Local Transmission of Zika Virus in Miami-Dade County: The Florida Department of Health Rises to the Challenge

As early as 2015, Florida and Centers for Disease Control and Prevention (CDC) public health officials recognized the potential danger of Zika for US residents and visitors. The Zika virus, a mosquito-borne flavivirus, is transmitted through the bite of the Aedes aegypti mosquito. A physician in Miami-Dade notified the Florida Department of Health (DOH) of the first non-travel-related Zika case in the United States. A 23-year old pregnant woman had presented on July 7, 2016, at 23 weeks of gestation, with a 3-day history of fever, widespread pruritic rash, and sore throat. Three more cases, involving men, were reported in Dade and Broward counties. These notifications set into motion additional activities from the DOH's Zika Playbook: increased mosquito surveillance; collaboration with the CDC on recommendations for mosquito abatement techniques; and increased awareness of the risks of Zika. In August, the department reported that active transmission of Zika virus was occurring in one small area in Miami-Dade County known as Wynwood. Mosquito trapping in the area with local transmission identified large numbers of the Zika vector, Aedes aegypti females and a large number of mosquito larval sites. Control efforts included larviciding, eliminating standing water, and backpack and truck spraying of insecticides. A communication strategy was developed that addressed risk mitigation, public concerns over application of noxious pesticides, loss of tourist revenue, and reproductive issues. It was reported on December 28, 2016, that there had been 256 locally acquired cases of infection of Zika, 1011 travel-related cases, and 208 pregnant women with laboratory evidence of Zika. At the end of 2018, 2 years after active Zika virus transmission was controlled in Florida, there have been 101 reported cases of Zika during 2018 but none have been linked to local transmission.