Zika Cluster In Utah

niman · July 18, 2016

Monday, July 18, 2016

Public Health Officials Investigating Unique Case of Zika

(Salt Lake City, UT) – Utah health officials confirmed today a new case of Zika in Utah and have launched an investigation to determine how the person became infected. The new case is a family contact who helped care for the individual who died from unknown causes and who had been infected with Zika after traveling to an area with Zika.

http://udohnews.blogspot.com/2016/07/public-health-officials-investigating.html?m=1

niman · July 18, 2016

Monday, July 18, 2016

Public Health Officials Investigating Unique Case of Zika

(Salt Lake City, UT) – Utah health officials confirmed today a new case of Zika in Utah and have launched an investigation to determine how the person became infected. The new case is a family contact who helped care for the individual who died from unknown causes and who had been infected with Zika after traveling to an area with Zika.

Laboratories at the Centers for Disease Control and Prevention and in Utah confirmed Zika infection in both Utah residents. A CDC team is in Utah to help with the investigation.

The new case is the eighth Utah resident to be diagnosed with Zika. Based on what is known now, the person has not recently traveled to an area with Zika and has not had sex with someone who is infected with Zika or who has traveled to an area with Zika. In addition, there is no evidence at this time that mosquitoes that commonly spread Zika (aedes species) virus are in Utah.

The investigation is focused on determining how the eighth case became infected after having contact with the deceased patient who had a uniquely high amount of virus in the blood.

“Our knowledge of this virus continues to evolve and our investigation is expected to help us better understand how this individual became infected,” said Dr. Angela Dunn, deputy state epidemiologist at the UDOH. “Based on what we know so far about this case, there is no evidence that there is any risk of Zika virus transmission among the general public in Utah.”

Public health investigators are interviewing the person and family contacts to learn more about the types of contact they had with deceased patient. They are also collecting samples for testing from family members and others who had contact with the deceased patient while they were ill and are working in the communities where the two cases lived to trap and test mosquitoes.

“We’re doing our part as public health officials to learn more about the virus and about this specific case,” said Gary Edwards, executive director of the SLCOHD. “In the meantime, the public, and especially pregnant women, should continue to take recommended steps to protect themselves from Zika virus.”

The CDC recommends that women who are pregnant not travel to areas with Zika. They should also use condoms or not have sex with partners who have traveled to or live in an area with Zika for the duration of their pregnancy. For a list of areas with Zika visit http://www.cdc.gov/zika/geo/index.html. CDC also recommends people take steps to prevent mosquito bites: http://www.cdc.gov/zika/prevention/prevent-mosquito-bites.html.

More tips on Zika prevention are available at http://health.utah.gov/epi/diseases/zika/.

# # #

Media Contacts:

Tom Hudachko

Utah Department of Health

(o) 801-538-6232

(m) 801-560-4649

Pam Davenport
Salt Lake County Health Department

(o) 385-468-4122

niman · July 18, 2016

By Associated Press |

Posted: Mon 10:21 AM, Jul 18, 2016

SALT LAKE CITY (AP)-- Utah health officials say a man who died after being infected with Zika virus passed it to a caregiver, creating a medical mystery about how it spread between them.

The Salt Lake County Health Department said Monday that the two people didn't have sexual contact and the type of mosquito that mainly spreads the virus is not found in the high-altitude area where they live.

Officials say the caregiver is a "family contact" but wouldn't give further details. The man who died caught the virus while traveling abroad to an area where mosquitoes are known to spread Zika.

It marked the first time a person in the continental U.S. died after being infected with the virus.

The exact cause of the death announced July 8 wasn't clear because the person was elderly and also had an underlying health condition.

http://www.nbc11news.com/content/news/Caregiver-gets-Zika-from-Utah-man-who-died-in-medical-mystery-387294131.html

niman · July 18, 2016

Map Update

https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

niman · July 18, 2016

Elderly Zika patient in Utah may have infected a family contact

By Lena H. Sun and Brady Dennis July 18 at 1:00 PM

Zika virus. (Purdue University/Kuhn and Rossmann/Getty Images)

A Utah resident who died after contracting Zika from travel abroad may have spread the virus to a family contact who did not leave the country, raising troubling questions about a possible new route of transmission of the mosquito-borne virus, state and federal officials said Monday.

Officials said they are investigating how the second person became infected. One possibility is close contact between the critically ill patient and the contact, who cared for the patient. Officials are also trapping and testing mosquitoes around both individuals' homes. The second person has since recovered, officials said.

“This case is unusual. The individual does not have any of the known risk factors we’ve seen thus far with Zika virus,” said Gary Edwards, health officer at the Salt Lake County Health Department, during a press conference.

He said the person had not traveled to a Zika-affected country and had not had sexual contact with anyone with the virus. Edwards also said the primary mosquitoes known for carrying Zika are not present in Utah, though officials are trapping and testing mosquitoes in the area as a precaution.

Edwards said the person is a “family contact” who had “helped provide care for the deceased patient.” Citing privacy, officials declined to provide additional details.

“At this time we don’t know if the contact between the new case and the deceased patient played any role in the transmission of the disease,” Edwards said. “There is uncertainty about how this new case contracted Zika. But we do not believe that there is risk of Zika transmission among the general population in Utah based on what we know so far."

The Centers for Disease Control and Prevention on Monday said that the deceased patient had traveled to a Zika-affected area, and that lab tests showed he had uniquely high amounts of virus in his blood -- more than 100,000 times higher than seen in other samples of infected people.

[First Zika-related death in adult in continental U.S. reported in Utah]

Public health investigators in Utah are interviewing the person who was infected and family contacts to learn more about the types of contact they had with deceased patient. They're also working with health-care facilities where the deceased patient was cared for to determine what contacts, if any, health-care workers may have had. They are also collecting samples for testing from family members and others who had contact with the deceased patient while the patient was ill.

niman · July 18, 2016

New Utah case of Zika virus baffles health officials

POSTED 10:24 AM, JULY 18, 2016, BY ASHTON EDWARDS, UPDATED AT 11:16AM, JULY 18, 2016

SALT LAKE CITY - Utah health officials have confirmed a new case of the Zika virus in Utah Monday.

Authorities are investigating how the person became infected.

According to the Utah Dept. of Health, the new case is a relative who helped care for the person who died from unknown causes and was infected with Zika after traveling to an area with Zika.

The Centers for Disease Control and Prevention have a team in Utah to investigate.

Officials said this new case if the eighth Utah residents to be diagnosed with the virus.

The health dept. said the new patient had not recently traveled to an area known to have Zika and had not had sexual contact with someone who was infected.

Authorities also said there is no evidence to show mosquitoes that carry Zika are currently in Utah.

The investigation is focused on determining how the eighth case became infected after having contact with the deceased patient who had a uniquely high amount of virus in the blood, according to the health dept.

“Our knowledge of this virus continues to evolve and our investigation is expected to help us better understand how this individual became infected,” said Dr. Angela Dunn, deputy state epidemiologist at the UDOH. “Based on what we know so far about this case, there is no evidence that there is any risk of Zika virus transmission among the general public in Utah.”

The CDC recommends women who are pregnant not travel to areas with Zika.

Health officials said they should also use condoms or not have sex with partners who have traveled to or live in an area with Zika
for the duration of their pregnancy.

http://fox13now.com/2016/07/18/new-case-of-zika-virus-in-utah-cdc-in-utah-to-investigate/

niman · July 18, 2016

Zika Virus Patient Who Died in Utah Infected 1 Other

by MAGGIE FOX

An elderly patient who died with a Zika virus infection in Utah infected another person and doctors said Monday they are not sure how it happened.

Zika's normally transmitted by mosquitoes and it can also be transmitted sexually. But neither appears to have been the case in Utah, officials in Salt Lake City said.

Image: US-HEALTH-ZIKA-VIRUS — Miami-Dade mosquito control worker Carlos Vargas looks for the Aedes aegypti mosquito larvae at a home in Miami, Florida, on June 08. Rhona Wise / AFP - Getty Images

They're not releasing very much information to protect the privacy of the patient and family, only identifying the new case as a "family contact." But it's another new twist in an epidemic that seems to be flummoxing medical experts over and over.

"The new case in Utah is a surprise, showing that we still have more to learn about Zika," said Dr. Erin Staples, a Centers for Disease Control and Prevention epidemiologist who's helping in the investigation.

"Fortunately, the patient recovered quickly, and from what we have seen with more than 1,300 travel-associated cases of Zika in the continental United States and Hawaii, non-sexual spread from one person to another does not appear to be common."

The first patient's death was reported July 8 and it was the first Zika-related death in the continental U.S. An elderly man died from a Zika infection in Puerto Rico in April.

"The new case is a family contact who helped care for the individual who died from unknown causes and who had been infected with Zika after traveling to an area with Zika," the Salt Lake County Department of Health said in a statement.

"We do believe this is a unique situation," said Dr. Angela Dunn, deputy state epidemiologist at the Utah Department of Health.

The patient had an unusually high level of Zika virus in his blood, Dunn told a news conference.

"Our knowledge of this virus continues to evolve and our investigation is expected to help us better understand how this individual became infected," Dunn added in a statement.

"Based on what we know so far about this case, there is no evidence that there is any risk of Zika virus transmission among the general public in Utah."

Related: Woman Infects Man With Zika

Zika is not normally deadly and it usually is not even very serious. By most reports, only about 20 percent of patients even notice their symptoms, which at worst are rash, fever and muscle aches.

Zika is most dangerous to developing fetuses. When a pregnant women is infected, the baby can develop horrendous birth defects. Like many other infections, Zika can also cause a rare paralyzing condition called Guillain-Barré syndrome.

Utah officials say they will be testing mosquitoes in the area just to be sure none of them could be carrying the virus, but Utah is not known to have the Aedes aegypti mosquitoes that usually transmit Zika.

They are also testing other close contacts of the patient.

It will be important to get more details about the case, said Dr. Amesh Adalja of the University of Pittsburgh Medical School Center for Health Security and a spokesman for the Infectious Diseases Society of America.

"It has got to be a body fluid type of transmission event here," Adalja told NBC News.

"Was this person drawing blood? Was she assisting in blood draws? Was she exposed to urine? Was she exposed to saliva?" he asked. It's possible it was a so-called needle-stick accident -- when someone administering drugs or drawing blood with a needle gets a puncture and becomes infected.

Related: Answers to Your Zika Questions

"It's hard to know but we don't know all the details of how this man died," Adalja added.

"He was discovered to be positive for Zika post-mortem. We don't know how it contributed to the person's death."

Zika has been unusually confusing because until last year, few considered it a dangerous or even an interesting virus. It wasn't until it hit Brazil that it was considered a big threat -- when it began to make many people noticeably ill and then started causing an increase in birth defects.

"When you have this sort of large-scale outbreak with so many cases, you are going to find out a lot about the virus," Adalja said.

http://www.nbcnews.com/storyline/zika-virus-outbreak/zika-virus-patient-who-died-utah-infected-1-other-n611706

niman · July 18, 2016

A New Zika Case in Utah Has Experts Stumped

Alexandra Sifferlin @acsifferlin

12:55 PM ET

It's not clear how the virus was transmitted

A person in Utah who did not travel to a Zika-affected country or have sex with someone who did is nevertheless infected with the virus, health authorities in the state confirm. Health officials are investigating how the person could have been infected.

The Salt Lake County Health Department has released limited information about the individual, but said the new patient cared for somebody who had been infected with Zika during travel and later died from unknown causes. Labs in Utah and at the U.S. Centers for Disease Control and Prevention (CDC), confirmed the infections. CDC officials are helping Utah experts investigate the case.

Health experts are interviewing the person who is infected as well as family contacts to learn more about the interactions with the person who died with a Zika infection. Samples are also being collected from family members and other people who had contact with the deceased individual.

The CDC did not respond immediately to requests for comment.

http://time.com/4410890/zika-infection-utah/?xid=tcoshare

niman · July 18, 2016

Son of Utah Man With Zika-Related Death Contracted the Virus

Authorities considering contact with bodily fluids, which hasn’t been identified as possible mode of transmission

By

BETSY MCKAY

July 18, 2016 1:28 p.m. ET

0 COMMENTS

A son of an elderly Utah man who died last month after becoming infected with Zika also contracted the virus, and health authorities said Monday they are trying to figure out how he was infected.

The son hasn’t traveled recently to an area where Zika is being circulated by mosquitoes, he didn’t have sexual contact with an infected person, and the Aedes mosquitoes that can spread Zika aren’t normally found in Utah, Angela Dunn,deputy state epidemiologist with the Utah Department of Health, said in an interview. Utah officials called the case “unique.”

The son did help to care for his ailing father, and Dr. Dunn said the elderly man had “a very high level” of Zika virus in his blood. That raises the possibility that the son was infected through contact with bodily fluids of the father while caring for him. That hasn’t been identified before as a possible mode of transmission of Zika, but Dr. Dunn said it is one of the possible routes of transmission that officials are now exploring.

How the Zika Virus Spreads From Mother to Fetus

0:00 / 0:00

New studies have shed light on how the Zika virus -- which can cause serious birth defects -- may be transmitted from infected mother to unborn child. Image: Dr. Indira U. Mysorekar, Dr. Bin Cao/Washington University (Originally published May 17, 2016)

Dr. Dunn identified the new case as a close family contact who cared for the deceased elderly man, but people familiar with the case confirmed that the contact is the deceased man’s son. He was ill but has recovered, Dr. Dunn said.

While the elderly man had Zika, he also had an underlying condition and the cause of his death isn’t known, Salt Lake County officials have said.

Public-health officials from Salt Lake County, the state and the Centers for Disease Control and Prevention said Monday they are exploring multiple possible routes of transmission, including contact with bodily fluids. Other family members are also being interviewed and tested, Utah officials said.

Dr. Dunn said that mosquito-control officials are capturing and testing mosquitoes around the homes of the deceased man and the son to search for evidence of Aedes mosquitoes and the virus. Salt Lake County actively monitors its mosquito populations and Aedes mosquitoes haven’t been found this year, she said.

While officials don’t know how the man was infected, Dr. Dunn said at a news conference Monday that they believe there is no risk to others. “We believe this is a unique case and does not pose a threat to the general Utah public,” she said.

Write to Betsy McKay at [email protected]

http://www.wsj.com/articles/son-of-utah-man-with-zika-related-death-contracted-the-virus-1468862925

niman · July 18, 2016

Map Update

https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=1FlIB7hHnVgGD9TlbSx5HwAj-PEQ

niman · July 18, 2016

Utah reports Zika infection in person who cared for man with virus

Monday, July 18, 2016 11:38 a.m. CDT

By Julie Steenhuysen

CHICAGO (Reuters) - A caregiver for an elderly Utah man who died while infected with Zika tested positive for the virus but has recovered, health officials said on Monday.

The U.S. Centers for Disease Control and Prevention said it has confirmed that a person who helped care for the man who died last month while infected with Zika contracted the virus. But, it said the patient recovered quickly.

Utah officials said the infected caregiver had not had any recent travel to an area where the Zika virus is being transmitted nor had the person had sex with an infected individual. Utah officials are still investigating how the person became infected.

Gary Edwards, director of the Salt Lake County Health Department, said the infected individual is a family contact of the man who died.

Edwards would not say how old the family contact was nor release the person's gender.

"We know that the patient had contact with the deceased patient while the deceased patient was very ill. The exact nature of that contact, we are still investigating," he said.

Edwards said the cause of the deceased person's death is still under investigation, but the man was infected with Zika at the time of death and officials believe the virus was a contributing factor. He contracted Zika on a trip to a country with active transmission.

The CDC said in a statement that testing showed extremely high levels of virus in the deceased man's blood, which were more than 100,000 times higher than seen in other samples of infected people.

“The new case in Utah is a surprise, showing that we still have more to learn about Zika,” Dr. Erin Staples, CDC's medical epidemiologist who is in Utah leading an investigation.

“Fortunately, the patient recovered quickly, and from what we have seen with more than 1,300 travel-associated cases of Zika in the continental United States and Hawaii, non-sexual spread from one person to another does not appear to be common.”

Tom Hudachko, director of communications for the Utah Department of Health, said the case is unique because the infected individual does not have any of the known risk factors associated with Zika.

Hudachko said state officials are not aware of any mosquitoes known to carry the Zika virus within Utah. He said there were a few Aedes aegypti mosquitoes - the kind that carry Zika - discovered in traps in the southwestern parts of the state several years ago, but there have not been any since.

He said the state does not have any Aedes albopictus mosquitoes, the other type that has been found capable of transmitting Zika.

"We're looking at all potential contacts between the deceased patient and the new case," he said.

"We're also doing mosquito trapping near the residence where these individuals lived to make sure this is not a potential route of transmission," Hudachko said.

SKIN LACERATIONS MAY PLAY A ROLE

According to the CDC, as of July 13, 2016, 1,306 cases of Zika have been reported in the continental United States and Hawaii; none of these have been the result of local spread by mosquitoes.

These cases include 14 believed to be the result of sexual transmission and one that was the result of laboratory exposure.

"We know bodily fluids like saliva and urine can harbor the virus, said Dr. Amesh Adalja, a spokesman for the Infectious Diseases Society of America.

He said it will be important to know whether the family contact of the deceased man had any skin lacerations or skin disease that might have allowed the virus access to the patient's blood.

(Reporting by Julie Steenhuysen; Editing by Bernard Orr and Cynthia Osterman)

http://kfgo.com/news/articles/2016/jul/18/utah-reports-zika-infection-in-person-who-cared-for-patient-with-virus/

niman · July 18, 2016

Officials investigating 'unique' Zika case in Utah

By Daphne Chen, Deseret News

Published: Monday, July 18 2016 11:25 a.m. MDT

Updated: 1 hour ago

An Aedes aegypti mosquito is photographed through a microscope at the Fiocruz institute in Recife, Pernambuco state, Brazil, Wednesday, Jan. 27, 2016. Health officials said they are investigating a "unique" case in Utah of a person infected by Zika who has not traveled to a Zika-infected area or had sexual contact with an infected person.

Felipe Dana, Associated Press

Enlarge photo»

Summary

Health officials said they are investigating a "unique" case in Utah of a person infected by Zika who has not traveled to a Zika-infected area or had sexual contact with an infected person.

SALT LAKE CITY — Health officials are investigating a "unique" case of Zika after a Utah resident who was a "family contact" of the Salt Lake County man who died in June also tested positive for the virus.

This is the first example in the U.S. of a person infected with Zika who did not recently travel to an affected area or have sexual contact with an infected person, said Dr. Erin Staples of the Centers for Disease Control and Prevention at a news conference on Monday.

The Salt Lake County man who died in June was the first Zika-related death in the U.S.

The family contact helped provide care for the now-deceased patient while sick, officials said.

Dr. Angela Dunn, Utah Department of Health deputy state epidemiologist, said officials are still trying to determine how the person became infected. The CDC is assisting state public health officials in the investigation, which Dunn emphasized is in its early stages.

Officials said at the conference that they are still uncertain about how the person contracted Zika.

The mosquito species that carries Zika is not typically found in Utah, according to Dunn. She said health officials are working with mosquito abatement districts to continue to trap and test mosquitos, with a focus on the areas where the deceased man stayed.

Because the virus can be found in blood, researchers believe the virus could also theoretically be transmitted through contact with infected blood, according to Staples. Evidence of blood transmission has been seen in some labs, she added.

The now-deceased individual also had "unusually high" levels of virus in the blood, according to Dunn, which she said makes this case "a unique situation."

Dunn said there is no evidence that the Zika virus can become airborne and said officials do not expect that to be a cause.

Health officials do not belive the case poses a threat to the general public.

"We do not believe that there is risk of Zika transmission among the general public in Utah based on what we know so far," said Gary Edwards, director of the Salt Lake County Health Department.

"We're in the early stages of a public health investigation and working hard to learn more," he added.

The case brings the total number of confirmed cases of Zika infection in Utah to eight. With the exception of this person, all the other infected people had recently traveled to a Zika-infected area, Dunn said.

Officials are continuing to warn people to take precautions when traveling to Zika-affected areas.

Dunn encouraged women who are pregnant or hope to become pregnant to avoid those areas and encouraged men to talk to their health care providers before and after travel.

People should also do their part to remove standing water that could attract mosquitos to the area, she said.

According to Dunn, the infected family contact experienced a mild illness, as with most Zika patients, and has fully recovered.

Email: [email protected]

Twitter: DaphneChen_

http://www.deseretnews.com/article/865658254/Officials-investigating-unique-Zika-case-in-Utah.html?pg=all

niman · July 19, 2016

D-brief

Zika Virus Case in Utah Raises New Questions for Scientists

By Nathaniel Scharping | July 18, 2016 4:07 pm

(Credit: Tacio Philip Sansonovski/Shutterstock)

Scientists from the Centers for Disease Control and Prevention (CDC) are scrambling to figure out how a Utah caregiver became ill with Zika.

The virus is overwhelmingly transmitted via bites from infected mosquitoes, but can also spread through sexual contact. The case in Utah seems to be the result of something completely different, however, say state officials. Scientists aren’t exactly sure how the person became infected, but they working to figure what’s behind this latest twist in the ongoing epidemic.

Patient Had Contact with Zika

According to the Wall Street Journal, the patient was caring for their elderly father, who became infected with the virus after traveling to an area with Zika. The elderly man eventually passed away, although it isn’t known how Zika factored into his death as he had other health complications as well. That man was the first person with Zika to die in the continental U.S. and his case was notable for the extremely high levels of the virus found in his blood — more than 100,000 times the level of people infected with the disease, according to the CDC.

The caregiver was briefly ill, but has since recovered, authorities say, and caution that this was likely an isolated case and should not be cause for alarm. It’s not known what kinds of bodily fluids the caregiver came into contact with while caring for their father, hinting that there could be a previously unknown means by which the disease spreads. Public health investigators in Utah are interviewing family members to learn more about the interactions the person had with their father while providing care.

New Method of Transmission?

In addition to mosquito bites, the disease can be transmitted through sexual contact, blood and urine, as well as from pregnant mothers to their fetuses. It is not known if any other bodily fluids, such as saliva, could also serve as vectors for the disease. Mosquito bites are the most common form of transmission, but the species of mosquito that carry the virus, Aedes aegyptiand Aedes albopictus are not found in Utah, although they are present in neighboring states. The caregiver had not traveled to any areas with a high Zika risk either, officials say. The CDC researchers say that they are casting a wide net in their search for the method of transmission, and say that it is still too early to rule out any possibilities.

“The new case in Utah is a surprise, showing that we still have more to learn about Zika,” said Erin Staples, an epidemiologist with the CDC in Utah, in a press release.

The CDC team is testing family members and acquaintances who may have had contact with the deceased patient in order to find out if the disease spread to anyone else. They are also conducting a survey of mosquitos in the area to see if any are carrying the virus.

“This is a unique situation,” said CDC director Tom Frieden, speaking to theWashington Post. He says that this is first documented instance of the disease spreading between two people without sexual contact. The CDC is also conducting genomic tests to see if this strain displays any mutations that could allow it to be transmitted differently, according to Frieden.

There have been 1,306 cases of Zika reported in the U.S. as of July 13, although only two resulted in deaths, but no reported instances of transmission via mosquito bites in the U.S. as of yet — the majority of cases resulted from travelers returning from infected areas. In addition, 14 cases likely resulted from the sexual transmission of the disease and one was the result of exposure in the laboratory, says the CDC.

http://blogs.discovermagazine.com/d-brief/2016/07/18/zika-virus-case-in-utah-perplexes-scientists/#.V44G5rgrJ-Q

niman · July 19, 2016

Is There a New Way to Get Zika?

By Brenda Goodman, MA
WebMD Health News

Reviewed by Brunilda Nazario, MD

July 18, 2016 -- The CDC is investigating a Zika mystery: how a Utah resident got the virus without traveling or sexual contact.

The new case is a relative and caregiver of an elderly Zika patient who died in late June. The deceased man had traveled to an area where Zika is spreading, and lab tests showed he had high amounts of the virus in his blood -- more than 100,000 times higher than those seen in other samples of infected people, according to the CDC. He also had a medical condition, which has not been disclosed.

The new patient developed mild symptoms and rapidly recovered, said CDC officials in a news conference. Neither patient was identified.

“The new case in Utah is a surprise, showing that we still have more to learn about Zika,” said Erin Staples, MD, PhD, the CDC’s medical epidemiologist on the ground in Utah, in a news release.

Doctors don’t know if the virus was passed directly from nonsexual contact with bodily fluids like saliva or urine or whether it might have been spread indirectly, through the bite of an infected mosquito. Scientists have found the Zika virus in human blood, semen, saliva, urine, breast milk, swabs from the genital tract, and in fluid in the eye.

If it was passed through a mosquito bite, it would be the first case of local transmission documented in the U.S., but that possibility seems unlikely because Utah isn’t known to have the kinds of mosquitoes that are known to carry Zika.

“Right now we’re assessing whether any other kind of transmission could be occurring,” said Michael Bell, MD, a medical epidemiologist with the CDC.

An estimated 80% of people infected with Zika don’t show symptoms. The others may have a fever, joint pain, and red eyes (known asconjunctivitis). But Zika can wreak havoc on the unborn, causing devastating birth defects including microcephaly, in which babies have unusually small heads and brain damage.

As of July 7, nine babies with birth defects linked to Zika have been reported in the U.S., according to the CDC. Six other pregnancy losses with birth defects were linked to the virus.

In a statement issued last week, Ary Faraji, PhD, manager of the Salt Lake City Mosquito Abatement District, said that neither of the two mosquito species that are known to transmit the virus have ever been found in Utah.

Casual contact seems unlikely also, Staples said. “From what we have seen with more than 1,300 travel-associated cases of Zika in the continental United States and Hawaii, non-sexual spread from one person to another does not appear to be common.”

CDC investigators are trapping mosquitoes in Utah in the communities where the family lives.

Robert Wirtz, PhD, an entomologist with the CDC, says that so far, the number of mosquitoes that have been trapped in Utah are low and they are mostly culex mosquitoes, which primarily feed on birds. Aedes aegypti and Aedes albopictus mosquitoes are believed to be the carriers in the Zika outbreak spreading through the Americas.

“As has been said, in our line of work, we never take anything off the table, but right now, we feel like transmission by aedes mosquitoes is highly unlikely,” he says.

Public health officials are interviewing the patient and other family members to learn what kind of contact they had with the deceased man. They are also collecting samples for testing from family members and others who had contact with the deceased patient to see if anyone else was infected, according to a news release from the Utah Department of Health.

“Based on what we know so far about this case, there is no evidence that there is any risk of Zika virus transmission among the general public in Utah,” says Angela Dunn, MD, deputy state epidemiologist at the Utah Department of Health.

As of July 13, 1,306 cases of Zika have been reported in the continental United States and Hawaii; none of these has been the result of local spread by mosquitoes. These cases include 14 believed to be the result of sexual transmission and one that was the result of a laboratory exposure.

http://www.webmd.com/news/20160718/cdc-investigates-mystery-zika-transmission

niman · July 19, 2016

Unusual US Zika virus case baffles experts

Experts are trying to work out exactly how a US carer has caught Zika after tending to a dying elderly man with the virus.

Until now it was thought that only mosquitoes and sex spread Zika, as well as the risk of mother-to-child transmission in the womb.

The carer, from Utah, did not have any of these known risk factors.

US officials say they are monitoring the situation carefully and carrying out more tests.

They stress that the chance of spread from one person to another without sexual contact is still very unlikely or rare.

Zika outbreak: What you need to know

The Centres for Disease Control says the patient, who died in June, had travelled to an area where Zika-infected mosquitoes are present.

Lab tests showed he had uniquely high amounts of the virus - more than 100,000 times higher than seen in other samples from infected people - in his blood.

The CDC has sent out an emergency response team to investigate.

They will be interviewing and testing family members of the carer and any health care workers who may have had contact with the deceased man.

Gary Edwards, director of the Salt Lake County Health Department, said the infected individual was a family contact of the man who died.

"We know that the patient had contact with the deceased patient while the deceased patient was very ill," he said.

"The exact nature of that contact, we are still investigating."

The investigators also plan to trap and test local mosquitoes to check that they are not carrying and spreading the virus.

Tom Hudachko, from the Utah Department of Health, said state officials were not aware of any mosquitoes known to carry the Zika virus within Utah.

He said there had been a few Aedes aegypti mosquitoes - the kind that carry Zika - discovered in traps in the south-western parts of the state several years ago, but there had not been any since.

CDC expert Dr Erin Staples said: "The new case in Utah is a surprise, showing that we still have more to learn about Zika.

"Fortunately, the patient recovered quickly, and from what we have seen with more than 1,300 travel-associated cases of Zika in the continental United States and Hawaii, non-sexual spread from one person to another does not appear to be common."

How Zika can spread

Bites from mosquitoes that carry the virus
Maternal transmission from mother to baby in the womb
Unprotected vaginal, oral or anal sexual intercourse - although rare, the virus can persist in semen
Zika virus has been found in other bodily fluids, including saliva and urine, but it is unknown whether it can spread through these routes
Blood transfusion - very likely but not confirmed

http://www.bbc.com/news/health-36833321

niman · July 19, 2016

Unique Zika Case of Utah Caregiver Under Investigation

A person who cared for a Zika-infected relative in Utah has contracted the disease, marking the first case in the continental U.S. in a patient who didn't travel to an affected area or have sex with an infected person, health officials said.

Unique Zika Case of Utah Caregiver Under Investigation

Left to right, Dr. Angela Dunn, deputy state epidemiologist at the Utah Department of Health; Gary Edwards, executive director, Salt Lake County Health Department; Dr. J. Erin Staples, Medical Epidemiologist, Centers for Disease Control and Prevention,and Dr. Edward Clark Associate Vice President Clinical Affairs University of Utah speak during a news conference on Monday. RICK BOWMER/AP

By LINDSAY WHITEHURST, Associated Press

SALT LAKE CITY (AP) — Health authorities in Utah are investigating a unique case of Zika found in a person who had been caring for a relative who had an unusually high level of the virus in his blood.

Exactly how the disease was transmitted is still a mystery, though the person has since recovered.

[RELATED: Mysterious Zika Spread in Utah Suggests New Mode of Transmission]

The elderly relative who died after contracting Zika abroad had amounts of the virus in his blood more than 100,000 times higher than other samples of infected people, according to the Centers for Disease Control and Prevention.

Though the tropical mosquito that mainly spreads Zika isn't typically found in Utah, officials haven't ruled out the possibility that the man brought a mosquito back with him from an area where he caught the virus, perhaps in a suitcase, according to the Centers for Disease Control and Prevention.

"The new case in Utah is a surprise, showing that we still have more to learn about Zika," CDC medical epidemiologist Dr. Erin Staples said.

Authorities did not give further details about either patient, citing health privacy laws. The new case was discovered after a doctor noticed the caregiver's Zika-like symptoms, which include rash, fever and pink eye, officials said.

He or she had cared for the older man both at home and in the hospital. That man died in late June and was the first death of a Zika-infected in the continental U.S. His age and another health condition made his exact cause of death unclear. The caregiver did not travel to an affected area.

Health workers are testing other people who had contact with the first patient. Officials are trapping mosquitoes in Utah to test them, though the species that spread the disease don't usually live in the state's high altitude and cold winters.

The CDC did not immediately revise its advice to health care workers or caregivers after the new case emerged.

"Based on what we know so far about this case, there is no evidence that there is any risk of Zika virus transmission among the general public in Utah," said Dr. Angela Dunn, deputy state epidemiologist at the Utah Department of Health.

Signs of Zika have been found in blood, urine, semen and saliva. There's no evidence yet that the Zika infection in this case is an unusual mutation, but researchers are exploring that possibility through genomic analysis.

Editorial cartoon on Zika and the Olympics

Editorial cartoons on Zika

EXPAND GALLERY

The virus causes only a mild illness in most people. But during recent outbreaks in Latin America, scientists discovered that infection during pregnancy has led to severe brain-related birth defects.

No cases of mosquito-spread Zika have been reported in the continental United States, according to the CDC. Health experts think mosquito transmission probably will occur in the U.S., but the expectation is that it will be in low-elevation, sweltering places where the insect has been a steady problem — such as southern Florida or southern Texas.

More than 1,300 Zika illnesses have been reported in the 50 states and the District of Columbia, including eight in Utah, according to health officials. Almost all were people who had traveled to Zika outbreak countries and caught the virus there.

Fourteen were people who had not traveled to Zika zones but had sex with someone who had.

The CDC has also been tracking pregnant women infected with Zika, and says they have five reports of pregnancy losses because of miscarriage, stillbirth or abortion.

___

Associated Press Medical Writer Mike Stobbe in New York and contributed to this report.

http://www.usnews.com/news/news/articles/2016-07-19/unique-zika-case-of-utah-caregiver-under-investigation

niman · July 19, 2016

GERMINATION

Strange New Case Might Change What We Know About Zika

A caregiver in Utah didn't contract Zika from a mosquito or sex, leading health officials to investigate a new route to transmission.

By Maryn McKenna

PUBLISHED JULY 18, 2016

Zika virus infection appears to have passed from one member of a Utah family to another, but not by any of the known paths of transmission: sex, pregnancy, or mosquito bite. The case, announced Monday by the Utah Department of Health and the Centers for Disease Control and Prevention, reveals that the risks posed by the novel, fast-moving virus are still not understood.

The agencies said in back-to-back press conferences that a “family contact” of an elderly man who died in June—and who was discovered after his death to have been the first Zika-related death in the continental U.S.—has also come down with the disease. That person, who helped care for the ailing man, experienced mild Zika symptoms of rash and fever and has recovered, the officials said. (The agencies declined to identify the family member; the Wall Street Journal reports it was his son.)

The first patient, the elderly man, traveled to a place where Zika is circulating and was probably infected there, the officials said. But trapping and testing by Utah mosquito-control teams, which operate in warm-weather months to search for West Nile virus, haves not uncovered either of the mosquito species believed to transmit Zika—meaning it is unlikely the dead man passed the virus to a mosquito which then passed it back to a human.

Gary Edwards, a health officer in the Salt Lake County Health Department, said in the Utah press conference: “This case is unusual. The individual does not have any of the known risk factors we’ve seen thus far with Zika.”

'Uniquely High Amounts' of Virus

The lack of other explanations poses the possibility that the family member became infected in a manner that scientists have not yet documented, possibly by exposure to bodily fluids. The virus has been found in blood, semen, urine, saliva, cervical mucus, breast milk, and the fluid inside the eyeball. The CDC has been warning blood banks to act as though Zika can be transmitted by transfusion, though there have been no transfusion cases identified so far.

“We are trying to determine if the contact between the very sick, elderly patient and the person played a role in how the person got sick,” Satish Pillai, a physician involved in the CDC’s Zika response, said during the press briefing. “We don’t have all the answers right now.”

The elderly man had an underlying health condition that officials have not described; when he died, officials were careful to say his demise was associated with Zika but not necessarily caused by it. The investigation into his death revealed that he had what the CDC called “uniquely high amounts” of virus in his blood, 100,000 times higher than has been recorded in other cases that have been analyzed.

That could indicate that the man’s blood, and possibly other bodily fluids, was uniquely infectious, because it carried so much more virus than usual. But federal officials said Monday that it’s not yet possible to know whether it was his underlying illness or a genetic factor or even the strain of Zika infecting him that allowed the virus to replicate to such high numbers in his system.

“A high viral load is something we take very seriously, and it is not something about which we have a very long experience,” Michael Bell, a physician and deputy director of the CDC division that handles infection prevention in hospitals, told reporters. “Someone who is extremely ill and debilitated from another disease process could have a diminished immune system that doesn’t fight the virus as well. On the other hand, someone with a high viral load could be more sick as a result of the actual viral infection.”

A Preexisting Link?

Before his death, the elderly man experienced thrombocytopenia, a disorder that can be triggered by infections and causes bleeding in internal organs, in the mouth and nose, and from nicks and cuts. Last week, physicians in Puerto Rico reported that two Zika patients there also developed thrombocytopenia, and one “died following multiple hemorrhages.”

That person, a 72-year-old man with high blood pressure, was the first person in the greater U.S. to die from a syndrome related to Zika. Other cases and deaths from blood disorders linked to Zika have been reported in Colombia, Suriname, and Polynesia. The physicians who treated the Puerto Rico patients warned this is something to be wary of—especially since both men were misdiagnosed with dengue and not identified as having Zika until the bleeding disorder began.

Asked whether an association between Zika infection and body fluids would be any cause for alarm, CDC officials pointed out that there have been 1,306 known cases of Zika in the U.S. so far, and only a few have involved person-to-person transmission. (That includes the revelation last Friday that Zika can be passed not only from male sexual partners to women, but from women to men as well.) Bell, from the CDC, said that hospital workers should already be protected because healthcare institutions all practice the “standard precautions” against body-fluid contact that have existed since the start of the AIDS epidemic.

“Currently we are not altering PPE [personal protective equipment] instructions,” the CDC’s Bell said. “What this highlights is the fact that when you have an infection like Zika, wherein a good percentage of patients don’t actually have symptoms, it means it is as important as ever to stick with good adherence to standard precautions … It is a great example of why we should never take chances.”

Equally, there’s no reason the general public should feel at risk, Pillai said: “We don’t have evidence right now that Zika can be passed by sneezing or coughing, routine touching, kissing, hugging, or sharing utensils. While we still don’t know exactly how this family contact became sick, what we do know is the primary mechanism of transmission is mosquito-borne. So we feel that should provide reassurance to the public.”

http://news.nationalgeographic.com/2016/07/mysterious-new-zika-transmission-utah/

Maryn McKenna, author of Superbug and Beating Back the Devil, is an internationally published journalist who writes about public health, global health, and food policy.

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Unique Zika Case of Utah Caregiver Under Investigation

A person who cared for a Zika-infected relative in Utah has contracted the disease, marking the first case in the continental U.S. in a patient who didn't travel to an affected area or have sex with an infected person, health officials said.

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Strange New Case Might Change What We Know About Zika

'Uniquely High Amounts' of Virus

A Preexisting Link?

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