Category: Zika Virus

First Zika Death in the United States

Zika mosquito
Zika can be deadly

The first Zika-related death has occurred in the continental United States. A resident of Salt Lake County in Utah died by contracting the virus after traveling to parts of the world where the Zika virus is active. The Salt Lake County resident was also elderly and had an underlying condition according to the press release from the Salt Lake County Health Department.

The announcement came July 8th. The health department also stated that while the person did test positive for the virus, due to health privacy laws (HIPAA), health officials cannot and will not release further details about the person, as well as their travel history other than the person died in late June, tested positive for Zika, was elderly and traveled to a Zika affected region.

Dangers

Mosquito experts assure residents of Salt Lake County that there is no threat of Zika virus infection from the mosquitos in the area. Dr. Ari Faraji, manager of the Salt Lake City Mosquito Abatement District stated, “The exotic mosquito species capable of transmitting Zika virus are not found along the Wasatch Front. In fact, so far this season, we have not deemed those two species (Aedes aegypti and Aedes albopictus) anywhere in Utah.”

Current Locations

Health officials haven’t identified any Zika infections transmitted by local mosquitoes in regions of the continental United States where mosquitoes capable of carrying Zika virus are found. The most updated information about where mosquitoes are spreading Zika can be found on the Centers for Disease Control and Prevention’s website.

Transmission

Health officials also caution that sexual activity can transmit Zika. Women that are trying to become pregnant or are pregnant should not have unprotected sex with a man that has recently traveled to a Zika affected region.

Travel Warnings

Dr. Dagmar Vitek, medical director of Salt Lake County Health Department said, “This unfortunate situation is a tragic reminder of how important it is to receive proper pre-travel education and to protect yourself from mosquitoes when traveling abroad. Travelers need to also be mindful of other diseases found around the world, including mosquito-borne illnesses like Dengue fever, malaria, and chikungunya.”

You can visit the CDC website on travel information for the latest information on the Zika virus areas, as well as information on other diseases that are showing prominence worldwide. It is also recommended that you contact your physician for recommended vaccines if you are planning on traveling to any third world or underdeveloped country, or if you are unsure if the country you are going to may require a vaccination. Please note, there is no vaccination for the Zika virus at this time, so take extra precautions if you are planning to visit an area currently affected with the Zika virus.

Zika Virus Hits 324 in New York

The New York Department of Health announced this Thursday, June 30th, that as of Tuesday, there are 324 positive cases of Zika virus in New York, with at least 233 in New York City.

Of the 324 cases, 22 have been in pregnant women. In his statement Thursday, Health Commissioner Howard Zucker said, “Mosquito-borne diseases are a major public health threat, one that we monitor closely here in New York. The program is especially important this year as we work aggressively to protect New Yorkers from Zika and minimize the impact of this devastating disease.”

Areas Currently Affected in the United States

Nationwide, the virus is spreading, fortunately, not at an alarming rate. The map below illustrates the disease by state.

The mosquito-borne virus has also been reported in the Commonwealth of Puerto Rico, the US Virgin Islands, and American Samoa.

Currently, in New York State, 18 of the state’s 57 counties outside of New York City have had a positive case of Zika as of last week. This includes two cases in Westchester, one in Putnam and three in Rockland. Dutchess, Monroe, Ontario and Tompkins county are also among those affected as well. The largest majority of Zika cases in New York have been in New York City with 241 and on Long Island, with 36 according to the data from the Department of Health.

Countries of High Risk

The people that are most at risk are those that have recently traveled to the Dominican Republic. Of the 233 that tested positive for Zika in New York City, 140 had reported recently arriving from the Dominican Republic. Other places frequently and recently visited by those that tested positive for the virus included Puerto Rico, with 20 cases, and Guyana with 14 cases.

Follow the Guidelines

The guidelines issued in February by the Department of Health are still in effect. These guidelines include a warning to all women that are pregnant or trying to become pregnant and who have traveled to Zika affected areas to be tested even with no symptoms. Zika virus infection can produce symptoms of fever and/or rash but can also produce zero symptoms.

Currently, pregnant women affected with Zika have a 1% – 29% of their baby being born with birth defects, including microcephaly. Zika virus is also associated with Guillain-Barre syndrome, a rare autoimmune syndrome that affected two people in New York City that were infected with Zika. They have since both recovered. Two other cases in New York City are thought to be a result of sexual transmission, which is a growing concern.

Dr. Tom Frieden, director of the Centers for Disease Control and Prevention said during a conference last month that in the coming months, thousands of pregnant women in Puerto Rico could become infected. Currently, a race to create a Zika vaccine is slowly coming into fruition as two new vaccines have shown to fight the virus in animal models.

Microcephaly Screening Won’t Catch All Cases of Zika in Newborns

Microcephaly is a condition in which the brain does not develop properly resulting in a physical deformity, specifically, a smaller than normal head.

It is one of the most common outcomes of Zika virus infection in newborns, but the infection cannot be accurately diagnosed in babies solely based on screening for the brain defect. According to researchers, in order to detect Zika virus infection in newborns, signs and symptoms of brain abnormalities, not just head circumference, should be included in the screening criteria.

After studying all suspected cases of microcephaly in newborns in Brazil, the researchers discarded 3 out of 5 cases because they ended up being normal newborn babies with small heads.

“However, one in five definite or probable Zika cases had head circumference values in the normal range, said lead author Professor Cesar G Victora from the Universidade Federal de Pelotas in Brazil. “Therefore, the current focus on microcephaly screening alone is too narrow.”

Of the 1501 live born cases investigated, 899 were discarded. However, Zika infection among 602 cases were categorized as probable or definite. Among these cases, the babies had small head circumference at birth and their mothers were more likely to have experienced a rash during pregnancy. The definite or probable cases were also 4 times more likely to die in the first weeks of life.

More than 100 of these cases had head circumferences with normal range, however. As such, they would not have been included in the analysis for Zika if the researchers had used smaller cutoffs for head circumference.

“Although we believe that the underreporting of microcephaly cases is rare during the epidemic, newborns infected with the virus late in pregnancy may go unreported due to their head size being within normal range,” Victora said.

According to the researchers, their findings suggest that some, but not all fetuses in pregnancies affected by Zika will have brain abnormalities and microcephaly. However, other fetuses will have abnormalities with normal head sizes, and others still will not be affected. A surveillance system should not just focus on microcephaly or even rash during pregnancy, as for one-third of definite or probable cases there was no history of rash.

Unfortunately, the researchers have not yet determined the ideal cut-off point for head circumference.

Olympics Danger – Journalists and Athletes Concerned About Zika

SZika Mosquitoince the World Health Organization declared the Zika virus outbreak a public health emergency, there has been a lot of international concern. This summer, Rio de Janeiro in Brazil is hosting the Summer Olympics, but unfortunately, Rio lies in a Zika virus-affected area. Some Rio officials are saying that the Zika risk at the Rio Olympics is low and “close to zero”.

However, recent reports show that the estimated rate of virus infections in Rio is 157 per 100,000 people, which is more than triple the national average of Brazil. Within the first three months of this year, there were close to 26,000 reported cases of Zika in Rio.

It is understandable that both athletes participating in the Olympics, as well as journalists, are starting to back out. NBC’s Today show anchor Savannah Guthrie recently announced she will not be covering the Rio Olympics because she is pregnant. NBC will be sending 2,000 employees to cover the Olympics but stated that no one will be required to travel if they think their health could be at risk.

Cyclist Tejay van Garderen also announced he is pulling out of the games due to the fear of catching Zika and passing it to his currently pregnant wife. Aussie golfer Marc Leishman also announced he will not be competing in Rio due to fear of contracting Zika due to his immune-compromised wife.

Even though Rio de Janeiro Olympic officials are deeming the games safe, experts (who aren’t concerned about monetary loss) are worried that game officials are overlooking the risks amid fears of losing profits.

Harvard Public Health Review recently published an article that half a million visitors to Rio for the Olympics pose a risk of spreading the virus once they return to their home countries. The study’s lead author Amir Attran said, “Zika infection is more dangerous, and Brazil’s outbreak more extensive than scientists reckoned a short time ago. Which leads to a bitter truth: the 2016 Olympics and Paralympic Games must be postponed, moved, or both, as a precautionary concession.”

Predicting Local Transmission of Zika in the United States

A study has determined that while weather conditions may be suitable for the mosquitoes that carry the Zika virus throughout the the United States, typically we see the Aedes (Ae.) aegypti mosquito during summer months (July-September). The highest concentration of these mosquitoes will occur in the Southeast and South Texas.

The researchers who published their work in PLOS Current Outbreaks, analyzed 50 US cities in or near the range where the specific type of mosquito, Ae. aegypti, carries and transmits the Zika virus is known to appear. They note that socioeconomic factors will likely influence contact with mosquitoes that carry the virus with impoverished communities at a higher risk due to elevated risk factors, such as lower use of air conditioning, poorer housing infrastructure, and decreased access to safe water and sanitation.

While the abundance of the mosquitoes was zero or near zero in the United States in January, with the exception of Southern Florida and Texas, the authors expect that to change as the weather warms. For example, by mid-summer, cities like Denver, Albuquerque and Louisville, which are not always in the range for Ae. aegypti, will see a potential abundance of the infected mosquitos.

However, the summer months are not the only times of risk. Conditions for the Ae. aegypti will remain suitable through November for southern and western states. Then, by December, most of the country will be unsuitable again with the exceptions of Southern Florida and Texas.

Furthermore, introduction of the virus into local populations of Ae. aegypti is more likely seen in cities that have high volumes of people arriving from areas where there is already transmission of the Zika virus going on, such as Houston, Texas; Miami, Florida and Orlando, Florida, as well as towns along the US-Mexico border.

However, one limitation of the study is that it only included the contiguous United States, so states and territories where risk of transmission of Ae. aegypti-transmitted viruses is already high, such as Hawaii, Puerto Rico and areas in the South Pacific were excluded.

“Despite the limitations, our analysis is a step towards simultaneously mapping the geographic and seasonal suitability of the vector mosquito Ae. aegypti in the contiguous United States,” the authors concluded. “There is a need for enhanced, long-term, nationally-coordinated, local-level surveillance of both Aedes mosquitoes and Aedes-transmitted viruses, particularly in areas where simulations indicate Ae. aegypti populations may be high and coincide with more frequent travel between the U.S. and countries where Zika is circulating.”

Long Island Prepares for Zika

Since the middle of March, nearly 480 cases of travel related Zika virus cases have been reported in the US. This is a huge increase from last month when that number was just 100. Some travelers returning from Zika affected areas are bringing the virus back with them.

This Zika Virus Podcast provides more information on the disease and it’s origion.

All over the United States, precautionary measures being taken to deal with Zika. Early this year a Zika virus testing station was set up at the Nassau University Medical Center in East Meadow Long Island.

The hospital staff warns of symptoms associated with the Zika virus that should not be taken lightly for those returning from areas such as South American and the Caribbean. Symptoms include a fever, chills, headache and/or muscle aches. Symptoms including pink eye, vomiting and skin rash are also seen in those affected with Zika virus. If you or anyone you know has been traveling to Zika affected areas and is experiencing any of these symptoms they should make their way to the emergency department to be properly evaluated and treated.

With confirmed cases of Zika coming from Long Island it comes at no surprise. Nassau county has one of the biggest Latin populations on the northeast. Many residents frequent Zika affected areas, therefore local testing in this area is essential and testing stations are available. The testing stations at Nassau University Medical Center offer free blood and urine tests are sent to one of three Zika testing labs in the US located in Albany.

If a person tests positive for Zika they are advised to avoid sexual contact for at least four weeks and are advised to avoid getting pregnant for at least four weeks. Zika virus can spread to the pregnant woman’s fetus and cause a birth defect know as microcephaly. Microcephaly is a neurological condition which causes a baby to be born with a small head and brain. It’s also associated with severe developmental issues and can cause death. Pregnant women that test positive for the virus will receive obstetric counseling at the Nassau hospital.

Walk-ins at the Nassau hospital or its satellite health center are currently available for those with symptoms that have traveled to Zika affected areas. Test results are quick and will only take two to three days.

What is the Zika Virus?


Zika MosquitoThe Zika virus is a disease that spreads to people primarily through the sting of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis. However, many people might not even know if they have been infected, as most people who contract the Zika virus won’t know they have the disease because they won’t have symptoms, according to the CDC. In addition, most people who have the virus, don’t get sick enough to go to the hospital, and they very rarely die of Zika.

Zika Symptoms

Transferring the Disease

Zika is mainly spread by mosquitoes, but there have been reported cases of the virus being spread through sexual intercourse. In addition, the Zika virus may be spread through blood transfusions.

Active Locations of the Virus

Currently, there are 39 countries and territories with reported active local transmission of the virus, including Puerto Rico. While there has yet to be any local transmission of the virus in the continental United States, experts expect that to change as the weather warms up.

The virus has been around for many decades, but suddenly, it is now increasing in the human population at an alarming rate. In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infection in Brazil and on Feb 1, 2016, the World Health Organization (WHO) declared Zika virus a public health emergency of international concern (PHEIC).

The following video illustrates the the sudden increase of the Zika virus

As Zika virus continues to spread worldwide, the urgent need for assistance in the countries affected grows. The International Atomic Energy Agency has recently announced a plan to help the 26 countries and territories reporting Zika virus infections.

Zike Virus World Map
The map above depicts the probability of occurrence (blue=none, red=highest occurrence).

Zika Risks to Humans

While the spread Zika virus is not on par with the deadly Ebola outbreak from 2014 that began in West Africa, the reason why Zika is causing such concern is because of the potential link to microcephaly. Women who are pregnant and develop a fever, rash, joint pain, or red eyes within 2 weeks of traveling to a country where Zika has been reported should see a doctor.

There has been a link between women infected with Zika and babies born with microcephaly, a birth defect that affects brain development, resulting in babies being born with much smaller heads than expected. Typically, microcephaly is not a common condition, and normally affects between 2 and 12 babies per 10,000.

Additional information can be found in Five Facts About the Zika Virus.

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