More funding will be required to respond to the additional needs arising from this recent crisis.

“We have this opportunity to save, improve and protect the health of millions of people before it gets worse,” says Dr Abdulmumini. “WHO is committed to containing the cholera outbreak in South Sudan but, without urgent funding, we cannot implement most of the planned interventions. We need donors and partners to urgently fund our operations.”

Florida: There are 17 new travel-related cases today with three in Palm Beach, two in Brevard, two in Broward, two in Orange, one in Escambia, one in Osceola, one in Polk, one in Seminole and four involving a pregnant women.

Florida Health

Florida at Night


Scientists at Washington University School of Medicine in St. Louis have identified antibodies capable of protecting against Zika virus infection, a significant step toward developing a vaccine, better diagnostic tests and possibly new antibody-based therapies.

Zika Virus Research Announcement


Fire Information Report for Sand

Fire Info//

Fire Information Report for Sand

Report Date: 27-JUL-2016

Burnt Area: 35,155 Acres
Location: Los Angeles County, California
Cause: Undetermined
Incident Team Type: IMT Type 1
Containment Status: 25% contained
Expected Containment: 07-Aug-16

A car bomb has exploded in a predominantly Kurdish town in northern Syria, killing at least 22 and wounding 50.

NBC News



ISIS terrorists carried out the attack on the Church of the Gambetta in Normandy

The Mirror

“….The Islamic State has claimed responsibility for the shocking attack, which saw four people taken hostage – one of whom is fighting for their life in hospital….”



Zika cases creeping upwards in Florida

Florida Department of Health

July 26, 2016



Communications Office
(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 Florida Department of Health will issue a Zika virus update each week day at 2 p.m. Updates will include a CDC-confirmed Zika case count by county and information to better keep Floridians prepared.

There are six new travel-related cases with two in Broward, one in Miami-Dade, one in Hillsborough, one in Orange and one involving a pregnant women. According to CDC, symptoms associated with the Zika virus last between seven to 10 days.

The department’s investigations into the possible non-travel related Zika virus cases in Miami-Dade and Broward counties are ongoing and the department will share more details as they become available.

Governor Rick Scott and State Surgeon General Dr. Celeste Philip are hosting a Zika roundtable this afternoon in Broward County to discuss with local leaders ongoing Zika preparedness and response needs.

Residents and visitors are urged to participate in requests for urine samples by the department in the areas of investigation. These results will help the department determine the number of people affected.

Zika prevention kits and repellent are being distributed in the areas of investigation, through local OBGYN offices and at both DOH-Broward and DOH-Miami-Dade.

CDC recommends that women who are pregnant or thinking of becoming pregnant postpone travel to Zika affected areas. According to CDC guidance, providers should consider testing all pregnant women with a history of travel to a Zika affected area for the virus. CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds.

Florida has been monitoring pregnant women with evidence of Zika regardless of symptoms since January. The total number of pregnant women who have been monitored is 49, with 15 having met the previous CDC case definition.

The Council of State and Territorial Epidemiologists and CDC released a new case definition for Zika that now includes reporting both asymptomatic and symptomatic cases of Zika. Prior to this change, states reported only symptomatic non-pregnant cases and pregnant cases regardless of symptoms. This change comes as a result of increased availability for testing in commercial laboratories.

All cases are travel-associated
. There have been no locally-acquired cases of Zika in Florida. For more information on the Zika virus, click here.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 2,396 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.

More Information on DOH action on Zika:

  • On Feb. 3, Governor Scott directed the State Surgeon General to issue a Declaration of Public Health Emergency for the counties of residents with travel-associated cases of Zika.
    • There have been 29 counties included in the declaration– Alachua, Brevard, Broward, Charlotte, Citrus, Clay, Collier, Duval, Escambia, Highlands, Hillsborough, Lake, Lee, Manatee, Martin, Miami-Dade, Okaloosa, Okeechobee, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Santa Rosa, Seminole, St. Johns, St. Lucie and Volusia – and will be updated as needed.
  • DOH encourages Florida residents and visitors to protect themselves from all mosquito-borne illnesses by draining standing water; covering their skin with repellent and clothing; and covering windows with screens.
  • DOH has a robust mosquito-borne illness surveillance system and is working with CDC, the Florida Department of Agriculture and Consumer Services and local county mosquito control boards to ensure that the proper precautions are being taken to protect Florida residents and visitors.
  • On April 6, Governor Scott and Interim State Surgeon General Dr. Celeste Philip hosted a conference call with Florida Mosquito Control Districts to discuss ongoing preparations to fight the possible spread of the Zika virus in Florida. There were 74 attendees on the call.
  • On May 11, Governor Scott met with federal leaders on the importance of preparing for Zika as we would a hurricane. Governor Scott requested 5,000 Zika preparedness kits from HHS Secretary Sylvia Burwell as well as a plan from FEMA on how resources will be allocated to states in the event an emergency is declared.
  • On June 1, Governor Scott requested for President Obama to provide preparedness items needed in order to increase Florida’s capacity to be ready when Zika becomes mosquito-borne in our state.
  • On June 9, Governor Scott spoke with Health and Human Services Secretary Sylvia Burwell and CDC Director Dr. Tom Frieden on Zika preparedness and reiterated the requests that he has continued to make to the federal government to prepare for the Zika virus once it becomes mosquito-borne in Florida. Governor Scott also requested that the CDC provide an additional 1,300 Zika antibody tests to Florida to allow individuals, especially pregnant women and new mothers, to see if they ever had the Zika virus.
  • On June 23, Governor Scott announced that he will use his emergency executive authority to allocate $26.2 million in state funds for Zika preparedness, prevention and response in Florida.
  • On June 28, the department announced the first confirmed case of microcephaly in an infant born in Florida whose mother had a travel-related case of Zika. The mother of the infant contracted Zika while in Haiti. Following the confirmation of this case, Governor Scott called on CDC to host a call with Florida medical professionals, including OBGYNs and physicians specializing in family medicine, to discuss the neurological impacts of Zika and what precautions new and expecting mothers should take.
  • On July 1, CDC hosted a call with Florida medical professionals, including OBGYNs, pediatricians and physicians specializing in family medicine, to discuss the neurological impacts of Zika and what precautions new and expecting mothers should take. More than 120 clinicians participated.
  • Florida currently has the capacity to test 4,769 people for active Zika virus and 2,129 for Zika antibodies.

Federal Guidance on Zika:

  • According to CDC, Zika illness is generally mild with a rash, fever and joint pain. CDC researchers have concluded that Zika virus is a cause of microcephaly and other birth defects.
  • The FDA released guidance regarding donor screening, deferral and product management to reduce the risk of transfusion-transmission of Zika virus. Additional information is available on the FDA website here.
  • CDC has put out guidance related to the sexual transmission of the Zika virus. This includes CDC recommendation that if you have traveled to a country with local transmission of Zika you should abstain from unprotected sex.

For more 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.

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