New Case of Local Zika Infection Reported in Florida

Latest one in Palm Beach County brings state total to 43; scientists predict 400 cases by summer's end

Thursday, August 25, 2016

THURSDAY, Aug. 25, 2016 (HealthDay News) -- Yet another case of local Zika infection has been reported in Florida, this time in Palm Beach County.

This latest report brings the total number of local infections in the state to 43, state health officials said in a statement Wednesday.

And that total will probably climb far higher by summer's end, scientists predicted Wednesday.

Nearly 400 local Zika infections will occur in the state by Sept. 15, with eight of those infections in pregnant women in their first trimester, according to projections from biostatisticians at the University of Florida (UF) and other institutions.

Not only that, the virus will likely spread to several other southeastern states, with handfuls of cases cropping up from Texas to South Carolina and even Oklahoma, the scientists added.

"It wasn't clear at first whether mosquito densities were high enough to sustain an outbreak in the U.S.," Dr. Ira Longini, a professor of biostatistics in the UF College of Public Health and Health Professions, said in a university statement.

Just two days ago, five cases of locally transmitted Zika infection were confirmed by Florida health officials, including one in the Tampa Bay area.

The other four cases were connected to mosquitoes in Miami's Wynwood arts district, the first area in Florida to report local transmission of Zika. According to the Florida Department of Health, the fifth was diagnosed in a Pinellas County resident who hasn't traveled internationally.

Health officials have begun door-to-door outreach in Pinellas County, and mosquito-control activities are also taking place there, state health department officials said in a statement. However, they added that they still believe local transmission of Zika is not taking place in Pinellas County because only one case has been confirmed so far.

The news comes just days after Florida Gov. Rick Scott called on federal health officials to send the state more resources to fight the growing transmission of Zika virus after five cases of local infection were reported in Miami Beach.

Until last week, local transmission of mosquito-borne Zika -- which can cause devastating birth defects in babies -- had been restricted to Wynwood. The U.S. Centers for Disease Control and Prevention had already advised that pregnant women not travel to the Wynwood area, and last Friday the agency extended that advisory to include the Zika-affected area of Miami Beach.

"Pregnant women should avoid travel to the designated area of Miami Beach, in addition to the designated area of Wynwood, because active local transmission of Zika has been confirmed," CDC director Dr. Tom Frieden said last Friday.

The Zika virus is typically transmitted via mosquitoes and can cause a transient illness. It is most dangerous to pregnant women, due to the virus' link to microcephaly, a devastating birth defect where babies are born with smaller than normal heads and underdeveloped brains.

Officials continue to struggle with controlling mosquitos in the Wynwood area of Miami, Frieden said.

"Although the state of Florida, with CDC's assistance, has mounted and continues to mount an aggressive response, the mosquitos are persistent and we won't know for at least another couple of weeks if these aggressive control measures have worked," Frieden said Friday.

Outside the Wynwood and Miami Beach areas, Florida health officials have investigated at least four other independent instances of mosquito-borne Zika transmission in Miami-Dade County, Frieden added.

"These are individual instances, and do not represent spread throughout the area," Frieden said.

Occasional individual cases of local transmission cropped up during earlier chikungunya and dengue outbreaks in Florida, but in most instances these did not amount to a new outbreak, Frieden explained.

"For every nine or so one-off cases, where there was a single case of transmission that was locally mosquito-borne, there was one cluster," he said. "The vast majority of local transmissions hit a dead end after one or two people in one household. That's what we would anticipate seeing here."

In other recent Zika news, experts have wondered if the virus might sometimes be transmitted through blood transfusions, and a cluster of infections in Brazil seems to support that notion.

Reporting Aug. 17 in the New England Journal of Medicine, doctors believe that a blood donor passed along the typically mosquito-borne virus in late January to two hospitalized patients who needed transfusions.

"These data show evidence for Zika virus transmission by means of [blood] platelet transfusion," reported a team led by Dr. Iara Motta, of the Jose Alencar Gomes da Silva National Cancer Institute in Rio de Janeiro, and Bryan Spencer of the American Red Cross in Dedham, Mass.

Health officials in the United States have already been preparing for the possibility of Zika transmission via blood transfusion. In March, the U.S. Food and Drug Administration approved an experimental test to check blood donations for the Zika virus.

The FDA also recommends that anyone who has traveled recently to an area where the Zika virus is active refrain from donating blood.

Elsewhere, Texas health officials have reported what appears to be the first case of Zika infection traveling across state lines. A resident of that state who visited Miami recently tested positive for the virus.

Things are much worse in the U.S. territory of Puerto Rico, where federal health officials have declared a public health emergency because Zika is spreading so rapidly among residents there. The number of Zika cases there now total 10,690, with 1,035 of those being pregnant women.

Health experts do stress that the vast majority of the more than 2,260 Zika infections so far reported in the continental United States have been linked to travel abroad -- to countries with Zika outbreaks in Latin America or the Caribbean.

Most of the thousands of Zika infections recorded globally have so far occurred in Latin America and the Caribbean. Brazil, especially, has reported the vast majority of cases of Zika-linked microcephaly.

U.S. officials said they don't expect to see a Zika epidemic in the United States similar to those in Latin America. The reason: better insect control as well as window screens and air conditioning that should help curtail any outbreaks.

In addition to mosquitoes, the Zika virus can be transmitted through sex. These infections in the United States are thought to have occurred because the patients' partners had traveled to countries where Zika is circulating, the CDC said.

The CDC advises pregnant women not to travel to an area where active Zika transmission is ongoing, and to use insect repellent and wear long pants and long-sleeved shirts if they are in those areas. Partners of pregnant women are advised to use a condom to guard against sexual transmission during pregnancy.

SOURCES: Aug. 19, 2016, news conferences, Gov. Rick Scott, Florida and Tom Frieden, M.D., director, U.S. Centers for Disease Control and Prevention; Aug. 18, 2016, The New York Times; Aug. 17, 2016, New England Journal of Medicine; Aug. 15, 2016, statement, Texas Department of State Health Services; March 30, 2016, statement, U.S. Food and Drug Administration; NBC News; University of Florida, news release, Aug. 24, 2016

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