Alarming Mosquito Spread Of Zika In Wynwood Florida

[niman]

Recent reports on the mosquito spread of Zika in the Wynwood area of Miami, Florida have highlighted the effects of CDC guidelines which focused on imported cases of Zika and largely ignored local spread.

Although the CDC and Florida Department of Health noted the spread of Zika in localized area in Wynwood, the more detailed media reports describe a very high attack rate involving local spread, beginning in early June.  The focus on imported cases creates a challenging environment for testing for cases who had not recently traveled outside of of the United States, and created the myth that local transmission was not a serious consideration in the continental US.

The WSJ report on the index location cited an unpublished report noting that 14 of the 30 employees at the index company had been symptomatic, beginning in early June, signaling local spread for two months prior to confirmation of the first local case (which was in Miami Dade county, but not linked to the Wynwood cluster).  

The description of the index location, which included multiple trips of employees to Brazil, as well as the roommate of the index case, matches a local pipe and plumbing supply company located in the hot zone.  Stored at the company's sites were pipes of a variety of sizes as well as cement buckets, which would provide an ideal environment for mosquito breeding.  The local company had expanded its business to the Caribbean and Central and South America, creating multiple opportunities for Zika seeding of the local mosquito population.  Moreover, the composition of the workforce would help explain the dominance of male confirmed cases. In addition, the report of symptoms in almost 50% of the local workforce suggests that the attack rate was near 100% since most Zika cases are asymptomatic.

This high attack rate was supported by uro-surveillance of residents near the intersection of NW 30th St & First Avenue, which is one block from the pipe company.  The surveillance of 52 asymptomatic residents identified 6 reported cases.  However, the frequency of infections was likely higher because the uro-surveillance would only detect recent infections, and cases infected in June or early July would largely test as negative due to viral clearance.  In contrast to the IgM testing of employees, CDC reports suggested that similar antibody testing was not done on asymptomatic residents.

In addition to the above results for local residents, media reports for another site, Wynwood Yards, which is located 1 1/2 blocks from the pipe company, cited multiple symptomatic employees, including hospitalized cases.  At least two of those employees have been PCR Zika confirmed, with results from most cases having not been reported yet.  Like the index company, the multiple symptomatic cases suggest a significantly larger number of employees who were infected, but were asymptomatic or had a limited number of mild symptoms.

These reports describe alarming mosquito spread while CDC guidelines excluded testing of non-travel cases and created an environment that significantly reduced consideration for testing of victims by health care providers.

 

Edited August 12, 2016 by niman

[niman]

Fourteen of the roughly 30 employees who work at the business in Wynwood reported they had typical Zika symptoms such as fever, rash, joint pain or conjunctivitis from early June to mid-July, according to the report.

The other infected man, a 26-year-old known as Miami-Dade #2, works at a business nearby with 11 employees. He and a customer were the only ones to report Zika symptoms, according to the report.

http://www.wsj.com/articles/pregnant-zika-victim-alerted-officials-to-florida-outbreak-1470821406

[niman]

One, a man in his late 20s known as Broward #2, has a job at a business that does work in Brazil and has several employees who travel there frequently, according to the report. The report didn’t name the business or say what kind of work it does.

The patient recently had a houseguest from Brazil

http://www.wsj.com/articles/pregnant-zika-victim-alerted-officials-to-florida-outbreak-1470821406

[niman]

 In the late 1980's Dennis decided to expand the operation into the Caribbean, Central and South America.

http://lehmanpipe.com/our-history.html

 

[niman]

Jul 29, 2016

Workers with the Florida Dept. of Health and Miami-Dade County Mosquito Control distribute mosquito repellent and collect urine samples from residents in the vicinity of NW 30th street and First Avenue.


Read more here:http://www.miamiherald.com/news/health-care/article92649717.html#storylink=cpy

[niman]

We had a couple of employees who were complaining about things like rashes, fever, headaches, joint pain. But at that time there had been no reported cases of Zika in the continental US.

We had a couple of employees who were admitted to local hospitals. So then we really started to get concerned.

We have multiple members of our team that are either pregnant or they have partners who are pregnant.

http://wlrn.org/post/wynwood-yard-founder-talks-closing-reopening-and-positive-zika-tests

[niman]

Map Update (zoom to Wynwood, north of downtown Miami)

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

[niman]

2 hours ago, niman said:

 In the late 1980's Dennis decided to expand the operation into the Caribbean, Central and South America.

http://lehmanpipe.com/our-history.html

 

pipes and buckets (Google Street View - Nov 2015)

https://www.google.com/maps/@25.8033151,-80.1991595,3a,30y,194.08h,84.61t/data=!3m6!1e1!3m4!1sOcG8or0QcFHI9-Ym8VsqmA!2e0!7i13312!8i6656

Edited August 12, 2016 by niman