RT Journal Article SR Electronic T1 Multiple introductions of Zika virus into the United States revealed through genomic epidemiology JF bioRxiv FD Cold Spring Harbor Laboratory SP 104794 DO 10.1101/104794 A1 Nathan D Grubaugh A1 Jason T Ladner A1 Moritz UG Kraemer A1 Gytis Dudas A1 Amanda L Tan A1 Karthik Gangavarapu A1 Michael R Wiley A1 Stephen White A1 Julien Thézé A1 Diogo M Magnani A1 Karla Prieto A1 Daniel Reyes A1 Andrea Bingham A1 Lauren M Paul A1 Refugio Robles-Sikisaka A1 Glenn Oliveira A1 Darryl Pronty A1 Hayden C Metsky A1 Mary Lynn Baniecki A1 Kayla G Barnes A1 Bridget Chak A1 Catherine A Freije A1 Adrianne Gladden-Young A1 Andreas Gnirke A1 Cynthia Luo A1 Bronwyn MacInnis A1 Christian B Matranga A1 Daniel J Park A1 James Qu A1 Stephen F Schaffner A1 Christopher Tomkins-Tinch A1 Kendra L West A1 Sarah M Winnicki A1 Shirlee Wohl A1 Nathan L Yozwiak A1 Joshua Quick A1 Joseph R Fauver A1 Kamran Khan A1 Shannon E Brent A1 Robert C Reiner, Jr. A1 Paola N Lichtenberger A1 Michael Ricciardi A1 Varian K Bailey A1 David I Watkins A1 Marshall R Cone A1 Edgar W Kopp IV A1 Kelly N Hogan A1 Andrew C Cannons A1 Reynald Jean A1 Robert F Garry A1 Nicholas J Loman A1 Nuno R Faria A1 Mario C Porcelli A1 Chalmers Vasquez A1 Elyse R Nagle A1 Derek AT Cummings A1 Danielle Stanek A1 Andrew Rambaut A1 Mariano Sanchez-Lockhart A1 Pardis C Sabeti A1 Leah D Gillis A1 Scott F Michael A1 Trevor Bedford A1 Oliver G Pybus A1 Sharon Isern A1 Gustavo Palacios A1 Kristian G Andersen YR 2017 UL http://biorxiv.org/content/early/2017/02/03/104794.abstract AB Zika virus (ZIKV) is causing an unprecedented epidemic linked to severe congenital syndromes1,2. In July 2016, mosquito-borne ZIKV transmission was first reported in the continental United States and since then, hundreds of locally-acquired infections have been reported in Florida3. To gain insights into the timing, source, and likely route(s) of introduction of ZIKV into the continental United States, we tracked the virus from its first detection in Miami, Florida by direct sequencing of ZIKV genomes from infected patients and Aedes aegypti mosquitoes. We show that at least four distinct ZIKV introductions contributed to the outbreak in Florida and that local transmission likely started in the spring of 2016 - several months before its initial detection. By analyzing surveillance and genetic data, we discovered that ZIKV moved among transmission zones in Miami. Our analyses show that most introductions are phylogenetically linked to the Caribbean, a finding corroborated by the high incidence rates and traffic volumes from the region into the Miami area. By comparing mosquito abundance and travel flows, we describe the areas of southern Florida that are especially vulnerable to ZIKV introductions. Our study provides a deeper understanding of how ZIKV initiates and sustains transmission in new regions.