By Brenda Goodman, MA
Reviewed By Brunilda Nazario, MD
Latest Infectious Disease News
Active transmission of Zika seems to be occurring in a small, 1-square-mile area just north of downtown Miami, Florida Gov. Rick Scott told reporters. The four Zika cases under investigation in Miami-Dade and adjoining Broward County are likely from mosquitoes, he said.
Three cases involve men, and one involves a woman. Scott did not say whether the woman is pregnant.
Zika prevention kits are being distributed in the affected areas, which include Miami's Wynwood neighborhood, an emerging arts district. Wynwood is often called "Little San Juan" because of its high percentage of Puerto Rican residents.
The announcement comes a day after the FDA asked the affected counties to stop collecting blood donations. On Friday, Scott said he had directed the state's Department of Health to establish new blood screening tests.
The finding raises the possibility that there may be a jump in Zika cases in areas where mosquitoes are transmitting the virus, and it comes just weeks after Congress left for the summer without acting on a bill that would have freed up $1.1 billion to help local health departments stanch such an outbreak.
Still, public health officials say the development is no reason to panic, but that it is more important than ever for people to take commonsense measures to protect themselves and their neighbors from mosquito bites.
Scott said people who live in the area and want to be tested for Zika should contact their local health department. He further urged residents to take precautions to prevent mosquito bites, including eliminating standing water and wearing insect repellent. He urged pregnant women to contact their doctors.
Since the Zika outbreak began last year, 64 countries have reported evidence of mosquito-borne transmission, according to the WHO. In Brazil, the hardest-hit nation, more than 1,600 cases of a Zika-linked birth defect called microcephaly have been confirmed in newborns.
Health officials had predicted that small pockets along the Gulf Coast would be the first to see the virus take up residence in U.S. mosquito populations. So far, Zika is following much the same pattern as outbreaks of a similar illness, dengue fever. Health experts don't expect transmission of Zika to become as widespread in the U.S. as it has in some Latin American countries.
Florida was expected to be a hot zone, and the state has been closely monitoring Zika cases there. The state has both species of mosquitoes known to carry the virus, and it has them year-round.
The first cases appeared in Miami-Dade County, which has reported more travel-related Zika cases than any other county in the U.S. As of July 28, they had 96 Zika cases, according to the Florida Department of Health.
The Miami area is also densely populated with pockets of poverty where people live without some of the comforts that keep Zika mosquitoes at bay, like air conditioning and window screens.
In the event of a local transmission, the CDC's response plan calls for:
- A rapid investigation, where investigators track down the contacts of the sick person to see if any others are also infected
- Alerting the local blood center, which may need to begin testing blood from area donors
- Activating one of the CDC's Emergency Response Teams (CERTs), which would travel to the area to assist state and county officials
- Intensifying the hunt for other cases of Zika in the area
- Communicating with the public about protection and prevention, especially for pregnant women
- Trapping and testing mosquitoes for Zika
- Reporting the case to international authorities like the World Health Organization
If no other cases are found, the CDC's plan calls for public health officials to maintain this level of response for 45 days, which is the time it takes for the virus to die out in mosquitoes.
If more cases are found, some worry it could deal a significant blow to the state's economy, which relies heavily on tourism.
"If this is a more sustained thing, I think the big issue will be the impact on the Florida economy," said Michael Farzan, PhD, a professor of immunology and microbial science at The Scripps Research Institute in Jupiter, FL. In an April letter to the New York Times, Farzan predicted the first locally transmitted Zika infection would happen in Miami. Tourism is the state's greatest source of income, and locally transmitted cases could mean tourists, especially pregnant women, would stay away.
"That's where it's really going to hurt us. That's why the inaction at the state and federal level is so frustrating."
The Florida Department of Health has urged residents to protect themselves by draining any places that could collect standing water inside or outside their homes. They further advised people to wear protective clothing, including long pants and long sleeves, and to use EPA-approved insect repellents and mosquito netting.
SOURCES: Michael Farzan, PhD, professor of immunology and microbial science, The Scripps Research Institute, Jupiter, FL. News release, Florida Department of Health. News release, CDC. CDC, Draft Interim Response Plan, June 2016. © 2016 WebMD, LLC. All rights reserved.